Evidence map›Paper›PMID 42281532›Full record

ArticleJournal of diabetes research2026

Exploring the Joint Impact of METS-VF and Functional Limitation on Cardiometabolic Multimorbidity Risk.

Xuhui Chen, Ying Wang, Jiaofen Wu, Yulian He, Huihui Chen, Honghua Ye, Jianhui Liu

Abstract read
In one paragraph

Article in Journal of diabetes research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Xuhui ChenDepartment of Pharmacy, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.ORCID https://orcid.org/0009-0002-9935-3967
Ying WangDepartment of Pharmacy, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.
Jiaofen WuDepartment of Pharmacy, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.
Yulian HeDepartment of Pharmacy, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.
Huihui ChenDepartment of Pharmacy, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.ORCID https://orcid.org/0009-0003-7632-9873
Honghua YeDepartment of Cardiology, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.
Jianhui LiuDepartment of Cardiology, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China, nbws.gov.cn.ORCID https://orcid.org/0009-0004-1341-0831

Funding

Medical and Health Research Project of Zhejiang Province WKJ-ZJ-2446Ningbo Key Research and Development Program 2024Z232
6 · The paper itself

Abstract

backgroundCardiometabolic multimorbidity (CMM) has emerged as a primary public health challenge, significantly increasing mortality risk and reducing quality of life. Although the metabolic score for visceral fat (METS-VF) and functional limitation are recognized individually as risk factors for cardiometabolic health, the bidirectional relationship between functional limitation and CMM suggests complex underlying mechanisms. However, research investigating the independent and joint effects of METS-VF (representing visceral obesity) and functional limitation on the risk of CMM onset is lacking. This study is aimed at systematically elucidating these associations to provide evidence for targeted interventions.

methodsThis prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 8140 participants were included in the cross-sectional analysis, and a sub-cohort of 5356 individuals free of CMM at baseline was followed longitudinally. CMM was defined as the coexistence of at least two cardiometabolic diseases: heart disease, diabetes, stroke, or hypertension. Functional limitation was assessed using activities of daily living (ADL) and instrumental ADL (IADL) scales. Multivariable Cox proportional hazards regression and restricted cubic spline (RCS) analysis were employed to evaluate the association between METS-VF, functional limitations, and CMM incidence.

resultsDuring the follow-up period, METS-VF demonstrated a nonlinear positive dose-response relationship with CMM risk. In the longitudinal analysis, participants in the high METS-VF group (defined by the RCS inflection point) exhibited a significantly elevated risk of developing CMM compared to the low-risk group (HR = 1.77, 95% CI: 1.39-2.26) after adjusting for confounders. Continuous functional limitations were also independently associated with incident CMM (HR = 1.12, 95% CI: 1.08-1.16). Notably, a joint effect was observed; participants with both high METS-VF and functional limitations faced the highest risk (HR = 2.43, 95% CI: 1.78-3.31). Receiver operating characteristic (ROC) analysis indicated that the combined model incorporating both factors achieved superior predictive accuracy (AUC = 0.680) compared to single-factor models.

conclusionMETS-VF and functional limitations are strong independent predictors of CMM, and their simultaneous presence exerts a significant joint effect on disease risk. The integration of METS-VF and functional assessment into clinical practice can enhance CMM risk stratification and facilitate the early identification of vulnerable high-risk subgroups.

Indexed as

Activities of Daily LivingCardiovascular DiseasesIntra-Abdominal FatMetabolic SyndromeObesity, AbdominalAgedCardiometabolic Risk FactorsChinaCross-Sectional StudiesDiabetes MellitusFemaleHumansHypertensionIncidenceLongitudinal StudiesMalecardiometabolic multimorbidityCHARLScohort studyfunctional limitationmetabolic score for visceral fat (METS-VF)visceral obesity

Identifiers

PMID42281532
PMCPMC13261289

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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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.