Association between visceral fat metabolism score and atherosclerotic cardiovascular disease: evidence from NHANES 2005 to 2016

Background: Obesity and metabolic disorders are key contributors to the development of atherosclerotic cardiovascular disease (ASCVD). This study sought to investigate the relationship between the newly introduced Metabolic Score for Visceral Fat (METS-VF) and ASCVD, utilizing data from the National Health and Nutrition Examination Survey (NHANES). Methods: Data from NHANES 2005–2016 were analyzed. Adults with complete METS-VF and ASCVD data were included. Weighted multivariate logistic regression models assessed associations between METS-VF and ASCVD. Smoothed curve fitting and subgroup analyses further explored the relationship. Receiver operating characteristic curves were used to compare the predictive performance of METS-VF with other indicators of visceral fat. Results: A total of 9979 participants were included, among whom 807 had ASCVD. In the fully adjusted model, each 1-unit increase in METS-VF was associated with a 43% higher ASCVD risk (OR = 1.43, 95% CI: 1.11–1.85). Compared with Q1, the ORs for Q2, Q3, and Q4 were 1.71, 1.72, and 2.10, respectively ( P for trend <0.05). The curve fitting showed a linear positive association. Subgroup analyses indicated significant associations in men, non-Hispanic Whites and Blacks, and participants without hypertension, who smoked, drank alcohol, or physically inactive. METS-VF showed better predictive ability (AUC = 0.734) than LAP, VAI, WC, and WHtR. Conclusions: METS-VF is a reliable, noninvasive, and cost-effective predictor of visceral obesity that demonstrates a linear positive correlation with ASCVD, supporting its use as an accurate measure of ASCVD risk.