Key result
Increased cardiometabolic index (CMI) is non-linearly associated with incident diabetes, showing a strong positive association when CMI is below 1.01 (HR 2.96) but no significant association above 1.01.
Why the study?
Evidence on the relationship between the cardiometabolic index and diabetes mellitus risk was limited.
Does an increased baseline cardiometabolic index predict the risk of incident diabetes mellitus in Japanese adults?
Cohort (n=15,453)
No
Does an increased baseline cardiometabolic index predict the risk of incident diabetes mellitus in Japanese adults?
Hazard Ratio: 1.65 (95% CI 1.43–1.9)
p-value: p=<0.0001
An increased baseline cardiometabolic index is non-linearly associated with a higher risk of incident diabetes in Japanese adults, with the steepest risk increase occurring at CMI levels below 1.01.
May inform DM risk stratification in Japanese adults; leaves open incremental value beyond established predictors.
Background: The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. However, evidence on the relationship between CMI and diabetes mellitus (DM) risk was limited. Our study aimed to explore the relationship between CMI and DM risk among a large cohort of Japanese adults. Methods: This retrospective cohort study recruited 15453 Japanese adults without diabetes at baseline who underwent physical examinations at the Murakami Memorial Hospital between 2004 and 2015. Cox proportional-hazards regression was applied to evaluate the independent relationship between CMI and diabetes. Our study performed a generalized smooth curve fitting (penalized spline technique) and an additive model (GAM) to determine the non-linear relationship between CMI and DM risk. In addition, a set of sensitivity analyses and subgroup analyses were employed to evaluate the relationship between CMI and incident DM. Results: After adjusting for confounding covariates, CMI was positively related to the DM risk in Japanese adults (HR: 1.65, 95%CI: 1.43-1.90, P<0.0001). A series of sensitivity analyses were also employed in this study to guarantee the reliability of the findings. In addition, our study discovered a non-linear association between CMI and diabetes risk. CMI's inflection point was 1.01. A strong positive association between CMI and diabetes incidence was also discovered to the left of the inflection point (HR: 2.96, 95%CI: 1.96-4.46, P<<0.0001). However, their association was not significant when CMI was higher than 1.01 (HR: 1.27, 95%CI: 0.98-1.64, P=0.0702). Interaction analysis showed that gender, BMI, habit of exercise, and smoking status interacted with CMI. Conclusion: Increased CMI level at baseline is associated with incident DM. The association between CMI and incident DM is also non-linear. A high CMI level is associated with an increased risk for DM when CMI is below 1.01.
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Zha et al. (2023) conducted a cohort in Diabetes Mellitus (n=15,453). Cardiometabolic index (CMI) vs. Lower CMI levels was evaluated on Incident diabetes (HR 1.65, 95% CI 1.43-1.90, p=<0.0001). Increased cardiometabolic index (CMI) is non-linearly associated with incident diabetes, showing a strong positive association when CMI is below 1.01 (HR 2.96) but no significant association above 1.01.
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