Association Between Cardiometabolic Index and Stroke: A Population- based Cross-sectional Study

Abstract

Background: Cardiometabolic index (CMI) is associated with several risk factors for stroke; however, few studies have assessed the role of CMI in stroke risk. Objective: This study aimed to assess the association between CMI and stroke in a population-based cross-sectional study. Methods: This study included 4445 general residents aged ≥40 years selected by multistage stratified random cluster sampling. CMI was calculated as the product of the ratio of waist circumference to height (WHtR) and the ratio of triglyceride levels to high-density lipoprotein cholesterol levels (TG/HDL-C). Participants were categorized according to CMI quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to assess the association between CMI and stroke. Results: A total of 4052 participants were included in the study, with an overall stroke prevalence of 7.2%. The prevalence of stroke increased with CMI quartiles, ranging from 4.4% to 9.2% (p for trend <0.001). Compared with Q1, stroke risk for Q2, Q3, and Q4 were 1.550-, 1.693-, and 1.704- fold, respectively. The area under the ROC curve (AUC) [95% CI] was (0.574 [0.558−0.589]) for CMI, 0.627 [0.612−0.642]) (p=0.0024) for WHtR, 0.556 [0.540−0.571]) (p<0.0001) for TG/HDL-C. CMI was inferior to WHtR, but CMI had marginal advantage over TG/HDL-C in terms of its stroke discrimination ability. Conclusion: Although there was a strong and independent association between CMI and stroke in the general population, CMI had limited discriminating ability for stroke. Thus, new parameters should be developed.

The associations between cardiometabolic index and non-alcoholic fatty liver disease

“…CMI is the binding product of TG/HDL-C ratio and WHtR. It has been shown to be closely associated with diabetes, cardiovascular disease, stroke, metabolic syndrome and kidney disease [10][11][12][13][14]. For the relationship between NAFLD and CMI, we found that the CMI value in the NAFLD group was signi cantly higher than that in the Non-NAFLD group.…”

“…It is calculated by multiplying the lipid ratio triglyceride (TG)/ high-density lipoprotein cholesterol(HDL-C) by the waist-to-height ratio(WHtR) [9]. CMI was further found to be closely associated with CVD, stroke, MetS, and kidney disease [10][11][12][13][14]. The importance of changes in blood lipids and obesity is self-evident for NAFLD, and waist-height ratio is more likely to identify NAFLD patients with abdominal obesity than BMI [13,15,16].…”

Association between the cardiometabolic index and NAFLD and fibrosis

“…It has been proposed as a predictive tool for assessing risks associated with type 2 diabetes and cardiovascular diseases 7 . Studies have identified correlations between the CMI and conditions such as hyperuricaemia, obstructive sleep apnoea, and stroke 8 – 10 . Given the promising diagnostic capability of the CMI for various metabolic disorders, its potential role in NAFLD diagnosis warrants further investigation.…”

Non-linear associations of cardiometabolic index with insulin resistance, impaired fasting glucose, and type 2 diabetes among US adults: a cross-sectional study

“…Owing to its integrated abdominal obesity and dyslipidemia indices, CMI was validated to be a robust and independent clinical adiposity discriminator as well as a closer correlation with metabolic abnormality than traditional anthropometric indicators (11,12). Additionally, prior CMI-related studies have demonstrated that CMI can detect the presence of obesity-related disorders and cardiovascular dysfunction, including diabetes, hyperuricemia, nonalcoholic fatty liver disease, hypertension, stroke, kidney disease, erectile dysfunction, and peripheral arterial disease (10,(13)(14)(15)(16)(17)(18)(19)(20).…”