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Cardiometabolic index: a new tool for screening the metabolically obese normal weight phenotype

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Abstract

Purpose

People with the metabolically obese normal weight (MONW) phenotype are considered as an extremely high-risk group for unfavorable health consequences, but they are frequently undetected due to deceptive body mass index (BMI) and complex assessment. This study aimed to explore the clinical usefulness of cardiometabolic index (CMI) in identifying MONW individuals.

Methods

This cross-sectional study involved a total of 47,683 normal-weight subjects aged ≥ 18 years. Participants underwent anthropometrics, routine biochemical tests, and questionnaires for a full evaluation of the metabolic profile. The odds ratio (OR) of CMI and MONW phenotype was determined by the Logistic regression models and the diagnostic accuracy of CMI was evaluated by the receiver operating characteristic (ROC) curve analysis.

Results

The prevalence of MONW phenotype was 11.0%. After multivariate adjustment, the ORs for MONW in the highest compared with the lowest quartile of CMI was 71.20 (95% CI 55.19–91.86), and 1-SD increment of CMI brought a 54% additional risk. In ROC analysis, compared with BMI and waist circumference, CMI showed superior performance for identifying MONW individuals with an AUC of 0.853 (95% CI 0.847–0.860) in men and 0.912 (95% CI 0.906–0.918) in women, respectively. Moreover, CMI exhibited the highest diagnostic accuracy in younger age groups (aged 18–34 for men; aged 18–34 and 35–44 for women), in which AUCs surpassed 0.9 in both sexes.

Conclusions

CMI could be served as a valuable indicator to identify MONW phenotype of Chinese adults, particularly for young people.

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Availability of data

Data sharing is available upon request to the corresponding author.

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Acknowledgements

We gratefully acknowledge all the participants in this study along with of the Third Xiangya Hospital for their assistance in collecting and examining the biochemical samples.

Funding

This study was supported by the National Natural Science Foundation of China (81770403) and the National Social Science Foundation of China (17AZD037).

Author information

Author notes

  1. Xinyao Liu and Qiaoyu Wu contributed equally to this study and shared first authorship.

Authors and Affiliations

  1. Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China

    X. Liu, Q. Wu, G. Yan, J. Duan, Y. Lu & H. Yuan

  2. Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China

    Z. Chen & P. Yang

  3. Centre for Disease Modelling, York University, Toronto, ON, Canada

    N. L. Bragazzi

  4. Key Laboratory of Medical Information Research, Central South University, Changsha, Hunan, China

    Y. Lu & H. Yuan

  5. National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha, Hunan, China

    Y. Lu & H. Yuan

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Liu, X., Wu, Q., Yan, G. et al. Cardiometabolic index: a new tool for screening the metabolically obese normal weight phenotype. J Endocrinol Invest 44, 1253–1261 (2021). https://doi.org/10.1007/s40618-020-01417-z

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