Association of trajectories and cumulative exposure of modified cardiometabolic index with cardiovascular disease in middle and older adults

作者：Yaxin Song, Hui Gao, Yifan Du, Yigao Gao, Tianchen Gao, J N Wei · 发表于：Scientific Reports · 年份：2026 · DOI：10.1038/s41598-026-63722-6 · 研究领域：Healthcare Systems and Public Health、Cardiovascular Health and Disease Prevention、Blood Pressure and Hypertension Studies

The Modified Cardiometabolic Index (MCMI), a new composite indicator, combines glucose, lipid metabolism, and fat accumulation levels and serves as an alternative predictor of cardiovascular disease (CVD). However, no prospective evidence exists linking long-term MCMI change patterns to Incident CVD. This study evaluated the association and dose–response relationship between MCMI change patterns and cumulative MCMI (cumMCMI) with incident CVD in middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS, N = 4324) and the English Longitudinal Study of Ageing (ELSA, N = 2707), and compared its predictive ability with cumulative triglyceride-to-glucose (TyG) index. Using K-means and group-based trajectory models, three MCMI change patterns were identified: stable low, moderate, and high-level groups. The Cox model adjusting for covariates revealed that moderate and high-level groups in both cohorts were associated with a significant increased incident CVD risk compared to stable low-level (CHARLS adjusted HR for high-level = 1.33, 95% CI 1.04 to 1.70; ELSA adjusted HR = 1.96, 95% CI 1.08 to 3.56). Restricted mean survival time (RMST) analysis revealed that participants with higher MCMI had a significantly shorter mean CVD-free survival time over the next 5 years (RMST = -0.070, 95% CI -0.119 to -0.021) in CHARLS. Restricted cubic spline (RCS) analysis demonstrated a significant positive linear association between cumMCMI and increased incident ...