Metabolic Score for Visceral Fat as a Predictor of All-Cause and
                    Cardiovascular Mortality in US Adults with Diabetes or
                    Prediabetes

Qichao Yang; Zhaoxiang Wang; Yong Yin; Mengjiao Xu; Yi Xue; Xuejing Shao; Huibo Qiao

doi:10.1055/a-2720-4884

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res
DOI: 10.1055/a-2720-4884

Original Article: Endocrine Care

Metabolic Score for Visceral Fat as a Predictor of All-Cause and Cardiovascular Mortality in US Adults with Diabetes or Prediabetes

Autoren

Qichao Yang

¹Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

²Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Zhaoxiang Wang

³Endocrinology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
Yong Yin

¹Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

²Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Mengjiao Xu

¹Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

²Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Yi Xue

¹Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

²Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Xuejing Shao

¹Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

²Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China
Huibo Qiao

¹Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China

²Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

Abstract

The metabolic score for visceral fat was a newly developed surrogate marker for evaluating visceral fat. This study aimed to investigate the relationship between the metabolic score for visceral fat and the mortality risk in US adults with diabetes or prediabetes. A cohort of 12,992 individuals with diabetes or prediabetes was identified from the US National Health and Nutrition Examination Survey (1999–2018). Baseline metabolic score for visceral fat measurements were recorded, and mortality outcomes were assessed by linking participants to the National Death Index records up to December 31, 2019. Multivariate Cox regression and restricted cubic spline models were employed to examine the relationship between the metabolic score for visceral fat and both all-cause mortality and cardiovascular mortality. Over a median follow-up of 97 months, a total of 2,438 all-cause deaths and 662 cardiovascular deaths were recorded. Multivariate Cox regression analysis indicated that individuals in the highest metabolic score for visceral fat quartile exhibited adjusted hazard ratios of 2.857 (95% confidence interval: 2.348–3.477) for all-cause mortality and 3.290 (95% confidence interval: 2.218–4.881) for cardiovascular mortality, compared to those in the lowest quartile. Additionally, a nonlinear relationship between the metabolic score for visceral fat and the mortality risk was observed, with inflection points identified at 7.093 for all-cause mortality and 7.220 for cardiovascular mortality. Elevated metabolic score for visceral fat levels are strongly associated with heightened risks of mortality among diabetic or prediabetic population, underscoring their potential utility as a prognostic indicator.

Keywords

metabolic score for visceral fat - diabetes - prediabetes - cardiovascular mortality - all-cause mortality

Volltext

Referenzen

References
1 Schmidt AM. Highlighting Diabetes Mellitus: The Epidemic Continues. Arterioscler Thromb Vasc Biol 2018; 38: e1-e8
2 [Anonymous]. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402: 203-234
3 Tabák AG, Herder C, Rathmann W. et al. Prediabetes: a high-risk state for diabetes development. Lancet 2012; 379: 2279-2290
4 Echouffo-Tcheugui JB, Perreault L, Ji L. et al. Diagnosis and Management of Prediabetes: A Review. JAMA 2023; 329: 1206-1216
5 Cai X, Zhang Y, Li M. et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ 2020; 370: m2297
6 Huang Y, Cai X, Mai W. et al. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ 2016; 355: i5953
7 Tian Y, Qiu Z, Wang F. et al. Associations of Diabetes and Prediabetes With Mortality and Life Expectancy in China: A National Study. Diabetes Care 2024; 47: 1969-1977
8 Neeland IJ, Ross R, Després JP. et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol 2019; 7: 715-725
9 Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev 2010; 11: 11-18
10 Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013; 93: 359-404
11 Bello-Chavolla OY, Antonio-Villa NE, Vargas-Vázquez A. et al. Metabolic Score for Visceral Fat (METS-VF), a novel estimator of intra-abdominal fat content and cardio-metabolic health. Clin Nutr 2020; 39: 1613-1621
12 Zhang F, Wang Y, Zhou J. et al. Association between Metabolic Score for Visceral Fat and the risk of hypertension in different ethnic groups: a prospective cohort study in Southwest China. Front Endocrinol (Lausanne) 2024; 15: 1302387
13 Yang R, Kuang M, Qiu J. et al. Assessing the usefulness of a newly proposed metabolic score for visceral fat in predicting future diabetes: results from the NAGALA cohort study. Front Endocrinol (Lausanne) 2023; 14: 1172323
14 Liu Q, Cui H, Si F. et al. Association of Cumulative Exposure to Metabolic Score for Visceral Fat With the Risk of Cardiovascular Disease and All-Cause Mortality: A Prospective Cohort Study. J Cachexia Sarcopenia Muscle 2025; 16: e13702
15 Jia S, Huo X, Zuo X. et al. Association of metabolic score for visceral fat with all-cause mortality, cardiovascular mortality, and cancer mortality: A prospective cohort study. Diabetes Obes Metab 2024; 26: 5870-5881
16 Zhu Y, Zou H, Guo Y. et al. Associations between metabolic score for visceral fat and the risk of cardiovascular disease and all-cause mortality among populations with different glucose tolerance statuses. Diabetes Res Clin Pract 2023; 203: 110842
17 Zou X, Zhou X, Zhu Z. et al. Novel subgroups of patients with adult-onset diabetes in Chinese and US populations. Lancet Diabetes Endocrinol 2019; 7: 9-11
18 Levey AS, Stevens LA, Schmid CH. et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-612
19 Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D. et al. METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes. Eur J Endocrinol 2018; 178: 533-544
20 Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012; 13: 275-286
21 Yan LJ, Zeng YR, Chan-Shan Ma RN. et al. J-shaped association between the visceral adiposity index and all-cause mortality in patients with chronic kidney disease. Nutrition 2022; 103-104: 111832
22 Jayedi A, Khan TA, Aune D. et al. Body fat and risk of all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Int J Obes (Lond) 2022; 46: 1573-1581
23 Bastien M, Poirier P, Lemieux I. et al. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis 2014; 56: 369-381
24 Després JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation 2012; 126: 1301-1313
25 Neeland IJ, Turer AT, Ayers CR. et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA 2012; 308: 1150-1159
26 Fox CS, Massaro JM, Hoffmann U. et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007; 116: 39-48
27 Freedland ES. Role of a critical visceral adipose tissue threshold (CVATT) in metabolic syndrome: implications for controlling dietary carbohydrates: a review. Nutr Metab (Lond) 2004; 1: 12
28 Bennett JP, Prado CM, Heymsfield SB. et al. Evaluation of visceral adipose tissue thresholds for elevated metabolic syndrome risk across diverse populations: A systematic review. Obes Rev 2024; 25: e13767
29 Neeland IJ, Poirier P, Després JP. Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management. Circulation 2018; 137: 1391-1406
30 Sturm W, Sandhofer A, Engl J. et al. Influence of visceral obesity and liver fat on vascular structure and function in obese subjects. Obesity (Silver Spring) 2009; 17: 1783-1788
31 Ferrannini E, Gastaldelli A, Iozzo P. Pathophysiology of prediabetes. Med Clin North Am 2011; 95: 327-339, vii–viii
32 Gastaldelli A, Basta G. Ectopic fat and cardiovascular disease: what is the link?. Nutr Metab Cardiovasc Dis 2010; 20: 481-490