Each 1-unit increase in METS-VF was associated with a 21.0% higher risk of incident peripheral arterial disease in Chinese hypertensive adults (HR 1.21, 95% CI 1.07-1.37).
Cohort (n=6,452)
Yes
Does a higher Metabolic Score for Visceral Fat (METS-VF) increase the risk of incident peripheral arterial disease in hypertensive patients?
The Metabolic Score for Visceral Fat (METS-VF) is positively associated with an increased risk of incident peripheral arterial disease in Chinese hypertensive adults, demonstrating a threshold effect at a score of 8.63.
Effect estimate: HR 1.21 per 1-unit increase in METS-VF (95% CI 1.07-1.37)
Absolute Event Rate: 4.12% vs 4.07%
p-value: p=0.002
Background The Metabolic Score for Visceral Fat (METS - VF), a novel metric for evaluating visceral adipose tissue, has been demonstrated to exhibit a significant correlation with an elevated cardiovascular risk. Nevertheless, its relationship with peripheral artery disease (PAD) remains ambiguous. Consequently, the present study aimed to explore the association between METS-VF and PAD. Methods and results This prospective study was based on a Chinese H-type hypertension cohort, comprising 6,452 patients. The association between METS-VF and PAD was evaluated using the Cox proportional hazards regression analysis and the method of restricted cubic splines (RCS). During an median follow-up time of 3.9 years, 266 PAD events occurred. The mean age of all participants was 63.20 ± 8.38 years. In the fully adjusted model, each 1-unit increase of METS-VF raised the risk of PAD by 21.0% (HR = 1.21, 95%CI: 1.07, 1.37). There was a saturation effect of METS-VF with an inflection point of 8.63 on PAD. For METS-VF 8.63, each unit increase was associated with a 69.0% higher risk of PAD (HR=1.69, 95%CI: 1.32–2.16), while for METS-VF ≥8.63, there was no significant association between them (HR=0.93, 95%CI: 0.73–1.19) (P for log-likelihood ratio test= 0.002). Subgroup analysis further showed a significant interaction between METS-VF and current smoking status (P for interaction0.05), with a stronger association observed in non-smokers. Conclusion METS-VF exhibited a saturation effect on PAD in hypertensive adults in China. Increased METS-VF was positively associated with a higher risk of PAD among hypertensive adults with METS-VF 8.63, and this association was more pronounced in non-smokers.
Li et al. (2026) conducted a cohort in Chinese hypertensive adults without baseline peripheral arterial disease (n=6,452). Metabolic Score for Visceral Fat (METS-VF) vs. Lower METS-VF (reference tertile) was evaluated on Incident peripheral arterial disease defined by ankle-brachial index ≤ 0.9 (HR 1.21 per 1-unit increase in METS-VF, 95% CI 1.07-1.37, p=0.002). Each 1-unit increase in METS-VF was associated with a 21.0% higher risk of incident peripheral arterial disease in Chinese hypertensive adults (HR 1.21, 95% CI 1.07-1.37).