Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study

Abstract Background Abdominal obesity, assessed via the body roundness index (BRI), is a critical determinant of health outcomes. This study explores the association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome in a natio...

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Main Authors: Chong Zhang, Cuijun Hao, Weiru Liang, Kun Hu, Tingting Guo, Yi Chen, Meng Ning, Yingwu Liu
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01649-0
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author Chong Zhang
Cuijun Hao
Weiru Liang
Kun Hu
Tingting Guo
Yi Chen
Meng Ning
Yingwu Liu
author_facet Chong Zhang
Cuijun Hao
Weiru Liang
Kun Hu
Tingting Guo
Yi Chen
Meng Ning
Yingwu Liu
author_sort Chong Zhang
collection DOAJ
description Abstract Background Abdominal obesity, assessed via the body roundness index (BRI), is a critical determinant of health outcomes. This study explores the association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome in a nationwide longitudinal cohort. Methods Data were derived from the China Health and Retirement Longitudinal Study, including individuals aged ≥ 45 years. Participants were categorized into early and advanced CKM syndrome stages. The BRI was used to measure abdominal obesity, and frailty was assessed using the frailty index. Results Higher BRI in individuals within early CKM syndrome stages was associated with an increased risk of frailty progression compared to those with advanced stages (adjusted hazard ratio [aHR] 1.30, 95% confidence interval [CI] 1.17–1.45 vs. aHR 1.16, 95% CI 0.96–1.40). High cumulative BRI with advanced CKM stages progression and persistent advanced CKM stages over time also predicted a greater risk of frailty. Furthermore, BRI outperformed body mass index (BMI) in predicting frailty progression after combined with conventional model (area under the curve [AUC] 0.708, 95% CI 0.694–0.722 vs. AUC 0.704, 95% CI 0.690–0.718; P = 0.033). Conclusions Abdominal obesity, indicated by BRI, is a strong predictor of frailty progression, particularly in early CKM stages. High cumulative BRI, along with advanced CKM progression and persistent advanced CKM stages, further increases frailty risk. Notably, BRI outperforms BMI in enhancing conventional frailty prediction models. These findings underscore the importance of monitoring abdominal obesity in early CKM stages to mitigate future frailty risk. Graphical Abstract
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series Diabetology & Metabolic Syndrome
spelling doaj-art-54fbb737994845249cd0304cb622f0712025-08-20T01:57:44ZengBMCDiabetology & Metabolic Syndrome1758-59962025-03-011711910.1186/s13098-025-01649-0Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal studyChong Zhang0Cuijun Hao1Weiru Liang2Kun Hu3Tingting Guo4Yi Chen5Meng Ning6Yingwu Liu7The Third Central Clinical College of Tianjin Medical UniversityThe Third Central Clinical College of Tianjin Medical UniversityState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeThe Third Central Clinical College of Tianjin Medical UniversityThe Third Central Clinical College of Tianjin Medical UniversityThe Third Central Clinical College of Tianjin Medical UniversityTianjin Key Laboratory of Extracorporeal Life Support for Critical DiseasesThe Third Central Clinical College of Tianjin Medical UniversityAbstract Background Abdominal obesity, assessed via the body roundness index (BRI), is a critical determinant of health outcomes. This study explores the association between abdominal obesity and frailty progression across different stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome in a nationwide longitudinal cohort. Methods Data were derived from the China Health and Retirement Longitudinal Study, including individuals aged ≥ 45 years. Participants were categorized into early and advanced CKM syndrome stages. The BRI was used to measure abdominal obesity, and frailty was assessed using the frailty index. Results Higher BRI in individuals within early CKM syndrome stages was associated with an increased risk of frailty progression compared to those with advanced stages (adjusted hazard ratio [aHR] 1.30, 95% confidence interval [CI] 1.17–1.45 vs. aHR 1.16, 95% CI 0.96–1.40). High cumulative BRI with advanced CKM stages progression and persistent advanced CKM stages over time also predicted a greater risk of frailty. Furthermore, BRI outperformed body mass index (BMI) in predicting frailty progression after combined with conventional model (area under the curve [AUC] 0.708, 95% CI 0.694–0.722 vs. AUC 0.704, 95% CI 0.690–0.718; P = 0.033). Conclusions Abdominal obesity, indicated by BRI, is a strong predictor of frailty progression, particularly in early CKM stages. High cumulative BRI, along with advanced CKM progression and persistent advanced CKM stages, further increases frailty risk. Notably, BRI outperforms BMI in enhancing conventional frailty prediction models. These findings underscore the importance of monitoring abdominal obesity in early CKM stages to mitigate future frailty risk. Graphical Abstracthttps://doi.org/10.1186/s13098-025-01649-0Cardiovascular-Kidney-MetabolicBody roundness indexAbdominal obesityFrailty
spellingShingle Chong Zhang
Cuijun Hao
Weiru Liang
Kun Hu
Tingting Guo
Yi Chen
Meng Ning
Yingwu Liu
Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study
Diabetology & Metabolic Syndrome
Cardiovascular-Kidney-Metabolic
Body roundness index
Abdominal obesity
Frailty
title Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study
title_full Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study
title_fullStr Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study
title_full_unstemmed Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study
title_short Abdominal obesity and frailty progression in population across different Cardiovascular-Kidney-Metabolic syndrome stages: a nationwide longitudinal study
title_sort abdominal obesity and frailty progression in population across different cardiovascular kidney metabolic syndrome stages a nationwide longitudinal study
topic Cardiovascular-Kidney-Metabolic
Body roundness index
Abdominal obesity
Frailty
url https://doi.org/10.1186/s13098-025-01649-0
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