Association between the cardiometabolic index and mortality risk in US adults: Data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018.

Background: Recently, studies have suggested the use of the cardiometabolic index (CMI) to reflect the risk of cardiometabolic disease. However, the association between the CMI and the risk of mortality remains unclear. The aim of the present study was to assess the associations between the CMI and the risk of mortality in the National Health and Nutrition Examination Survey (NHANES) population.

Methods: This present study analyzed data from the entire 1999 to 2018 NHANES cycle and ultimately included 20,570 individuals. All individuals were classified into 3 groups based on their CMI tertile, which was calculated by multiplying the waist-to-height ratio (WHtR) by the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio. The study endpoints included all-cause mortality, cardiovascular mortality, and diabetes-related mortality. Kaplan‒Meier survival and Cox regression analyses were performed to determine the association between the CMI and mortality risk.

Results: A total of 2660 (12.9%) individuals experienced all-cause death. Kaplan‒Meier survival curves suggested significant differences in mortality risk among the 3 groups (log-rank P < .001). According to the multivariate Cox regression analysis, the CMI was significantly associated with diabetes-related mortality risk (hazard ratio: 1.75, 95% CI: 1.38-2.22, P < .001) but not all-cause mortality or cardiovascular disease (CVD) mortality after adjusting for confounding risk factors.

Conclusions: A higher CMI was independently associated with an increased risk of diabetes-related mortality but not all-cause mortality or CVD mortality in the NHANES population.