Metabolic score for visceral fat profiles and incident cardiovascular disease in adults with CKM syndrome stages 0-3: a CHARLS longitudinal study.

Elevated baseline METS-VF in the fourth quartile was associated with significantly increased risk of incident CVD.

• HR = 1.615 (95% CI: 1.243–2.097) in the fully adjusted model
• The association remained significant following false discovery rate (FDR) correction
• Study followed 3,815 adults with CKM syndrome stages 0–3 from 2015 to 2020
• Mean follow-up was 4.4 years; 18.7% of participants developed CVD

Elevated cumulative METS-VF in the fourth quartile was associated with the highest risk of incident CVD among the METS-VF profile measures examined.

• HR = 1.824 (95% CI: 1.397–2.381) in the fully adjusted model
• This association remained significant following FDR correction
• Cumulative METS-VF reflected longitudinal exposure across multiple time points

Stable high-level METS-VF trajectory (Class 3), identified by latent class growth modeling, was associated with increased CVD risk.

• HR = 1.288 (95% CI: 1.033–1.610) for Class 3 (stable high-level METS-VF)
• Trajectory patterns were identified using latent class growth modeling (LCGM)
• The association remained significant following FDR correction

The associations between METS-VF profiles and incident CVD were stronger in late-stage CKM syndrome compared to early-stage CKM syndrome.

• Stratified analyses by CKM syndrome stage showed more pronounced associations at later stages
• Sensitivity analyses including inverse probability weighting (IPW) and Fine-Gray model supported robustness
• CKM syndrome stages examined were 0 through 3

The association between METS-VF profiles and incident CVD was more pronounced in males than females.

• Females had significant associations only in the highest quartile of METS-VF
• Males showed more consistent and pronounced associations across METS-VF profile levels
• Stratified analyses by demographics were used to assess these differences

Weighted quantile sum (WQS) regression identified Metabolic Score for Insulin Resistance (METS-IR) as the primary contributing factor to METS-VF's association with CVD.

• METS-IR weight was 0.397 in 2011 and 0.375 in 2015
• WQS regression was employed to decompose the contribution of individual components
• These weights were the highest among all components examined

Estimated glucose disposal rate (eGDR) significantly mediated the relationship between METS-VF profiles and incident CVD.

• eGDR mediated 65.38% of the baseline METS-VF effect on CVD (P < 0.001)
• eGDR mediated 56.72% of the cumulative METS-VF effect on CVD (P < 0.001)
• Mediation analysis was used to quantify the indirect pathway through eGDR
• Supplementary mediation analysis using BMI-based METS-VF (METS-VFBMI) produced consistent findings