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中国中老年人心血管代谢指数与新发中风的关联:一项全国性前瞻性队列研究

Association of cardiometabolic index and new-onset stroke in middle-aged and elderly Chinese: a national prospective cohort study.

作者信息

Yang Yibo, Xiao ZhenKun, Teng Jing, Zhong Hailong, Duan Yonghong, Zhou Min, Wang Bing, Liu Aihua

机构信息

Department of Neurosurgery, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, China.

Institute of Cardiovascular Disease, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, Hunan, 421001, China.

出版信息

BMC Neurol. 2025 Mar 13;25(1):105. doi: 10.1186/s12883-025-04129-0.

Abstract

BACKGROUND AND AIMS

The Cardiometabolic Index (CMI), a novel metabolic marker, has been associated with various metabolic diseases in previous studies. However, its relationship with stroke risk remains underexplored. This study investigates the potential correlation between CMI and stroke risk among Chinese adults aged 45 and older.

METHODS

In the China Health and Retirement Longitudinal Study (CHARLS), participants were categorized into four groups based on CMI quartiles. The primary outcome was the incidence of new strokes during the follow-up period. A Cox proportional hazards model was used to analyze the relationship between CMI and stroke risk among the elderly. Kaplan-Meier survival analysis compared incidence rates across CMI levels, and restricted cubic splines (RCS) assessed potential non-linear relationships between CMI and stroke. Subgroup analyses verified the robustness of these findings.

RESULTS

The study included 6620 patients (45% male), with 417 new stroke cases reported over an average follow-up of seven years. Multivariate analysis indicated a significant association between increased CMI and higher stroke risk [HR, 1.132 (1.021-1.273), P = 0.003]. The RCS model revealed a nonlinear increase in stroke risk with rising CMI levels (P for nonlinearity = 0.006). No significant interactions were detected between CMI and the selected subgroups (all P values for interaction > 0.05).

CONCLUSION

CMI significantly correlates with stroke risk in the elderly Chinese population, suggesting its potential utility in early risk stratification.

摘要

背景与目的

心脏代谢指数(CMI)是一种新型代谢标志物,先前研究已表明其与多种代谢性疾病相关。然而,其与中风风险的关系仍未得到充分研究。本研究调查了45岁及以上中国成年人中CMI与中风风险之间的潜在相关性。

方法

在中国健康与养老追踪调查(CHARLS)中,参与者根据CMI四分位数被分为四组。主要结局是随访期间新中风的发生率。采用Cox比例风险模型分析老年人中CMI与中风风险之间的关系。Kaplan-Meier生存分析比较了不同CMI水平的发病率,受限立方样条(RCS)评估了CMI与中风之间潜在的非线性关系。亚组分析验证了这些结果的稳健性。

结果

该研究纳入了6620名患者(45%为男性),在平均七年的随访期间报告了417例新中风病例。多变量分析表明,CMI升高与中风风险增加之间存在显著关联[风险比(HR),1.132(1.021 - 1.273),P = 0.003]。RCS模型显示,中风风险随着CMI水平升高呈非线性增加(非线性P值 = 0.006)。未检测到CMI与选定亚组之间存在显著交互作用(所有交互作用P值均>0.05)。

结论

CMI与中国老年人群的中风风险显著相关,表明其在早期风险分层中具有潜在应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ebb/11905718/27ac63bd4463/12883_2025_4129_Fig1_HTML.jpg

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