Wang Hui, Li Longlong, Yang Yi, Tao Siyu, Li Yuan, Li Hangyu, Chen Heshan, Wu Ping
College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan province, 610075, China.
Department of Rheumatology, Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, Sichuan province, 610075, China.
BMC Gastroenterol. 2025 Jul 31;25(1):547. doi: 10.1186/s12876-025-04161-x.
Obesity is a well-established risk factor for gallstone formation, but traditional anthropometric measures (e.g., BMI, waist circumference) inadequately assess metabolically active visceral adiposity. The novel Metabolic Score for Visceral Fat (METS-VF) may better capture obesity-related metabolic dysfunction. We aimed to investigate the association between METS-VF and gallstone prevalence and compare its predictive performance against conventional obesity indices (WC, LAP, VAI) in a U.S. national cohort.
This cross-sectional study analyzed nationally representative data from 3,010 US adults in NHANES 2017-2020 (aged 20-85 years, 51.3% male, multi-ethnic population). We employed weighted multivariable logistic regression to examine the METS-VF-gallstones association, with restricted cubic splines testing nonlinearity. Predictive performance of METS-VF versus traditional indices (WC/LAP/VAI) was compared using ROC curves and XGBoost machine learning.
Among 3,010 U.S. adults (mean age 47.8 ± 17.0 years, 51.3% male) in the NHANES 2017-2020 cohort, multivariable analysis revealed METS-VF as the strongest independent predictor of gallstones (adjusted OR = 2.02, 95%CI:1.20-3.40). Notably, METS-VF demonstrated significantly superior discriminative ability with the highest AUC of 0.712 (95%CI:0.684-0.739) compared to conventional indices (WC:0.635, LAP:0.609, VAI:0.530; all P < 0.05).
The cross-sectional analysis demonstrates a significant association between METS-VF and gallstone prevalence (OR = 2.02, 95% CI:1.20-3.40), with relatively better predictive performance compared to conventional adiposity indices (AUC = 0.712). Its simple calculation using routine clinical measurements makes it ideally suited for implementation in primary care screening programs targeting high-risk populations with visceral adiposity. While these findings position METS-VF as a promising screening marker, its etiological role requires verification through longitudinal studies.
肥胖是胆结石形成的一个公认风险因素，但传统人体测量指标（如体重指数、腰围）无法充分评估具有代谢活性的内脏脂肪。新型内脏脂肪代谢评分（METS-VF）可能能更好地反映与肥胖相关的代谢功能障碍。我们旨在研究METS-VF与胆结石患病率之间的关联，并在美国全国队列中比较其与传统肥胖指标（腰围、脂质蓄积产物、内脏脂肪指数）相比的预测性能。
这项横断面研究分析了2017 - 2020年美国国家健康与营养检查调查（NHANES）中3010名美国成年人（年龄20 - 85岁，男性占51.3%，多民族人群）具有全国代表性的数据。我们采用加权多变量逻辑回归来研究METS-VF与胆结石的关联，并使用受限立方样条检验非线性关系。使用ROC曲线和XGBoost机器学习比较METS-VF与传统指标（腰围/脂质蓄积产物/内脏脂肪指数）的预测性能。
在2017 - 2020年NHANES队列的3010名美国成年人（平均年龄47.8 ± 17.0岁，男性占51.3%）中，多变量分析显示METS-VF是胆结石最强的独立预测因素（调整后比值比 = 2.02，95%置信区间：1.20 - 3.40）。值得注意的是，与传统指标（腰围：0.635，脂质蓄积产物：0.609，内脏脂肪指数：0.530；所有P < 0.05）相比，METS-VF表现出显著更优的判别能力，AUC最高达0.712（95%置信区间：0.684 - 0.739）。
横断面分析表明METS-VF与胆结石患病率之间存在显著关联（比值比 = 2.02，95%置信区间：1.20 - 3.40），与传统肥胖指标相比具有相对更好的预测性能（AUC = 0.712）。其使用常规临床测量进行简单计算，使其非常适合在针对内脏脂肪过多高危人群的初级保健筛查项目中应用。虽然这些发现使METS-VF成为一个有前景的筛查标志物，但其病因学作用需要通过纵向研究来验证。
