Potential mediating role of triglycerides in the nonlinear association between body roundness index and MASLD in nondiabetic adults

A Chinese study found that a measure of visceral adiposity, known as the body roundness index (BRI), has a strong and nonlinear relationship with metabolic dysfunction-associated steatotic liver disease (MASLD) in non-diabetic adults. After accounting for various factors, higher BRI was independently linked to increased MASLD risk, with women, individuals aged 40 or older, those with a body mass index over 25 kg/m², and non-hypertensive individuals experiencing stronger associations.

Generalized additive models showed an inverted-U-shaped association between BRI and MASLD, with a saturation point at BRI equal to 4.80. Further analysis suggested that triglyceride levels may partially mediate the connection between BRI and MASLD, accounting for 12.08% of the total statistical effect. The findings indicate that elevated BRI is strongly and nonlinearly associated with MASLD risk, even in traditionally low-risk subgroups, and that serum triglycerides might play a role in the pathway from visceral fat accumulation to hepatic steatosis, warranting further prospective research.