Background: This study sought to elucidate the associations of cardiometabolic index (CMI), as a metabolism-related index, with all-cause and cardiovascular mortality among the older population. Utilizing data from the National Health and Nutrition Examination Survey (NHANES), we further explored the potential mediating effect of inflammation within these associations. Methods: A cohort of 3029 participants aged over 65 years old, spanning six NHANES cycles from 2005 to 2016, was enrolled and assessed. The primary endpoints of the study included all-cause mortality and cardiovascular mortality utilizing data from National Center for Health Statistics (NCHS). Cox regression model and subgroup analysis were conducted to assess the associations of CMI with all-cause and cardiovascular mortality. The mediating effect of inflammation-related indicators including leukocyte, neutrophil, lymphocyte, systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR) were evaluated to investigate the potential mechanism of the associations between CMI and mortality through mediation package in R 4.2.2. Results: The mean CMI among the enrolled participants was 0.74±0.66, with an average age of 73.28±5.50 years. After an average follow-up period of 89.20 months, there were 1,015 instances of all-cause deaths and 348 cardiovascular deaths documented. In the multivariable-adjusted model, CMI was positively related to all-cause mortality (Hazard Ratio (HR)=1.11, 95% CI=1.01-1.21). Mediation analysis indicated that leukocytes and neutrophils mediated 6.6% and 13.9% of the association of CMI with all-cause mortality. Conclusion: Elevated CMI is positively associated with all-cause mortality in the older adults. The association appeared to be partially mediated through inflammatory pathways, indicating that CMI may serve as a valuable indicator for poor prognosis among the older population.

Objectives: Insulin resistance is a well-established contributor to inflammation; however, the specific association between the triglyceride glucose (TyG) index, a biomarker reflecting insulin resistance, and arthritis remains unexplored. As a result, the main aim of this study was to examine the correlation between the TyG index and arthritis. Methods: This observational study used data from the National Health and Nutrition Examination Survey (NHANES), which was conducted between 2007 and 2018. To investigate the relationship between the TyG index and arthritis, various statistical analyses were employed, including weighted multivariable logistic regression analysis, subgroup analysis, curve fit analysis, and threshold effect analysis. Results: In total, 14,817 patients were enrolled in the trial, with 4,191 individuals (28.29%) diagnosed with arthritis. An increased risk of arthritis was found to be significantly correlated with higher TyG index values (odds ratio OR = 1.15, 95% confidence interval CI: 1.07–1.23), according to the results of multivariable logistic regression analysis after full adjustment. Subgroup analysis and interaction tests further indicated that the TyG index exhibited an additive effect when combined with other established risk factors, including age (OR = 1.29; 95% CI: 1.17–1.41), body mass index (BMI) (OR = 1.43; 95% CI: 1.24–1.69), and diabetes (OR = 1.20; 95% CI: 1.11–1.31). Additionally, curve fit analysis and threshold effect analysis demonstrated a nonlinear relationship with a breakpoint identified at 8.08 µmol/L. Conclusion: The TyG index was positively correlated with arthritis in adults under 60 years of age in the United States who had normal weight and no diabetes. Further large-scale prospective studies are warranted for a comprehensive analysis of the role of the TyG index in arthritis.

This study aimed to analyze the associations of cardiometabolic index (CMI) with diabetic statuses and insulin resistance (IR) using data from the National Health and Nutrition Examination Survey (NHANES) and examined the potential mediating role of inflammation in these correlations. This study enrolled 9477 participants across four NHANES cycles from 2011 to 2018. The primary outcomes of the study included the risk of having prediabetes, diabetes and the level of the homeostasis model assessment of IR (HOMA-IR). Other outcomes including the levels of fasting blood glucose (FBG), hemoglobin A1c (HbA1c), oral glucose tolerance test (OGTT) results, fasting insulin, the risk of oral hypoglycemic medicine use, insulin use, and retinopathy were also collected and analyzed. Logistic regression model, subgroup analysis, restricted cubic spine (RCS), and Pearson correlation coefficients were conducted to assess the associations of CMI with diabetic statuses and IR. The mediating role of inflammation was evaluated to investigate the potential mechanism of the associations between CMI and diabetic statuses. Among included participants, the CMI levels in normal participants, prediabetes and diabetes in this study were 0.48, 0.73 and 1.07. After multivariable adjustment, CMI was positively associated with the risk of prediabetes (OR = 1.49, 95% CI = 1.24–1.79), diabetes (OR = 2.14, 95% CI = 1.82–2.50) and the level of HOMA-IR (β = 2.57, 95% CI = 2.14–3.01). Besides, an increased CMI was correlated with higher levels of FBG, HBA1c, OGTT results and fasting insulin as well as the greater risk of oral hypoglycemic medicine use and insulin use. The RCS showed an inverted L-shaped association of CMI with prediabetes and diabetes (P for non-linearity < 0.001). According to Pearson correlation coefficients, higher CMI was linked to higher rises in HOMA-IR (r = 0.224, P < 0.001). Inflammation-related indicators including leukocyte and neutrophil demonstrated significant mediating effects in the associations of CMI with prediabetes (15.5%, 9.8%), diabetes (5.1%, 6.0%) and HOMA-IR (3.3%, 2.6%). CMI was positively associated with the risk of worse diabetic statuses and higher level of IR while the associations may be partially mediated by inflammation-related indicators, suggesting that CMI could be a promising indicator for the prediction of severe diabetes and IR.

Objectives: The association between the neutrophil percentage to albumin ratio (NPAR) and the risk of osteoarthritis (OA) and rheumatoid arthritis (RA) remains unclear. This study aims to investigate the association between NPAR and the risk of OA and RA.Methods: This cross-sectional study analyzed data from 92,062 American adults in the NHANES database between 1999 and 2016. Various statistical analyses were conducted to investigate the associations between NPAR and the risks of OA and RA, including multivariable logistic regression, subgroup analysis, smooth curve fitting, and threshold effect analysis.Results: After screening, the final study population included 36,147 participants, with 3,881 individuals diagnosed with OA and 2,178 with RA. After adjusting for confounding factors, higher NPAR levels were associated with an increased risk of RA (OR=1.05; 95% CI: 1.03-1.07; P <0.0001), but not with OA (OR=1.01; 95% CI: 0.99-1.02; P =0.755). This association was remarkably consistent across subgroups by age, sex, body mass index (BMI), alcohol consumption, hypertension, diabetes, and smoking status. Further analyses using curve fitting and threshold effect models revealed a nonlinear association between NPAR and RA, with an inflection point identified at 15.56.Conclusion: High levels of NPAR is positively associated with the prevalence of RA. This provides us with new insights for the management and treatment of RA patients.