Prevalence of cardiovascular-kidney-metabolic syndrome in areas of Southern China where ethnic minority populations reside: a cross-sectional study

Introduction: Epidemiological data and the comorbidity situation of cardiovascular-kidney-metabolic disease (CKM) in ethnic minority regions of southern China are lacking. This study aimed to (1) estimate the prevalence and stage distribution of CKM syndrome and (2) identify factors associated with CKM stages and explore the interrelationships among coexisting chronic conditions in a multi-ethnic population in southern China. Methods: We analyzed data from the 2020-2021 China Cardiovascular Disease and Risk Factors Surveillance project in Guangxi. CKM syndrome was defined as the coexistence of cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders. The primary outcome was CKM stage (0-4), and binary CKM variables were used in regression analyses. Prevalence was estimated using data from questionnaires, physical examinations, and laboratory tests. Regression and network analyses were conducted to examine factors associated with CKM and the interrelationships among chronic conditions. Results: Among 8,552 participants (median age 50 [IQR 36-63]; 41.9% male; 66.6% urban; 42.3% Zhuang), the age- and sex-adjusted prevalence of CKM stages 1-4 was 76.4% (95% CI: 75.5-77.3%), with 17.2% at stage 1, 57.7% at stages 2-3, and 1.4% at stage 4 (all p < 0.001). The prevalence of CKM stages 2-4 was significantly higher among males, older individuals, rural residents, and non-Zhuang populations (p < 0.05). Factors independently associated with CKM (stages 2-4) included male sex, older age, rural residence, lower education level, alcohol consumption, low fruit intake, high red meat intake, and hyperuricemia (all p < 0.05). The prevalence of individual chronic conditions was as follows: hypertension, 39.7%; non-hypertension CVD (other CVD), 1.6%; CKD, 13.8%; obesity, 12.2%; and diabetes, 12.1%. Hypertension was a central condition linking CVD, CKD, hyperuricemia, obesity, and diabetes. Conclusion: This study reveals a substantial burden of CKM stages 2-3 in Guangxi, China, affecting over half of the population, especially rural elderly men. The findings highlight the need for targeted prevention strategies focusing on modifiable factors associated with CKM in ethnic minority regions.