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Background <p>This study aimed to evaluate the association between METS-VF and cardiovascular outcomes as well as total mortality (TM) in type 2 diabetes.</p> Methods <p>Participants were drawn from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. Cox proportional hazards regression analyses and Restricted cubic spline (RCS) models were employed to assess the relationship between METS-VF and major adverse cardiovascular events (MACEs) and TM. Additionally, the incremental predictive value of METS-VF was evaluated.</p> Results <p>During a median follow-up of 8.82 years, 1,914 participants (18.96%) died, including 656(6.49%) from cardiovascular causes. The study proved higher METS-VF were significantly positively associated with MACEs and TM in Cox models. RCS analyses revealed a J-shaped non-linear relationship between METS-VF and both MACEs and TM, with inflection points of 6.62 and 7.31, respectively. Above these inflection points, METS-VF was positively correlated with MACEs (HR 1.70, 95% CI 1.27–2.27) and TM (HR 2.04, 95% CI 1.37–3.03). Stratified analysis identified that METS-VF had a significant predictive value for MACEs particularly in patients with type 2 diabetes who are not taking aspirin.</p> Conclusions <p>METS-VF is significantly associated with elevated risk of MACEs and TM in patients with type 2 diabetes, exhibiting a clear inflection point. These findings indicate that METS-VF may serve as a robust biomarker for predicting the risk of cardiovascular events in patients with type 2 diabetes, underscoring the importance of managing visceral obesity.</p>

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Association of metabolic score for visceral fat with cardiovascular risk and total mortality in patients with type 2 diabetes: insights from ACCORD study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月16日

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  • Peiqi Tang,
  • Ying Xin,
  • Maojun Liu,
  • Cheng Zeng,
  • Xinqun Hu

摘要

Background

This study aimed to evaluate the association between METS-VF and cardiovascular outcomes as well as total mortality (TM) in type 2 diabetes.

Methods

Participants were drawn from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. Cox proportional hazards regression analyses and Restricted cubic spline (RCS) models were employed to assess the relationship between METS-VF and major adverse cardiovascular events (MACEs) and TM. Additionally, the incremental predictive value of METS-VF was evaluated.

Results

During a median follow-up of 8.82 years, 1,914 participants (18.96%) died, including 656(6.49%) from cardiovascular causes. The study proved higher METS-VF were significantly positively associated with MACEs and TM in Cox models. RCS analyses revealed a J-shaped non-linear relationship between METS-VF and both MACEs and TM, with inflection points of 6.62 and 7.31, respectively. Above these inflection points, METS-VF was positively correlated with MACEs (HR 1.70, 95% CI 1.27–2.27) and TM (HR 2.04, 95% CI 1.37–3.03). Stratified analysis identified that METS-VF had a significant predictive value for MACEs particularly in patients with type 2 diabetes who are not taking aspirin.

Conclusions

METS-VF is significantly associated with elevated risk of MACEs and TM in patients with type 2 diabetes, exhibiting a clear inflection point. These findings indicate that METS-VF may serve as a robust biomarker for predicting the risk of cardiovascular events in patients with type 2 diabetes, underscoring the importance of managing visceral obesity.