{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:17:27Z","timestamp":1788329847740,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The body mass index (BMI) is widely used to assess obesity but fails to reflect fat distribution. The body roundness index (BRI) has been proposed as a better surrogate for central obesity, yet direct comparisons of their predictive power remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed 341\u2009336 adults from the Taiwan MJ cohort, free of cardiovascular disease at baseline, with a mean follow\u2010up of 19.1\u2009years. Anthropometric, laboratory, and lifestyle data were analyzed to compare the predictive performance of BRI and BMI for all\u2010cause and cardiovascular mortality. Mediation analysis using CRP (C\u2010reactive protein) was conducted to evaluate the role of inflammation in the relationship between these anthropometric indices and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">BRI showed a significant J\u2010shaped association with death, with increased risks at extremes. In multivariable models, BRI outperformed BMI in discriminating all\u2010cause (area under the receiver operating characteristic curve, 70.5% versus 59.3%) and cardiovascular death (area under the receiver operating characteristic curve, 75.4% versus 62.7%). Categorical net reclassification improvement analysis indicated that BRI significantly enhanced risk prediction for all\u2010cause (net reclassification improvement, 44.5%) and cardiovascular death (net reclassification improvement, 30.2%). Crucially, CRP levels mediated 23.9% of BRI's effect on all\u2010cause death and 13.2% on cardiovascular death, while no significant mediation was observed with BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">BRI provides superior mortality prediction compared with BMI, likely due to its association with visceral adiposity and inflammation. These findings highlight BRI's potential as a more accurate tool for risk stratification and the importance of targeting inflammation to mitigate obesity\u2010related risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048324","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:13:57Z","timestamp":1787829237000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Body Mass Index: Body Roundness Index, Inflammation, and Death"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-6513","authenticated-orcid":false,"given":"Donna Shu\u2010Han","family":"Lin","sequence":"first","affiliation":[{"name":"Shin Kong Wu Ho\u2010Su Memorial Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1893-6360","authenticated-orcid":false,"given":"Su\u2010Kiat","family":"Chua","sequence":"additional","affiliation":[{"name":"Shin Kong Wu Ho\u2010Su Memorial Hospital","place":["Taipei, Taiwan"]},{"name":"Fu Jen Catholic University","place":["New Taipei City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3790-484X","authenticated-orcid":false,"given":"Jen\u2010Kuang","family":"Lee","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]},{"name":"National Taiwan University College of Medicine","place":["Taipei, Taiwan"]},{"name":"National Taiwan University College of Medicine","place":["Taipei, Taiwan"]},{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]},{"name":"National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0176-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60318-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000367"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.113905"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-023-00847-5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/diab.35.9.990"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1914"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307563"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-024-01008-5"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.11"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20408"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13023"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.034768"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15051"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw282"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60749-6"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6894"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jshs.2021.03.001"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.2196\/24346"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02085-y"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69251-9"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025438"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.067264"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm243"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.107.159228"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.676379"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.10.063"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.11.058"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182111607"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-021-01905-x"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31820a91b9"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001186"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001184"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1707914"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/86.2.353"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12576"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2007.334"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1079\/BJN20061745"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/60.1.23"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.048324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:02:33Z","timestamp":1788328953000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.048324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":39,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1161\/JAHA.125.048324"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.048324","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"assertion":[{"value":"2025-11-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e048324"}}