Cardiovascular Indexes and Oxidative Balance in Advanced Cardiovascular–Kidney–Metabolic Syndrome

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2025-07-29 DOI:10.1002/oby.24356

Zhaoqi Yan, Xiangyi Pu, Xing Chang, Ruxiu Liu

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引用次数: 0

Abstract

Objective

The cardiovascular–kidney–metabolic (CKM) syndrome lacks clear strategies for risk reduction.

Methods

This study utilized data from NHANES focusing on adults with CKM. Participants were categorized into early and advanced CKM. A multivariable logistic regression model evaluated the relationship between oxidative balance score (OBS) levels—total, dietary, and lifestyle—and advanced CKM. The mediating effects of cardiovascular indexes, atherogenic index of plasma (AIP), and cardiac metabolic index (CMI) were also analyzed. The SHapley Additive exPlanations (SHAP) in machine learning interpret the importance of indexes' components.

Results

Higher OBS levels were significantly associated with a lower risk of advanced CKM. Specifically, a total OBS ≥ 28 correlated with a 36% reduced risk compared to scores ≤ 16. AIP and CMI were linked to increased advanced CKM risk at levels > 0.56 and > 0.57, respectively. Mediation analysis showed AIP and CMI potentially mediated 0.68% and 4.08% of the OBS-advanced CKM risk association. SHAP highlighted the importance of carotene and niacin.

Conclusions

This study is the first to identify an inverse association between higher OBS and advanced CKM risk, with cardiovascular indexes emerging as potential mediators, which lay the groundwork for future longitudinal and interventional studies to elucidate potential causal pathways.

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晚期心血管-肾-代谢综合征的心血管指标和氧化平衡。

目的：心血管肾代谢综合征（CKM）缺乏明确的风险降低策略。方法：本研究利用NHANES的数据，重点研究成人慢性肾病。参与者被分为早期和晚期CKM。多变量logistic回归模型评估氧化平衡评分（OBS）水平（总体、饮食和生活方式）与晚期CKM之间的关系。并分析心血管指数、血浆动脉粥样硬化指数（AIP）、心脏代谢指数（CMI）的中介作用。机器学习中的SHapley加性解释（SHAP）解释了指标组成部分的重要性。结果：较高的OBS水平与较低的晚期CKM风险显著相关。具体而言，总OBS≥28与评分≤16的风险降低36%相关。AIP和CMI分别在> 0.56和> 0.57水平与晚期CKM风险增加相关。中介分析显示，AIP和CMI分别介导了0.68%和4.08%的obs -晚期CKM风险关联。SHAP强调了胡萝卜素和烟酸的重要性。结论：本研究首次发现较高的OBS与晚期CKM风险之间存在负相关关系，心血管指标可能成为潜在的中介因素，为未来的纵向和介入性研究奠定基础，以阐明潜在的因果途径。

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

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.