Cardiometabolic risk factor burden, psychological symptoms, and immune cardiovascular symptom profiles in adults: a cross-sectional study

Abstract Immune-related and cardiovascular symptoms may co-occur with cardiometabolic and psychological risk factors, but their joint symptom structure remains unclear. This study examined correlates, latent phenotypes, and item-level networks of immune-related and cardiovascular symptom burden in adults. In this cross-sectional study of 524 participants, immune symptom burden (ISB), cardiovascular symptom burden (CSB), and total symptom burden were calculated from 12 symptom items. Reliability, factor structure, multivariable linear regression, cardiometabolic risk-factor categories, latent class analysis, and exploratory EBICglasso network analysis were evaluated. Participants were 42.2% male and 57.8% female, with mean age 51.16 ± 8.83 years and BMI 28.33 ± 2.91 kg/m². Mean ISB, CSB, and total symptom-burden scores were 4.09 ± 3.13, 4.42 ± 3.60, and 8.52 ± 5.62, respectively. The bifactor model showed the best fit (CFI = 0.995, RMSEA = 0.016), supporting a general symptom-burden construct with domain-specific structure. In adjusted models, ISB was independently associated with age, BMI, and depressive symptoms; CSB with BMI, insomnia severity, and depressive symptoms; and total symptom burden with age, BMI, insomnia severity, and depressive symptoms. Symptom burden increased descriptively across cardiometabolic risk-factor categories, although risk-factor count was not independently associated after adjustment. Latent class analysis supported a two-class solution, and exploratory networks identified fatigue-related symptoms as central cross-domain bridge symptoms. Immune-related and cardiovascular symptom burden clustered with adiposity, psychological symptoms, and distinct symptom phenotypes. These findings support integrated cardiometabolic and psychosocial assessment in public-health symptom surveillance.