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The joint effect of cardiometabolic index and high-sensitivity C-reactive protein on incident cardiovascular disease:
Jin-Hong Zhou1, Zi-Jia Li2, Lu-Lu Du1
1Jinzhou Medical University Graduate Training Base, the 960th Hospital of People's Liberation Army Joint Logistics Support Force, Jinzhou, Liaoning Province, 121000, China.
Insights
High cardiometabolic index (CMI) and high high-sensitivity C-reactive protein (hsCRP) significantly increase cardiovascular disease (CVD) risk. Combining these markers aids in early CVD risk stratification.
Area of Science:
- Cardiology
- Metabolic Health
- Inflammation Research
Background:
- Cardiovascular disease (CVD) risk prediction often relies on individual markers.
- The combined predictive role of the cardiometabolic index (CMI) and high-sensitivity C-reactive protein (hsCRP) for new-onset CVD is not well understood.
Purpose of the Study:
- To investigate the synergistic effect of CMI and hsCRP on the risk of developing new-onset cardiovascular disease (CVD).
Main Methods:
- Prospective cohort study of 7856 CVD-free adults from the CHARLS study.
- Participants categorized by median CMI and hsCRP levels (cutoff: 2 mg/L).
- Median 7-year follow-up with 1502 CVD incidents recorded. Mediation analyses were performed.
Main Results:
- Individuals with both high CMI and high hsCRP exhibited the highest risks for CVD (HR 1.54), stroke (HR 2.27), and heart disease (HR 1.37) compared to the reference group.
- Blood pressure and fasting glucose partially mediated CMI's association with outcomes.
- A bidirectional mediation was observed between CMI and hsCRP for stroke risk.
Conclusions:
- Joint elevation of CMI and hsCRP identifies individuals at significantly higher risk of CVD, stroke, and heart disease.
- This highlights the combined role of metabolic and inflammatory pathways in cardiovascular pathogenesis.
- Integrating both CMI and hsCRP is recommended for enhanced early CVD risk stratification.
Background And Aim:
The combined role of the cardiometabolic index (CMI), a marker of visceral obesity and dyslipidemia, and high-sensitivity C-reactive protein (hsCRP), an inflammatory marker, in predicting cardiovascular disease (CVD) risk remains unexplored. This study investigates their synergistic effect on new-onset CVD.
Methods And Results:
In this prospective cohort of 7856 CVD-free adults from CHARLS study, participants were categorized by median CMI and hsCRP (cutoff: 2 mg/L). Over a median 7-year follow-up, 1502 CVD incidents occurred. Compared with the low CMI and low hsCRP reference group, individuals with both high CMI and high hsCRP showed the highest risks of CVD (HR 1.54, 95 % CI 1.33-1.78), stroke (HR 2.27, 95 % CI 1.74-2.97), and heart disease (HR 1.37, 95 % CI 1.15-1.63), although multiplicative and additive interaction tests were not statistically significant. Mediation analyses indicated that blood pressure measures, and fasting glucose for heart disease, partially mediated CMI's association with outcomes. A bidirectional mediation relationship was observed between CMI and hsCRP for stroke risk. These findings remained consistent in sensitivity analyses, including competing risk models, subgroup analyses across population strata, and analyses using multiple imputation or an alternative hsCRP cutoff (3 mg/L).
Conclusion:
The joint elevation of CMI and hsCRP identifies individuals at the highest risk of CVD, stroke, and heart disease, underscoring the combined contribution of metabolic and inflammatory pathways to cardiovascular pathogenesis. This supports the integration of both markers for early risk stratification.
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