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

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.