Guo Yanjun, Su Wei, Tao Lulong, Zhang Guoxin, Wang Kun
Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Department of General Surgery, Division of Hepatobiliary and Transplantation Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
BMC Gastroenterol. 2025 Apr 17;25(1):265. doi: 10.1186/s12876-025-03876-1.
Cardiometabolic index (CMI) was proposed ten years ago as an indicator combining obesity and dyslipidemia. This study aimed to investigate the relationships between newly modified CMI (MCMI) with non-alcoholic fatty liver disease (NAFLD) and liver fibrosis.
This cross-sectional study included participants in the 2017-2018 National Health and Nutrition Examination Survey database (NHANES). Linear regression was used to explore the relationship between MCMI and Baseline characteristics. Logistic regression was conducted to analyze the correlation among MCMI with NAFLD and liver fibrosis. Furthermore, restricted cubic spline (RCS) was performed to estimate nonlinear relationships. Receiver operating characteristic curve (ROC) was used to assess the diagnostic performance of MCMI for NAFLD and liver fibrosis.
A total of 1385 participants were enrolled in the study. After adjusting covariates, participants with high MCMI were related to increased risk of NAFLD (OR = 3.52, 95%CI: 1.44-8.61), compared with those having low MCMI. A linear association was observed between MCMI and NAFLD (p for nonlinear = 0.074), and a J-shaped nonlinear relationship was found between MCMI and liver fibrosis (p for nonlinear = 0.002). The area under the curve (AUC) for MCMI to identify NAFLD was 0.821 (95% CI 0.799-0.843), which was higher than that of CMI (AUC = 0.761, 95%CI: 0.735-0.786), fatty liver index for the U.S. population (USFLI, AUC = 0.799, 95%CI: 0.776-0.822), Triglyceride glucose index (TyG, AUC = 0.738, 95%CI: 0.712-0.765), NAFLD liver fat score (NLFS, AUC = 0.786, 95%CI: 0.761-0.810) and hepatic steatosis index (HSI, AUC = 0.799, 95%CI: 0.775-0.822).
The novel MCMI was positively corelated to the risk of NAFLD. In addition, MCMI was an effective predictor for both NAFLD and liver fibrosis.
心脏代谢指数(CMI)于十年前被提出,作为一种综合肥胖和血脂异常的指标。本研究旨在探讨新改良的心脏代谢指数(MCMI)与非酒精性脂肪性肝病(NAFLD)及肝纤维化之间的关系。
这项横断面研究纳入了2017 - 2018年国家健康与营养检查调查数据库(NHANES)中的参与者。采用线性回归来探讨MCMI与基线特征之间的关系。进行逻辑回归分析MCMI与NAFLD及肝纤维化之间的相关性。此外,采用受限立方样条(RCS)来估计非线性关系。使用受试者工作特征曲线(ROC)评估MCMI对NAFLD和肝纤维化的诊断性能。
本研究共纳入1385名参与者。在调整协变量后,与低MCMI参与者相比,高MCMI参与者患NAFLD的风险增加(OR = 3.52,95%CI:1.44 - 8.61)。观察到MCMI与NAFLD之间存在线性关联(非线性p值 = 0.074),且MCMI与肝纤维化之间存在J形非线性关系(非线性p值 = 0.002)。MCMI识别NAFLD的曲线下面积(AUC)为0.821(95%CI 0.799 - 0.843),高于CMI(AUC = 0.761,95%CI:0.735 - 0.786)、美国人群脂肪肝指数(USFLI,AUC = 0.799,95%CI:0.776 - 0.822)、甘油三酯葡萄糖指数(TyG,AUC = 0.738,95%CI:0.712 - 0.765)、NAFLD肝脏脂肪评分(NLFS,AUC = 0.786,95%CI:0.761 - 0.810)和肝脂肪变性指数(HSI,AUC = 0.799,95%CI:0.775 - 0.822)。
新型MCMI与NAFLD风险呈正相关。此外,MCMI是NAFLD和肝纤维化的有效预测指标。