Association of cardiovascular-kidney-metabolic syndrome with cardiovascular, cancer, and all-cause mortality among US adults: A prospective study

AIMS: Cardiovascular-kidney-metabolic (CKM) syndrome, comprising chronic kidney disease, cardiovascular disease (CVD), and metabolic syndrome, poses a significant threat to global public health. This study aimed to explore its influence on CVD, cancer, and all-cause mortality among US adults. METHODS: A total of 17,642 participants from the National Health and Nutrition Examination Survey 1999-2018 dataset were included and classified into different CKM stages. Weighted Cox regression and Kaplan-Meier survival analyses were conducted to evaluate the relationships between CKM stages and cancer, CVD, and all-cause mortality. Additionally, Fine-Gray competitive risk models were used to further assess cause-specific mortality outcomes. RESULTS: Participants with advanced CKM stages demonstrated significantly higher risks of cancer, CVD, and all-cause mortality. Compared to individuals in CKM stage 0, those in CKM stage 4 demonstrated significantly higher risks of all-cause mortality (hazard ratio [HR]: 2.89, 95% confidence interval [CI]: 1.99-4.20), CVD mortality (HR: 9.73, 95% CI: 3.06-30.92), and cancer mortality (HR: 2.41, 95% CI: 1.13-5.15). Kaplan-Meier survival curves and competitive risk models confirmed a progressive increase in mortality risk with advancing CKM stages. CONCLUSIONS: Stages of CKM syndrome are positively associated with cancer, CVD, and all-cause mortality risk, highlighting the significance of early detection and effective management.