Exp Gerontol. 2026 Mar 19:113102. doi: 10.1016/j.exger.2026.113102. Online ahead of print.
ABSTRACT
BACKGROUND: The cardiometabolic index (CMI) and remnant cholesterol (RC) reflect different aspects of adiposity and triglyceride-rich lipoprotein metabolism in cardiovascular-kidney-metabolic (CKM) syndrome. Whether their combined levels are associated with cardiovascular risk in early CKM stages remains unclear.
METHODS: We analysed data from the China Health and Retirement Longitudinal Study (2011-2020). A total of 7089 participants with CKM stages 0-3 were followed for incident composite cardiovascular disease (CVD), with heart disease and stroke assessed separately. Kaplan-Meier curves compared cumulative incidence across four joint CMI and RC groups. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) after multivariable adjustment. Additive and multiplicative interaction between CMI and RC was assessed. Subgroup analyses were conducted by age, sex, residence, education and marital status.
RESULTS: Kaplan-Meier analyses indicated increasing cumulative incidence of CVD, heart disease and stroke across the four joint groups. In fully adjusted Cox models, compared with Group 1, the HR (95% CI) for CVD was 1.23 (1.04-1.45) in Group 2, 1.38 (1.18-1.63) in Group 3 and 1.42 (1.20-1.68) in Group 4. Heart disease and stroke showed similar patterns. No statistically significant interaction was detected on additive or multiplicative scales. Subgroup analyses were broadly consistent, with no significant interactions.
CONCLUSION: Higher combined CMI and RC levels were associated with increased risks of incident CVD, heart disease and stroke in CKM stages 0-3. Joint assessment of CMI and RC may improve risk stratification and help prioritize candidates for intensified lifestyle and lipid management in early-stage CKM.
PMID:41864370 | DOI:10.1016/j.exger.2026.113102