The Journal of Practical Medicine ›› 2026, Vol. 42 ›› Issue (18): 3278-3288.doi: 10.3969/j.issn.1006-5725.2026.18.006

• Chronic Disease Control • Previous Articles    

Association between metabolic score for visceral fat and heart failure in individuals with diabetes or prediabetes: NHANES 1999-2018

Ning Kang, Ying Zhang()   

  1. Department of Cardiology,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Southern Medical University,Guangzhou 510080,Guangdong,China
  • Received:2026-06-01 Revised:2026-07-23 Accepted:2026-07-24 Online:2026-09-25 Published:2026-10-19
  • Contact: Ying Zhang
  • About author:

    Kang Ning designed the study, developed the study model, performed the statistical analyses, and prepared the manuscript. Zhang Ying provided expert guidance throughout the study design and implementation, contributed to manuscript writing and revision, conceived the study, and supervised the overall study. All authors read and approved the final manuscript as submitted.

Abstract:

Objective This study aimed to investigate the association between metabolic score for visceral fat (METS-VF) and the risk of heart failure (HF) in adults with diabetes or prediabetes. Methods Based on data from the National Health and Nutrition Examination Survey (NHANES) in the United States from 1999 to 2018, adults aged ≥ 20 years with diabetes or prediabetes were included. Participants were grouped according to their METS-VF quartiles. Multivariate logistic regression analysis was used to analyze the association between METS-VF and HF. Restricted cubic spline (RCS), subgroup, and receiver operating characteristic (ROC) curve analyses were further performed. Results A total of 12 090 participants were included, of whom 504 had HF. Higher METS-VF was significantly associated with HF [highest quartile vs. lowest quartile: OR = 2.998, 95%CI: 1.645 ⁃ 5.465, P < 0.001]. RCS analysis showed a significant non-linear relationship between METS-VF and HF (overall P < 0.001, non-linear P < 0.05), with a potential inflection point of 7.024. Subgroup analysis revealed a significant interaction in individuals with a history of cancer or myocardial infarction (interaction P < 0.05). ROC curve analysis showed that METS-VF achieved an AUC of 0.701 (95%CI: 0.677 ⁃ 0.724) for identifying HF, outperforming METS-IR and WHtR. Conclusions In adults with diabetes or prediabetes, higher METS-VF is significantly associated with HF, and a non-linear threshold effect exists. METS-VF may serve as a practical indicator for identifying individuals with HF.

Key words: metabolic score for visceral fat, heart failure, diabetes, prediabetes, NHANES

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