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Nonlinear association between body roundness index and asthma in U.S. children and adolescents: a cross-sectional study (NHANES 1999-2023).

Created on 19 Aug 2026

Authors

Yan Wang, Hong Zhang, Lei Li, Xinglin Chen

Published in

The Journal of asthma : official journal of the Association for the Care of Asthma. Pages 1-13. Aug 18, 2026. Epub Aug 18, 2026.

Abstract

Body Roundness Index (BRI) is a new measure of central fat distribution linked to asthma risks, but its connection to asthma in children is unclear. This study investigates the relationship between BRI and asthma in U.S. children and adolescents.
We conducted a cross-sectional study of 32 738 participants aged 3-17 years using National Health and Nutrition Examination Survey (NHANES) data (1999-2023). BRI was calculated from height and waist, and logistic regression estimated the BRI-asthma association, adjusting for age, sex, race/ethnicity, education level, poverty income ratio, physical activity, and passive smoking (serum cotinine).
In the study population, 5609 (17.13%) had asthma. A nonlinear association was observed between BRI and asthma. We identified a critical BRI threshold value of approximately 3.59. For BRI values below 3.59, each unit increase in BRI was associated with higher odds of asthma (OR = 1.25, 95% CI: 1.18-1.32, P < 0.001). In contrast, for BRI values above 3.59, the increase in odds was more modest, yet remained significant (OR = 1.06, 95% CI: 1.02-1.09, P = 0.001). A log-likelihood ratio test confirmed the nonlinear association (P < 0.001).
In this study of U.S. children and adolescents, a higher BRI was associated with a greater risk of having asthma. The relationship was nonlinear, with a pronounced increase in asthma risk at lower BRI levels, while the increase leveled off at higher levels. Given the cross-sectional design, causality cannot be inferred.

PMID:
42611922
Bibliographic data and abstract were imported from PubMed on 19 Aug 2026.

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