Cardiometabolic Index: A New Marker for Mortality Risk in CKM Syndrome

The Cardiometabolic Index (CMI) has emerged as a significant composite marker for assessing metabolic dysfunction, particularly in individuals with early-stage cardiovascular-kidney-metabolic (CKM) syndrome. Understanding the implications of CMI is crucial for metabolic health, as it may provide insights into mortality risks that traditional measures like Body Mass Index (BMI) do not capture. This study analyzed data from 11,280 adults participating in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, focusing on those with CKM stages 0-3. The research revealed that during a median follow-up of 6.2 years, there were 623 all-cause deaths and 159 cardiovascular deaths among participants. Notably, individuals in the highest quartile of CMI had a 55% increased risk of all-cause mortality (hazard ratio [HR] = 1.55) and a 91% increased risk of cardiovascular mortality (HR = 1.91) compared to those in the lowest quartile. The study also identified significant nonlinear associations, indicating that specific CMI thresholds (2.51 for all-cause mortality and 1.06 for cardiovascular mortality) are critical for risk stratification. Furthermore, in subgroups such as overweight individuals and those with diabetes, CMI outperformed BMI in predicting mortality risk, emphasizing its potential utility in clinical settings. For individuals monitoring their metabolic health, these findings suggest that focusing solely on BMI may overlook significant risks associated with metabolic dysfunction. The CMI could serve as a more sensitive marker for identifying those at higher risk of mortality, particularly among individuals who may appear metabolically healthy but are classified as normal weight. This underscores the importance of comprehensive metabolic assessments that include CMI, especially for those with metabolic syndrome components. In terms of biomarkers, CMI is closely related to lipid metabolism indicators such as triglycerides and HDL cholesterol, which are critical in assessing cardiovascular health. The CMI formula incorporates the triglycerides/HDL ratio, linking it directly to lipid metabolism. Therefore, individuals can benefit from regular monitoring of these biomarkers alongside CMI to gain a clearer picture of their metabolic health. In conclusion, the Cardiometabolic Index presents a valuable tool for assessing mortality risk in early-stage CKM syndrome. Its ability to identify high-risk individuals, particularly those with metabolically unhealthy phenotypes, highlights the need for broader awareness and utilization of CMI in clinical practice. Individuals are encouraged to discuss this index with their healthcare providers to better understand their metabolic health and take proactive steps towards improving it.