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- The discriminatory ability of the body roundness index and body mass index for metabolic diseases in Korean adults: a comparative study
- Soo Jeong Yoon, Ho-Jang Kwon
- Epidemiol Health. 2025;47:e2025069. Published online December 9, 2025
- DOI: https://doi.org/10.4178/epih.e2025069
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- 29 Download
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Abstract
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AbstractOBJECTIVES
Obesity is a major risk factor for metabolic diseases; however, body mass index (BMI), the most widely used anthropometric indicator, inadequately reflects fat distribution. The body roundness index (BRI) has been proposed as a more precise measure of abdominal obesity.METHODSData from the 2007-2022 Korea National Health and Nutrition Examination Survey (KNHANES) were used. Discrimination for diabetes, hypertension, hypercholesterolemia, and metabolic syndrome was assessed by calculating the area under the receiver operating characteristic curve (AUROC) and estimating odds ratios (ORs).RESULTSAUROC values ranged from 0.739 to 0.844 for BMI and 0.745 to 0.851 for BRI, with both indices demonstrating their highest performance for metabolic syndrome. BRI outperformed BMI for 3 metabolic diseases except hypertension, with the largest AUROC difference observed for diabetes (0.01). Quintile-based ORs showed stronger associations for BRI, indicating approximately 2-fold higher risks for diabetes and metabolic syndrome compared with BMI. Subgroup analyses identified the most pronounced differences for diabetes in female aged 45 years or older and for metabolic syndrome in male aged 45 years or older. For both indices, the risk associated with increasing quintiles was greater in the younger age group, especially among female under 45 years, in whom the risk of metabolic syndrome was markedly higher in the highest BRI quintile compared with the lowest quintile.CONCLUSIONSBRI showed superior discriminatory power and stronger associations with metabolic diseases compared with BMI, suggesting that it may complement BMI as a useful screening indicator in clinical and public health settings. -
SummaryKorean summary
본 연구에서 2007–2022년 국민건강영양조사 자료를 이용해 BRI(body roundness index) 와 BMI(body mass index)의 대사질환 판별력과 연관성을 비교한 결과, 전반적으로 BRI가 BMI보다 더 높은 판별력과 더 강한 연관성을 보였음을 확인했다. 특히 BRI의 BMI보다 우수한 판별력은 45세 이상 여성의 당뇨병과 45세 이상 남성의 대사증후군에서 가장 뚜렷했다. 따라서 BRI는 BMI를 보완하는 지표로서, 임상 및 공중보건 영역에서 대사질환 고위험군 선별에 추가적 가치를 제공할 수 있을 것으로 판단된다.Key Message
Using data from the 2007–2022 Korea National Health and Nutrition Examination Survey, this study compared the discriminatory performance and associations of the body roundness index (BRI) and body mass index (BMI) with metabolic diseases and found that, overall, BRI demonstrated superior discriminatory ability and stronger associations than BMI. The advantage of BRI over BMI was most pronounced for diabetes in women aged 45 years or older and for metabolic syndrome in men aged 45 years or older. Therefore, BRI may serve as a complementary indicator to BMI, providing additional value for identifying high-risk groups for metabolic diseases in clinical and public health settings.
- Effect modification of consecutive high concentration days on the association between fine particulate matter and mortality: a multi-city study in Korea
- Hyungryul Lim, Sanghyuk Bae, Jonghyuk Choi, Kyung-Hwa Choi, Hyun-Joo Bae, Soontae Kim, Mina Ha, Ho-Jang Kwon
- Epidemiol Health. 2022;44:e2022052. Published online June 9, 2022
- DOI: https://doi.org/10.4178/epih.e2022052
- 17,268 View
- 354 Download
- 1 Web of Science
- 1 Crossref
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Abstract
Summary
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Supplementary Material -
AbstractOBJECTIVES
Although there is substantial evidence for the short-term effect of fine particulate matter (PM<sub>2.5</sub>) on daily mortality, few epidemiological studies have explored the effect of prolonged continuous exposure to high concentrations of PM<sub>2.5</sub>. This study investigated how the magnitude of the mortality effect of PM<sub>2.5</sub> exposure is modified by persistent exposure to high PM<sub>2.5</sub> concentrations.METHODSWe analyzed data on the daily mortality count, simulated daily PM<sub>2.5</sub> level, mean daily temperature, and relative humidity level from 7 metropolitan cities from 2006 to 2019. Generalized additive models (GAMs) with quasi-Poisson distribution and random-effects meta-analyses were used to pool city-specific effects. To investigate the effect modification of continuous exposure to prolonged high concentrations, we applied categorical consecutive-day variables to the GAMs as effect modification terms for PM<sub>2.5</sub>.RESULTSThe mortality risk increased by 0.33% (95% confidence interval [CI], 0.16 to 0.50), 0.47% (95% CI, -0.09 to 1.04), and 0.26% (95% CI, -0.08 to 0.60) for all-cause, respiratory, and cardiovascular diseases, respectively, with a 10 μg/m3 increase in PM<sub>2.5</sub> concentration. The risk of all-cause mortality per 10 μg/m3 increase in PM<sub>2.5</sub> on the first and fourth consecutive days significantly increased by 0.63% (95% CI, 0.20 to 1.06) and 0.36% (95% CI, 0.01 to 0.70), respectively.CONCLUSIONSWe found increased risks of all-cause, respiratory, and cardiovascular mortality related to daily PM<sub>2.5</sub> exposure on the day when exposure to high PM<sub>2.5</sub> concentrations began and when exposure persisted for more than 4 days with concentrations of ≥35 μg/m3. Persistently high PM<sub>2.5</sub> exposure had a stronger effect on seniors. -
SummaryKorean summary
한국의 7개 대도시를 배경으로 수행한 본 시계열 연구를 통하여 2006년부터 2019년까지의 기간 동안에 초미세먼지의 단기 노출이 일별 사망률을 증가시키며, 교호작용모형을 통해 일평균 35 μg/m3 이상의 고농도 지속기간이 처음 시작되는 날과 넷째 지속일에 이러한 사망효과가 커짐을 보고하였다. 이러한 고농도 지속기간의 교호작용은 65세 이상 연령군에서 더욱 두드러졌다.Key Message
With our Korean multi-city study design from 2006 to 2019, the short-term effects of PM2.5 on mortality were greater when the high PM2.5 concentration duration began during the day and lasted for approximately 4 days, and the elderly may be more affected by persistently high PM2.5. -
Citations
Citations to this article as recorded by
- Estimating Health and Economic Benefits from PM2.5 Reduction in Fishery-Based Communities: A Sector-Specific Approach to Sustainable Air Quality Management in the Philippines
James Roy Lesidan, Nadine Grace Caido, Oliver Semblante, Floro Junior Roque, Jejomar Bulan, Jumar Cadondon, Maria Cecilia Galvez, Edgar Vallar
Sustainability.2025; 17(3): 1316. CrossRef
- Estimating Health and Economic Benefits from PM2.5 Reduction in Fishery-Based Communities: A Sector-Specific Approach to Sustainable Air Quality Management in the Philippines
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