Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2022 Sep 16;13:1004855. doi: 10.3389/fendo.2022.1004855. eCollection 2022.
Cardiometabolic index (CMI) is a well promising indicator for predicting obesity-related diseases, but its predictive value for metabolic associated fatty liver disease (MAFLD) is unclear. This study aimed to investigate the relationship between CMI and MAFLD and to evaluate the predictive value of CMI for MAFLD.
A total of 943 subjects were enrolled in this cross-sectional study. CMI was calculated by multiplying the ratio of triglycerides and high-density lipoprotein cholesterol (TG/HDL-C) by waist-to-height ratio (WHtR). Multivariate logistic regression analysis was used to systematically evaluate the relationship between CMI and MAFLD. Receiver operating characteristic (ROC) curves were used to assess the predictive power of CMI for MAFLD and to determine the optimal cutoff value. The diagnostic performance of high CMI for MAFLD was validated in 131 subjects with magnetic resonance imaging diagnosis.
Subjects with higher CMI exhibited a significantly increased risk of MAFLD. The odds ratio for a 1-standard-deviation increase in CMI was 3.180 (2.102-4.809) after adjusting for various confounding factors. Further subgroup analysis showed that there were significant additive interactions between CMI and MAFLD risk in gender, age, and BMI ( for interaction < 0.05), and the area under the ROC curve(AUC) of CMI for predicting MAFLD were significantly higher in female, young, and nonobese subgroups than that in male, middle-aged and elderly, and obese subgroups (all < 0.05). Moreover, among nonobese subjects, the AUC of CMI was significantly higher than that of waist circumference, BMI, TG/HDL-C, and TG (all < 0.05). The best cutoff values of CMI to diagnose MAFLD in males and females were 0.6085 and 0.4319, respectively, and the accuracy, sensitivity, and specificity of high CMI for diagnosing MAFLD in the validation set were 85.5%, 87.5%, and 80%, respectively.
CMI was strongly and positively associated with the risk of MAFLD and can be a reference predictor for MAFLD. High CMI had excellent diagnostic performance for MALFD, which can enable important clinical value for early identification and screening of MAFLD.
代谢相关脂肪性肝病（MAFLD）是一种与肥胖相关的代谢性疾病，心血管代谢指数（CMI）是一种预测肥胖相关疾病的良好指标，但它对 MAFLD 的预测价值尚不清楚。本研究旨在探讨 CMI 与 MAFLD 的关系，并评估 CMI 对 MAFLD 的预测价值。
本研究为横断面研究，共纳入 943 例受试者。CMI 通过将甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）的比值乘以腰围身高比（WHtR）计算得出。采用多变量 logistic 回归分析系统评估 CMI 与 MAFLD 的关系。采用受试者工作特征（ROC）曲线评估 CMI 对 MAFLD 的预测能力，并确定最佳截断值。在 131 例经磁共振成像诊断的受试者中验证了高 CMI 对 MAFLD 的诊断性能。
CMI 较高的受试者 MAFLD 风险显著增加。在校正了各种混杂因素后，CMI 每增加 1 个标准差，MAFLD 的比值比为 3.180（2.102-4.809）。进一步的亚组分析表明，CMI 与 MAFLD 风险在性别、年龄和 BMI 之间存在显著的相加交互作用（ < 0.05），在女性、年轻和非肥胖亚组中，CMI 预测 MAFLD 的 ROC 曲线下面积（AUC）显著高于男性、中年和老年以及肥胖亚组（均 < 0.05）。此外，在非肥胖受试者中，CMI 的 AUC 显著高于腰围、BMI、TG/HDL-C 和 TG（均 < 0.05）。男性和女性诊断 MAFLD 的最佳 CMI 截断值分别为 0.6085 和 0.4319，在验证集中，高 CMI 诊断 MAFLD 的准确性、敏感性和特异性分别为 85.5%、87.5%和 80%。
CMI 与 MAFLD 的风险呈强烈正相关，可作为 MAFLD 的参考预测指标。高 CMI 对 MAFLD 具有良好的诊断性能，可为 MAFLD 的早期识别和筛查提供重要的临床价值。
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