BRI is a multifaceted predictor of chronic disease mortality, with higher BRI conferring significant protective effects against all-cause mortality in the overall population and in hypertension, lung disease, asthma, and dyslipidemia, while elevated BRI increased liver disease mortality risk.
Key Findings
Results
Higher BRI levels were associated with reduced all-cause mortality risk in the overall population over a 9-year follow-up.
Study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) with 11,750 middle-aged and older Chinese adults.
Follow-up period covered 9 years from baseline (2011-2012) to 2020.
HR = 0.94, 95% CI = 0.89-0.98 for the overall population.
Cox proportional hazards models were used to assess associations.
BRI was calculated using waist circumference and height.
Results
Higher BRI was associated with significantly lower all-cause mortality risk among participants with hypertension.
HR = 0.93, 95% CI = 0.87-0.98 for hypertension subgroup.
RCS modelling revealed a significant non-linear relationship between BRI and mortality risk for hypertension (non-linear P < 0.05).
Kaplan-Meier survival curves were used to provide survival rate estimates.
Association was identified within the CHARLS longitudinal cohort of middle-aged and older Chinese adults.
Results
Higher BRI was associated with significantly lower all-cause mortality risk among participants with lung disease.
HR = 0.87, 95% CI = 0.78-0.97 for lung disease subgroup.
RCS modelling revealed a significant non-linear relationship between BRI and mortality risk for lung disease (non-linear P < 0.05).
The lung disease subgroup showed one of the stronger protective associations observed across chronic disease subgroups.
Results
Higher BRI was associated with significantly lower all-cause mortality risk among participants with asthma.
HR = 0.77, 95% CI = 0.63-0.95 for asthma subgroup.
The association with asthma remained essentially linear (non-linear P > 0.05).
Asthma showed the strongest protective association of all subgroups examined, with an HR of 0.77.
Results
Higher BRI was associated with significantly lower all-cause mortality risk among participants with dyslipidemia.
HR = 0.90, 95% CI = 0.84-0.97 for dyslipidemia subgroup.
The association with dyslipidemia remained essentially linear (non-linear P > 0.05).
This protective association was consistent with the direction of effect seen in other chronic disease subgroups except liver disease.
Results
Elevated BRI was associated with significantly increased mortality risk among participants with liver disease.
HR = 1.32, 95% CI = 1.04-1.68 for liver disease subgroup.
This finding was in the opposite direction compared to all other significant associations observed.
The authors note this association varies by disease pathophysiology, contrasting with the protective effects seen in hypertension, lung disease, asthma, and dyslipidemia.
Results
BRI demonstrated non-linear relationships with mortality for hypertension and lung disease but linear relationships for dyslipidemia, asthma, and the overall population.
Non-linear P < 0.05 for hypertension and lung disease subgroups.
Non-linear P > 0.05 for dyslipidemia, asthma, and the overall population.
Restricted cubic spline (RCS) models were used to explore nonlinear effects.
These differential patterns suggest disease-specific mechanisms underlying the BRI-mortality relationship.
Sun X, Deng Q, Li Z, Lin C, Song G, Chen S, et al.. (2025). Body roundness index and mortality risk in chronic diseases: a national prospective longitudinal study in China.. Aging clinical and experimental research. https://doi.org/10.1007/s40520-025-03252-9