Sex-specific contribution of lipid accumulation product and cardiometabolic index in the identification of nonalcoholic fatty liver disease among Chinese adults

Background Lipid accumulation product (LAP) and cardiometabolic index (CMI) are two novel obesity-related indexes associated with enhancing metabolic disease (MD) risk. Current evidences suggest that the differences in sex hormones and regional fat distribution in both sexes are directly correlated with MD and nonalcoholic fatty liver disease (NAFLD) risk. Hence, NAFLD incidences reflect sex differences. Herein, we examined the accuracy of LAP and CMI in diagnosing NAFLD in both sexes. Methods Overall, 14,407 subjects, who underwent health check-up in the northeastern China, were enrolled in this study, and their corresponding LAP and CMI were calculated. Abdominal ultrasonography was employed for NAFLD diagnosis. Multivariate analyses were analyzed potential correlations between LAP and/or CMI and NAFLD. Odds ratios (ORs) and 95% confidence intervals (CIs) were evaluated. Receiver operating characteristic curve analyses was executed for the exploration of the diagnostic accuracies. Areas under the curves (AUCs) with 95%CIs were calculated. Results NAFLD prevalence increased with elevated quartiles of LAP and CMI in both sexes. In multivariate logistic regression analyses, LAP and CM expressed as continuous variables or quartiles, significantly correlated with NAFLD. The ORs for the top versus bottom quartile of LAP and CMI for NAFLD were 13.183 (95%CI = 8.512–20.417) and 8.662 (95%CI = 6.371–11.778) in women and 7.544 (95%CI = 5.748–9.902) and 5.400 (95%CI = 4.297–6.786) in men. LAP and CMI exhibited larger AUCs, compared to other obesity-related indexes in terms of discriminating NAFLD. The AUCs of LAP and CMI were 0.860 (95%CI = 0.852–0.867) and 0.833 (95%CI = 0.825–0.842) in women and 0.816 (95%CI = 0.806–0.825) and 0.779 (95%CI = 0.769–0.789) in men. Conclusions LAP and CMI are convenient indexes for the screening and quantification of NAFLD within a Chinese adult population. Their associations with NAFLD are substantially greater in women than men.

Association between cardiometabolic index and stroke: A population-based cross-sectional study

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.

Correlation Between Cardiometabolic Index and Microalbuminuria in Type 2 Diabetic Patients

Background: In recent years, cardiometabolic index (CMI) has been introduced to predict the risk of diabetes in the general population and is also strongly associated with cardiovascular disease, hypertension, and ischemic stroke, but the relationship between CMI and diabetic microalbuminuria remains unclear. This study intends to investigate the relationship between CMI and microalbuminuria in patients with type 2 diabetes mellitus(T2DM). Methods: 524 subjects (mean age 57.28 ± 10.52 years, 283 males and 241 females) from the Department of Endocrinology, Southwestern Medical University Hospital, China (data collected from June 2017 to June 2019) participated in this study. CMI was calculated by triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C) multiply waist-to-height ratio(WHtR). Microalbuminuria was identified by the urinary albumin‐to‐creatinine ratio (UACR) when the value was between 30–300 mg/g. Multivariate logistic regression aimed to explore the association between CMI and diabetic microalbuminuria; The receiver operating characteristic (ROC) analysis was employed to evaluate the predictive value of CMI for microalbuminuria in T2DM patients. Results: The prevalence of microalbuminuria in all participants was 37.8% in men and 41.1% in women. Regardless of gender, CMI was significantly more unfavorable in the microalbuminuria group. The incidence of microalbuminuria increased dose-responsively with increasing CMI quartiles. Modeling CMI as a continuous variable in a multivariate-adjusted model, we observed an independent effect of each 1 SD increase in CMI on the risk of developing microalbuminuria. The relationship was more pronounced in women than in men. In women, the odds ratio(OR) for microalbuminuria was 5.666 (95% CI: 2.247-14.289) in the highest quartile of CMI compared with the lowest quartile; in men, the OR was nearly 4-fold increased(OR: 4.667, 95% CI: 1.910-11.405) in the same situation. The AUC for CMI was 0.681 (0.613 to 0.749) in women and 0.648 (0.582-0.713) in men. Conclusion: High levels of CMI were independently associated with diabetic microalbuminuria, and CMI, a novel index covering lipids and central obesity, explained the gender differences in obesity-related microalbuminuria excretion, an effect that was substantially increased in women. The results of this study provide important insights into the potential usefulness and clinical relevance of CMI for microalbuminuria in Chinese patients with T2DM.Registration number: ChiCTR2100047930Date of registration: On June 27, 2021 (retrospectively registered)

Usefulness of cardiometabolic index for the estimation of diabetes risk among general population in rural China: a community-based study

