ArticleCardiovascular diabetology2026
LDL-C combined with Chinese visceral adiposity index as a risk stratification tool for cardiometabolic multimorbidity in middle-aged and older Chinese adults: a national prospective cohort study.
Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundCardiometabolic multimorbidity (CMM) poses a growing public health challenge, calling for better primary prevention strategies. While both elevated LDL-C and visceral adiposity (assessed by Chinese visceral adiposity index (CVAI)) are established risk factors, their combined utility for risk stratification is unclear.
methodsThis prospective analysis included 8813 CMM-free adults from the China Health and Retirement Longitudinal Study (CHARLS). We proposed a novel integrated metric, the Visceral Lipoprotein Risk (VLR) index, defined as CVAI × LDL-C (mg/dL). Its association with incident CMM was evaluated using Cox regression, Kaplan-Meier analysis, and restricted cubic spline (RCS). The incremental predictive value of VLR was assessed via receiver operating characteristic (ROC) analysis, with robustness examined through sensitivity analyses. Mediation analysis explored underlying pathways.
resultsOver a median follow-up of 9 years, 729 (8.27%) participants developed CMM. After multivariable adjustment, each standard deviation (SD) increase in VLR was associated with an 31% higher risk of CMM (HR: 1.31, 95%CI 1.24–1.39). Participants in the highest VLR quartile had a 3.12-fold increased risk (95%CI 2.39–4.08) compared to the lowest quartile. Kaplan-Meier curves (log-rank P < 0.001) and RCS models confirmed a strong, positive, and non-linear dose-response relationship. The VLR index demonstrated good discriminative ability (AUC: 0.78). Subgroup analyses revealed effect heterogeneity, which mediation analysis attributed to distinct underlying pathways: while Triglyceride-Glucose Index (TyG) and Atherogenic Index of Plasma (AIP) were key mediators in the overall population, white blood cell (WBC) count emerged as a significant but minor mediator (proportion mediated 3.17%) in individuals free of any baseline cardiometabolic disease (CMD), whereas HbA1c remained the predominant mediator in the obese subgroup.
conclusionsThe VLR index, its non-linear association and mediation mechanisms underscore biological plausibility and utility for refined risk stratification, offering a practical tool for early identification and targeted primary prevention in middle-aged and older adults.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.