LAUSR

The Cardiometabolic Index (CMI), a composite marker integrating lipid profiles (triglycerides-to-HDL-C ratio) and abdominal obesity (waist-to-height ratio), we aimed to assess its association with gallstone prevalence. We analyzed data from 2,692 participants in the NHANES 2017–2020 dataset. Gallstones were identified through self-reported data, which may introduce bias in the diagnosis. This limitation should be considered when interpreting the results. Logistic regression modelling, smoothed curve fitting and threshold effect analysis assessed the association between CMI and gallstones. Higher CMI was significantly associated with an increased risk of gallstones (OR = 1.90, 95% CI: 1.37–2.62, P < 0.0001). A threshold effect was observed at CMI = 0.85, below which risk increased significantly (OR = 2.62, 95% CI:1.34–5.12, P = 0.0049), but became non-significant above this value. The association was stronger in women. Our findings support the use of CMI as a potential predictive marker for gallstone risk, suggesting its integration into clinical assessments for early detection and prevention.