What question did this study set out to answer?

This study aims to evaluate the association between the cardiometabolic index and the incidence of cardiovascular disease in older Chinese adults.

March 8, 2026

Cardiometabolic index and cardiovascular disease incidence in middle-aged and older Chinese: A nationwide prospective cohort study.

Key Result

Higher cardiometabolic index was associated with a 39% increased risk of cardiovascular disease in Chinese adults aged ≥45 years over 7 years (OR=1.39, P=0.017).

Key Points

This study aims to evaluate the association between the cardiometabolic index and the incidence of cardiovascular disease in older Chinese adults.
Data from 7830 adults aged ≥45 years were collected from the China Health and Retirement Longitudinal Study.
Cardiometabolic index was calculated using waist circumference, height, triglycerides, and HDL cholesterol.
Logistic regression was used to estimate the odds ratios for incident cardiovascular disease.
Nonlinear associations were assessed with restricted cubic spline models.
Effect modification analyses examined interactions with diabetes status and alcohol consumption.
During 7 years of follow-up, 24.4% of participants developed cardiovascular disease.
Higher CMI was linked to an increased risk of CVD (odds ratio = 1.39).
A nonlinear relationship was found, indicating greater risk with increasing CMI levels.

Structured PICO

Does a higher cardiometabolic index predict incident cardiovascular disease in middle-aged and older adults?

Population

7,830 Chinese adults aged ≥45 years who were free of cardiovascular disease at baseline, mean age 58.7 years, 54.9% female.

Intervention

Higher Cardiometabolic Index (CMI)

Comparator

Lower Cardiometabolic Index (CMI)

Outcome

Incident cardiovascular disease (CVD) during follow-uphard clinical

The cardiometabolic index is a significant, nonlinear predictor of incident cardiovascular disease in middle-aged and older Chinese adults, suggesting its utility in risk stratification.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The cardiometabolic index (CMI), which integrates lipid metabolism and central obesity measures, has uncertain value for predicting cardiovascular disease (CVD). We evaluated the association between CMI and incident CVD in Chinese adults. Data were drawn from the China Health and Retirement Longitudinal Study. We selected 7830 adults aged ≥45 years who were free of CVD at the 2011 to 2012 baseline and followed them in 2013, 2015, and 2018. CMI was calculated as (waist circumference/height) × (triglycerides/high-density lipoprotein cholesterol). Incident CVD during follow-up was the primary outcome. Multivariable logistic regression estimated odds ratios and 95% confidence intervals, and restricted cubic spline models assessed nonlinear associations. Stratified analyses examined effect modification. In total, 54.9% of participants were female, the mean age was 58.7 years (standard deviation 8.8), and the mean CMI was 1.89 (0.23). During the 7-year follow-up, 1914 individuals (24.4%) developed CVD. Higher CMI was associated with increased CVD risk after multivariable adjustment (odds ratio = 1.39; 95% confidence interval: 1.11-1.96; P = .017). Interactions were observed for diabetes status and current alcohol consumption. Restricted cubic spline analysis showed a nonlinear increase in CVD risk with rising CMI (P for nonlinearity = .002). Higher CMI was significantly associated with incident CVD in middle-aged and older adults, with a nonlinear rise in risk as CMI increased.

Bookmark