Association of Conicity Index and Body Roundness Index with Multimorbidity Among Adults in Guangzhou, China: A Cross-Sectional Study and Implications for Nutritional Risk Stratification.

BACKGROUND

Optimizing nutritional care for people with multimorbidity requires effective and feasible tools for early risk identification. This study aimed to investigate the associations of conicity index (C-index) and body roundness index (BRI) with multimorbidity among adults in Guangzhou, and to explore their potential utility in identifying individuals who may benefit from prioritized nutritional assessment.

METHODS

Based on the Fourth Adult Chronic Disease and Risk Factor Surveillance Program in Guangzhou, a total of 15,532 adults were recruited in this cross-sectional study. Multiple logistic regression analysis, restricted cubic spline (RCS) analysis and receiver operating characteristic curve (ROC) analysis with DeLong's test were performed.

RESULTS

The prevalence of multimorbidity was 38.95%. Higher C-index and BRI quartiles were significantly associated with increased multimorbidity risk. Compared with the lowest quartile, the adjusted OR for the highest C-index quartile was 1.98 (95% CI: 1.78-2.21), and for the highest BRI quartile it was 3.05 (95% CI: 2.74-3.41). A dose-response relationship was observed (p < 0.001). BRI showed statistically significantly higher discriminative ability relative to traditional anthropometric indices, though its overall discriminative performance was modest (AUC = 0.678).

CONCLUSIONS

C-index and BRI are strongly and positively associated with multimorbidity. These simple, non-invasive indices may support community-based risk stratification and help identify individuals who warrant further clinical and nutritional assessment.