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Joint association of the inflammatory marker and cardiovascular-kidney-metabolic syndrome stages with all-cause and cardiovascular disease mortality: a national prospective study
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Joint association of the inflammatory marker and cardiovascular-kidney-metabolic syndrome stages with all-cause and cardiovascular disease mortality: a national prospective study
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Journal Article
Joint association of the inflammatory marker and cardiovascular-kidney-metabolic syndrome stages with all-cause and cardiovascular disease mortality: a national prospective study
2025
Overview
Background
Cardiovascular-kidney-metabolic (CKM) syndrome and systemic inflammation significantly contribute to mortality. However, the joint associations of CKM stages and systemic inflammation with all-cause and cardiovascular disease (CVD) mortality remain unclear. This study aimed to evaluate the independent and joint associations of CKM stages and systemic inflammation with all-cause and CVD mortality in a representative cohort of United States adults.
Methods
We analyzed data from 29,459 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (1999–2018). CKM stages were classified based on metabolic risk factors, CVD, and chronic kidney disease. Systemic inflammation was assessed using multiple indicators, and time-dependent ROC analysis identified the systemic inflammatory response index (SIRI) as the most effective inflammatory marker. The associations of CKM stages and SIRI with mortality were evaluated.
Results
Over a median follow-up of 109 months, 5,583 all-cause deaths and 1,843 CVD-specific deaths occurred. Both advanced CKM stages and elevated SIRI were associated with higher risks of all-cause and CVD mortality. Individuals with advanced CKM stages (Stages 3–4) and elevated SIRI (> 0.81) had the highest risks of all-cause (HR: 1.84, 95% CI: 1.65–2.05) and CVD mortality (HR: 2.50, 95% CI: 2.00–3.12). These associations were particularly pronounced in adults aged < 60 years (
P
for interaction < 0.001).
Conclusions
Advanced CKM stages and elevated SIRI are associated with increased risks of all-cause and CVD mortality, particularly in younger adults. These findings highlight the significance of targeted interventions to address systemic inflammation and CKM progression, potentially improving long-term outcomes in high-risk populations.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Adults
/ Aged
/ Analysis
/ Cardiovascular Diseases - mortality
/ Cardiovascular-kidney-metabolic syndrome
/ Complications and side effects
/ Diabetes
/ Exercise
/ Female
/ Humans
/ Joints
/ Kidneys
/ Male
/ Medicine
/ Metabolic Syndrome - mortality
/ Obesity
/ Surveys
/ Systemic inflammatory response index
/ United States - epidemiology
/ Vaccine
