Association between the body roundness index and all-cause mortality in patients with metabolic dysfunction- associated steatotic liver disease

Abstract

Background: The body roundness index (BRI) is a novel anthropometric measure derived from waist circumference and height that reflects abdominal adiposity. Previous studies have demonstrated that BRI has predictive value for all-cause mortality in the general population and in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) in the United States. However, the association between BRI and all-cause mortality in patients with MASLD from northern Chinese populations remains unclear.

Methods: In this population-based prospective cohort study, we analyzed 28,898 MASLD patients (mean age 52.3 ± 12.2 years) from the Kailuan Study, an ongoing longitudinal investigation of Chinese industrial workers. The primary outcome was all-cause mortality. The Cox proportional hazards regression model was utilized to assess the association between BRI and the risk of all-cause mortality in the MASLD population by calculating hazard ratios (HR) with 95% confidence intervals (CI).

Results: During a median follow-up of 13.62 years (interquartile range 12.85-15.16), 3,895 deaths were occurred. After adjustment for confounders, each standard deviation increase in BRI was associated with a 13% increased risk of all-cause mortality (HR = 1.13, 95% CI: 1.07-1.19, P < 0.001). Multivariable Cox regression analysis revealed that compared with subjects in the lowest BRI quartile (Q1), those in the third (Q3) and fourth (Q4) quartiles had hazard ratios for all-cause mortality of 1.14 (95% CI: 1.02-1.28) and 1.21 (95% CI: 1.06-1.37) (P for trend < 0.001), respectively.

Conclusion: BRI demonstrated a positive association with all-cause mortality in the MASLD population.

Keywords: all-cause mortality; body roundness index (BRI); cohort study; epidemiology; metabolic dysfunction-associated steatotic liver disease (MASLD).