ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicThe Role of Adipose Tissue Dysfunction in the Pathogenesis of Obesity ComorbiditiesView all 7 articles
The Nonlinear Association Between Body Roundness Index and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes
Provisionally accepted
- The Affiliated Hospital of Qingdao University, Qingdao, China
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Background: Left ventricular diastolic dysfunction (LVDD) is a common complication of type 2 diabetes (T2DM), closely associated with obesity and visceral adiposity. The body roundness index (BRI) is a novel anthropometric measure that may better reflect visceral fat distribution, yet its relationship with LVDD in T2DM remains unclear. Objective: To investigate the association between BRI and LVDD risk in patients with T2DM, focusing on nonlinear relationships and potential threshold effects. Methods: This cross-sectional study included 1317 patients with T2DM. Multivariable logistic regression and generalized additive models (GAM) were used to assess associations, with adjustment for key confounders. Threshold effects were evaluated using a two-step recursive approach, and subgroup analyses were performed. Results: After full adjustment, each 1-unit increase in BRI was associated with a 30% higher risk of LVDD (OR: 1.30, 95% CI: 1.10–1.60, p < 0.001). A nonlinear relationship was identified with an inflection point at BRI = 8.1. Below this point, the association was stronger (OR: 1.50, 95% CI: 1.20–1.80, P < 0.001). Diabetic kidney disease significantly modified this association (P for interaction = 0.02). Conclusion: BRI is nonlinearly associated with LVDD risk in T2DM, with a threshold effect at BRI = 8.1. The association is stronger in patients with diabetic kidney disease, suggesting BRI could serve as a valuable marker for stratification and prevention of LVDD in high-risk populations.
Keywords: Body roundness index, Cross-sectional study, Left ventricular diastolic dysfunction, Non-linear association, type 2 diabetes mellitus
Received: 21 Sep 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Li, Wang, Ma and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Nailong Yang
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