Objective:

To investigate the relationship between METS-VF profiles and the incidence of cardiovascular disease (CVD) in adults with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–3, and to quantify the mediating role of estimated glucose disposal rate (eGDR).

Key Findings:

• METS-VF is a superior predictor of CVD risk compared to traditional metrics in CKM syndrome, suggesting a need for its integration into clinical practice.
• The relationship between METS-VF and CVD incidence varies across CKM syndrome stages, indicating tailored approaches may be necessary.
• eGDR mediates the relationship between METS-VF and CVD, highlighting the role of insulin sensitivity in cardiovascular risk management.

Interpretation:

The findings suggest that METS-VF is a valuable tool for assessing CVD risk in CKM syndrome, with implications for targeted interventions based on disease stage, potentially improving patient outcomes.

Limitations:

• The study is observational and cannot establish causation.
• Data on CVD events were self-reported, which may introduce bias and affect the reliability of the findings.
• The analysis is limited to a specific population, which may affect generalizability.

Conclusion:

METS-VF effectively predicts CVD risk in CKM syndrome, emphasizing the importance of monitoring visceral fat and insulin sensitivity in clinical practice.