Evidence map›Paper›PMID 39952015›Full record

ArticleThe journal of nutrition, health & aging2025

Associations of cardiovascular-kidney-metabolic syndrome stages with premature mortality and the role of social determinants of health.

Ruixin Zhu, Ran Wang, Jingjing He, Langrun Wang, Huiyu Chen, Yifan Wang, Peng An, Keji Li, Fazheng Ren, Weili Xu and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journal of nutrition, health & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed.

  1. Article
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  3. Prognostic Value of Albumin/Globulin Ratio for Mortality in Stage 2 Cardiovascular-Kidney-Metabolic Syndrome: A Nationwide Cohort Analysis (1999-2018).High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ruixin ZhuKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Ran WangKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Jingjing HeKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Langrun WangKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Huiyu ChenKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Yifan WangKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Peng AnKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Keji LiDepartment of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China.
Fazheng RenKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China.
Weili XuDepartment of Neurobiology, Care Sciences & Society, Karolinska Institutet, Solna, Sweden.
J Alfredo MartinezCentro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain; Department of Medicine and Endocrinology, University of Valladolid, Valladolid, Spain.
Anne RabenDepartment of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark; Department for Clinical and Translational Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
Jie GuoKey Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China; Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Solna, Sweden. Electronic address: jie.guo@ki.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe American Heart Association defined cardiovascular-kidney-metabolic (CKM) syndrome as a novel multi-stage disorder. We examined the associations of CKM stages with premature mortality and the role of social determinants of health (SDOHs).

designA prospective cohort study. SETTING AND

participantsA nationally representative sample of US adults from NHANES 1999-2018. MEASUREMENTS: CKM included 5 stages (stages 0-4), reflecting progressive pathophysiology. Premature mortality (deaths before 75 years) were ascertained via linkage to the National Death Index with follow-up until 2019. Cox proportional-hazards models adjusted for age, sex, race/ethnicity, medical history, and other confounding factors were used to calculate the hazard ratios (HR) and 95% CIs for CKM-mortality associations.

resultsAmong 27,909 participants (mean age 49.7 years, 49.0% females), 1762 premature deaths occurred over a median follow-up of 8.3 years. Compared with stage 0, the adjusted HRs for all-cause premature mortality at CKM stages 1-4 were 0.88 (95% CI 0.66-1.17), 1.31 (0.99-1.73), 1.94 (1.31-2.87), and 2.19 (1.61-2.98), respectively. For CVD premature mortality, the adjusted HRs for CKM stages 1-4 were 1.12 (0.46-2.72), 1.74 (0.71-4.28), 3.93 (1.53-10.12), and 6.48 (2.95-14.20), respectively. Among adults at CKM stages 3-4, unfavorable SDOHs, particularly not living with a partner, low family income, lack of private health insurance, unemployment, or ≥2 cumulative SDOHs (4.16, 95% CI 3.35-5.18) were associated with increased all-cause premature mortality. Among those at CKM stages 0-2, unfavorable SDOHs were also related to increased premature mortality.

conclusionCKM stages 3-4, but not stages 1-2, were associated with increased risks of premature mortality compared with stage 0. The risks were increased by unfavorable SDOHs across CKM stages.

Indexed as

Cardiovascular DiseasesKidney DiseasesMetabolic SyndromeMortality, PrematureSocial Determinants of HealthAdultAgedFemaleHumansMaleMiddle AgedNutrition SurveysProportional Hazards ModelsProspective StudiesRisk FactorsUnited StatesCardiovascular diseaseCardiovascular–kidney–metabolic healthDiabetesHealth disparitiesObesity

Identifiers

PMID39952015
PMCPMC12180020

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.