Frontiers in Medicine · Oct 14, 2026

Cardiometabolic biomarker profiles associated with estimated 10-year ASCVD risk by the China-PAR model in an older adult health examination cohort: a cross-sectional study

By Zhang L, Chen P, Zhou W et al.

OBJECTIVE: To characterize the associations between cardiometabolic biomarker profiles and estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk calculated using the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) equation in adults aged ≥60 years undergoing routine physical examinations. METHODS: Participants aged ≥60 years were recruited from a hospital health examination center. Ten-year ASCVD risk was calculated using the China-PAR equation and classified as low-to-intermediate (<10%) or high (≥10%). Associations between continuous biomarkers and the risk score were assessed using Spearman correlation with false discovery rate correction. Exploratory LASSO logistic regression was used for feature selection for China-PAR-defined high-risk status, followed by mutually adjusted logistic regression and quartile-stratified analyses. RESULTS: A total of 511 participants were included (median age 67 years; 62.8% male), and 191 (37.4%) were classified as high risk by China-PAR. Waist-to-hip ratio (WHR; rho = 0.43), fasting plasma glucose (FPG; rho = 0.40), and cystatin C (CysC; rho = 0.39) showed the strongest correlations with the calculated risk score. Exploratory LASSO feature selection retained CysC, FPG, atherogenic coefficient (AC), and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Per one-standard-deviation increase, FPG [adjusted odds ratio [aOR] = 2.772, 95% confidence interval [CI]: 2.047-3.753] and CysC (aOR = 2.731, 95% CI: 1.881-3.964) showed the strongest associations with China-PAR-defined high-risk status. All four biomarkers showed graded trends across quartiles in the overall population and in descriptive sex-stratified analyses. CONCLUSIONS: CysC, FPG, AC, and NT-proBNP were associated with higher estimated China-PAR risk. Because FPG and AC overlap clinically or mathematically with variables used to construct China-PAR, their associations should be interpreted partly in the context of score construction. CysC and NT-proBNP are not components of the China-PAR equation and warrant prospective evaluation. These findings characterize biomarker profiles associated with higher estimated cardiovascular risk and may help increase clinical awareness of unfavorable cardiometabolic and cardiorenal features during routine health examinations.

doi.org/10.3389/fmed.2026.1897876 Open access PubMed 42952873 Biomarkers