Yang Qihang, Shi Pengfei, Pan Lanxia, Huang Zongqiang
Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
BMC Cardiovasc Disord. 2025 May 15;25(1):369. doi: 10.1186/s12872-025-04812-7.
Social determinants of health (SDOH) contributed to preventable health inequities. However, association between SDOH and mortality in populations with cardiovascular-kidney-metabolic (CKM) syndrome remain still unclear. This study aims to investigate this association and the influence of SDOH on life expectancy in CKM syndrome populations.
A cohort study using data from the 2001-2018 National Health and Nutrition Examination Survey (NHANES). Participants with incomplete data were excluded.
CKM stages 1-4 were considered as CKM syndrome according to American Heart Association's suggestions. Ten measures of SDOH were assessed, and the combined score of SDOH were calculated as the sum of the weighted scores for each SDOH. Participants were then categorized into 3 groups according to SDOH tertiles. After adjustment for confounders, cox regression models were fitted to investigate the association between SDOH and all-cause mortality. Restricted cubic splines (RCS), subgroup analysis, and interaction analysis were also constructed.
During a median follow-up of 7.33 years (IQR 4.17-10.58), a total of 10,040 participants with CKM syndrome were enrolled. The linear positive association between SDOH and the risk of all-cause mortality was observed. Results were consistent in subgroup analysis and several sensitivity analyses, and interaction analysis showed that this association can be modified by drinking. We also found that unfavorable SDOH correlated with shorter life expectancy compared to favorable SDOH.
Unfavorable SDOH associated with higher risk of all-cause mortality and shorter life expectancy in populations with CKM syndrome, addressing the importance of integrating SDOH into the management of CKM syndrome.
Not applicable.
健康的社会决定因素（SDOH）导致了可预防的健康不平等。然而，SDOH与心血管-肾脏-代谢（CKM）综合征人群死亡率之间的关联仍不明确。本研究旨在调查这种关联以及SDOH对CKM综合征人群预期寿命的影响。
一项队列研究，使用2001 - 2018年国家健康与营养检查调查（NHANES）的数据。排除数据不完整的参与者。
根据美国心脏协会的建议，将CKM 1 - 4期视为CKM综合征。评估了10项SDOH指标，并计算SDOH的综合得分，即每个SDOH加权得分之和。然后根据SDOH三分位数将参与者分为3组。在调整混杂因素后，采用Cox回归模型研究SDOH与全因死亡率之间的关联。还构建了受限立方样条（RCS）、亚组分析和交互作用分析。
在中位随访7.33年（IQR 4.17 - 10.58）期间，共纳入10,040名CKM综合征参与者。观察到SDOH与全因死亡风险之间存在线性正相关。亚组分析和多项敏感性分析结果一致，交互作用分析表明这种关联可因饮酒而改变。我们还发现，与有利的SDOH相比，不利的SDOH与较短的预期寿命相关。
在CKM综合征人群中，不利的SDOH与全因死亡率较高和预期寿命较短相关，这凸显了将SDOH纳入CKM综合征管理的重要性。
不适用。
