Abstract:
Background Body roundness index（BRI）is a simple measure of central obesity and is strongly associated with cardiovascular disease. People with metabolically obese normal weight（MONW）have a higher risk of cardiovascular disease and are significantly associated with central obesity. The triglyceride glucose（TyG）index is an indicator of insulin resistance. There are limited studies on the relationship between BRI，TyG index and MONW phenotypes in gender#2;specific elderly populations. Objective To explore differences in the risk of prevalence of the BRI and MONW phenotypes in the elderly population by gender，and to explore the TyG index as a potential factor in their differences by gender. Methods Permanent residents ≥ 60 years of age who underwent physical examination in 10 cities and counties in Anhui Province from 2017-07-01 to 2021-06-30 were selected as study subjects. A unified questionnaire was used to collect information on gender， age，and disease history of the study subjects，collect information on physical examination and laboratory tests，and calculate BRI and TyG indices. Men and women will be classified into metabolically healthy normal weight（MHNW）phenotype and MONW phenotype according to metabolic status and BMI level，respectively：male MHNW phenotype（n=5 384），male MONW phenotype（n=6 251）；female MHNW phenotype（n=4 498），female MONW phenotype（n=8 264）. Males and females were divided into 4 levels according to BRI quartiles，males：M1，M2，M3，and M4，and females：F1，F2，F3， and F4，respectively.Logistic regression analyses were performed to explore the association between BRI quartile levels and the risk of elevated TyG index and the risk of prevalence of MONW phenotypes respectively，using the Z test was used to compare the differences between the OR value of male and female. Results A total of 24 397 investigators were included in this study， including 11 635（47.7%）males and 12 762（52.3%）females，with a median age of 67（64，70） years，and 9 882（40.5%） with MHNW phenotype and 14 515（59.5%）with MONW phenotype. Hypertension，diabetes mellitus，dyslipidaemia，systolic blood pressure，diastolic blood pressure，TyG index，BRI，fasting glucose（FPG），total cholesterol（TC），triglyceride （TG），and low-density lipoprotein cholesterol（LDL-C）in the elderly population of different genders with MONW phenotype were higher than in the MHNW phenotype，and smoking and high-density lipoprotein cholesterol（HDL-C）were lower than in the MHNW phenotype（P<0.05）；prevalence of MONW phenotype，hypertension，diabetes mellitus，dyslipidaemia，TyG index，FPG，and TG were higher than those of low level BRI，and HDL-C was lower than those of low level BRI in the elderly population of different genders with high level BRI（P<0.05）. The results of univariate logistic regression analysis showed that the risk of elevated TyG index was increased at BRI M2/F2，M3/F3，and M4/F4 levels in elderly populations of different genders compared with BRI M1/F1 levels（P<0.05）；and the risk of elevated TyG index increased with increasing BRI levels（Ptrend<0.001 for male，Ptrend<0.001 for female）；and the risk of elevated TyG index was higher at BRI M2，M3，and M4 levels in older men than at BRI F2，F3，and F4 levels in older women（P<0.05）. Multifactorial Logistic regression analyses after correction for confounders showed that the risk of MONW phenotype prevalence was increased at the BRI M2/F2，M3/F3，and M4/F4 levels in the elderly population of different genders compared with the BRI M1/F1 level（P<0.05）；and the risk of MONW phenotype prevalence increased with the increase of the BRI level（Ptrend<0.001 for male，Ptrend<0.001 for female）；and the risk of the MONW phenotype was higher in older men than in older women at BRI levels M2 and M4（P<0.05）. Conclusion BRI levels were significantly and positively associated with the risk of the MONW phenotype in older adults of different genders，with high levels of BRI more strongly associated with the risk of the MONW phenotype in older men，with the TyG index being a potential factor contributing to the gender difference.
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