ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
This article is part of the Research TopicNutritional Management of Childhood and Adolescent Obesity and Related Diseases - Volume IIView all articles
Body Roundness Index Outperforms Traditional Obesity Metrics in Predicting Cardiometabolic Risk Among Children and Adolescents: The EMSNGS Study
Provisionally accepted
- Shenzhen Children's Hospital, Shenzhen, China
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Objective: Novel obesity indices, the body roundness index (BRI) and a body shape index (ABSI), have been proved to be superior over body mass index (BMI) for predicting metabolic syndrome and cardiovascular events in adults. However, their performance in pediatric populations remains unexplored. Study design: A large-scale cross-sectional study, Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen (EMSNGS) project, was conducted in 2021 including 4,794 children and adolescents aged 6–17 years. Quantile regression models were used to analyse factors influencing ABSI and BRI. Associations between the 2 novel obesity indices and cardiovascular metabolic risk index (CMRI) were evaluated using logistic regression and receiver operating characteristic (ROC) curves. Results: In total, 1,971 participants (1,131 boys, 840 girls) exhibited CMRI ≥1. BRI was associated with pubertal development and weight status in both sexes. ABSI was only associated with weight status. BRI was associated with CMRI ≥1, whereas ABSI was not (P > 0.05). Compared with waist-to-hip ratio, waist-to-height ratio, and BMI, BRI at the 75th percentile (BRI P75th) demonstrated optimal sensitivity–specificity balance. The area under the ROC curve (95% CI), sensitivity, specificity, and Youden index were 0.752 (0.732–0.771), 71.3%, 79.1%, and 0.504 for boys and 0.693 (0.670–0.716), 61.8%, 76.8%, and 0.386 for girls, respectively. Conclusion: After adjustment for sex and pubertal stages, BRI P75th remained significantly associated with elevated cardiometabolic risk in children and adolescents, supporting its potential utility as an early screening indicator.
Keywords: A Body Shape Index, Adolescent, Body roundness index, cardiometabolic risk index, cardiovascular disease, Children
Received: 04 Dec 2025; Accepted: 31 Jan 2026.
Copyright: © 2026 Hu, Xu, Su, Li, Zhao, Pan and Wang. 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: Zhe Su
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