Funding Acknowledgements Type of funding sources: None. Background Cardiometabolic index (CMI) defines adiposity based on triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and waist-to-height ratio (WHtR). This newly proposed metric has been used to detect multiple cardiovascular risk factors, but data relative to diabetes in the general population are lacking. This study aims to validate CMI’s utility of discriminating diabetes and compares it with other indexes among general Chinese population. Methods Analyses were based on a cross-sectional study of 11,478 participants that underwent assessment of metabolic and anthropometric parameters in rural areas of northeastern China in 2013. CMI was calculated by TG/HDL-C × WHtR. Multivariate logistic regressions were performed to clarify CMI’s association with diabetes, ROC analyses were engaged to investigate CMI’s discriminating ability for diabetes. Results The prevalence of diabetes was 9.93% in males while 10.76% in females, and increased with CMI’s increment. After full adjustment, each SD increment of CMI had odds ratios (ORs) for diabetes of 1.471 (1.367–1.584) and 1.422 (1.315–1.539) in females and males, respectively. Compared with bottom categories of CMI, the top quartiles had ORs of 3.736 (2.783–5.015) in females and 3.697 (2.757–4.958) in males. The ROC results showed an excellent discriminating power of CMI (AUC: 0.702 for females, 0.664 for males). Conclusions An increasing CMI was correlated with higher odds of diabetes, supporting CMI as a useful and economic measure to screen and quantify diabetes in general Chinese population. Monitoring and promoting achievement of dyslipidemia and abdominal obesity based on CMI may improve subclinical and cardiovascular outcomes. Abstract Figure.

Body Adiposity Index Is Predictive of Weight Loss after Roux-en-Y Gastric Bypass

<b><i>Background/Aims:</i></b> Roux-en-Y gastric bypass (RYGB) is one of the most effective therapies for morbid obesity, yet some patients who have taken the surgery still undergo insufficient weight loss. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), and cardiometabolic index (CMI) have been regarded as clinical indicators of adiposity phenotypes that associated closely with obesity-related metabolic diseases. However, no studies have evaluated the relationship between these indexes and weight loss after bariatric surgery. In this prospective study, we aimed to evaluate whether VAI, LAP, BAI, and CMI would predict postoperative weight loss outcomes after RYGB. <b><i>Methods:</i></b> This study included 38 men and 67 women who have undergone RYGB between January 2017 and May 2018 and recorded their %TWL (percent of total weight loss), %EBMIL (percent of excess body mass index loss), %EWL (percent of excess weight loss), anthropometric indices, and biochemical parameters before and 12 months after the surgery. In addition, VAI, LAP, BAI, and CMI were measured with anthropometric measures or lipid profiles using related equations and analyzed with metabolic characteristics. <b><i>Results:</i></b> Subjects with lower BAI (&#x3c;32.54 in men and 37.39 in women) displayed higher %EBMIL and %EWL 12 months after surgery. BAI was independently associated with %EWL 12 months after surgery in both men and women (both <i>p</i> &#x3c; 0.05). The area under the receiver operating characteristic curve for BAI was significantly higher (0.773 in men and 0.818 in women) than VAI, LAP, and CMI. <b><i>Conclusions:</i></b> BAI serves as a reliable surrogate marker of the weight loss outcome after RYGB. The predictivity of adiposity indexes in beneficial outcomes after weight loss therapies is of important referential value for the implementation and optimization of individualized and refined weight loss treatments for obese patients.

The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults

There is growing evidence of the dietary impact on obesity-induced low-grade chronic inflammation and the associated chronic non-communicable diseases modification. We determined changes in body composition and cardiometabolic and inflammatory status of participants with obesity after 24 weeks of a dietary intervention based on an energy-reduced anti-inflammatory diet and examined the relationship of these changes with changes in the inflammatory potential of the diet. The anthropometric and body composition parameters of 81 participants (average age of 43 years, 74 women) were assessed. Metabolic status was determined using the glycemic and lipid statuses, and the cardiometabolic index and inflammatory status were determined using the concentration of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α). The inflammatory potential of the diet was assessed using the Dietary Inflammatory Index (DII®). Intervention with an anti-inflammatory diet resulted in a significant reduction in body weight and visceral adipose tissue and caused improvements in the participants’ cardiometabolic and inflammatory statuses. The anti-inflammatory diet was shown to be effective regarding obesity management. The study data could advance current scientific knowledge in the field of inflammation and diet, provide guidelines for obesity management, and find its application in routine clinical practice.

Serum endocan levels in relation to traditional and non-traditional anthropometric indices in adult population

Background and Aim: Association between endocan and non-traditional anthropometric indices, as distinct cardiovascular disease risk factors, has not been examined in previous studies. Endocan is a novel inflammation biomarker with its higher levels involved in cardiometabolic diseases development. Taking into consideration that obesity is an independent risk factor for many cardiometabolic diseases, we aimed to explore the relationship between endocan levels and novel anthropometric indices [i.e., body adiposity index (BAI), cardiometabolic index (CMI), a body shape index, body roundness index, conicity index, lipid accumulation product index and visceral adiposity index] and traditional ones [i.e., waist circumference, hip circumference, body mass index, waist-to-height ratio and waist-to-hip ratio] in adult population.Methods: A total of 177 participants were included. Anthropometric indices and biochemical parametres were measured. Results: Univariate regression analysis demonstrated positive correlations of endocan and almost all anthropometric data. To explore independent associations of endocan and anthropometric parameters, the Model which fulfilled criteria for ordinal regression testing was created. Adjusted odds for BAI given in the Model (OR=1.120, 95% CI 1.036-1.212, P=0.004), demonstrated that a rise in BAI by 1 unit increased the probability of higher endocan concentration by 12%. As well, a rise in CMI for 1 unit, increased probability for higher endocan levels for 2.6 times (OR=2.599, 95% CI 1.006-6.712, P=0.049). A total of 20.1% of variation in endocan levels could be explained by this Model.Conclusion: Non-traditional obesity indices, BAI and CMI independently correlated with higher serum endocan levels in adult population.