The highest quartile of cumulative metabolic score for visceral fat increased cardiovascular disease risk by 42% compared to the lowest quartile in patients with CKM stages 0-3.
Cohort (n=3,341)
Yes
Does higher cumulative Metabolic Score for Visceral Fat (cumMETS-VF) increase CVD incidence in adults aged ≥45 years with CKM stages 0-3?
Cumulative exposure to visceral fat, measured by cumMETS-VF, is significantly associated with an increased risk of incident cardiovascular disease in patients with early-stage cardiovascular-kidney-metabolic syndrome, particularly in stage 2.
Effect estimate: HR 1.42 (95% CI 1.11-1.82)
p-value: p=<0.001
The American Heart Association (AHA)'s cardiovascular-kidney-metabolic (CKM) syndrome framework emphasizes prevention during early stages (stages 0-3). The metabolic score for visceral fat (METS-VF) provides accurate cardiometabolic risk assessment, yet studies rely on single-time measurements. We investigated cumulative Metabolic Score for Visceral Fat (cumMETS-VF) exposure and cardiovascular disease (CVD) risk across CKM stages 0-3. Using the China Health and Retirement Longitudinal Study (CHARLS) 2011–2020, we included 3,341 adults aged ≥45 years with CKM stages 0-3 and no CVD history (mean age 58±9 years, 53.1% female). CumMETS-VF was calculated from 2011-2015, and CVD incidence (coronary heart disease and stroke) was assessed during 2015–2020. Multivariable Cox models, restricted cubic splines (RCS) , and CKM-stratified analyses were performed. During 60-month follow-up, 634 CVD events (18.9%) occurred. The highest cumMETS-VF quartile showed 42% increased CVD risk versus the lowest (Hazard Ratio(HR) = 1.42, 95% Confidence Interval(CI): 1.11–1.82, P for trend < 0.001). A J-shaped nonlinear association was observed (P-nonlinearity < 0.001). CKM stage significantly modified this association (P for interaction=0.039), with the strongest effect in stage 2 (HR =1.59, 95% CI: 1.16–2.17) but no significance in stages 0-1. Each 1-Standard Deviation(SD) increase in cumMETS-VF conferred 14% higher CVD risk (HR =1.14, 95% CI: 1.06–1.23). CumMETS-VF exposure showed a J-shaped association with CVD risk in CKM stages 0-3 patients, significantly modified by CKM stage, enabling risk stratification and early intervention.
Chen et al. (Mon,) conducted a cohort in Cardiovascular-kidney-metabolic (CKM) syndrome stage 0-3 (n=3,341). Cumulative Metabolic Score for Visceral Fat (cumMETS-VF) highest quartile vs. Lowest quartile of cumMETS-VF was evaluated on First occurrence of cardiovascular disease (coronary heart disease and stroke) (HR 1.42, 95% CI 1.11-1.82, p=<0.001). The highest quartile of cumulative metabolic score for visceral fat increased cardiovascular disease risk by 42% compared to the lowest quartile in patients with CKM stages 0-3.