Key result
A 1-SD increase in the Metabolic score for visceral fat (METS-VF) was associated with a 17% higher hazard of cardiovascular disease mortality (aHR 1.17) in Mexican adults.
Why the study?
Visceral adipose tissue is associated with CVD mortality, but the comparative performance of VAT-related clinical surrogates remains poorly characterized.
Do VAT-related clinical surrogates predict CVD mortality in adults?
Cohort (n=102,385)
Do VAT-related clinical surrogates predict CVD mortality in adults?
Four VAT-related clinical surrogates, particularly METS-VF, demonstrated good discriminatory performance for long-term CVD mortality, offering a scalable risk assessment tool for resource-limited settings.
These surrogates may aid scalable CVD mortality prediction where imaging is limited; leaves open prospective validation against standard risk scores.
BACKGROUND: Visceral adipose tissue (VAT) has been associated with cardiovascular disease (CVD) mortality. However, the comparative performance of VAT-related clinical surrogates remains poorly characterized. OBJECTIVES: To evaluate the performance of seven VAT-related clinical surrogates for predicting CVD and cause-specific CVD mortality. METHODS: We analyzed data from the Mexico City Prospective Cohort, a population-based prospective cohort study, with baseline recruitmetn between 1998 - 2004 and ongoing mortality follow-up. CVD mortality included deaths from cardiac, stroke-related, and other vascular causes. Seven VAT-related surrogates (METS-VF, CVAI, EVA, DAAT, LAAP, VAI, and DAI) were estimated using clinical, biochemical, and anthropometric data at baseline. Associations with outcomes were evaluated using Cox regression models to estimate adjusted hazard ratios (aHRs). Discrimination was assessed with Harrell's C-statistic (Cs) and fixed-point at 10-years receiver operating characteristic (ROC) curves, and calibration with slope plots. RESULTS: In a subsample of 102,385 participants (median age: 47 years; 67% female), 4,068 (3.97%) died from any CVD causes. METS-VF (Cs: 0.722; aHR: 1.17, 95% CI: 1.12-1.23), EVA (Cs: 0.72; 1.14, 1.12-1.23), CVAI (Cs: 0.70; 1.13, 1.09-1.18), and DAAT (Cs: 0.626; 1.13, 1.09-1.18) were positively associated with CVD mortality and showed the highest predictive capacity among the surrogates. Adding METS-VF to a CVD risk score among individuals classified as intermediate risk improved discrimination for CVD mortality. CONCLUSIONS: In this large cohort of Mexican adults, four VAT-related clinical surrogates, particularly METS-VF, demonstrated good discriminatory performance for long-term CVD mortality. These indices could help to identify individuals with high VAT accumulation and high CVD risk in resource-limited settings.
No takes yet. Share an insight, caveat, or question.
Martinez-Luna et al. (2026) conducted a cohort in Cardiovascular mortality (n=102,385). Visceral adipose tissue (VAT) clinical surrogates (e.g., METS-VF) vs. Lower VAT surrogate values was evaluated on Cardiovascular disease (CVD) mortality (aHR 1.17, 95% CI 1.12-1.23). A 1-SD increase in the Metabolic score for visceral fat (METS-VF) was associated with a 17% higher hazard of cardiovascular disease mortality (aHR 1.17) in Mexican adults.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: