The comorbidity of hypertension and diabetes modifies the association of body roundness index with chronic kidney disease: findings from two cross-sectional studies in China and the US

This study aimed to investigate the potential effect of the comorbidity of hypertension and diabetes on the association of body roundness index (BRI) with chronic kidney disease (CKD). A total of 20,261 participants from Fuqing Cohort Study (FQCS) in China and 6,434 participants from the U.S. National Health and Nutrition Examination Survey (NHANES) were included. Multivariable logistic regression model was used to assess the association between BRI and CKD. Stratified analyses by hypertension and diabetes status were performed. In the total population, higher BRI (BRI Q4 vs. Q1) was significantly associated with an increased risk of CKD after adjustment for BMI in both cohorts (FQCS: OR = 1.87 (95% CI: 1.56–2.24); NHANES: OR = 2.74 (95% CI: 1.55–4.84)). When considering the co-existence of hypertension and diabetes, the positive association was only significant in hypertension-diabetes comorbidity population (BRI Q4 vs. Q1: OR = 1.98 (95% CI: 95% CI:1.42–2.75)), and hypertension-only population (BRI Q4 vs. Q1: OR = 1.60 (95% CI: 1.21–2.13)), but not in the diabetes-only group (BRI Q4 vs. Q1: OR = 0.97 (95% CI: 0.53–1.77)), or non-hypertensive and non-diabetic group (BRI Q4 vs. Q1: OR = 1.36 (95% CI: 0.95–1.93)) in FQCS, while the association was only significant in hypertension-diabetes comorbidity subgroup in NHANES (BRI Q4 vs. Q1: OR = 3.72 (95% CI: 1.87–7.40)). High BRI was associated with an increased risk of CKD, especially in hypertension-diabetes comorbidity, highlighting the need for targeted prevention strategies.