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Diet, Metabolism, and Disease / Liver Disease Diagnosis and Treatment · Journal article
Scientific Reports · September 10, 2026
Encouraging direction, but not yet definitive.
This cross-sectional study of 582 overweight and obese adults found that higher CMI values were significantly associated with elevated hepatic enzymes (ALT, AST), higher triglycerides, fasting glucose, greater central adiposity, and increased metabolic syndrome prevalence (all P < 0.05), with associations persisting after adjustment for confounders. The observational design cannot establish causation, and longitudinal studies are needed to clarify whether CMI predicts hepatic or metabolic deterioration.
Cross-sectional analysis. Adults aged 18–65 years with overweight or obesity. Intervention: Cardiometabolic Index (CMI) categorization into tertiles. Compared with: Lowest CMI tertile versus highest CMI tertile. n = 582.
Highest CMI tertile showed significantly higher triglycerides, fasting glucose, ALT, and AST versus lowest tertile (all P < 0.05) Higher CMI associated with greater central adiposity and overall fat mass compared to lowest CMI category Highest CMI category had higher prevalence of metabolic syndrome (P < 0.05)
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CMI shows promise as a composite marker for identifying metabolic and hepatic dysfunction in overweight/obese populations; however, clinicians should recognize this as an observational association requiring confirmation through prospective studies before adoption for prognostic or therapeutic decision-making.
Cross-sectional study demonstrating clear associations between CMI and hepatic enzymes and metabolic markers in overweight/obese adults, but limited by observational design and inability to establish causation.
As stated by the source record.
Quoted from the source exactly as published.
CMI shows promise as a composite marker for identifying metabolic and hepatic dysfunction in overweight/obese populations; however, clinicians should recognize this as an observational association requiring confirmation through prospective studies before adoption for prognostic or therapeutic decision-making.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
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.
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