Association of body roundness index with cardiovascular disease and all‐cause mortality among Chinese adults

Abstract Aims To determine the impact of body roundness index (BRI) on the 10‐year risk of cardiovascular disease (CVD) and all‐cause mortality in Chinese adults. Materials and Methods We utilized data from a nationwide prospective cohort of 165 785 Chinese adults (aged ≥40 years, free of CVD and cancer at baseline), which was extracted from the China Cardiometabolic Disease and Cancer Cohort (4C). Cox regression and restricted cubic splines quantified BRI‐outcome associations and identified optimal BRI cutoffs. Results During a median follow‐up of 10.1 years, we documented 10 538 CVD events and 8679 deaths. A monotonic increasing dose–response association was observed between BRI and CVD risk, while BRI and all‐cause mortality exhibited a U‐shaped relationship ( p for non‐linear <0.001), with the nadir at a BRI of 3.9. Gender differences indicated that increased CVD risk was associated with higher BRI in men. As age increases, the excess risk of CVD and mortality associated with BRI diminishes, with a significant harmful effect of low BRI observed on mortality in individuals aged ≥75 years. Moreover, the inclusion of BRI in the model significantly enhanced the C‐statistic for CVD prediction by 0.00412 ( p <0.001) and for mortality prediction by 0.00045 ( p = 0.0097). Conclusions Our findings indicate a positive association between BRI and CVD and a U‐shaped association between BRI and mortality. These findings underscore the importance of the BRI in assessing the risk of CVD and all‐cause mortality, particularly when considering different genders and age groups.