Abstract
OBJECTIVE: Obesity is a key risk factor for kidney stones (KS). The body roundness index (BRI) is a newer measure for assessing body fat distribution. Studies in Western populations have linked BRI to KS risk, but no such research has been conducted in Asian populations. This study aimed to examine the association between BRI and KS in Chinese adults. MATERIALS AND METHODS: This cross-sectional study included 78 386 Chinese adults who underwent abdominal ultrasound examination. Data on demographic characteristics, clinical history and laboratory parameters were collected. The diagnosis of KS was based on the ultrasound findings. Multivariable logistic regression examined the association between the BRI and KS risk. The analysis incorporated subgroup analyses, dose-response relationship assessment and mediation analysis. RESULTS: Multivariable-adjusted logistic regression analyses revealed that the BRI was significantly positively correlated with KS risks in both genders, with a more pronounced effect observed in males (OR 1.16, 95% CI 1.12 to 1.20) compared with females (OR 1.11, 95% CI 1.04 to 1.20). Participants in the highest BRI tertile had a 47% and 23% higher KS risk in males and a 23% higher KS risk in females, respectively, compared with the lowest tertile. Dose-response analysis showed a non-linear relationship between BRI and KS risk in both males and females. Mediation analysis indicated that low-density lipoprotein cholesterol accounted for 7.2% of the association in females, whereas hypertension (14.8%) and uric acid (12.5%) were the primary mediating factors in males. Subgroup analyses confirmed that the association was modified by age and diabetes in females and by diabetes in males. CONCLUSION: The findings demonstrate a significant association between elevated BRI and increased KS risk, underscoring the necessity of implementing gender-specific strategies and considering mediating factors in KS prevention.