Opportunistic screening for incident cardiometabolic disease in metabolically healthy non-obese individuals: a prospective cohort study
Authors' conclusion
The VAT/SAT ratio identifies MHN individuals at elevated cardiometabolic risk beyond conventional anthropometric measures, with particularly strong associations for incident diabetes.
Study context
- Population
- Metabolically healthy non-obese (MHN) UK Biobank participants (BMI < 30 kg/m², no diabetes or concurrent hypertension and hyperlipidemia); VAT and subcutaneous adipose tissue (SAT) quantified from whole-body MRI by deep learning
- Participants
- 22,040 participants
- Exposure
- High vs low VAT/SAT ratio; VAT/SAT ratio vs waist circumference (WC) for risk classification
- Outcome
- Incident major adverse cardiovascular events (MACE)
- Follow-up
- Median 4.2 years [interquartile range 3.4-5.6]
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)P value
High VAT/SAT ratiovs Low VAT/SAT ratioafter full adjustment
1.30(1.02–1.66)
P = 0.037- VAT/SAT ratio vs WC
- Net reclassification improvement (NRI) 0.088 (95% CI 0.019–0.158); P = 0.013
- Fully adjusted model + VAT/SAT vs Fully adjusted model
- C-index 0.694 vs. 0.690; P = 0.036
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Incident T2DHigh VAT/SAT ratiovs Low VAT/SAT ratioAfter full adjustment | 1.77 (1.34–2.33) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Incident T2DVAT/SAT ratio vs WC | NRI 0.102 (95% CI 0.024–0.181) | P = 0.010 |
| Incident T2DFully adjusted model + VAT/SAT vs Fully adjusted model | C-index 0.723 vs. 0.715 | P < 0.001 |
Original publication
Opportunistic screening for incident cardiometabolic disease in metabolically healthy non-obese individuals: a prospective cohort study. Cardiovasc Diabetol. Published 1 July 2026. doi:10.
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