ArticleHealthcare (Basel, Switzerland)2026
Physical Activity and Bidirectional Stage Transitions in Cardiovascular-Kidney-Metabolic Syndrome: A Cohort Study.
Article in Healthcare (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Long-term cardiovascular risk with cardiovascular-kidney-metabolic syndrome in U.S adults.American heart journal plus : cardiology research and practice · 2026Article
- Association of accelerometer-measured physical activity and the risk of incident cardiovascular diseases within the AHA cardiovascular-kidney-metabolic syndrome 0-4 framework: a prospective cohort of the UK Biobank.Frontiers in endocrinology · 2026Article
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Authors and funding
3 authors.
Funding
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Abstract
backgroundCardiovascular-Kidney-Metabolic (CKM) syndrome involves interconnected cardiovascular, renal, and metabolic conditions. The dose-response relationship between physical activity and bidirectional CKM stage transitions remains unclear.
methodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS), cross-sectional analysis pooled 14,310 observations from 10,868 participants. Logistic regression with clustered robust standard errors accounted for intra-individual correlation. Longitudinal analysis (
resultsCompared with Q1, Q2, Q3, and Q4 were associated with 43.1%, 52.5%, and 53.1% lower risk of high-risk CKM stages, respectively. RCS analysis demonstrated nonlinear dose-response relationships between physical activity and CKM stage progression. Subgroup analyses showed more pronounced protective effects in older adults and single individuals. During 4-year follow-up, 31.6% experienced progression and 6.8% showed improvement. Stage 4 acted as a complete absorbing state without any reversal. Transition intensity analysis revealed that transitions between adjacent stages were notably higher than cross-stage transitions. The Q4 physical activity level significantly reduced transitions from low-risk to high-risk states (HR = 0.598, 95% CI: 0.459-0.777) and promoted transitions from high-risk to low-risk states (HR = 2.995, 95% CI: 1.257-7.134).
conclusionsModerate-to-high physical activity effectively reduces CKM progression risk and promotes improvement, providing evidence for CKM prevention and management.
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