ArticleBMC cardiovascular disorders2026
Metabolic vulnerability index increased risk of all-cause mortality among individuals with stage 4 cardiovascular-renal-metabolic syndrome: a prospective cohort study in UK biobank.
Article in BMC cardiovascular disorders, 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
backgroundThe Metabolic Vulnerability Index (MVX), a novel composite marker of inflammation and malnutrition, has an undetermined prognostic value in stage 4 cardiovascular-kidney-metabolic (CKM) syndrome.
objectiveTo investigate the association between MVX and the risk of all-cause mortality among patients with stage 4 CKM syndrome.
methodsWe included 20,927 participants with stage 4 CKM syndrome in the UK Biobank. Sex-specific MVX scores were calculated by aggregating six biomarkers (glycoprotein acetyls (GlycA), small high-density lipoprotein particles (sHDL), valine, leucine, isoleucine, and citrate). We applied Cox proportional-hazards models to investigate the association between MVX and all-cause mortality and evaluated the performance of MVX in predicting mortality.
resultsDuring a median 13.45 years of follow-up (IQR:12.54-14.32 years), a total of 4,613 participants (22.04%) died. The fully adjusted Cox regression model indicated that a graded association between MVX quartiles and all-cause mortality, with the highest MVX quartile showing the greatest risk (HR = 1.67, 95% CI: 1.49-1.87, P < 0.001). A consistent positive association was observed between MVX score and mortality risk at 5, 10, and 15 years (P < 0.05). Subgroup analyses showed that females and individuals with cardiovascular disease (CVD) exhibited a higher mortality risk (P for interaction < 0.001). MVX significantly improved the predictive value of all-cause mortality beyond established risk factors (estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), lipid accumulation Product (LAP)) (Uno's C-statistic: 0.713, 95% CI: 0.705-0.721, P < 0.001).
conclusionsElevated MVX scores were independently associated with higher all-cause mortality risk in stage 4 CKM syndrome, supporting its potential for risk stratification.
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