Exploration Of Metabolic Score For Visceral Fat As A Predictor Of Atherosclerotic Cardiovascular Disease

Objective Atherosclerotic cardiovascular disease(ASCVD)is the most important disease endangering peoples health.ASCVD including acute coronary syndrome,myocardial infarction,stable or unstable angina,coronary artery or other blood vessel revascularization,ischemic stroke,transient ischemic attack,peripheral artery disease,these events led to the highest prevalence and mortality rate.Early prevention and control of ASCVD risk factors can effectively reduce the prevalence and mortality of ASCVD.Data show that the rise in obesity in recent years has increased the risk of cardiovascular disease and death.Previous studies have shown that the main cause of obesity or overweight disease is the accumulation of visceral adipose tissue,and visceral adipose tissue is an important risk factor for atherosclerotic cardiovascular disease.METS-VF(Metabolic Score for Visceral Fat)has recently been proposed as a measure of Visceral Fat,and the purpose of this study was to investigate whether METS-VF could predict the risk of atherosclerotic cardiovascular disease.Methods This study is based on the " The Northeast China Rural Cardiovascular Health Study(NCRCHS)",a prospective study conducted from 2013 to 2018.Three countylevel cities,three towns,and 26 villages located in the east,south,and north of Liaoning Province were selected by stratified random cluster sampling method.A total of 11,956 resident villagers,aged over 35,were recruited,excluding those with ASCVD events,pregnancy or recent pregnancy plan,malignant tumor or mental illness,and 8930 of them signed the informed consent voluntarily.The enrolled subjects were required to undergo physical measurement,questionnaire survey,and blood collection.Subsubjects were followed up in 2018 to collect new ASCVD events,including non-fatal acute myocardial infarction,fatal or non-fatal stroke,and fatal coronary heart disease,and the date of each event was recorded.Subjects were divided into four groups based on the baseline METS-VF interquartile range.The Cox risk prediction model of ASCVD was constructed to calculate the risk ratio of ASCVD events in different METS-VF groups after the adjustment of various factors.The adjustment factors include Gender,age,family income level,education level,smoking status,alcohol consumption status,family history of coronary heart disease and stroke,triglyceride(TG),high-density lipoprotein cholesterol(HDL),fasting plasma glucose(FPG),body mass index(BMI),and metabolic score for insulin resistance(METS-IR),etc.The receiver operating characteristic curve(ROC)of different indicators was plotted,and the METS-VF was compared with other indicators.IBM SPSS 22.0 software and Medcalc software were used for data analysis in this study.In statistical analysis,the difference was statistically significant,and the requirement was p < 0.05.Results A total of 8190 people were eventually included in this study,with a median follow-up of 4.66 years.A total of 420 events of ASCVD occurred,with an overall incidence of 125.84 per 10,000 person-years,with a 95% confidence interval(113.88-137.80).By grouping METS-VF,the incidence increased with the increase of METSVF.Male incidence was 127.80,with a 95% confidence interval(110.11-145.49),and female incidence was 124.14,with a 95% confidence interval(107.91-140.37).Overall,the male incidence was higher than the female incidence.After adjusting for confounding factors,Cox regression model analysis results showed that compared with METS-VF ≤6,the risk of ASCVD events in subjects who are 6<METS-VF≤6.47,6.47<METS-VF≤6.84,and METS-VF>6.84 increased by 41%,46%,and 83%respectively [HR=1.41(1.02-1.95),1.46(1.07-1.99),1.825(1.31-2.55)].Compared with BMI(AUC=0.530),WHTR(AUC=0.576),TG(AUC=0.569),FPG(AUC=0.563),HDL-C(AUC=0.519),LAP(AUC=0.572)and VAI(AUC=0.555),MET-VF(AUC=0.608)can better identify the occurrence probability of ASCVD events.Conclusion This study found that METS-VF is an independent predictor of ASCVD events.Due to its advantages of easy access to indicators and easy calculation,the risk of ASCVD can be known only through simple assessment,which is conducive to the implementation of individualized prevention and intervention,to reduce the incidence of ASCVD events.