Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, China.
Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, 130 Dong'an Road, Shanghai, 200032, China.
Atherosclerosis. 2024 Oct;397:118585. doi: 10.1016/j.atherosclerosis.2024.118585. Epub 2024 Aug 30.
Poor cardiovascular-kidney-metabolic (CKM) health is a major determinant of all-cause mortality, which poses a significant burden on global public health systems and socio-economics. However, the association between different stages of CKM syndrome and the risk of all-cause mortality remains unclear. This study aimed to evaluate the association between different stages of CKM syndrome and risk of all-cause mortality.
A total of 97,777 adults from the Kailuan Study were included. Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) of all-cause mortality according to different stages of CKM syndrome.
Over a median follow-up of 15.0 (14.7-15.2) years, we identified 14,805 all-cause mortality cases. The stage of CKM syndrome was positively associated with the risk of all-cause mortality (p-trend <0.001). Compared with Stage 0, the multivariable-adjusted HRs (95 % CIs) of all-cause mortality were 1.24 (1.06-1.45) for Stage 1, 1.72 (1.48-2.00) for Stage 2, 2.58 (2.22-3.01) for Stage 3 and 3.73 (3.19-4.37) for Stage 4. Moreover, the observed associations were more pronounced in younger adults (aged <60 years) compared with older adults (p for interaction <0.001).
Our data showed that a higher stage of CKM syndrome was associated with a higher risk of all-cause mortality, with a particularly pronounced association observed in younger adults. The study emphasized the need for targeted public health strategies and clinical management tailored to the stages of CKM syndrome, aiming to alleviate its burden on individuals and healthcare systems.
心血管-肾脏-代谢（CKM）健康不良是全因死亡率的主要决定因素，这对全球公共卫生系统和社会经济造成了重大负担。然而，CKM 综合征的不同阶段与全因死亡率的风险之间的关联尚不清楚。本研究旨在评估 CKM 综合征的不同阶段与全因死亡率风险之间的关系。
共纳入来自开滦研究的 97777 名成年人。应用 Cox 比例风险回归模型，根据 CKM 综合征的不同阶段，估计全因死亡率的风险比（HRs）和 95%置信区间（CIs）。
在中位随访 15.0（14.7-15.2）年期间，我们共确定了 14805 例全因死亡病例。CKM 综合征的阶段与全因死亡率的风险呈正相关（p 趋势<0.001）。与阶段 0 相比，多变量调整后的全因死亡率 HR（95%CI）在阶段 1 为 1.24（1.06-1.45），阶段 2 为 1.72（1.48-2.00），阶段 3 为 2.58（2.22-3.01），阶段 4 为 3.73（3.19-4.37）。此外，在年龄较小（<60 岁）的成年人中，观察到的相关性比年龄较大（≥60 岁）的成年人更为明显（交互作用 p<0.001）。
我们的数据表明，CKM 综合征的较高阶段与全因死亡率的风险增加相关，在年龄较小的成年人中观察到的相关性更为明显。该研究强调需要针对 CKM 综合征的各个阶段制定有针对性的公共卫生策略和临床管理，以减轻其对个人和医疗保健系统的负担。
