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. 2025 Apr 17;25(1):265.
doi: 10.1186/s12876-025-03876-1.

The association between modified cardiometabolic index with non-alcoholic fatty liver disease and liver fibrosis: a cross-sectional study

Yanjun Guo  1 , Wei Su  1 , Lulong Tao  1 , Guoxin Zhang  2 , Kun Wang  3
Affiliations

The association between modified cardiometabolic index with non-alcoholic fatty liver disease and liver fibrosis: a cross-sectional study

Yanjun Guo et al. BMC Gastroenterol. .

Abstract

Background: Cardiometabolic index (CMI) was proposed ten years ago as an indicator combining obesity and dyslipidemia. This study aimed to investigate the relationships between newly modified CMI (MCMI) with non-alcoholic fatty liver disease (NAFLD) and liver fibrosis.

Methods: This cross-sectional study included participants in the 2017-2018 National Health and Nutrition Examination Survey database (NHANES). Linear regression was used to explore the relationship between MCMI and Baseline characteristics. Logistic regression was conducted to analyze the correlation among MCMI with NAFLD and liver fibrosis. Furthermore, restricted cubic spline (RCS) was performed to estimate nonlinear relationships. Receiver operating characteristic curve (ROC) was used to assess the diagnostic performance of MCMI for NAFLD and liver fibrosis.

Results: A total of 1385 participants were enrolled in the study. After adjusting covariates, participants with high MCMI were related to increased risk of NAFLD (OR = 3.52, 95%CI: 1.44-8.61), compared with those having low MCMI. A linear association was observed between MCMI and NAFLD (p for nonlinear = 0.074), and a J-shaped nonlinear relationship was found between MCMI and liver fibrosis (p for nonlinear = 0.002). The area under the curve (AUC) for MCMI to identify NAFLD was 0.821 (95% CI 0.799-0.843), which was higher than that of CMI (AUC = 0.761, 95%CI: 0.735-0.786), fatty liver index for the U.S. population (USFLI, AUC = 0.799, 95%CI: 0.776-0.822), Triglyceride glucose index (TyG, AUC = 0.738, 95%CI: 0.712-0.765), NAFLD liver fat score (NLFS, AUC = 0.786, 95%CI: 0.761-0.810) and hepatic steatosis index (HSI, AUC = 0.799, 95%CI: 0.775-0.822).

Conclusions: The novel MCMI was positively corelated to the risk of NAFLD. In addition, MCMI was an effective predictor for both NAFLD and liver fibrosis.

Keywords: Liver fibrosis; Modified cardiometabolic index; Non-alcoholic fatty liver disease.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The procedures and protocols of NHANES have been reviewed and approved by the National Center for Health Statistics Research Ethics Review Board and written informed consent was obtained from each participant. All analyses in this study were performed in accordance with the NHANES guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of participant enrollment
Fig. 2
Fig. 2
Restricted cubic spline plot of the nonlinear associations between MCMI with NAFLD (A) and liver fibrosis (B). The associations were adjusted for age, race, education, BMI, diabetes, dyslipidemia and uric acid. MCMI modified cardiometabolic index; NAFLD non-alcoholic fatty liver disease; BMI body mass index
Fig. 3
Fig. 3
ROC curves for NAFLD (A) and liver fibrosis (B). ROC receiver operating characteristic curve; NAFLD non-alcoholic fatty liver disease; AUC area under the curve; MCMI modified cardiometabolic index; CMI cardiometabolic index; USFLI fatty liver index for the U.S. population; TyG Triglyceride glucose index; NLFS NAFLD liver fat score; HSI Hepatic steatosis index; FNI Fibrotic nonalcoholic steatohepatitis index; FIB- 4 Fibrosis- 4 Index; NFS NAFLD Fibrosis Score
See this image and copyright information in PMC

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