Association Between Cardiometabolic Index and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

This study aims to investigate the association between the cardiometabolic index (CMI) and the presence of diabetic retinopathy (DR) among individuals diagnosed with type 2 diabetes mellitus (T2DM).

A retrospective analysis was performed on clinical data from 2571 T2DM patients in Anhui Medical University Affiliated Lu'an Hospital. Based on fundus examination, subjects were classified into a group without DR (NDR, n=1606) and a group with DR (n=965). Clinical data and laboratory parameters were collected, and CMI was calculated, and explore its correlation with DR.

Among the 2571 patients, CMI values were markedly elevated in the DR cohort compared to the NDR cohort (P<0.001). Trend analysis showed that DR prevalence increased progressively across CMI quartiles (12.8%, 22.2%, 49.4%, 65.8%, P < 0.001), with a significant positive linear correlation (r = 0.430, P < 0.001). Multivariable analysis identified female sex (OR = 1.240, P = 0.020), longer diabetes duration (OR = 1.060, P < 0.001), higher CMI (OR = 1.167, P < 0.001), and elevated UACR (OR = 1.001, P < 0.001) were independent risk factors for DR. RCS analysis indicated that DR risk increased markedly when CMI exceeded 1.01 (P for overall < 0.001). ROC analysis demonstrated that CMI showed superior predictive performance for DR (AUC = 0.760, sensitivity = 74.8%, specificity = 68.8%) compared with diabetes duration (AUC = 0.640), UACR (AUC = 0.624), and sex (AUC = 0.527).

The higher level of CMI is significantly related to DR in T2DM patients, and this correlation is independent of diabetic retinopathy. Therefore, in clinical practice, CMI may become an effective metabolic indicator for evaluating the risk of DR.