Journal Article

The association between the BRI and all-cause and cardiovascular mortality in COPD patients

Zeng, Lijuan, Chen, Riken, Li, Huan, Su, Yihuan, Chen, Qinghua, Zhang, Baozhi, Li, Xing, Cai, Yuli, Li, Wenxi, Cheng, Junfen, Liu, Xinyao, Chen, Huimin, Chen, Zhaojun, Yang, Yitian

2025

Overview

Objective Waist circumference (WC) has been linked to exacerbations in chronic obstructive pulmonary disease (COPD), but the relationship between WC, height, and the Body Roundness Index (BRI) with mortality in COPD patients remains unclear. This study investigates the association between BRI and both all-cause and cardiovascular mortality in COPD patients. Methods Data from 3,672 COPD participants (1,517 men and 2,155 women; mean age: 53.17 ± 16.46 years) were obtained from NHANES (1999–2018). Multivariable Cox proportional hazards models, Kaplan–Meier analysis, Nelson-Aalen cumulative hazard plots, and restricted cubic spline analyses were used to assess the relationship between BRI and mortality. ROC curves were constructed to evaluate BRI’s predictive performance. Subgroup and sensitivity analyses ensured robustness of the models. Results The BRI was associated with all-cause (HR: 1.12, 95% CI: 1.05–1.19) and cardiovascular mortality (HR: 1.14, 95% CI: 1.01–1.29). Kaplan–Meier curves and Nelson-Aalen plots demonstrated that higher BRI quartiles correlated with lower survival probabilities and increased cumulative mortality incidence. ROC curve analysis showed that BRI outperformed other models in predicting all-cause [AUC: 0.81 (0.79–0.82)] and cardiovascular mortality [AUC: 0.79 (0.76–0.81)]. A significant interaction was observed between BRI and alcohol consumption for all-cause mortality. Results remained consistent after excluding participants who died within two years (HR: 1.10, 95% CI: 1.03–1.18) and in the alcohol-consuming subgroup (HR: 1.14, 95% CI: 1.05–1.24). Conclusion The BRI is associated with increased all-cause and cardiovascular mortality in COPD patients, with higher BRI quartiles linked to greater mortality risk. Targeting BRI may offer a potential strategy to reduce mortality in this population.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Abdomen / Adult / Aged / Alcohol / All-cause mortality / Analysis / Body fat / Body mass index / Body measurements / Body size / BRI / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - mortality / Cardiovascular mortality / Cause of Death / Chronic obstructive pulmonary disease / Complications and side effects / COPD / Critical Care Medicine / Education / Family income / Female / Gender / Health aspects / Health status indicators / Humans / Insulin resistance / Intensive / Internal Medicine / Kaplan-Meier Estimate / Lung diseases / Lung diseases, Obstructive / Male / Marital status / Medical laboratories / Medicine / Medicine & Public Health / Metabolism / Metabolites / Middle Aged / Missing data / Mortality / Nutrition Surveys / Obesity / Overweight / Patient outcomes / Pneumology/Respiratory System / Population / Proportional Hazards Models / Pulmonary Disease, Chronic Obstructive - complications / Pulmonary Disease, Chronic Obstructive - mortality / Risk Factors / ROC Curve / Secondary schools / Sensitivity analysis / Statistics / Survival analysis / United States - epidemiology / Variables / Waist Circumference