不同糖代谢状态下心脏代谢指数与动脉粥样硬化性心血管疾病的关联：来自1999 - 2020年美国国家健康与营养检查调查（NHANES）的见解

Associations between the cardiometabolic index and atherosclerotic cardiovascular disease acorss different glucose metabolism statuses: insights from NHANES, 1999-2020.

作者信息

Wei Qiong, Cheng Xu, Li Min, Wu Keying, Chen Meng, Zhang Dongmei

机构信息

Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Hospital, No.5 Haiyuncang Hutong, Dongcheng District, Beijing, 100700, China.

School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Sunshine South Street, Fangshan District, Beijing, 100029, China.

出版信息

Lipids Health Dis. 2025 Mar 15;24(1):93. doi: 10.1186/s12944-025-02508-7.

DOI:10.1186/s12944-025-02508-7

PMID:40089751

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11910843/

Abstract

BACKGROUND

The cardiometabolic index (CMI) serves as a significant marker of diabetes mellitus (DM) and may predict the potential for cardiovascular disease development. Nevertheless, the correlation between CMI and atherosclerotic cardiovascular disease (ASCVD) among individuals exhibiting varying glucose metabolism statuses (GMS) continues to be unclear.

METHODS

Overall, 24,006 individuals aged 20 and above were enrolled in the research, drawn from the National Health and Nutrition Examination Survey (NHANES) database. Individuals in the study was classified into three distinct categories according to the level of fasting plasma glucose or glycated haemoglobin: normal glucose regulation, prediabetes, and DM. Multivariate logistic regression models and smoothed curve-fitting techniques were applied to investigate the correlation between CMI and ASCVD risk across varying GMS. Additionally, subgroup analyses stratified by relevant factors were performed to identify potential effect modifiers in this relationship.

RESULTS

Overall, 2352 participants (9.8%) with ASCVD were included. An increasing trend in ASCVD risk was observed for each successive CMI tertile. After adjusting for all related covariates, a significantly positive association was observed between CMI and ASCVD (P = 0.0004). Participants with DM in the highest CMI tertile had a 114% higher ASCVD risk compared to those in the lowest tertile (OR = 2.14; 95% CI = 1.30-3.53). Smoothed curve-fitting consistently confirmed the correlation between CMI and ASCVD across diverse GMS. Subgroup analyses and interaction tests highlighted statistically significant differences within the drinking status subgroup (P-interaction = 0.0479) and GMS subgroups (P-interaction = 0.0397).

CONCLUSION

This research suggests a positive association between ASCVD and CMI in adults in the United States, particularly among individuals with DM.

摘要

背景

心脏代谢指数（CMI）是糖尿病（DM）的重要标志物，可能预测心血管疾病的发生风险。然而，不同糖代谢状态（GMS）个体中CMI与动脉粥样硬化性心血管疾病（ASCVD）之间的相关性仍不明确。

方法

本研究共纳入24006名年龄在20岁及以上的个体，数据来自美国国家健康与营养检查调查（NHANES）数据库。根据空腹血糖或糖化血红蛋白水平，将研究对象分为三个不同类别：血糖正常、糖尿病前期和糖尿病。应用多因素逻辑回归模型和平滑曲线拟合技术，研究不同GMS下CMI与ASCVD风险之间的相关性。此外，进行相关因素分层的亚组分析，以确定该关系中的潜在效应修饰因素。

结果

共纳入2352例（9.8%）患有ASCVD的参与者。随着CMI三分位数的升高，ASCVD风险呈上升趋势。在调整所有相关协变量后，CMI与ASCVD之间存在显著正相关（P = 0.0004）。CMI最高三分位数组中的糖尿病参与者相比最低三分位数组，ASCVD风险高114%（OR = 2.14；95%CI = 1.30 - 3.53）。平滑曲线拟合一致证实了不同GMS下CMI与ASCVD之间的相关性。亚组分析和交互作用检验突出了饮酒状态亚组（P交互作用 = 0.0479）和GMS亚组（P交互作用 = 0.0397）内的统计学显著差异。