2011 - 2018年美国成年人心血管 - 肾脏 - 代谢综合征的患病率、差异及死亡率
Prevalence, Disparities, and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in US Adults, 2011-2018.
作者信息
Kim Ji-Eun, Joo Jungnam, Kuku Kayode O, Downie Carolina, Hashemian Maryam, Powell-Wiley Tiffany M, Shearer Joseph J, Roger Véronique L
机构信息
Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md; Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, South Korea.
Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.
出版信息
Am J Med. 2025 Jun;138(6):970-979.e7. doi: 10.1016/j.amjmed.2025.01.031. Epub 2025 Feb 3.
BACKGROUND
Cardiovascular-kidney-metabolic syndrome reflects the complex interplay between metabolic risk factors, cardiovascular and chronic kidney disease. Differences in disease burden by demographics, social determinants of health, and mortality are not well characterized.
METHODS
Data from adults who completed the National Health and Nutrition Examination Survey between 2011 and 2018 were used to estimate age-adjusted prevalence and 95% confidence intervals (CI) for cardiovascular-kidney-metabolic syndrome stages. Joinpoint regression was used to identify linear trends. Kaplan-Meier curves were used to examine all-cause mortality risk by stages.
RESULTS
Among 8474 adults in the study, the median age was 46.8 years, 49.1% were male, and 65.0% were non-Hispanic White. Age-adjusted prevalence of stages 0-4 were 11.2%, 28.1%, 47.4%, 5.3%, and 8.1%, respectively. The highest proportion of stage 4 was among adults aged ≥60 years, males, and non-Hispanic Black individuals. The advanced stages 3-4 were associated with lower educational attainment, income, and employment and higher mortality with a crude death rate of 188.8 per 1000 person-years.
CONCLUSION
Approximately 13% of adults were in advanced stages, which disproportionately affect non-Hispanic Black adults and increased over time. These results provide a roadmap for targeted intervention strategies.
背景
心血管-肾脏-代谢综合征反映了代谢风险因素、心血管疾病和慢性肾脏病之间复杂的相互作用。关于按人口统计学、健康的社会决定因素和死亡率划分的疾病负担差异，目前尚无充分描述。
方法
利用2011年至2018年期间完成美国国家健康与营养检查调查的成年人数据，估计心血管-肾脏-代谢综合征各阶段的年龄调整患病率和95%置信区间（CI）。采用连接点回归确定线性趋势。使用Kaplan-Meier曲线按阶段检查全因死亡风险。
结果
在该研究的8474名成年人中，年龄中位数为46.8岁，男性占49.1%，非西班牙裔白人占65.0%。0至4期的年龄调整患病率分别为11.2%、28.1%、47.4%、5.3%和8.1%。4期比例最高的是年龄≥60岁的成年人、男性和非西班牙裔黑人个体。3至4期与较低的教育程度、收入和就业率相关，死亡率较高，粗死亡率为每1000人年188.8例。
结论
约13%的成年人处于晚期，这对非西班牙裔黑人成年人影响尤大，且随时间推移有所增加。这些结果为有针对性的干预策略提供了路线图。
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