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The nonlinear correlation between the cardiometabolic index and the risk of diabetes: A retrospective Japanese cohort
Fubing Zha1,2, Changchun Cao3, Mengru Hong3
1Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Insights
The cardiometabolic index (CMI) is linked to a higher risk of developing diabetes mellitus (DM). This association is non-linear, with increased risk observed when CMI is below 1.01.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- The cardiometabolic index (CMI) is a novel indicator of cardiometabolic health.
- Limited evidence exists on the relationship between CMI and diabetes mellitus (DM) risk.
- This study investigates the CMI-DM risk association in Japanese adults.
Purpose of the Study:
- To explore the relationship between the cardiometabolic index (CMI) and the risk of developing diabetes mellitus (DM).
- To determine if the association between CMI and DM risk is linear or non-linear.
- To identify potential interaction factors influencing the CMI-DM risk relationship.
Main Methods:
- Retrospective cohort study of 15,453 Japanese adults without baseline diabetes.
- Cox proportional-hazards regression and generalized additive models (GAM) were used.
- Sensitivity and subgroup analyses were conducted to ensure result reliability.
Main Results:
- Adjusted analysis revealed a positive association between CMI and DM risk (HR: 1.65).
- A non-linear relationship was observed, with an inflection point at CMI=1.01.
- A strong positive association was found for CMI < 1.01 (HR: 2.96), but not for CMI > 1.01 (HR: 1.27).
- Gender, BMI, exercise, and smoking status interacted with CMI.
Conclusions:
- Elevated baseline CMI is associated with incident DM in Japanese adults.
- The CMI-DM risk association is non-linear, particularly significant at lower CMI values (<1.01).
- CMI may serve as a valuable indicator for predicting DM risk.
Background:
The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. However, evidence on the relationship between CMI and diabetes mellitus (DM) risk was limited. Our study aimed to explore the relationship between CMI and DM risk among a large cohort of Japanese adults.
Methods:
This retrospective cohort study recruited 15453 Japanese adults without diabetes at baseline who underwent physical examinations at the Murakami Memorial Hospital between 2004 and 2015. Cox proportional-hazards regression was applied to evaluate the independent relationship between CMI and diabetes. Our study performed a generalized smooth curve fitting (penalized spline technique) and an additive model (GAM) to determine the non-linear relationship between CMI and DM risk. In addition, a set of sensitivity analyses and subgroup analyses were employed to evaluate the relationship between CMI and incident DM.
Results:
After adjusting for confounding covariates, CMI was positively related to the DM risk in Japanese adults (HR: 1.65, 95%CI: 1.43-1.90, P<0.0001). A series of sensitivity analyses were also employed in this study to guarantee the reliability of the findings. In addition, our study discovered a non-linear association between CMI and diabetes risk. CMI's inflection point was 1.01. A strong positive association between CMI and diabetes incidence was also discovered to the left of the inflection point (HR: 2.96, 95%CI: 1.96-4.46, P<<0.0001). However, their association was not significant when CMI was higher than 1.01 (HR: 1.27, 95%CI: 0.98-1.64, P=0.0702). Interaction analysis showed that gender, BMI, habit of exercise, and smoking status interacted with CMI.
Conclusion:
Increased CMI level at baseline is associated with incident DM. The association between CMI and incident DM is also non-linear. A high CMI level is associated with an increased risk for DM when CMI is below 1.01.
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