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Background <p>Sarcopenia, the progressive depletion of skeletal muscle mass and strength, worsens daily living outcomes and survival in individuals diagnosed with cancer. It arises from complex interactions between primary malignancy, antineoplastic interventions, and treatment-related sequelae, making early risk assessment a clinical priority. The body roundness index (BRI), an anthropometric metric superior to body mass index in body composition profiling, has shown diagnostic utility across metabolic and cardiovascular domains. However, its prognostic value in cancer-associated sarcopenia remains underexplored. This bicontinental study pioneers the clinical validation of BRI for sarcopenia prediction, proposing an objective quantification framework to optimize early screening and personalized therapeutic strategies in oncological practice.</p> Methods <p>A cross-national dual-cohort design was implemented, using data from the US National Health and Nutrition Examination Survey multi-cancer cohort (<i>n</i> = 1,688) and a Chinese gastrointestinal oncology cohort (<i>n</i> = 713). Multivariable logistic regression adjusted demographics, lifestyle, comorbidities, cancer-related characteristics, and laboratory markers to examine the independent association between BRI and sarcopenia. Subgroup analyses with race- and cancer type-specific interaction terms were conducted to assess effect modification patterns, whereas nonlinear relationships were examined using smooth curve fitting and threshold effect models to identify critical thresholds. A predictive tool was developed and validated through receiver operating curve analysis and decision curve analysis to assess its diagnostic performance and clinical utility.</p> Results <p>BRI was positively associated with sarcopenia risk in both cohorts (US: odds ration [OR] = 1.62, 95% confidence interval [CI] = 1.48–1.77, <i>P</i> &lt; 0.001; Chinese: OR = 2.39, 95% CI = 1.82–3.15, <i>P</i> &lt; 0.001), with distinct threshold effects observed (US cohort critical BRI value = 6.73; Chinese cohort critical BRI value = 3.01). The predictive model showed good performance (US cohort area under the curve (AUC): 0.80 training, 0.82 validation; Chinese cohort AUC: 0.66 training, 0.78 validation). Decision curve analysis for both cohorts exhibited broad clinical applicability.</p> Conclusion <p>This study is the first to establish BRI independently predicts sarcopenia risk in patients with cancer. Additionally, a BRI-based model integrating sex and age combines the advantages of accuracy, specificity, and cost-effectiveness, demonstrating significant clinical utility.</p>

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Body roundness index as a novel anthropometric predictor of sarcopenia in patients with cancer: a bicontinental cohort study across Chinese and American populations

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • Yang Yu,
  • Yuan Hong,
  • Peng Zhang,
  • Kang Cheng,
  • Bo Chen

摘要

Background

Sarcopenia, the progressive depletion of skeletal muscle mass and strength, worsens daily living outcomes and survival in individuals diagnosed with cancer. It arises from complex interactions between primary malignancy, antineoplastic interventions, and treatment-related sequelae, making early risk assessment a clinical priority. The body roundness index (BRI), an anthropometric metric superior to body mass index in body composition profiling, has shown diagnostic utility across metabolic and cardiovascular domains. However, its prognostic value in cancer-associated sarcopenia remains underexplored. This bicontinental study pioneers the clinical validation of BRI for sarcopenia prediction, proposing an objective quantification framework to optimize early screening and personalized therapeutic strategies in oncological practice.

Methods

A cross-national dual-cohort design was implemented, using data from the US National Health and Nutrition Examination Survey multi-cancer cohort (n = 1,688) and a Chinese gastrointestinal oncology cohort (n = 713). Multivariable logistic regression adjusted demographics, lifestyle, comorbidities, cancer-related characteristics, and laboratory markers to examine the independent association between BRI and sarcopenia. Subgroup analyses with race- and cancer type-specific interaction terms were conducted to assess effect modification patterns, whereas nonlinear relationships were examined using smooth curve fitting and threshold effect models to identify critical thresholds. A predictive tool was developed and validated through receiver operating curve analysis and decision curve analysis to assess its diagnostic performance and clinical utility.

Results

BRI was positively associated with sarcopenia risk in both cohorts (US: odds ration [OR] = 1.62, 95% confidence interval [CI] = 1.48–1.77, P < 0.001; Chinese: OR = 2.39, 95% CI = 1.82–3.15, P < 0.001), with distinct threshold effects observed (US cohort critical BRI value = 6.73; Chinese cohort critical BRI value = 3.01). The predictive model showed good performance (US cohort area under the curve (AUC): 0.80 training, 0.82 validation; Chinese cohort AUC: 0.66 training, 0.78 validation). Decision curve analysis for both cohorts exhibited broad clinical applicability.

Conclusion

This study is the first to establish BRI independently predicts sarcopenia risk in patients with cancer. Additionally, a BRI-based model integrating sex and age combines the advantages of accuracy, specificity, and cost-effectiveness, demonstrating significant clinical utility.