Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018

Abstract Background The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD. Methods We obtained participant-related data from the National Health a...

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Main Authors: Lu Zhang, Cuiying Liang, Zhaoqi Yan, Qingzhen Li
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-00826-1
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author Lu Zhang
Cuiying Liang
Zhaoqi Yan
Qingzhen Li
author_facet Lu Zhang
Cuiying Liang
Zhaoqi Yan
Qingzhen Li
author_sort Lu Zhang
collection DOAJ
description Abstract Background The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD. Methods We obtained participant-related data from the National Health and Nutrition Examination Survey (NHANES), including complete information on DKD, CMI, and other covariates. We employed weighted multivariable logistic regression models, restricted cubic spline (RCS) regression analysis, subgroup analyses, and interaction tests to explore the relationship between CMI and DKD. Additionally, we utilized receiver operating characteristic (ROC) curves to compare the performance of CMI in identifying DKD relative to a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), and lipid accumulation product (LAP) indices. Results According to the logistic regression analysis, a positive correlation between CMI and DKD was observed among the 2371 participants included in the study (OR: 1.40, 95% CI: 1.19–1.66). RCS analysis indicated that this relationship is nonlinear. When CMI was converted from a continuous variable to quartiles, the prevalence of DKD in the highest quartile group showed a significant 84% increase compared to the lowest quartile group (OR: 1.84, 95% CI: 1.24–2.72). The area under the ROC curve of CMI for identifying DKD was 0.67, outperforming other indices. The results of subgroup analyses and interaction tests were stable. Conclusion Elevated CMI is associated with an increased risk of DKD and can serve as a low-cost screening tool, allowing physicians to potentially identify high-risk diabetic patients early and implement timely interventions to slow the progression of DKD.
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spelling doaj-art-4b28ce6fb2134c4ebd9b3eb9319ff0fa2025-08-20T03:07:43ZengBMCJournal of Health, Population and Nutrition2072-13152025-04-014411910.1186/s41043-025-00826-1Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018Lu Zhang0Cuiying Liang1Zhaoqi Yan2Qingzhen Li3School of Clinical Medicine, Jiangxi University of Chinese MedicineFaculty of Medicine, The Chinese University of Hong KongGuang’anmen Hospital, China Academy of Chinese Medical SciencesAffiliated Hospital of Jiangxi University of Chinese MedicineAbstract Background The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD. Methods We obtained participant-related data from the National Health and Nutrition Examination Survey (NHANES), including complete information on DKD, CMI, and other covariates. We employed weighted multivariable logistic regression models, restricted cubic spline (RCS) regression analysis, subgroup analyses, and interaction tests to explore the relationship between CMI and DKD. Additionally, we utilized receiver operating characteristic (ROC) curves to compare the performance of CMI in identifying DKD relative to a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), and lipid accumulation product (LAP) indices. Results According to the logistic regression analysis, a positive correlation between CMI and DKD was observed among the 2371 participants included in the study (OR: 1.40, 95% CI: 1.19–1.66). RCS analysis indicated that this relationship is nonlinear. When CMI was converted from a continuous variable to quartiles, the prevalence of DKD in the highest quartile group showed a significant 84% increase compared to the lowest quartile group (OR: 1.84, 95% CI: 1.24–2.72). The area under the ROC curve of CMI for identifying DKD was 0.67, outperforming other indices. The results of subgroup analyses and interaction tests were stable. Conclusion Elevated CMI is associated with an increased risk of DKD and can serve as a low-cost screening tool, allowing physicians to potentially identify high-risk diabetic patients early and implement timely interventions to slow the progression of DKD.https://doi.org/10.1186/s41043-025-00826-1Cardiac metabolic indexType 2 diabetes mellitusDiabetic kidney diseaseCross-sectional studyRestricted cubic spline
spellingShingle Lu Zhang
Cuiying Liang
Zhaoqi Yan
Qingzhen Li
Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018
Journal of Health, Population and Nutrition
Cardiac metabolic index
Type 2 diabetes mellitus
Diabetic kidney disease
Cross-sectional study
Restricted cubic spline
title Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018
title_full Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018
title_fullStr Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018
title_full_unstemmed Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018
title_short Association between cardiac metabolic index and diabetic kidney disease: a cross-sectional study of NHANES 1999–2018
title_sort association between cardiac metabolic index and diabetic kidney disease a cross sectional study of nhanes 1999 2018
topic Cardiac metabolic index
Type 2 diabetes mellitus
Diabetic kidney disease
Cross-sectional study
Restricted cubic spline
url https://doi.org/10.1186/s41043-025-00826-1
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AT zhaoqiyan associationbetweencardiacmetabolicindexanddiabetickidneydiseaseacrosssectionalstudyofnhanes19992018
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