Abstract: Objective To investigate the association between carotid intima-media thickness (cIMT) and the clustering of multiple metabolic abnormalities within a general population age 35-75 years. Methods Employing a cluster random sampling method, 938 permanent residents from five counties and two districts of Jiaxing City were enrolled as the study cohort between May 2022 and April 2025. General demographic data were collected, physical examinations and biochemical assessments were conducted, and the number of metabolic abnormality indices was recorded. cIMT values were quantitatively measured and documented. A linear regression analysis was performed utilizing the number of metabolic abnormalities as the independent variable and cIMT as the dependent variable. Furthermore, a multivariate logistic regression analysis (with cIMT thickening as the dependent variable) was conducted to evaluate the impact of the clustering of multiple metabolic abnormalities on cIMT thickening, following adjustments for confounding variables including age and sex. Results Among the 938 participants age 35-75 years from the general population, the prevalence of metabolic abnormality indices was as follows: 0 abnormalities in 339 individuals (36.14%), 1 in 276 individuals (29.42%), 2 in 186 individuals (19.83%), and ≥3 in 137 individuals (14.61%). A statistically significant, progressive increase in cIMT was observed concurrently with an escalation in the number of metabolic abnormality indices (P<0.05). Multiple linear regression analysis revealed that each single-unit increase in the number of metabolic abnormalities was associated with a mean cIMT elevation of 0.050 mm (95% CI: 0.042-0.058). Multivariate logistic regression analysis delineated that age 60-75 years (OR=1.443), male sex (OR=1.468), current smoking (OR=1.414), heavy alcohol consumption (OR=1.682), insufficient physical activity (OR=1.348), BMI≥28.0 kg/m² (OR=1.504), waist-to-hip ratio (OR=1.138 per 0.1 increment), and the number of metabolic abnormalities (2 abnormalities: OR=1.685; ≥3 abnormalities: OR=1.845) were all significantly associated factors for cIMT thickening (all P<0.05). Conclusion In the general population, the clustering of multiple metabolic abnormalities exhibits a positive correlation with elevated cIMT. The risk of developing cIMT thickening escalates progressively in tandem with the increasing number of metabolic abnormalities within an individual.

Key words: General population, Metabolic abnormalities, Carotid intima-media thickness, Association study