ArticleEndocrine2026
Separate and joint associations of morning plasma cortisol and aldosterone with Cardiovascular - Kidney - Metabolic syndrome in Chinese Hakka adults.
Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdvanced stages of cardiovascular-kidney-metabolic syndrome (CKMs) are associated with a markedly increased risk of mortality. However, the individual and combined effects of cortisol (COR) and aldosterone (ALD) on CKMs remain unclear. We aimed to investigate their separate and joint associations with CKMs stages and major components.
methodThis cross-sectional study included 8,781 participants to investigate the separate and joint associations of COR and ALD with CKMs and its components, using linear regression, logistic regression, restricted cubic spline analyses (RCS), interaction analyses, and stratified analyses.
resultBeyond associations with CKMs staging-related continuous indicators and key components, higher quartiles of COR (Q4 vs. Q1, OR = 1.56, 95%CI, 1.26–1.95) and ALD (Q4 vs. Q1, OR = 1.33, 95%CI, 1.07–1.64) were independently associated with higher odds of advanced CKMs. RCS revealed significant nonlinear associations between log-transformed COR and ALD levels and advanced CKMs. A significant additive interaction was observed between COR and ALD on advanced CKMs (RERI = 0.94, 95%CI, 0.35–1.52; AP = 0.41, 95%CI, 0.30–0.52; S = 3.75, 95%CI, 1.84–7.63). Co-exposure analyses showed a 46% higher odds of advanced CKMs in the “High COR, High ALD” group (OR = 1.46, 95%CI, 1.19–1.80, P < 0.001) compared to the “Low COR, Low ALD” group, with consistent trends across most subgroups.
conclusionBoth COR and ALD show significant associations with advanced CKMs. The joint assessment of COR and ALD improves the identification of high-risk individuals, underscoring the value of adrenal hormone profiling in CKMs risk stratification.
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