Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study

Abstract Background The cardiometabolic index (CMI) is a novel metric for assessing cardiometabolic health and type 2 diabetes mellitus (DM), yet its relationship with insulin resistance (IR) and prediabetes (preDM) is not well-studied. There is also a gap in understanding the nonlinear associations...

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Main Authors: An-Bang Liu, Yan-Xia Lin, Ting-Ting Meng, Peng Tian, Jian-Lin Chen, Xin-He Zhang, Wei-Hong Xu, Yu Zhang, Dan Zhang, Yan Zheng, Guo-Hai Su
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-024-01676-4
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author An-Bang Liu
Yan-Xia Lin
Ting-Ting Meng
Peng Tian
Jian-Lin Chen
Xin-He Zhang
Wei-Hong Xu
Yu Zhang
Dan Zhang
Yan Zheng
Guo-Hai Su
author_facet An-Bang Liu
Yan-Xia Lin
Ting-Ting Meng
Peng Tian
Jian-Lin Chen
Xin-He Zhang
Wei-Hong Xu
Yu Zhang
Dan Zhang
Yan Zheng
Guo-Hai Su
author_sort An-Bang Liu
collection DOAJ
description Abstract Background The cardiometabolic index (CMI) is a novel metric for assessing cardiometabolic health and type 2 diabetes mellitus (DM), yet its relationship with insulin resistance (IR) and prediabetes (preDM) is not well-studied. There is also a gap in understanding the nonlinear associations between CMI and these conditions. Our study aimed to elucidate these associations. Methods We included 13,142 adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2020. CMI was calculated by multiplying the triglyceride-to-high density lipoprotein cholesterol (TG/HDL-C) by waist-to-height ratio (WHtR). Using weighted multivariable linear and logistic regression explored the relationships of CMI with glucose metabolism markers, IR, preDM, and DM. Nonlinear associations were assessed using generalized additive models (GAM), smooth curve fittings, and two-piecewise logistic regression. Results Multivariate regression revealed positive correlations between CMI and glucose metabolic biomarkers, including FBG (β = 0.08, 95% CI: 0.06–0.10), HbA1c (β = 0.26, 95% CI: 0.22–0.31), FSI (β = 4.88, 95% CI: 4.23–5.54), and HOMA-IR (β = 1.85, 95% CI: 1.56–2.14). There were also significant correlations between CMI and increased risk of IR (OR = 3.51, 95% CI: 2.94–4.20), preDM (OR = 1.49, 95% CI: 1.29–1.71), and DM (OR = 2.22, 95% CI: 2.00-2.47). Inverse nonlinear L-shaped associations were found between CMI and IR, preDM, and DM, with saturation inflection points at 1.1, 1.45, and 1.6, respectively. Below these thresholds, increments in CMI significantly correlated with heightened risks of IR, preDM, and DM. Conclusions CMI exhibited inverse L-shaped nonlinear relationships with IR, preDM, and DM, suggesting that reducing CMI to a certain level might significantly prevent these conditions.
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spelling doaj-art-dff1a316c22f44d69a0baa7f7135a49b2025-08-20T02:17:50ZengBMCBMC Endocrine Disorders1472-68232024-10-0124111310.1186/s12902-024-01676-4Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional studyAn-Bang Liu0Yan-Xia Lin1Ting-Ting Meng2Peng Tian3Jian-Lin Chen4Xin-He Zhang5Wei-Hong Xu6Yu Zhang7Dan Zhang8Yan Zheng9Guo-Hai Su10Shandong First Medical University & Shandong Academy of Medical SciencesDepartment of Cardiology, Central Hospital Affiliated to Shandong First Medical UniversityShandong First Medical University & Shandong Academy of Medical SciencesDepartment of Cardiology, Central Hospital Affiliated to Shandong First Medical UniversityDepartment of Cardiology, Central Hospital Affiliated to Shandong First Medical UniversityShandong First Medical University & Shandong Academy of Medical SciencesShandong First Medical University & Shandong Academy of Medical SciencesDepartment of Cardiology, Central Hospital Affiliated to Shandong First Medical UniversityDepartment of Cardiology, Central Hospital Affiliated to Shandong First Medical UniversityDepartment of Cardiology, Central Hospital Affiliated to Shandong First Medical UniversityShandong First Medical University & Shandong Academy of Medical SciencesAbstract Background The cardiometabolic index (CMI) is a novel metric for assessing cardiometabolic health and type 2 diabetes mellitus (DM), yet its relationship with insulin resistance (IR) and prediabetes (preDM) is not well-studied. There is also a gap in understanding the nonlinear associations between CMI and these conditions. Our study aimed to elucidate these associations. Methods We included 13,142 adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2020. CMI was calculated by multiplying the triglyceride-to-high density lipoprotein cholesterol (TG/HDL-C) by waist-to-height ratio (WHtR). Using weighted multivariable linear and logistic regression explored the relationships of CMI with glucose metabolism markers, IR, preDM, and DM. Nonlinear associations were assessed using generalized additive models (GAM), smooth curve fittings, and two-piecewise logistic regression. Results Multivariate regression revealed positive correlations between CMI and glucose metabolic biomarkers, including FBG (β = 0.08, 95% CI: 0.06–0.10), HbA1c (β = 0.26, 95% CI: 0.22–0.31), FSI (β = 4.88, 95% CI: 4.23–5.54), and HOMA-IR (β = 1.85, 95% CI: 1.56–2.14). There were also significant correlations between CMI and increased risk of IR (OR = 3.51, 95% CI: 2.94–4.20), preDM (OR = 1.49, 95% CI: 1.29–1.71), and DM (OR = 2.22, 95% CI: 2.00-2.47). Inverse nonlinear L-shaped associations were found between CMI and IR, preDM, and DM, with saturation inflection points at 1.1, 1.45, and 1.6, respectively. Below these thresholds, increments in CMI significantly correlated with heightened risks of IR, preDM, and DM. Conclusions CMI exhibited inverse L-shaped nonlinear relationships with IR, preDM, and DM, suggesting that reducing CMI to a certain level might significantly prevent these conditions.https://doi.org/10.1186/s12902-024-01676-4Cardiometabolic indexInsulin resistancePrediabetesDiabetesNonlinear association
spellingShingle An-Bang Liu
Yan-Xia Lin
Ting-Ting Meng
Peng Tian
Jian-Lin Chen
Xin-He Zhang
Wei-Hong Xu
Yu Zhang
Dan Zhang
Yan Zheng
Guo-Hai Su
Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study
BMC Endocrine Disorders
Cardiometabolic index
Insulin resistance
Prediabetes
Diabetes
Nonlinear association
title Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study
title_full Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study
title_fullStr Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study
title_full_unstemmed Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study
title_short Associations of the cardiometabolic index with insulin resistance, prediabetes, and diabetes in U.S. adults: a cross-sectional study
title_sort associations of the cardiometabolic index with insulin resistance prediabetes and diabetes in u s adults a cross sectional study
topic Cardiometabolic index
Insulin resistance
Prediabetes
Diabetes
Nonlinear association
url https://doi.org/10.1186/s12902-024-01676-4
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