Title: Cardiometabolic Index as a Predictor of Gallstone Risk: Evidence from NHANES 2017–
2020
Version: 1 Date: 31 Jan 2025
Reviewer's report:
This study investigates the association between the Cardiometabolic Index (CMI) and gallstones
using NHANES data from 2017 to 2020, analyzing 5,421 participants. The authors report a
significant correlation, particularly noting that individuals in the highest CMI quartile had a 90%
higher risk of gallstones compared to those in the lowest quartile. Their findings suggest that
CMI may serve as a predictive marker for gallstone risk, with a saturation effect above a certain
threshold.
The use of self-reported data for both gallstone diagnosis and comorbidities is highly
problematic. Self-reported conditions are prone to recall bias, misclassification, and
underdiagnosis, especially for asymptomatic gallstones that are often detected incidentally on
imaging. The reliability of these findings is significantly weakened by the lack of objective
clinical confirmation, making it difficult to draw robust conclusions from the reported
associations.
While the study is well-structured, its contribution to the field is questionable, as the association
between cardiometabolic risk factors and gallstones is already well established. Obesity,
dyslipidemia, insulin resistance, and metabolic syndrome are all recognized risk factors for
gallstones, and CMI essentially encapsulates these same variables. Since this study does not
introduce a novel mechanism or significantly enhance predictive capability beyond existing
models, its incremental value is minimal.
The discussion is adequately lengthy but fails to engage deeply with the broader context of
predictive indices. There are other established markers for cardiometabolic health—such as
triglyceride-glucose (TyG) index or waist-to-height ratio—that could have been compared to
CMI in terms of predictive power for gallstones. A more critical comparison of these indices
would strengthen the argument for CMI’s utility and provide a more comprehensive perspective.
Title: Cardiometabolic Index as a Predictor of Gallstone Risk: Evidence from NHANES 2017–
2020
Version: 1 Date: 31 Jan 2025
Reviewer's report:
This study investigates the association between the Cardiometabolic Index (CMI) and gallstones
using NHANES data from 2017 to 2020, analyzing 5,421 participants. The authors report a
significant correlation, particularly noting that individuals in the highest CMI quartile had a 90%
higher risk of gallstones compared to those in the lowest quartile. Their findings suggest that
CMI may serve as a predictive marker for gallstone risk, with a saturation effect above a certain
threshold.
The use of self-reported data for both gallstone diagnosis and comorbidities is highly
problematic. Self-reported conditions are prone to recall bias, misclassification, and
underdiagnosis, especially for asymptomatic gallstones that are often detected incidentally on
imaging. The reliability of these findings is significantly weakened by the lack of objective
clinical confirmation, making it difficult to draw robust conclusions from the reported
associations.
While the study is well-structured, its contribution to the field is questionable, as the association
between cardiometabolic risk factors and gallstones is already well established. Obesity,
dyslipidemia, insulin resistance, and metabolic syndrome are all recognized risk factors for
gallstones, and CMI essentially encapsulates these same variables. Since this study does not
introduce a novel mechanism or significantly enhance predictive capability beyond existing
models, its incremental value is minimal.
The discussion is adequately lengthy but fails to engage deeply with the broader context of
predictive indices. There are other established markers for cardiometabolic health—such as
triglyceride-glucose (TyG) index or waist-to-height ratio—that could have been compared to
CMI in terms of predictive power for gallstones. A more critical comparison of these indices
would strengthen the argument for CMI’s utility and provide a more comprehensive perspective.
Please review this paper.
user
Title: Cardiometabolic Index as a Predictor of Gallstone Risk: Evidence from NHANES 2017–
2020
Version: 1 Date: 31 Jan 2025
Reviewer's report:
This study investigates the association between the Cardiometabolic Index (CMI) and gallstones
using NHANES data from 2017 to 2020, analyzing 5,421 participants. The authors report a
significant correlation, particularly noting that individuals in the highest CMI quartile had a 90%
higher risk of gallstones compared to those in the lowest quartile. Their findings suggest that
CMI may serve as a predictive marker for gallstone risk, with a saturation effect above a certain
threshold.
The use of self-reported data for both gallstone diagnosis and comorbidities is highly
problematic. Self-reported conditions are prone to recall bias, misclassification, and
underdiagnosis, especially for asymptomatic gallstones that are often detected incidentally on
imaging. The reliability of these findings is significantly weakened by the lack of objective
clinical confirmation, making it difficult to draw robust conclusions from the reported
associations.
While the study is well-structured, its contribution to the field is questionable, as the association
between cardiometabolic risk factors and gallstones is already well established. Obesity,
dyslipidemia, insulin resistance, and metabolic syndrome are all recognized risk factors for
gallstones, and CMI essentially encapsulates these same variables. Since this study does not
introduce a novel mechanism or significantly enhance predictive capability beyond existing
models, its incremental value is minimal.
The discussion is adequately lengthy but fails to engage deeply with the broader context of
predictive indices. There are other established markers for cardiometabolic health—such as
triglyceride-glucose (TyG) index or waist-to-height ratio—that could have been compared to
CMI in terms of predictive power for gallstones. A more critical comparison of these indices
would strengthen the argument for CMI’s utility and provide a more comprehensive perspective.
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