Relative fat mass and cardiovascular risk in Chinese adults: a nationwide prospective cohort study.

Each 1-unit increase in RFM was associated with a 3% higher CVD risk in Chinese adults.

• Adjusted HR=1.03, 95% CI: 1.02-1.05
• Analysis conducted using Cox regression models
• Study population: 7,027 adults aged ≥45 years without baseline CVD from CHARLS (2011-2020)
• Median follow-up was 9 years

Participants in the highest RFM quartile had 46% greater CVD risk compared to those in the lowest quartile.

• Adjusted HR=1.46, 95% CI: 1.05-2.03
• P-trend=0.004 across quartiles
• Association was assessed using Cox regression models adjusted for conventional risk factors

Over a median 9-year follow-up, 24.6% of participants developed CVDs.

• Sample comprised 7,027 adults aged ≥45 years
• All participants were free of CVD at baseline
• Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), 2011-2020

Sex-stratified analyses revealed consistent RFM-CVD associations in both males and females, with stronger effects observed in males.

• Associations were confirmed across both sexes
• Effect modification by sex was evaluated in subgroup analyses
• RFM was calculated using validated sex-specific equations

Adding RFM to conventional Framingham risk factors significantly improved CVD prediction.

• AUC improved from 0.634 to 0.640 with the addition of RFM
• Net reclassification improvement (NRI) = 0.140
• Integrated discrimination improvement (IDI) = 0.004
• P<0.001 for both NRI and IDI

Subgroup analyses confirmed robust RFM-CVD associations across age groups and participants without comorbidities.

• Analyses evaluated effect modification across multiple subgroups
• Associations were consistent among those without comorbidities
• Age groups were separately examined to assess consistency of findings