ReviewActa diabetologica2026
Load-capacity index and cardiometabolic risk: a longitudinal meta-analysis.
Review in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsThe load-capacity index (LCI), defined as the ratio of fat mass to fat-free mass, represents a novel composite biomarker integrating metabolic load and functional capacity. This systematic review and meta-analysis aimed to determine the longitudinal association between LCI and incident cardiometabolic disease risk.
methodsWe systematically searched PubMed, Embase, Web of Science, Cochrane Central, and Scopus from inception through January 2026 for longitudinal cohort studies reporting the association between LCI and cardiometabolic outcomes. Random-effects meta-analysis was performed using the DerSimonian-Laird method. Heterogeneity was assessed using Cochran's Q, τ², and I² statistics. Study-specific log(HR) values and standard errors are reported in the Supplementary Material to enable full reproducibility.
resultsEighteen longitudinal cohort studies comprising 129,777 participants and 5647 cardiometabolic events were included (mean follow-up: 11.4 years). Higher LCI was significantly associated with increased cardiometabolic risk (pooled HR = 1.174, 95% CI: 1.145-1.204; p < 0.0001). There was low between-study heterogeneity (I² = 11.6%; Cochran's Q = 19.22, df = 17, p = 0.3159; τ² = 0.000347). The association was consistent across age groups, sex, and body composition assessment methods (p-interaction > 0.05 for all). LCI provided incremental predictive value beyond established risk factors (NRI: 0.15-0.28; ΔC-statistic: 0.025-0.041).
conclusionsHigher LCI is independently and consistently associated with increased cardiometabolic disease risk across diverse populations (HR = 1.174, corresponding to a 17.4% increased risk per unit increase). LCI provides clinically meaningful incremental predictive value and warrants consideration as a robust supplementary tool to guide preventive interventions.
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