Zhu Rui, Deng Chao-Ren, Wu Shao-Ping
School of Laboratory Medicine. Chengdu Medical College.
School of Laboratory Medicine. Chengdu Medical College. Department of Radiology. Sichuan Tai Kang Hospital.
Nutr Hosp. 2025 Apr 21;42(2):333-340. doi: 10.20960/nh.05548.
Objective: to investigate the correlation between cardiometabolic index (CMI) and lumbar spine bone mineral density (LSBMD) in U.S. adults. Methods: the study selected eligible participants from the National Health and Nutrition Examination Survey (NHANES) database from 2011 to 2018. After adjusting for age, gender, race/ethnicity, body mass index (BMI), liver function markers, kidney function markers, blood routine indicators, metabolic markers, and chronic disease status, a logistic regression model combined with a restricted cubic spline model, smooth curve fitting, and threshold effect analysis was used to examine the association between CMI and LSBMD. Subgroup analysis was performed to verify the robustness of the results. Result: among the 3,885 participants, for each unit increase in CMI, LSBMD decreased by 0.011 g/cm². Additionally, a turning point was identified at CMI = 0.797. When CMI was below 0.797, LSBMD decreased as CMI increased, showing a strong negative correlation (β = -0.077, 95 % CI: -0.097 to -0.058, p < 0.001). However, beyond this threshold, the relationship between CMI and LSBMD was no longer significant. Subgroup analysis revealed that the negative correlation between CMI and BMD was consistent across most subgroups (such as gender, BMI, hypertension, and high cholesterol), but instability was observed in subgroups such as individuals aged 51-59, Mexican Americans, non-Hispanic Blacks, and those with diabetes. Conclusion: there exists a non-linear inverse correlation with CMI and LSBMD, showing that CMI could be a potential contributing factor for decreased bone mineral density, with a more pronounced effect within a specific range.
研究美国成年人心脏代谢指数（CMI）与腰椎骨密度（LSBMD）之间的相关性。方法：该研究从2011年至2018年的美国国家健康与营养检查调查（NHANES）数据库中选取符合条件的参与者。在调整年龄、性别、种族/民族、体重指数（BMI）、肝功能指标、肾功能指标、血常规指标、代谢指标和慢性病状态后，使用逻辑回归模型结合受限立方样条模型、平滑曲线拟合和阈值效应分析来检验CMI与LSBMD之间的关联。进行亚组分析以验证结果的稳健性。结果：在3885名参与者中，CMI每增加一个单位，LSBMD下降0.011g/cm²。此外，在CMI = 0.797处确定了一个转折点。当CMI低于0.797时，LSBMD随CMI增加而下降，呈现出强负相关（β = -0.077，95%CI：-0.097至-0.058，p < 0.001）。然而，超过这个阈值后，CMI与LSBMD之间的关系不再显著。亚组分析显示，CMI与骨密度之间的负相关在大多数亚组（如性别、BMI、高血压和高胆固醇）中是一致的，但在51 - 59岁个体、墨西哥裔美国人、非西班牙裔黑人以及糖尿病患者等亚组中观察到不稳定性。结论：CMI与LSBMD之间存在非线性负相关，表明CMI可能是骨密度降低的一个潜在影响因素，在特定范围内影响更为明显。
