Associations of Cardiovascular-Kidney-Metabolic Syndrome with Premature Mortality and Life Expectancies in US Adults: A Cohort Study.

IF 2.9 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiorenal Medicine Pub Date : 2025-01-01 Epub Date: 2025-07-01 DOI:10.1159/000546618

Lubi Lei, Jingkuo Li, Wenbo Ding, Wei Wang, Yanwu Yu, Boxuan Pu, Yue Peng, Lihua Zhang, Yuanlin Guo

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Abstract

Background: The American Heart Association has recently updated the Cardiovascular-Kidney-Metabolic (CKM) Health Advisory, proposing a new framework for defining, staging, and predicting CKM risk. However, the prevalence and adverse effects of the CKM stages remain insufficiently characterized.

Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) (1999-2018), including 18,350 US adults aged 20-79 years. CKM syndrome encompasses subclinical or clinical cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic risk factors. The participants were categorized into 4 CKM stages based on their clinical severity. We assessed associations of CKM stages with mortality risk and life expectancy.

Results: Only 12.9% of participants were classified as having CKM stage 0. The prevalence of CKM stages 1, 2, 3, and 4 was 23.1%, 53.6%, 3.6%, and 6.7%, respectively. Compared with CKM stage 0, individuals in stage 4 had a markedly higher risk of all-cause mortality (HR: 4.30, 95% CI: 2.95-6.26) and lost 15.5 (12.5-19.8) years of life at age 50 years. Sex and racial/ethnic disparities were also observed.

Conclusions: A higher CKM stage was strongly associated with increased mortality and reduced life expectancy. Our findings underscore the urgent need for enhanced CKM health management, social support, and policy intervention.

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心血管-肾-代谢综合征与美国成人过早死亡率和预期寿命的关系：一项队列研究

背景：美国心脏协会最近更新了心血管-肾脏-代谢（CKM）健康咨询，提出了一个定义、分期和预测CKM风险的新框架。然而，CKM分期的患病率和不良反应仍然没有充分的特征。方法：我们分析了美国国家健康与营养检查调查（NHANES）（1999-2018）的数据，其中包括18350名20-79岁的美国成年人。CKM综合征包括亚临床或临床心血管疾病（CVD）、慢性肾脏疾病（CKD）和代谢危险因素。参与者根据其临床严重程度分为4个CKM阶段。我们评估了CKM分期与死亡风险和预期寿命的关系。结果：只有12.9%的参与者被归类为CKM 0期。CKM 1、2、3、4期患病率分别为23.1%、53.6%、3.6%、6.7%。与CKM 0期相比，CKM 4期患者的全因死亡率（HR: 4.30, 95% CI: 2.95-6.26）明显更高，50岁时寿命减少15.5（12.5-19.8）年。还观察到性别和种族/族裔差异。结论：较高的CKM分期与死亡率增加和预期寿命缩短密切相关。我们的研究结果强调了加强CKM健康管理、社会支持和政策干预的迫切需要。

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

Cardiorenal Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-UROLOGY & NEPHROLOGY

CiteScore

5.40

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The journal ''Cardiorenal Medicine'' explores the mechanisms by which obesity and other metabolic abnormalities promote the pathogenesis and progression of heart and kidney disease (cardiorenal metabolic syndrome). It provides an interdisciplinary platform for the advancement of research and clinical practice, focussing on translational issues.