Zheng Congyi, Cai Anping, Sun Muyi, Wang Xin, Song Qingjie, Pei Xuyan, Cao Xue, Tian Yixin, Lip Gregory Y H, Parati Gianfranco, Wang Zengwu, Feng Yingqing, Zhou Zhen
Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, China.
JACC Asia. 2025 Jul;5(7):898-910. doi: 10.1016/j.jacasi.2025.04.007. Epub 2025 Jun 10.
Cardiovascular-kidney-metabolic (CKM) syndrome is a novel staging framework used to evaluate CKM health. The burden of CKM syndrome in China is relatively unknown, and such data may inform future health priority.
The purpose of this study was to assess the prevalence and mortality risk across CKM stages.
Nationally representative populations (n = 33,685) were included from the China Hypertension Survey. The weighted prevalence of each CKM stage was calculated. All-cause, cardiovascular (CV), and non-CV death associated with CKM stages were analyzed using Cox regression analysis. Population attributable fraction (PAF) was calculated to estimate the mortality burden related to each CKM stage.
Between 2012 and 2015, 18.8% of Chinese adults met criteria for stage 0, 15.5% for stage 1, 42.1% for stage 2, 14.7% for stage 3, and 8.9% for stage 4, with advanced stage (stages 3-4) was 23.6%. After 5-year follow-up, compared with stage 0, adjusted HR for all-cause death in stage 1 was 0.77 (95% CI: 0.51-1.15), stage 2 was 1.36 (95% CI: 1.04-1.77), stage 3 was 2.47 (95% CI: 1.91-3.19), and stage 4 was 4.00 (95% CI: 3.07-5.22). Similarly, adjusted HRs for CV death and non-CV death progressively increased from stage 2 to 4 (both P-trend values < 0.001). For all-cause, CV, and non-CV death, PAFs increased with advancing CKM stages. For instance, for all-cause death, PAFs caused by stages 2, 3, and 4 were 13.4%, 18.6%, and 22.0%.
Poor CKM health is widespread in China, underscoring the urgent need for collaborative and comprehensive management strategies to tackle CKM syndrome epidemic.
心血管-肾脏-代谢（CKM）综合征是一种用于评估CKM健康状况的新型分期框架。CKM综合征在中国的负担相对未知，此类数据可能为未来的卫生重点工作提供参考。
本研究旨在评估CKM各阶段的患病率和死亡风险。
纳入中国高血压调查中具有全国代表性的人群（n = 33,685）。计算每个CKM阶段的加权患病率。使用Cox回归分析与CKM阶段相关的全因死亡、心血管（CV）死亡和非CV死亡。计算人群归因分数（PAF）以估计与每个CKM阶段相关的死亡负担。
2012年至2015年期间，18.8%的中国成年人符合0期标准，15.5%符合1期标准，42.1%符合2期标准，14.7%符合3期标准，8.9%符合4期标准，晚期（3-4期）为23.6%。经过5年随访，与0期相比，1期全因死亡的校正风险比（HR）为0.77（95%置信区间：0.51-1.15），2期为1.36（95%置信区间：1.04-1.77），3期为2.47（95%置信区间：1.91-3.19），4期为4.00（95%置信区间：3.07-5.22）。同样，CV死亡和非CV死亡的校正HR从2期到4期逐渐增加（两者P趋势值均<0.001）。对于全因死亡、CV死亡和非CV死亡，PAF随着CKM阶段的进展而增加。例如，对于全因死亡，2期、3期和4期导致的PAF分别为13.4%、18.6%和22.0%。
CKM健康状况不佳在中国普遍存在，这凸显了迫切需要采取协作性和综合性管理策略来应对CKM综合征流行的必要性。
Zotero 插件
