Body Roundness Index Predicts Incident Cardiometabolic-depression Multimorbidity: A Dose-response Analysis of 19,802 Adults in China Health and Retirement Longitudinal Study and English Longitudinal Study of Ageing Cohorts
- 1Department of Cardiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Centre for Geriatric Diseases, Beijing, China (Song, Hu, Xia, Yin)
Abstract
Objective:: To examine the association between body roundness index (BRI) and cardiometabolic-depression multimorbidity.
Methods:: This study used data from 2 prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA). Firstly, the relationship between baseline BRI and the incidence of cardiometabolic-depression multimorbidity was analyzed using Cox regression models. Subsequently, stratified Cox models with interaction terms were conducted among different groups. To investigate the potential nonlinear relationships, restricted cubic spline (RCS) regression of hazard ratio (HR) was employed. Furthermore, longitudinal associations between BRI and cardiometabolic-depression multimorbidity over time were estimated by using a generalized estimating equations (GEE) model.
Results: A total of 12,840 participants from CHARLS (female = 52.7%, mean age = 58.39 y) and 6962 from ELSA (female = 55.0%, mean age = 65.94 y) were included according to inclusion and exclusion criteria. Cox models revealed consistent and significant associations between BRI (continuous and quartiles) and cardiometabolic-depression multimorbidity risk. Fully adjusted HRs showed a progressive increase compared with Q1, indicating a strong graded association (p for trend <.001). Stratified analyses showed no significant interactions by demographic and lifestyle factors. In both cohorts, RCS analyses revealed particularly steep risk gradients beyond BRI values of 4. GEE analyses confirmed significant longitudinal associations with cardiometabolic-depression multimorbidity risk. Sensitivity analyses including landmark, outlier exclusion, and multiple imputation approach consistently supported these findings.
Conclusions:: Higher BRI consistently predicts cardiometabolic-depression multimorbidity across populations in a dose-dependent pattern. These findings highlight BRI’s potential for early risk stratification and integrated care approaches that target metabolic-mental health interactions.
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BibTeX
@article{song2026body,
title = {{Body Roundness Index Predicts Incident Cardiometabolic-depression Multimorbidity: A Dose-response Analysis of 19,802 Adults in China Health and Retirement Longitudinal Study and English Longitudinal Study of Ageing Cohorts}},
author = {Fei Song and Mengjin Hu and Jinggang Xia and Chunlin Yin},
journal = {Biopsychosocial Science and Medicine},
year = {2026},
month = aug,
doi = {10.1097/psy.0000000000001517},
url = {https://doi.org/10.1097/psy.0000000000001517},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Body Roundness Index Predicts Incident Cardiometabolic-depression Multimorbidity: A Dose-response Analysis of 19,802 Adults in China Health and Retirement Longitudinal Study and English Longitudinal Study of Ageing Cohorts
AU - Fei Song
AU - Mengjin Hu
AU - Jinggang Xia
AU - Chunlin Yin
PY - 2026
DA - 2026/08/03
JO - Biopsychosocial Science and Medicine
DO - 10.1097/psy.0000000000001517
UR - https://doi.org/10.1097/psy.0000000000001517
AB - Objective:: To examine the association between body roundness index (BRI) and cardiometabolic-depression multimorbidity. Methods:: This study used data from 2 prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA). Firstly, the relationship between baseline BRI and the incidence of cardiometabolic-depression multimorbidity was analyzed using Cox regression models. Subsequently, stratified Cox models with interaction terms were conducted among different groups. To investigate the potential nonlinear relationships, restricted cubic spline (RCS) regression of hazard ratio (HR) was employed. Furthermore, longitudinal associations between BRI and cardiometabolic-depression multimorbidity over time were estimated by using a generalized estimating equations (GEE) model. Results: A total of 12,840 participants from CHARLS (female = 52.7%, mean age = 58.39 y) and 6962 from ELSA (female = 55.0%, mean age = 65.94 y) were included according to inclusion and exclusion criteria. Cox models revealed consistent and significant associations between BRI (continuous and quartiles) and cardiometabolic-depression multimorbidity risk. Fully adjusted HRs showed a progressive increase compared with Q1, indicating a strong graded association (p for trend <.001). Stratified analyses showed no significant interactions by demographic and lifestyle factors. In both cohorts, RCS analyses revealed particularly steep risk gradients beyond BRI values of 4. GEE analyses confirmed significant longitudinal associations with cardiometabolic-depression multimorbidity risk. Sensitivity analyses including landmark, outlier exclusion, and multiple imputation approach consistently supported these findings. Conclusions:: Higher BRI consistently predicts cardiometabolic-depression multimorbidity across populations in a dose-dependent pattern. These findings highlight BRI’s potential for early risk stratification and integrated care approaches that target metabolic-mental health interactions.
SN - 2998-8748
SN - 2998-8756
ER -