Combined Role of Zinc and Anemia and their Association with 10-Year Atherosclerotic Cardiovascular Disease Risk in Patients with Early-Stage Chronic Kidney Disease

This study aimed to investigate the combined impact of zinc (Zn) intake and anemia on the atherosclerotic cardiovascular disease (ASCVD) risk score of patients with chronic kidney disease (CKD). A total of 2,612 individuals diagnosed with CKD from the National Health and Nutrition Examination Survey 2007-2018 were included in this study. The 10-year ASCVD risk was the outcome variable, and patients with a risk score of ≥ 20% were categorized as having a high 10-year ASCVD risk, whereas those with a risk score of < 20% were considered to be low risk. We used weighted univariate and multivariate logistic regression models to assess the independent and joint associations of Zn intake and anemia with high 10-year ASCVD risk. After adjusting all covariates, patients with CKD with adequate Zn intake had lower odds of developing high 10-year ASCVD risk [odds ratios = 0.59, 95% confidence intervals: 0.39-0.90] than those with inadequate Zn intake. We noted a significant association between anemia and developing high 10-year ASCVD risk. Considering the adequate Zn intake and non-anemia group as a reference, patients with CKD who had both inadequate Zn intake and non-anemia had higher odds of developing high 10-year ASCVD risk; those who had both adequate Zn intake and anemia had higher odds of developing high 10-year ASCVD risk. patients with CKD with both inadequate Zn intake and anemia exhibited a nearly two-fold higher 10-year ASCVD risk compared with those with both adequate Zn intake and non-anemia. A joint effect of Zn intake and anemia on the high 10-year ASCVD risk was observed.