Kunutsor Setor K, Rikhtehgaran Reyhaneh, Connelly Margery A, Shalaurova Irina, Bakker Stephan J L, Dullaart Robin P F
Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R2H 2A6, Canada.
Labcorp, Morrisville, NC 27560, USA.
Nutrients. 2025 May 22;17(11):1747. doi: 10.3390/nu17111747.
: The metabolic vulnerability index (MVX)-a composite biomarker reflecting metabolic malnutrition and inflammation-is associated with increased mortality risk, but its association across different levels of chronic disease burden has not been explored. We aimed to examine the associations of MVX and its subcomponents (Inflammation Vulnerability Index, IVX and Metabolic Malnutrition Index, MMX) with all-cause mortality according to multimorbidity status. : In the PREVEND study, which included 6054 participants (mean age 54 years; 49.5% male), MVX was calculated using six plasma biomarkers measured simultaneously via nuclear magnetic resonance spectroscopy. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. : During a median follow-up of 14.0 years, 911 deaths were recorded. In analyses adjusted for several established risk factors, the HRs (95% CIs) of mortality per 1 standard deviation increment in MVX were 1.32 (1.13-1.54; < 0.001), 1.23 (1.08-1.40; = 0.002), and 1.29 (1.16-1.43; < 0.001) for individuals with no disease, one disease, and multimorbidity, respectively. The corresponding HRs (95% CIs) were 1.22 (1.05-1.42; = 0.010), 1.17 (1.03-1.34; = 0.015), and 1.25 (1.13-1.38; < 0.001) for IVX and 1.29 (1.11-1.48; = 0.001), 1.16 (1.02-1.31; = 0.032), and 1.14 (1.03-1.25; = 0.004) for MMX. The ratio of HRs showed no statistical evidence that sex modified the associations of MVX, IVX, and MMX with mortality in each multimorbidity category. However, the associations appeared stronger in males with chronic disease and in females without chronic conditions, suggesting possible sex-related trends. MVX, IVX, and MMX are independent risk indicators of all-cause mortality regardless of the burden of chronic disease, with MVX showing the strongest associations across different multimorbidity statuses. MMX should be interpreted as a proxy for metabolic malnutrition rather than a direct nutritional assessment tool.
代谢脆弱性指数（MVX）是一种反映代谢性营养不良和炎症的综合生物标志物，与死亡风险增加相关，但尚未探讨其在不同慢性病负担水平中的关联。我们旨在根据多病共存状况研究MVX及其子成分（炎症脆弱性指数，IVX和代谢性营养不良指数，MMX）与全因死亡率的关联。
在包含6054名参与者（平均年龄54岁；49.5%为男性）的预防和发展（PREVEND）研究中，MVX通过同时使用核磁共振波谱法测量的六种血浆生物标志物来计算。估计了具有95%置信区间（CI）的风险比（HR）。
在中位随访14.0年期间，记录了911例死亡。在针对几个已确定的风险因素进行调整的分析中，MVX每增加1个标准差，无疾病个体、患一种疾病个体和多病共存个体的死亡HR（95%CI）分别为1.32（1.13 - 1.54；P < 0.001）、1.23（1.08 - 1.40；P = 0.002）和1.29（1.16 - 1.43；P < 0.001）。IVX的相应HR（95%CI）分别为1.22（1.05 - 1.42；P = 0.010）、1.17（1.03 - 1.34；P = 0.015）和1.25（1.13 - 1.38；P < 0.001），MMX的相应HR（95%CI）分别为1.29（1.11 - 1.48；P = 0.001）、1.16（1.02 - 1.31；P = 0.032）和1.14（1.03 - 1.25；P = 0.004）。HR的比值未显示出性别改变MVX、IVX和MMX与各多病共存类别中死亡率关联的统计学证据。然而，在患有慢性病的男性和无慢性病的女性中，这种关联似乎更强，表明可能存在与性别相关的趋势。MVX、IVX和MMX是全因死亡率的独立风险指标，无论慢性病负担如何，其中MVX在不同的多病共存状况中显示出最强的关联。MMX应被解释为代谢性营养不良的替代指标，而非直接的营养评估工具。
