Reviews in Cardiovascular Medicine · Mar 19, 2026

Associations Between the Modified Cardiometabolic Index and Stroke in Patients With Different Glucose Metabolism Statuses: Evidence From a Nationally Representative Survey

By Deng T, Wu G, Liang X et al.

BACKGROUND: The association between the modified cardiometabolic index (MCMI) and the risk of incident stroke across patients with different glycemic statuses remains unclear. This study aimed to investigate the relationship between baseline MCMI levels and incident stroke in Chinese middle-aged and older adults with varying glucose metabolism states. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018. Kaplan-Meier curves, multivariable Cox proportional hazards models, and restricted cubic spline analyses were employed to assess the relationship between the MCMI and stroke risk stratified by glycemic status. Subgroup and sensitivity analyses were performed to confirm the robustness of the findings. RESULTS: A total of 7455 participants were included. A total of 457 individuals (6.13%) experienced stroke events during a median follow-up of 7 years. A significant linear association was observed between a higher MCMI and increased stroke risk. A nonlinear relationship was detected among participants with normal glucose regulation (NGR), with a sharp increase in risk beyond an MCMI threshold of 1.904 (hazard ratio (HR) = 1.85; 95% confidence interval (CI): 1.24-2.76; p = 0.003). An increased MCMI was also associated with increased stroke risk in individuals with prediabetes (HR = 1.34, 95% CI: 1.03-1.75) but not in individuals with diabetes. The associations varied across subgroups according to gender, residence, body mass index, and use of cardiovascular medications. Sensitivity analyses supported the stability of the results. CONCLUSION: An elevated MCMI is positively associated with incident stroke, particularly in individuals with NGR or prediabetes. Early identification of a high MCMI may be valuable for stroke prevention, risk stratification, and timely intervention in community populations.

doi.org/10.31083/rcm45989 Open access PubMed 41923750 Biomarkers