Non-linear association of cardiometabolic index with gallstone disease in US adults: A cross-sectional study

Obesity and disorders of lipid metabolism are key factors in gallstone formation. The cardiometabolic index (CMI) is a new marker combining obesity indicators (WHtR) and lipid levels (TG/HDL-C). The aim of this study was to investigate whether CMI is associated with the prevalence of gallstone disease (GSD) in adults.

This study was a cross-sectional study by cohort data from the National Health and Nutrition Examination Survey (NHANES) January 2017-March 2020 cycle. Using sample-weighted multivariate logistic regression analysis, sample weighted restricted cubic spline (RCS), the receiver operating characteristic (ROC) and subgroup analysis to assist us with gaining insight into the association between CMI and GSD.

Among the 2825 included participants, 307 of them were patients with GSD. In a model adjusting for multiple covariates, each unit increase in CMI increased the odds of GSD by 16% (OR = 1.16; 95% CI = 1.04-1.30; P = 0.015). Compared to participants with the lowest CMI, those with the highest index had a significantly increased risk of GSD (OR = 2.52; 95% CI = 1.45-4.36; P = 0.006). The sample-weighted multivariable adjusted RCS revealed a nonlinear relationship between CMI and GSD. ROC analysis revealed that CMI had a high predictive effect on the diagnosis of GSD (AUC = 0.680). Subgroup analysis suggested the influence of gender differences on the relationship between CMI and GSD.

The present study found that elevated CMI significantly increased the risk of GSD and emphasized the non-linear relationship between both. These results suggest that CMI could be a potential marker for early screening and intervention of GSD, thus providing guidance for future clinical management of GSD.