Abstract
Background: Considering the reported link between obesity and diabetic kidney disease (DKD), this study investigated the association between body roundness index (BRI) and DKD. Methods: Cross-sectional data were obtained from the National Metabolic Management Center (MMC) of Yuhuan Second People's Hospital and Taizhou Central Hospital (Taizhou University Hospital) between September 2017 and May 2024. BRI was calculated using waist circumference (WC) and height. BRI was analyzed as a continuous and categorical variable to examine its association with DKD. Multivariate logistic regression and restricted cubic spline (RCS) analyses of the interplay between the BRI and DKD were conducted. Subgroup analysis was also performed. Results: Among 12,231 analyzed individuals, 5020 (41.0%) exhibited DKD. The BRI of individuals with DKD was higher than that of those without (p < 0.001). Compared with those in the first BRI tertile (T1), those in T2 or T3 showed higher DKD prevalence rates (T1 33.4% vs. T2 41.3% vs. T3 48.3%, p < 0.001). Compared with individuals in T1, those in T2 and T3 exhibited fully adjusted odds ratios for the relationship between BRI and DKD of 1.25 (95% confidence interval [CI]: 1.13-1.37, p < 0.001) and 1.42 (95% CI: 1.28-1.57, p < 0.001), respectively. A significant trend across BRI tertiles for DKD odds was observed (p for trend < 0.001). RCS regression with three knots at clinically relevant percentiles (5th, 50th, and 95th) confirmed a dose-response relationship between BRI and DKD, demonstrating positive linearity (p for nonlinearity = 0.628). Conclusion: BRI demonstrated significant positive associations with DKD, supporting its utility as a clinical risk indicator for early identification of high-risk individuals. Prospective cohort studies are warranted to evaluate BRI's predictive capacity for incident DKD.