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糖尿病是心脏代谢指数与胆结石之间的关键联系:一项大型横断面研究。

Diabetes is the missing link between cardiometabolic index and gallstones: a large cross-sectional study.

作者信息

Zhang Yu, Gu Xiangqian, Lv Hua, Wan Daiwei, Wu Yilin, Wu Ji

机构信息

Department of Gastrointestinal Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi Medical Center, Wuxi, Jiangsu, China.

Department of Hepatobiliary Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi Medical Center, Wuxi, Jiangsu, China.

出版信息

Sci Rep. 2025 Mar 22;15(1):9947. doi: 10.1038/s41598-025-93908-3.

Abstract

The cardiometabolic index (CMI), which integrates individual lipid and visceral fat parameters, represents a superior new predictive tool for cardiovascular and metabolic disorders, but its predictive value for gallstones (GS) is unclear. Therefore, the present study used this vacancy to explore the relationship between CMI levels and GS in US adults, assess the mediating role of diabetes mellitus in the pathogenesis of both, and provide new clinical ideas for early prevention and screening of GS in patients with diabetes mellitus. This survey extracted information from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 vintage cycle. Cross-sectional analyses and a variety of statistical techniques were used to analyze the correlation between CMI and GS, including logistic regression, propensity score matching, subject work curves, and restricted cubic spline (RCS). Furthermore, mediation analysis was used to investigate whether and to what extent diabetes mediated the effect of CMI on GS. After analysis of 3,395 participants, a significant positive correlation was observed between elevated CMI levels and increased prevalence of GS In the fully corrected model (Model 4), the prevalence of GS exhibited a 23% increase for every incremental unit rise in logarithmically transformed CM. Mediation analysis showed that diabetes largely mediated the association between CMI and GS, with a mediation ratio of 15.1%. Higher CMI levels are closely linked to a greater occurrence of GS, and diabetes plays a key mediating role in the pathogenesis of both. Addressing dyslipidemia while not neglecting blood glucose levels, and co-management of the two may be a proven way to reduce GS risk.

摘要

心脏代谢指数(CMI)综合了个体脂质和内脏脂肪参数,是一种用于预测心血管和代谢紊乱的新型高级工具,但其对胆结石(GS)的预测价值尚不清楚。因此,本研究利用这一空白,探讨美国成年人CMI水平与GS之间的关系,评估糖尿病在两者发病机制中的中介作用,并为糖尿病患者早期预防和筛查GS提供新的临床思路。本调查从2017 - 2020年全国健康与营养检查调查(NHANES)中提取信息。采用横断面分析和多种统计技术分析CMI与GS之间的相关性,包括逻辑回归、倾向得分匹配、受试者工作曲线和受限立方样条(RCS)。此外,采用中介分析来研究糖尿病是否以及在多大程度上介导了CMI对GS的影响。在对3395名参与者进行分析后,发现CMI水平升高与GS患病率增加之间存在显著正相关。在完全校正模型(模型4)中,对数转换后的CM每增加一个单位,GS患病率就会增加23%。中介分析表明,糖尿病在很大程度上介导了CMI与GS之间的关联,中介比例为15.1%。较高的CMI水平与更高的GS发生率密切相关,糖尿病在两者的发病机制中起关键中介作用。在不忽视血糖水平的同时解决血脂异常问题,对两者进行共同管理可能是降低GS风险的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d6a/11929793/b755bd0bcca5/41598_2025_93908_Fig1_HTML.jpg

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