Abstract
BackgroundThe metabolic score for visceral fat (METS-VF), which integrates measures of visceral adiposity, insulin resistance, and demographic variables, serves as a composite indicator of metabolic health. However, the association between METS-VF and atrial fibrillation (AF) risk is unclear. This study aimed to investigate the prospective association between METS-VF and incident AF within the UK Biobank cohort.MethodsA total of 400,668 participants from the UK Biobank were included in the analysis. Flexible parametric survival models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between METS-VF and AF incidence. Additional subgroup and sensitivity analyses were conducted to evaluate the consistency of the results.ResultsOver a cumulative follow-up of 62,789,030 person-months, 28,764 individuals were diagnosed with AF. In multivariable-adjusted models, elevated METS-VF levels were significantly associated with a heightened risk of AF, with an adjusted HR of 1.38 (95% CI, 1.34-1.42). When stratified by METS-VF quartiles, the adjusted HRs for the second, third, and fourth quartiles were 1.08 (95% CI, 1.03-1.12), 1.14 (95% CI, 1.09-1.19), and 1.44 (95% CI, 1.37-1.50), respectively (P for trend < 0.001). The association remained stable across multiple sensitivity analyses.ConclusionsElevated METS-VF is independently linked to a greater risk of incident AF. These findings underscore the potential utility of METS-VF as a clinical marker for early identification of individuals at elevated AF risk, supporting its role in targeted prevention and personalized cardiovascular risk management.Clinical trial numberNot applicable.