Background Modified Cardiometabolic Index (MCMI) is a novel metabolic assessment metric integrating waist-to-height ratio (WHtR), lipid, and fasting plasma glucose (FPG). Rheumatoid arthritis (RA), as an autoimmune disease, is closely linked to metabolic status, yet the relation of MCMI to RA remains unclear. Phenotypic age acceleration (PAA), reflecting biological aging, possibly mediates the relation of MCMI to RA. Our study aimed to elucidate the relation of MCMI to RA and assess the mediating effect of PAA. Methods 1999–2010 and 2015–2020 National Health and Nutrition Examination Survey (NHANES) data on 10,564 adults were analyzed. RA status was determined via questionnaire. MCMI was calculated based on WHtR, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and FPG. PAA was derived as the residual of phenotypic age (PA) regressed on chronological age. The association of MCMI with RA was examined via weighted logistic regression (WLR), restricted cubic splines (RCS) assessed potential nonlinearity, and mediation analysis examined the effect of PAA. Results In multivariable-adjusted models, every one-unit rise in MCMI was related to a 45.1% higher RA prevalence (OR = 1.451, 95% CI: 1.250–1.685). MCMI was split into tertiles. The highest tertile (T3) displayed a significantly higher RA prevalence than the lowest tertile (T1) (OR = 1.879, 95% CI: 1.379–2.559). RCS analysis indicated a linear relation of MCMI to RA (P for nonlinear = 0.331). PAA accounted for 17.446% of the relation of MCMI to RA in mediation analysis (P < 0.001). Conclusion MCMI is positively associated with RA risk, with PAA partially mediating this relationship. These findings suggest that metabolic dysregulation may influence RA development through accelerated biological aging, providing a novel perspective for early prevention and metabolic interventions in RA. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • These findings suggest that poorer metabolic health may be associated with RA, partly through accelerated biological aging. • In practice, metabolic assessment may help identify people at higher risk of RA and support earlier lifestyle or clinical interventions. • The results also highlight biological aging as a possible pathway linking metabolism and RA. </entry> </row> </tbody> </tgroup> </Table>

Association between Modified Cardiometabolic Index and rheumatoid arthritis: the mediating role of phenotypic age acceleration

期刊论文
发表日期：

2026年7月6日

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Wang Huang,
Binwen Xia,
Heng Yang,
Hongtao Pan,
Tingting Liu,
Chunning Hu

摘要

Background

Modified Cardiometabolic Index (MCMI) is a novel metabolic assessment metric integrating waist-to-height ratio (WHtR), lipid, and fasting plasma glucose (FPG). Rheumatoid arthritis (RA), as an autoimmune disease, is closely linked to metabolic status, yet the relation of MCMI to RA remains unclear. Phenotypic age acceleration (PAA), reflecting biological aging, possibly mediates the relation of MCMI to RA. Our study aimed to elucidate the relation of MCMI to RA and assess the mediating effect of PAA.

Methods

1999–2010 and 2015–2020 National Health and Nutrition Examination Survey (NHANES) data on 10,564 adults were analyzed. RA status was determined via questionnaire. MCMI was calculated based on WHtR, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and FPG. PAA was derived as the residual of phenotypic age (PA) regressed on chronological age. The association of MCMI with RA was examined via weighted logistic regression (WLR), restricted cubic splines (RCS) assessed potential nonlinearity, and mediation analysis examined the effect of PAA.

Results

In multivariable-adjusted models, every one-unit rise in MCMI was related to a 45.1% higher RA prevalence (OR = 1.451, 95% CI: 1.250–1.685). MCMI was split into tertiles. The highest tertile (T3) displayed a significantly higher RA prevalence than the lowest tertile (T1) (OR = 1.879, 95% CI: 1.379–2.559). RCS analysis indicated a linear relation of MCMI to RA (P for nonlinear = 0.331). PAA accounted for 17.446% of the relation of MCMI to RA in mediation analysis (P < 0.001).

Conclusion

MCMI is positively associated with RA risk, with PAA partially mediating this relationship. These findings suggest that metabolic dysregulation may influence RA development through accelerated biological aging, providing a novel perspective for early prevention and metabolic interventions in RA.

Key Points

• These findings suggest that poorer metabolic health may be associated with RA, partly through accelerated biological aging.

• In practice, metabolic assessment may help identify people at higher risk of RA and support earlier lifestyle or clinical interventions.

• The results also highlight biological aging as a possible pathway linking metabolism and RA.