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Horm Metab Res 2025; 57(10): 583-592
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

Authors

  • Qichao Yang

    1   Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
    2   Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

  • Zhaoxiang Wang 

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

  • Yong Yin

    1   Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
    2   Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

  • Mengjiao Xu

    1   Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
    2   Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

  • Yi Xue

    1   Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
    2   Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

  • Xuejing Shao

    1   Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
    2   Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

  • Huibo Qiao

    1   Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
    2   Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, China

Supported by: The Changzhou Young Talent Development Plan of Health Commission CZQM2022029
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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 - prediabetes - cardiovascular mortality - all-cause mortality


Publication History

Received: 06 April 2025

Accepted after revision: 09 October 2025

Accepted Manuscript online:
09 October 2025

Article published online:
03 November 2025

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