Evidence map›Paper›PMID 41650110›Full record

ArticleEndocrinology, diabetes & metabolism2026

Associations of Multimarkers of Metabolic Malnutrition and Inflammation With All-Cause Mortality and Their Interplay With Thyroid Function.

Setor K Kunutsor, Reyhaneh Rikhtehgaran, Yanning Xu, Margery A Connelly, Irina Shalaurova, Layal Chaker, Stephan J L Bakker, Robin P F Dullaart

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In one paragraph

Article in Endocrinology, diabetes & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Setor K KunutsorSection of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID https://orcid.org/0000-0002-2625-0273
Reyhaneh RikhtehgaranSection of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Yanning XuDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.
Margery A ConnellyLabcorp, Morrisville, North Carolina, USA.
Irina ShalaurovaLabcorp, Morrisville, North Carolina, USA.
Layal ChakerDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.
Stephan J L BakkerDepartment of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Robin P F DullaartDepartment of Internal Medicine, Division of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe metabolic vulnerability index (MVX)-a composite biomarker reflecting metabolic malnutrition and inflammation-has been linked to increased mortality risk in populations with cardiovascular disease. Thyroid function, a key regulator of metabolism and inflammation, may confound or modify this relationship, but evidence in the general population is limited.

objectivesTo evaluate the interplay between MVX and its subcomponents (inflammation vulnerability index, IVX and metabolic malnutrition index, MMX), thyroid function, and mortality risk in the general population.

methodsIn the PREVEND prospective study, which included 5446 participants (mean age 54 years; 49.9% male), both MVX (estimated using six metabolites measured simultaneously through nuclear magnetic resonance spectroscopy) and thyroid function (FT3, FT4, TSH) were evaluated at baseline. Hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality were estimated.

resultsDuring a median follow-up of 14.1 years, 806 deaths were recorded. Spline analyses showed graded dose-response relationships of MVX, IVX and MMX with mortality risk. In separate analyses adjusted for several established risk factors, the HRs (95% CIs) of mortality were 1.28 (1.18-1.38), 1.23 (1.14-1.32) and 1.16 (1.07-1.25) per 1 standard deviation increment in MVX, IVX and MMX, respectively. The HRs remained consistent on further adjustment for FT3, FT4 and TSH. Sex as well as levels of FT3, FT4 and TSH did not significantly modify the associations.

conclusionsThe MVX and its subcomponents (IVX and MMX) are independently associated with all-cause mortality, consistent with graded dose-response relationships. Thyroid function does not confound or modify these associations.

Indexed as

BiomarkersInflammationMalnutritionThyroid GlandFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRisk FactorsThyroid Function TestsThyrotropinBiomarkersThyrotropinautoimmunitycohort studyinflammationmalnutritionmetabolic vulnerability indexmortalitythyroid function

Identifiers

PMID41650110
PMCPMC12880609

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.