Abstract
OBJECTIVE: To evaluate the association between body roundness index (BRI) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk and to compare its predictive performance with body mass index (BMI). METHODS: We included 13,086 adults aged 40-79 years undergoing health examinations in Taiwan between 2012 and 2019. ASCVD risk was estimated using the ACC/AHA Pooled Cohort Equations. Ordinal logistic regression assessed associations, and receiver operating characteristic curves compared the predictive performance of BRI and BMI. RESULTS: Higher BRI was significantly associated with increased ASCVD risk. In the multivariable ordinal logistic regression model, each one-unit increase in BRI was associated with an adjusted odds ratio of 1.58 (95 % CI: 1.54, 1.63) for higher ASCVD risk. Participants in the highest BRI quartile had 4.07-fold higher odds (95 % CI: 3.69, 4.49, p for trend <0.01) of being in a higher ASCVD risk category than those in the lowest quartile. BRI demonstrated superior predictive performance to BMI, with AUCs of 0.72 vs. 0.69 for intermediate risk and 0.70 vs. 0.68 for high risk. CONCLUSIONS: BRI is significantly associated with 10-year ASCVD risk and shows superior discriminative ability, supporting its use in cardiovascular risk stratification in East Asian populations.