Abstract / Summary
The body roundness index (BRI) is an emerging anthropometric indicator of abdominal obesity. However, the longitudinal association between BRI trajectories and the risk of hyperuricemia remains unclear. This study aimed to examine the association between long-term BRI trajectories and incident hyperuricemia among middle-aged and older Chinese adults. This prospective cohort study included 4565 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (CHARLS) who were free of hyperuricemia at baseline. Group-based trajectory modeling was used to identify distinct BRI trajectories across the 2011, 2013, and 2015 waves. Multivariable logistic regression models were applied to estimate odds ratios for hyperuricemia assessed at the 2015 follow-up, with Model 2 (adjusting for demographic and lifestyle factors) designated as the primary model. Four distinct BRI trajectories were identified: low (19.2%), moderate-low (35.9%), moderate-high (28.8%), and high (16.1%). At the 2015 assessment, 458 participants (10.03%) were identified with hyperuricemia. In the primary model, participants in the moderate-low, moderate-high, and high trajectory groups had significantly higher odds of hyperuricemia compared with the low group, with odds ratios (ORs) of 1.92 (95% CI 1.35–2.73), 3.04 (95% CI 2.13–4.35), and 4.80 (95% CI 3.26–7.05), respectively (P for trend < 0.001). These associations persisted for the moderate-high and high groups after additional adjustment for baseline BRI and serum uric acid (ORs 1.79 and 2.35, respectively). Extended adjustment models incorporating additional clinical and laboratory covariates yielded consistent results. Higher long-term BRI trajectories were associated with greater odds of hyperuricemia among middle-aged and older Chinese adults, and this association persisted after additional adjustment for baseline BRI and serum uric acid. These findings support the relevance of longitudinal adiposity patterns to hyperuricemia risk, while the exposure–outcome overlap limits causal and prospective interpretation.