Metabolism Score for Visceral Fat (METS-VF): A New Predictive Surrogate for CKD Risk

Figures & data

Figure 1 Flowchart for the selection of study subjects.

Abbreviations: ACR, urinary microalbumin to creatinine ratio; SCR, serum creatinine; CKD, chronic kidney disease; METS-VF, Metabolism Score for Visceral Fat.

Table 1 Clinical and Demographic Characteristics of Participants

Variable	Non-CKD (N=528)	CKD (N=103)	P value
Age (years)	52.65±11.39	64.74±11.07	P<0.001
Male, n (%)	256(84.49)	47(15.51)	0.596
High school or higherer (%)	235(90.04)	26(9.96)	P<0.001
Current smoking, n (%)	73(90.12)	8(9.88)	0.093
Current alcohol use, n (%)	39(92.86)	3(7.14)	0.096
Physical activity, n (%)	286(80.11)	71(19.89)	0.006
Obesity, n (%)	202(38.26)	54(52.43)	0.007
Diabetes, n (%)	38(7.20)	16(15.53)	0.006
Hypertension, n(%)	222(42.05)	76(73.39)	P<0.001
SBP(mmHg)	129.65±17.63	145.91±19.68	P<0.001
DBP(mmHg)	82.24±10.82	86.4±9.99	P<0.001
FPG(mmol/L)	4.91(4.6–5.33)	5.12(4.78–5.67)	0.001
FINS(mU/l)	8.86(6.56–12.1)	9.57(7.25–14.4)	0.025
TG(mmol/L)	1.24(0.91–1.77)	1.53(1.09–2.34)	P<0.001
TC(mmol/L)	5.4±1.01	5.57±1.03	0.137
LDL-C(mmol/L)	3.22±0.87	3.28±0.92	0.565
HDL-C (mmol/L)	1.53±0.33	1.47±0.35	0.083
SCR (umol/L)	78(69–90)	89(78–110)	P<0.001
eGFR(mL/min/1.73m^2)	84.11(75.26–94.18)	59.33(54.09–81.39)	P<0.001
ACR (mg/g)	0.99(0.67–1.48)	4.07(1.6–6.41)	P<0.001
hs-CRP(mg/L)	2.2±5.18	3.1±6.19	0.117
SOD(U/L)	153.78±15.59	151.11±14.87	0.109
BMI(kg/m^2)	24.05±3.35	25.06±3.39	0.005
WC(cm)	84.54±9.84	87.93±9.95	0.001
WHtR	0.52±0.06	0.56±0.06	P<0.001
HOMA-IR	1.98(1.39–2.84)	2.35(1.57–3.72)	0.004
METS-IR	6.71±0.8	7.04±0.97	P<0.001
VAI	1.3(0.87–2.04)	1.76(1.08–2.94)	P<0.001
METS-VF	6.15(5.7–6.51)	6.51(6.22–6.77)	P<0.001

Abbreviations: CKD, chronic kidney disease; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; FINS, fasting insulin; TG, triglycerides; TC, total cholesterol; LDL-C, low density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; SCR, serum creatinine; eGFR, estimated glomerular filtration rate; ACR, urinary microalbumin to creatinine ratio; hs-CRP, high-sensitivity C-reactive protein; SOD, superoxide dismutase; BMI, body mass index; WC, waist circumference; WHtR, waist-to-height ratio; HOMA-IR, homeostatic model assessment of insulin resistance; METS-IR, Metabolic Score for Insulin Resistance; VAI, Visceral Adiposity Index; METS-VF, Metabolism Score for Visceral Fat.

Table 2 Multivariable Logistic Regression to Analyze the Correlation Between Metabolic Score for Visceral and CKD Risk

	Quartile 1	Quartile 2	Quartile 3	Quartile 4	P Trend	Per 1-SD
Range	≤5.75	5.75–6.23	6.23–6.56	>6.56
Incidence rate (%)	6.37(2.51–10.23)	10.06(5.34–14.79)	19.48(13.15–25.81)	29.19(22.09–36.29)
Model 1^a	1 (Ref)	1.64(0.72–3.75)	3.56(1.67–7.56)	6.06(2.94–12.51)	P<0.001	2(1.58–2.54)
Model 2^b	1 (Ref)	1.52(0.66–3.49)	3.29(1.53–7.07)	5.81(2.78–12.14)	P<0.001	2(1.56–2.55)
Model 3^c	1 (Ref)	1.19(0.5–2.79)	1.91(0.85–4.27)	3.04(1.39–6.64)	0.001	1.58(1.21–2.06)

Notes: ^aUnadjusted. ^bAdjusted for education level, tobacco and alcohol consumption, physical activity. ^cAdjusted for education level, tobacco and alcohol consumption, physical activity level, SBP, DBP, hs-CRP, SOD.

Abbreviations: Ref, reference; SBP, systolic blood pressure; DBP, diastolic blood pressure; hs-CRP, high-sensitivity C-reactive protein; SOD, superoxide dismutase.

Figure 2 Subgroup analyses of the association between metabolic score for visceral fat and CKD risk.

Abbreviations: OR, odd ratios; CI, confidence interval; METS-VF, Metabolism Score for Visceral Fat.

Table 3 Comparison of Values for Area Under the Receiver Operating Characteristic Curve for METS-VF, WHtR, VAI, HOMA-IR, and BMI with CKD Risk

	AUC (95% CI)	Cutoff value	Sensitivity%	Specificity%	Youden Index	P-value
METS-VF	0.692(0.654–0.728)	6.432	60.19	71.02	0.3122	<0.001
WhtR	0.652(0.613–0.689)	0.545	58.25	66.48	0.2473	<0.001
VAI	0.626(0.587–0.664)	1.371	70.87	53.03	0.2390	<0.001
HOMA-IR	0.589(0.549–0.628)	3.491	32.04	84.47	0.1651	0.005
BMI	0.585(0.545–0.623)	23.833	65.05	50.38	0.1543	0.005

Abbreviations: METS-VF, Metabolism Score for Visceral Fat; WHtR, waist-to-height ratio; VAI, Visceral Adiposity Index; HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index.

Figure 3 Comparison of the correlation between METS-VF, WHtR, VAI, HOMA-IR, and BMI and CKD risk.

Abbreviations: METS-VF, Metabolism Score for Visceral Fat; WHtR, waist-to-height ratio; VAI, Visceral Adiposity Index; HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index.