# The metabolic score for visceral fat and risk of peripheral arterial disease in hypertension patients: a prospective cohort study

## TL;DR

This study found that a higher metabolic score for visceral fat increases the risk of peripheral artery disease in hypertensive patients, especially in non-smokers.

## Contribution

The study reveals a saturation effect of the METS-VF score on PAD risk in hypertensive patients.

## Key findings

- Each 1-unit increase in METS-VF raised the risk of PAD by 21.0% in fully adjusted models.
- A saturation effect was observed at METS-VF of 8.63, with no significant risk increase beyond this point.
- The association between METS-VF and PAD was stronger in non-smokers than in smokers.

## Abstract

The Metabolic Score for Visceral Fat (METS - VF), a novel metric for evaluating visceral adipose tissue, has been demonstrated to exhibit a significant correlation with an elevated cardiovascular risk. Nevertheless, its relationship with peripheral artery disease (PAD) remains ambiguous. Consequently, the present study aimed to explore the association between METS-VF and PAD.

This prospective study was based on a Chinese H-type hypertension cohort, comprising 6,452 patients. The association between METS-VF and PAD was evaluated using the Cox proportional hazards regression analysis and the method of restricted cubic splines (RCS). During an median follow-up time of 3.9 years, 266 PAD events occurred. The mean age of all participants was 63.20 ± 8.38 years. In the fully adjusted model, each 1-unit increase of METS-VF raised the risk of PAD by 21.0% (HR = 1.21, 95%CI: 1.07, 1.37). There was a saturation effect of METS-VF with an inflection point of 8.63 on PAD. For METS-VF < 8.63, each unit increase was associated with a 69.0% higher risk of PAD (HR=1.69, 95%CI: 1.32–2.16), while for METS-VF ≥8.63, there was no significant association between them (HR=0.93, 95%CI: 0.73–1.19) (P for log-likelihood ratio test= 0.002). Subgroup analysis further showed a significant interaction between METS-VF and current smoking status (P for interaction<0.05), with a stronger association observed in non-smokers.

METS-VF exhibited a saturation effect on PAD in hypertensive adults in China. Increased METS-VF was positively associated with a higher risk of PAD among hypertensive adults with METS-VF < 8.63, and this association was more pronounced in non-smokers.