Lipids & metabolic liver disease
LDL-C combined with Chinese visceral adiposity index as a risk stratification tool for cardiometabolic multimorbidity in middle-aged and older Chinese adults: a national prospective cohort study
Authors' conclusion
The VLR index, its non-linear association and mediation mechanisms underscore biological plausibility and utility for refined risk stratification, offering a practical tool for early identification and targeted primary prevention in middle-aged and older adults.
Study context
- Population
- Cardiometabolic Multimorbidity (CMM)-free middle-aged and older Chinese adults, China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 8,813 CMM-free adults
- Exposure
- Higher vs lower Visceral Lipoprotein Risk index
- Outcome
- Incident cardiometabolic multimorbidity (CMM)
- Follow-up
- Median 9 years
Methodological detailsnational, population-based (CHARLS)
- National
- Population-based (CHARLS)
Main finding
As reported in the abstract
Incident CMM
Hazard ratio (95% CI)
Per SD increase in VLRmultivariable-adjusted
1.31(1.24–1.39)
Per SD increase in VLR, as printed
- Highest Visceral Lipoprotein Risk (VLR) quartile vs Lowest VLR quartile
- fold increased risk 3.12 (95% CI 2.39–4.08)
- Participants who developed CMM
- 729 (8.27%)
- Strong, positive, non-linear dose-response relationship (Kaplan-Meier, restricted cubic spline (RCS))
- log-rank P < 0.001
Observational data: associations, not effects.
Further findings
Discrimination of VLR index for CMM
- AUC
- 0.78
Mediation analysis
- White blood cell (WBC) count proportion mediated, individuals free of baseline cardiometabolic disease (CMD)
- 3.17%
- TyG and Atherogenic Index of Plasma (AIP) key mediators in overall population
- HbA1c predominant mediator in obese subgroup
- Subgroup analyses revealed effect heterogeneity
Original publication
LDL-C combined with Chinese visceral adiposity index as a risk stratification tool for cardiometabolic multimorbidity in middle-aged and older Chinese adults: a national prospective cohort study. Cardiovasc Diabetol. Published 26 April 2026. doi:10.
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