Higher cardiometabolic index (CMI) was associated with increased cardiometabolic multimorbidity risk (OR 1.25 per 1-SD increase) but not superior to waist circumference (OR 1.46).
Do cardiometabolic index, BMI, and waist circumference predict incident cardiometabolic multimorbidity in older adults?
In older adults, the cardiometabolic index is associated with long-term risk of cardiometabolic multimorbidity but does not outperform traditional adiposity measures like BMI and waist circumference.
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Background/Objectives: The cardiometabolic index (CMI) is a simple anthropometric–metabolic indicator that has recently gained attention as a marker of cardiometabolic risk. This study compared the associations and predictive utility of CMI, body mass index (BMI), and waist circumference (WC) for cardiometabolic multimorbidity (CMM). Methods: Data were drawn from 3348 adults (mean age 63.5 years; 45.1% male) in the English Longitudinal Study of Ageing who were free of hypertension, coronary heart disease, diabetes, and stroke at wave 4 (2008–2009). CMI was calculated using the triglyceride-to-HDL-cholesterol ratio and the waist-to-height ratio. Incident CMM at wave 10 (2021–2023) was defined as the presence of ≥2 of these conditions: hypertension, cardiovascular disease, diabetes, or stroke. Odds ratios (ORs) with 95% confidence intervals (CIs) and measures of discrimination were estimated. Results: During 12–15 years of follow-up, 197 CMM cases were recorded. CMI, BMI, and WC were each linearly related to CMM. Higher CMI was associated with increased CMM risk (per 1-SD increase: OR 1.25, 95% CI 1.08–1.44; highest vs. lowest tertile: OR 1.88, 95% CI 1.09–3.25), with similar effect sizes for BMI. WC showed stronger associations (per 1-SD increase: OR 1.46, 95% CI 1.25–1.71; highest vs. lowest tertile: OR 2.16, 95% CI 1.35–3.44). Adding CMI to a base model resulted in a small, non-significant improvement in discrimination (ΔC-index = 0.0032; p = 0.55) but significantly improved model fit (−2 log-likelihood p = 0.004), with comparable effects for BMI and greater improvements for WC. Conclusions: In this older UK cohort, higher CMI levels were associated with increased long-term risk of CMM but did not outperform traditional adiposity measures such as BMI and WC.
Kunutsor et al. (Tue,) reported a other. Higher cardiometabolic index (CMI) was associated with increased cardiometabolic multimorbidity risk (OR 1.25 per 1-SD increase) but not superior to waist circumference (OR 1.46).