Metabolic syndrome mediates the association between body roundness index and incident stroke risk in Chinese adults aged 45 years and older: Evidence from the CHARLS

Diabetes Res Clin PractPublished Prospective cohort study

Authors' conclusion

In metabolically healthy individuals, BRI shows a moderate predictive value for stroke, partly mediated by blood pressure.

Study context

Population
Participants of the CHARLS cohort, with and without metabolic syndrome (MetS)
Exposure
Body roundness index (BRI) and incident stroke, by MetS status; mediation by MetS components
Outcome
Incident stroke

Main finding

As reported in the abstract

Association of BRI with stroke by MetS status
Hazard ratio (95% CI)P value
Without MetS
2.50(1.69–3.67)
P < 0.001
With MetS
0.97(0.43–2.18)
P < 0.935

Observational data: associations, not effects.

Further findings

OutcomeWithout MetSWith MetS
Stroke discrimination (ROC)
AUC0.6600.638

Stroke discrimination (ROC)

BRI outperformed traditional indices in stroke discrimination

Mediation of BRI-stroke association

Proportion explained by metabolic components
about 22 %
Proportion explained by blood pressure
11 %
Other components not individually significant; mediation modest

Original publication

Metabolic syndrome mediates the association between body roundness index and incident stroke risk in Chinese adults aged 45 years and older: Evidence from the CHARLS. Diabetes Res Clin Pract. Published 10 December 2025. doi:10.1016/j.diabres.2025.113050

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