Association of the cardiometabolic index with hepatic enzymes and metabolic profiles among adults with overweight and obesity

Abstract

Growing evidence suggests that composite metabolic indices may offer valuable insights into obesity-related complications. The Cardiometabolic Index (CMI), a surrogate marker of adverse lipid profiles and central adiposity, has emerged as a promising indicator of cardiometabolic risk. Nevertheless, its association with liver-related biomarkers and metabolic phenotypes in overweight and obese populations has not been sufficiently investigated. This study aimed to examine the relationship between CMI and liver enzymes, as well as to characterize metabolic phenotypes across different levels of CMI in adults with overweight and obesity. In this cross-sectional analysis, 582 adults aged 18–65 years with overweight or obesity were included. Anthropometric indices, blood pressure, and biochemical markers—including lipid profile, hepatic enzymes, and fasting glucose—were measured. Participants were categorized into tertiles of CMI, which was calculated using established formulas. Individuals in the highest CMI category exhibited greater central adiposity and overall fat mass compared with those in the lowest category. They also had significantly higher levels of triglycerides, fasting glucose, alanine aminotransferase (ALT), and aspartate aminotransferase (AST), as well as a higher prevalence of metabolic syndrome (all P < 0.05). These associations remained statistically significant after adjustment for potential confounding variables. Higher CMI values are associated with unfavorable metabolic characteristics and higher liver enzymes in individuals with overweight and obesity. Future longitudinal studies are warranted to clarify causal associations and underlying biological mechanisms for the associations between CMI and metabolic and hepatic enzymes in individuals with overweight or obesity.