Association between cardiometabolic index and cardiometabolic multimorbidity in non-alcoholic fatty liver disease patients: evidence from a cross-sectional study

The Cardiometabolic Index (CMI), which combines abdominal obesity and lipid levels, has been shown to be associated with non-alcoholic fatty liver disease (NAFLD). NAFLD, through various mechanisms, can lead to cardiometabolic multimorbidity (CMM). Therefore, the aim of this study was to investigate the relationship between CMI and the occurrence of CMM in individuals with NAFLD. This cross-sectional study included 5,993 individuals with NAFLD from the National Health and Nutrition Examination Survey (NHANES) cycles between 1999 and 2018. Weighted multivariable analysis was used to assess the association between CMI and CMM, with stratified and Restricted Cubic Spline (RCS) analyses. The findings revealed a statistically significant positive correlation between CMI levels and CMM risk in NAFLD patients across all three models. Furthermore, stratified analysis indicated that this relationship was more pronounced in females. RCS analysis revealed a nonlinear relationship between CMI and CMM. Our analysis demonstrates a clear positive association between CMI and CMM in U.S. adults with NAFLD, particularly pronounced in females. These findings suggest that CMI may serve as a valuable indicator for assessing the risk of CMM in U.S. adults with NAFLD, providing critical insights for the development of more effective intervention strategies.