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The relationship between cardiometabolic Index and diabetic kidney disease in people with diabetes
Jianping Kong1, Wenting Tao2, Yuhong Sun3
1Department of Nephrology, Nanjing Lishui People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China.
Insights
The cardiometabolic index (CMI) is linked to an increased risk of diabetic kidney disease (DKD) in US adults with diabetes. This association becomes significant when CMI exceeds 1.7, particularly in smokers.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- The cardiometabolic index (CMI) is associated with various health conditions, including diabetes and kidney dysfunction.
- The specific relationship between CMI and diabetic kidney disease (DKD) requires further elucidation.
Purpose of the Study:
- To investigate the correlation between the cardiometabolic index (CMI) and the risk of developing diabetic kidney disease (DKD) in a US adult population with diabetes.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2003-2018.
- Employed multivariable logistic regression, Generalized Additive Models (GAM) with smooth curve fitting, and two-stage regression analysis.
- Conducted subgroup analyses and interaction tests to explore variations in the CMI-DKD relationship.
Main Results:
- A significant positive correlation was found between higher CMI levels and increased DKD risk (OR=1.11, 95% CI: 1.05, 1.17, p<0.0001) after adjusting for multiple confounders.
- A nonlinear relationship was observed, with a threshold effect at CMI=1.7, beyond which the risk of DKD increased.
- The association was particularly pronounced in individuals with varying smoking statuses (p for interaction=0.0216).
Conclusions:
- Elevated cardiometabolic index (CMI) significantly correlates with an increased risk of diabetic kidney disease (DKD) in diabetic patients.
- A threshold effect exists, with CMI levels above 1.7 indicating a heightened risk.
- Further large-scale prospective studies are recommended to validate these findings.
Introduction:
Studies have shown a strong correlation between the cardiometabolic index (CMI) and health issues such as diabetes, atherosclerosis, and decreased renal function. Nevertheless, the correlation between CMI and diabetic kidney disease (DKD) remains ambiguous. The objective of this study is to evaluate the correlation between CMI and DKD in patients with diabetes in the United States.
Methods:
The study involved individuals who were part of the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2018. A multivariable logistic regression analysis was employed for investigating the correlation between CMI and DKD. The study employed Generalized Additive Models (GAM) and smooth curve fitting methods for investigating the nonlinear relationship between CMI and DKD. Two-stage regression analysis was applied for investigating threshold effects in the connection between CMI and DKD. In addition, subgroup analysis and interaction tests were also carried out.
Results:
This analysis included a total of 6,540 adults with diabetes. After adjusting for variables including age, sex, race, education level, smoking status, household income and poverty rate, body mass index, hypertension status, aspartate aminotransferase, alanine aminotransferase, serum albumin, and serum globulin, we discovered a significant connection between CMI levels and the risk of DKD (OR=1.11, 95% CI: 1.05, 1.17, p<0.0001). Individuals with varying smoking statuses showed variations in this connection according to subgroup analysis and interaction tests (p for interaction=0.0216). Conversely, this correlation appeared similar across different genders, ages, races, BMI categories, hypertension statuses, and insulin usage among people with diabetes (all p for interaction >0.05). A nonlinear relationship existed between CMI and DKD, with threshold analysis indicating a turning point at CMI=1.7. A positive correlation was observed between CMI levels in people with diabetes and the risk of DKD when CMI exceeded 1.7.
Conclusion:
The risk of DKD was significantly positively correlated with the CMI levels of people with diabetes. Further larger prospective studies are required to confirm our results.
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