Abstract
With the increasing prevalence of hypertension, studying the relationship between hypertension and metabolism-related diseases has become particularly important. However, no research has yet investigated the association between metabolic scores in hypertensive patients and cardiometabolic multimorbidity. This article explores the relationship between the Metabolic Score for Visceral Fat (METS-VF), the Metabolic Score for Insulin Resistance (METS-IR), the Cardiometabolic Index (CMI), and the risk of Cardiometabolic Multimorbidity (CMM) in hypertensive patients, providing a theoretical basis for their health management. Using cluster random sampling, 16,303 workers aged 18 to 70 with a working duration of ≥ 1 year from 6 oilfield bases in Karamay City were selected to collect general data. The relationship between metabolic scores and the risk of CMM in hypertensive patients was analyzed using a Logistic regression model combined with restricted cubic spline curves, and further subgroup interaction analysis was conducted to identify potential influencing factors. In addition, the predictive value for CMM was assessed using covariate-adjusted receiver operating characteristic (ROC)curves.Finally, three sensitivity analyses were performed. (1) The study included a total of 16,303 patients with hypertension, among whom 5,988 had CMM, with a prevalence rate of 36.7%. Compared to the non-CMM group, the CMM group showed statistically significant differences in gender, age, smoking, alcohol consumption, BMI, waist circumference, FPG, TC, TG, LDL-C, UA, BUN, ALT, AST, and HDL levels (all P < 0.05). (2) Logistic regression and dose-response relationship: After controlling for confounding factors, the results showed that higher METS-VF, METS-IR, and CMI were all risk factors for CMM, with odds ratios of 3.11 (95% CI: 2.78 ~ 3.49), 7.89 (95% CI: 6.76 ~ 9.22), and 11.51 (95% CI: 9.97 ~ 13.29), respectively (all P for trend < 0.05). Notably, there was a non-linear dose-response relationship between METS-VF, METS-IR, CMI, and the risk of CMM (all P for non-linearity < 0.001). (3) The subgroup interaction analysis results showed a consistent relationship between the three metabolic scores and CMM patients with different stratification variables. It was also found that there were interactions between these three scores and gender, age, smoking, alcohol consumption, and BMI. (4) The adjusted ROC curve results showed that the AUCs for METS-VF, METS-IR, and CMI were 0.803, 0.840, and 0.821, respectively (all P < 0.05), indicating that these indices have good predictive value in identifying the risk of cardiometabolic comorbidities. METS-VF, METS-IR, and CMI exhibit complex interactions with the prevalence of CMM in hypertensive patients, leading to an increased risk of CMM and demonstrating good predictive ability for cardiometabolic comorbidities, which suggests their potential utility in the early prevention and intervention of cardiometabolic comorbidities.