Xie Chunming, Chen Xianpei, Zhang Jiakun, Jiang Xueqing, Xu Jing, Lin Hao
Digestive Endoscopy Center, Pingyang Hospital of Wenzhou Medical University, Wenzhou City, China.
Department of Gastroenterology, Pingyang Hospital of Wenzhou Medical University, Wenzhou City, China.
BMC Gastroenterol. 2025 Apr 10;25(1):238. doi: 10.1186/s12876-025-03833-y.
Metabolic score for visceral fat (METS-VF) as an effective marker of visceral obesity has been correlated with non-alcoholic fatty liver disease (NAFLD). This study aims to explore the correlation between METS-VF and both all-cause mortality and cardiovascular disease (CVD)-related mortality among individuals with NAFLD.
A cohort of 6,759 subjects diagnosed with NAFLD was selected from the NHANES during the period from 1999 to 2018. Within this cohort, the prognostic utility of METS-VF for predicting CVD-related and all-cause mortality was assessed.
There was a total of 1254 all-cause deaths (18.6%) and 418 CVD-related deaths (6.2%) at a median follow-up for 9.3 years. Multivariate Cox regression analysis and restricted cubic splines analysis indicated that METS-VF can exhibit a positive non-linearly correlation with CVD mortality (HR: 4.15, 95% CI: 2.31-7.44, p < 0.001) and all-cause mortality (HR: 5.27, 95% CI: 3.75-7.42, p < 0.001), with an identified inflection point at 7.436. Subgroup analyses further revealed a stronger correlation between METS-VF and all-cause mortality among subjects without diabetes. Furthermore, the areas under the curve (AUC) for 1-, 3-, 5-, and 10-year survival rates were 0.756, 0.740, 0.747 and 0.746 for all-cause mortality, and 0.774, 0.751, 0.746 and 0.758 for CVD mortality, respectively, which performs better than the other obesity and IR related index.
Elevated METS-VF independently contributes to an increased risk of both all-cause and CVD mortality in individuals with NAFLD.
Not applicable.
内脏脂肪代谢评分（METS-VF）作为内脏肥胖的有效标志物，已与非酒精性脂肪性肝病（NAFLD）相关联。本研究旨在探讨NAFLD患者中METS-VF与全因死亡率和心血管疾病（CVD）相关死亡率之间的相关性。
从1999年至2018年期间的美国国家健康与营养检查调查（NHANES）中选取了6759名被诊断为NAFLD的受试者队列。在该队列中，评估了METS-VF对预测CVD相关死亡率和全因死亡率的预后效用。
在中位随访9.3年期间，共有1254例全因死亡（18.6%）和418例CVD相关死亡（6.2%）。多变量Cox回归分析和受限立方样条分析表明，METS-VF与CVD死亡率（风险比：4.15，95%置信区间：2.31-7.44，p<0.001）和全因死亡率（风险比：5.27，95%置信区间：3.75-7.42，p<0.001）呈正非线性相关，确定的拐点为7.436。亚组分析进一步显示，在无糖尿病的受试者中，METS-VF与全因死亡率之间的相关性更强。此外，全因死亡率的1年、3年、5年和10年生存率的曲线下面积（AUC）分别为0.756、0.740、0.747和0.746，CVD死亡率的曲线下面积分别为0.774、0.751、0.746和0.758，其表现优于其他肥胖和胰岛素抵抗相关指标。
升高的METS-VF独立导致NAFLD患者全因死亡率和CVD死亡率风险增加。
不适用。
