Abstract:

Objective To investigate the association between the body roundness index (BRI) and carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM), and to evaluate the predictive value of BRI. Methods This retrospective study included 1, 136 patients with T2DM treated at Cangzhou People's Hospital between January 2018 and December 2024. Multivariable logistic regression was used to examine the association between BRI and cIMT. A generalized additive model (GAM) was employed to fit smooth curves and visualize the exposure-response relationship. Predictive performance was evaluated using receiver operating characteristic (ROC) curve and compared with body mass index (BMI). Subgroup analysis was used to evaluate the correlation between BRI and cIMT in T2DM patients in different populations. Results Overall, 608 patients met criteria for cIMT thickening. Across BRI quartiles, the incidence of cIMT increased significantly with higher BRI (P<0.01). After adjustment for potential confounders, multivariate logistic regression analysis showed that BRI remained an independent risk factor for cIMT (OR=1.35; 95%CI: 1.11-1.65; P=0.003). Compared with the lowest quartile (Q1), adjusted odds ratios for Q2, Q3, and Q4 were 2.23(95%CI: 1.53-3.24; P<0.01), 3.44(95%CI: 2.17-5.44; P<0.01), and 3.96(95%CI: 2.03-7.42; P<0.01), respectively. ROC curve analysis showed that the area under the curve (AUC) for BRI in predicting cIMT was 0.70, with sensitivity and specificity of 74.2% and 61.7%, respectively, and BRI outperformed BMI (Z=2.398; P=0.017). Subgroup analysis showed significant interactions with diabetes duration (interaction P<0.05). Conclusion BRI is an effective predictor of cIMT in T2DM patients, which helps to identify high-risk patients and guide early intervention.

Key words: type 2 diabetes mellitus, body roundness index, carotid artery disease, carotid intima-media thickness