Associations of Body Roundness Index with Hypertension Risk and Blood Pressure in Diabetes and Prediabetes Adults: A Study Based on the NHANES Databas.

Abstract

Background: Visceral obesity is considered an important risk factor for hypertension. However, there is little research on visceral obesity and hypertension in patients with diabetes or prediabetes. Body roundness index (BRI) serves as a proxy for visceral adiposity. Therefore, the purpose of this study is to investigate the relationship between BRI and hypertension and blood pressure in diabetes (DM) or prediabetes (preDM).

Methods: This study includes data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, including 5368 participants with DM and preDM. Weighted multiple regression, restricted cubic spline (RCS), and subgroup analysis were used to evaluate the correlation between BRI and hypertension risk as well as blood pressure.

Results: This study included a total of 1565 DM subjects and 3803 preDM participants. The prevalence of hypertension in the two groups was 67.80% and 42.28%, respectively. After adjusting for potential confounding factors, BRI was significantly positively correlated with the risk of hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in both DM and preDM. In the fully adjusted model, an increase in BRI was positively associated with the risk of hypertension in both DM and preDM participants (DM OR: 1.25, 95% CI: 1.16-1.34, P < 0.0001; preDM OR: 1.20, 95% CI: 1.14-1.26, P < 0.0001). Further RCS analysis revealed a significant nonlinear relationship between BRI and hypertension and DBP in DM and preDM, while there was a linear positive correlation with SBP. Interaction analysis indicated that in male preDM, BRI was associated with a higher risk of hypertension (male OR: 1.28, 95% CI: 1.19-1.39, female OR: 1.12, 95% CI: 1.07-1.17, P for interaction <0.01). Additionally, in preDM under the age of 60, BRI showed a stronger positive correlation with SBP and DBP (OR: 1.23, 95% CI: 0.94-1.52, P < 0.0001; OR: 0.68, 95% CI: 0.45-0.90, P < 0.0001). However, these findings were not observed in DM.

Conclusions: In diabetes and prediabetes, BRI exhibits a significant positive correlation with the risk of hypertension, as well as with systolic and diastolic blood pressure. Based on these findings, BRI may serve as a biomarker for managing the progression of hypertension in patients with DM and preDM.