Association between metabolic score for visceral fat and incident diabetes mellitus in middle-aged and older Chinese adults: A prospective cohort study.

BACKGROUND: The association between Metabolic Score for Visceral Fat (METS-VF) and incident diabetes mellitus remains controversial. In this study, we examined this association in a middle-aged and older Chinese population. METHODS: We analyzed 7,606 participants (median age: 58years) from the China Health and Retirement Longitudinal Study. Associations between METS-VF and incident diabetes mellitus were assessed using Cox proportional hazards models to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Subgroup and sensitivity analyses were conducted to assess the robustness. RESULTS: During a median of 9.00 years of follow-up, 1,219 incident cases of diabetes mellitus occurred. After adjustment for potential confounders, METS-VF was positively associated with the risk of incident diabetes mellitus (per additional SD increase: HR = 1.38, 95 % CI: 1.23-1.54). A nonlinear dose-response association of METS-VF with risk of diabetes mellitus was observed (P overall < 0.001 and P nonlinear < 0.001). Similar significant associations were observed in the subgroup analyses by age and sex at baseline, and sensitivity analyses were consistent with the primary analysis. CONCLUSIONS: Higher METS-VF was associated with an increased risk of incident diabetes mellitus in a middle-aged and older Chinese population, as a potential tool for monitoring and guiding primary prevention strategies.