{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:14:32Z","timestamp":1788412472429,"version":"build-2803163510"},"reference-count":55,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["058299\/Z\/99"],"award-info":[{"award-number":["058299\/Z\/99"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Visceral adipose tissue (VAT) has been associated with cardiovascular disease (CVD) mortality. However, the comparative performance of VAT\u2010related clinical surrogates remains poorly characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the performance of seven VAT\u2010related clinical surrogates for predicting cause\u2010specific CVD mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed data from the Mexico City Prospective Cohort, a population\u2010based prospective cohort study, with baseline recruitment between 1998 and 2004 and ongoing mortality follow\u2010up. CVD mortality included deaths from cardiac, stroke\u2010related and other vascular causes. Seven VAT\u2010related surrogates (METS\u2010VF, CVAI, EVA, DAAT, LAP, VAI and DAI) were estimated using clinical, biochemical and anthropometric data at baseline. Associations with outcomes were evaluated using Cox regression models to estimate adjusted hazard ratios (aHR). Discrimination was assessed with Harrell's C\u2010statistic (Cs) and calibration with slope plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In a subsample of 102\u2009385 participants without diabetes (median age: 47\u2009years; 67% female) followed through a median of 20.13\u2009years, 4068 (3.97%) died from any CVD causes. An increase in 1\u2010SD unit of METS\u2010VF (Cs: 0.73; aHR: 1.23, 95% CI: 1.18\u20131.29), EVA (Cs: 0.73; aHR: 1.19, 1.15\u20131.24), CVAI (Cs: 0.71; aHR: 1.19, 1.15\u20131.23) and DAAT (Cs: 0.63; aHR: 1.18, 1.14\u20131.23) was associated with CVD mortality and showed the highest predictive capacity and good calibration among the surrogates. Adding METS\u2010VF to the Globorisk score among individuals classified as intermediate risk slightly improved discrimination for CVD mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large cohort of Mexican adults, four VAT\u2010related clinical surrogates, particularly METS\u2010VF, showed good discriminatory performance for long\u2010term CVD mortality. Our results could support future studies that could incorporate VAT estimation to improve CVD risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71095","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:19:24Z","timestamp":1784690364000},"page":"9196-9209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Performance of Seven Clinical Surrogates of Visceral Adipose Tissue for Cardiovascular Mortality: A Sub\u2010Analysis of 102\u2009385 Adults From the Mexico City Prospective Study"],"prefix":"10.1111","volume":"28","author":[{"given":"Jes\u00fas Ernesto","family":"Mart\u00ednez\u2010Luna","sequence":"first","affiliation":[{"name":"Department of Endocrinology Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez  Mexico City Mexico"},{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Fernanda","family":"Su\u00e1rez\u2010Vel\u00e1zquez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez  Mexico City Mexico"},{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario C\u00e9sar","family":"Torres\u2010Ch\u00e1vez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez  Mexico City Mexico"},{"name":"Facultad de Medicina Mexicali, Universidad Aut\u00f3noma de Baja California  Mexicali Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo C.","family":"Cardoso\u2010Salda\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Reyes\u2010Barrera","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Berumen","sequence":"additional","affiliation":[{"name":"Experimental Research Unit Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Kuri\u2010Morales","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"},{"name":"Instituto Tecnol\u00f3gico y de Estudios Superiores de Monterrey  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Tapia\u2010Conyer","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Alegre\u2010D\u00edaz","sequence":"additional","affiliation":[{"name":"Experimental Research Unit Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Ferm\u00edn\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico  Mexico City Mexico"},{"name":"Research Division Instituto Nacional de Geriatr\u00eda  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline A.","family":"Seiglie","sequence":"additional","affiliation":[{"name":"Diabetes Unit Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Yaxmehen","family":"Bello\u2010Chavolla","sequence":"additional","affiliation":[{"name":"Research Division Instituto Nacional de Geriatr\u00eda  Mexico City Mexico"},{"name":"Department of Global Health and Population Harvard T.H. 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