Global Burden of the Key Components of Cardiovascular-Kidney-Metabolic Syndrome.

IF 10.3 1区医学 Q1 UROLOGY & NEPHROLOGY

Journal of The American Society of Nephrology Pub Date : 2025-03-05 DOI:10.1681/ASN.0000000658

Zhaomin Xie, Chaolun Yu, Qingmei Cui, Xirui Zhao, Juncheng Zhuang, Shiqun Chen, Haixia Guan, Jie Li

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引用次数: 0

Abstract

Background: Cardiovascular-kidney-metabolic (CKM) syndrome highlights the interconnected nature of metabolic diseases, CKD, and cardiovascular diseases, representing a significant and growing public health burden. This study aimed to quantify the global burden of CKM syndrome by examining its key components, including high body mass index, diabetes, CKD, atrial fibrillation and flutter, lower extremity peripheral arterial disease, ischemic heart disease, and stroke.

Methods: Data were derived from the Global Burden of Disease 2021 platform, which provided estimates for incidence, prevalence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs). A decomposition analysis was performed to assess the contributions of population growth, aging, and epidemiologic changes to the burden of CKM syndrome. A NORDPRED model was used to project future trends in DALYs, years of life lost, and years lived with disability through 2046.

Results: Globally, ischemic heart disease and stroke were the major contributors to the CKM syndrome–related burden in 2021. Regions with a middle sociodemographic index (SDI), such as Southeast Asia and the Western Pacific, experienced the largest burden. However, age-standardized DALY rates were inversely related to SDI, with regions of lower SDI exhibiting higher rates. From 1990 to 2021, DALYs for the seven key components of CKM syndrome increased, primarily driven by population growth and aging. However, age-standardized DALY rates varied across components, with stroke (−38.7% [95% uncertainty interval: −43.4% to −34.0%]), peripheral arterial disease (−30.1% [−33.5% to −27.2%]), and ischemic heart disease (−28.8% [−32.5% to −25.2%]) showing a declining trend, whereas diabetes (38.2% [29.7%–47.0%]) and high body mass index (25.5% [16.6%–33.7%]) exhibited an increasing trend. Further projection analysis suggested a consistent trend in the changes in CKM syndrome–related burden from 2022 to 2046, with increases ranging from 55.9% for stroke to 105.7% for atrial fibrillation and flutter.

Conclusions: The findings of this study highlight the substantial and growing CKM syndrome–related burden.

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心血管-肾-代谢综合征关键成分的全球负担。

背景：心血管-肾-代谢（CKM）综合征强调了代谢性疾病、慢性肾脏疾病和心血管疾病之间的相互联系，代表了一个重要的和日益增长的公共卫生负担。本研究旨在通过检查CKM综合征的关键组成部分，包括高体重指数（BMI）、糖尿病、慢性肾脏疾病、心房颤动和扑动、下肢外周动脉疾病、缺血性心脏病和中风，来量化CKM综合征的全球负担。方法：数据来自全球疾病负担（GBD） 2021平台，该平台提供了发病率、患病率、死亡率、残疾生存年数（YLDs）、生命损失年数（YLLs）和残疾调整生命年（DALYs）的估计。采用分解分析来评估人口增长、老龄化和流行病学变化对慢性肾病综合征负担的影响。采用NORDPRED模型预测到2046年DALYs、YLLs和YLDs的未来趋势。结果：在全球范围内，缺血性心脏病和中风是2021年CKM综合征相关负担的主要贡献者。社会人口指数（SDI）处于中等水平的地区，如东南亚和西太平洋，负担最重。然而，年龄标准化的DALY率与SDI呈负相关，SDI较低的地区表现出较高的比率。从1990年到2021年，CKM综合征7个关键组成部分的DALYs增加，主要受人口增长和老龄化的推动。然而，年龄标准化DALY率在各组成部分之间存在差异，卒中（-38.7%[95%不确定区间（UI）： -43.4%至-34.0%]）、外周动脉疾病（-30.1%[-33.5%至-27.2%]）和缺血性心脏病（-28.8%[-32.5%至-25.2%]）呈下降趋势，而糖尿病（38.2%[29.7%至47.0%]）和高BMI（25.5%[16.6%至33.7%]）呈上升趋势。进一步的预测分析表明，从2022年到2046年，CKM综合征相关负担的变化趋势是一致的，从卒中的55.9%到房颤和扑动的105.7%。结论：本研究的结果强调了CKM综合征相关负担的实质性和不断增长，强调了迫切需要全面和有针对性的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of The American Society of Nephrology 医学-泌尿学与肾脏学

CiteScore

22.40

自引率

2.90%

发文量

492

审稿时长

3-8 weeks

期刊介绍： The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews. Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication. JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.