A total of 1,385 participants showed a high (MCMI) is associated with a 3.52 times greater risk of (NAFLD).
A linear association exists between MCMI and NAFLD risk, while a J-shaped nonlinear relationship is observed with liver fibrosis.
MCMI demonstrates an area under the curve (AUC) of 0.821 for identifying NAFLD, which exceeds the performance of several other indices.
Compared to the original cardiometabolic index (CMI), MCMI shows improved diagnostic capability for NAFLD.
The study indicates that higher levels of MCMI may serve as an effective predictor for both NAFLD and liver fibrosis.
Simplified
BACKGROUND: 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 () with (NAFLD) and liver fibrosis.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: The novel MCMI was positively corelated to the risk of NAFLD. In addition, MCMI was an effective predictor for both NAFLD and liver fibrosis.
Key numbers
3.52
Increased Risk of
Odds ratio comparing high vs. low
0.821
AUC for Diagnosis
Area under the curve for
0.002
J-shaped Relationship with Liver Fibrosis
P-value for the nonlinear association
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Declarations. Ethics approval and consent to participate: The procedures and protocols of NHANES have been reviewed and approved by the National Center for Health Statistics Research Ethics Review Board and written informed consent was obtained from each participant. All analyses in this study were performed in accordance with the NHANES guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
