Cardiometabolic index is a novel predictor for osteoporosis in type 2 diabetes mellitus patients with MAFLD: a cross-sectional study.

Introduction: As a new index of obesity and metabolism, the cardiometabolic index (CMI) has been shown to play an important role in the prediction and diagnosis of metabolic diseases. However, the relationship between CMI and osteoporosis (OP) in type 2 diabetes mellitus (T2DM) patients with metabolism-associated fatty liver disease (MAFLD) remains unclear. The present study aims to explore the relationship between them and provide new insights for the clinical management of OP in patients with T2DM.

Material and methods: A total of 429 T2DM patients with MAFLD were selected. Characteristics of the participants were compared across the quartiles of CMI. Spearman correlation analysis was conducted to examine the correlation between CMI and BMD. Regression models were utilized to investigate the relationship between CMI and bone mineral density (BMD) as well as OP. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic efficacy of CMI for identifying OP in T2DM patients with MAFLD.

Results: The present study found that after adjustment for multivariate analysis, CMI was negatively correlated with lumbar spine (LS) BMD (β = -0.158, p < 0.001), femoral neck (FN) BMD (β = -0.129, p = 0.004), and hip BMD (β = -0.350, p < 0.001) in T2DM patientswith MAFLD. Furthermore, CMI was significantly associated with OP [odds ratio (OR) = 2.297, 95% confidence interval (CI): 1.198-4.424, p = 0.012]. The receiver operating characteristic curve (ROC) curve revealed that the area under the curve (AUC) of CMI for predicting OP in T2DM patients with MAFLD was 0.755 (95% CI: 0.676-0.833, p < 0.001), with an optimal threshold of 1.948. The predictive accuracy for OP was higher in female patients (AUC: 0.863, p < 0.001) compared to male patients (AUC: 0.716, p < 0.001).

Conclusion: CMI shows a significant negative correlation with BMD in T2DM patients with MAFLD. It is an independent risk factor for OP in this patient population, offering a new direction for the prevention and screening of OP in individuals with T2DM. Moreover, CMI demonstrated greater diagnostic efficiency in postmenopausal female patients over the age of 50 years compared to male patients of the same age group.