Abstract
BACKGROUND: Obesity has increasingly become a major global public health issue of growing concern and is strongly linked to the deterioration of lung function. In contrast to the conventional body mass index (BMI), the body roundness index (BRI), a more contemporary approach to evaluating body shape, offers a more precise representation of body fat and visceral fat levels. The main aim of this study is to explore the correlation between BRI and lung function. METHODS: The data utilized in this study were obtained from the National Health and Nutrition Examination Survey (NHANES), encompassing a sum of 12,061 participants. To examine the association between BRI and several pulmonary function measures-specifically FVC, FEV1, PEF, and FEF 25-75%-the study employed multiple linear regression models, restricted cubic splines (RCS) analysis, receiver operating characteristic (ROC) curve analysis and subgroup analyses. RESULTS: The findings of the study reveal a significant inverse relationship between BRI and several lung function indicators: FVC (β = -0.05, 95% CI [-0.06, -0.05]), FEV1 (β = -0.03, 95% CI [-0.04, -0.03]), PEF (β = -0.03, 95% CI [-0.04, -0.01]), and FEF 25-75% (β = -0.014, 95% CI [-0.023, -0.005]). The RCS analysis further suggests a non-linear pattern, where lung function remains stable or experiences a slight increase at lower BRI values. However, beyond a specific threshold, a marked decline in lung function is observed. Furthermore, ROC analysis demonstrated that BRI had superior predictive performance compared to BMI for reduced lung function, with particularly greater discriminative ability for large airway indicators. Additionally, subgroup analysis indicates that this negative association is more evident among males, older adults, and individuals who smoke. CONCLUSIONS: An elevated BRI is independently associated with lower lung function parameters in high-risk groups. These findings imply that BRI may serve as a useful tool for the early detection of individuals who are at an increased risk of impaired lung function. Furthermore, continuous monitoring of BRI is crucial for enabling timely intervention and mitigating potential lung function decline.