ArticleBMC cardiovascular disorders2026
Association between cumulative metabolic score for visceral fat and cardiovascular disease risk in cardiovascular-kidney-metabolic syndrome stage 0-3 patients: a prospective cohort analysis based on CHARLS database.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
aimsThe 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. METHODS AND
resultsUsing 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).
conclusionCumMETS-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.
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