Joint association of physical activity and sedentary time with all-cause and cardiovascular mortality among advanced CKM syndrome participants, insights from NHANES 2007-2018.

Yuzhe Huang, Quanjun Liu, Shuhua Chen, Hong Xiang, Haijiao Long, Jie Ouyang, Junxi Liao, Shiying Qin, Hongwei Lu

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Article in Clinical and experimental medicine, 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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9 authors.

Yuzhe Huang *Center for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.

Quanjun Liu *Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China.

Shuhua ChenDepartment of Biochemistry, School of Life Sciences, Central South University, Changsha, China.

Hong XiangCenter for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.

Haijiao LongCenter for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.

Jie OuyangCenter for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.

Junxi LiaoDepartment of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.

Shiying QinDepartment of Biochemistry, School of Life Sciences, Central South University, Changsha, China.

Hongwei LuCenter for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China. hongweilu@csu.edu.cn.

Funding

the National Natural Science Foundation of China grant no. 82270519, 82470475the Postgraduate Research & Practice Innovation Program of Central South University grant no. 2025ZZTS0816

6 · The paper itself

Abstract

Cardiovascular-kidney-metabolic (CKM) syndrome represents the interconnection of metabolic dysfunction, chronic kidney disease, and cardiovascular disease, with advanced stages associated with high mortality. However, the associations of leisure-time physical activity (PA) and sedentary time with mortality in participants with advanced CKM syndrome remain unclear. This study conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Multivariate Cox proportional hazards models, restricted cubic spline (RCS) analyses, and subgroup analyses were applied to examine the independent and joint associations of leisure-time PA and sedentary time with all-cause and cardiovascular mortality among participants with advanced CKM syndrome. Among advanced CKM participants, physical inactivity was associated with higher risks of all-cause (HR = 2.43, 95% CI: 1.98-2.97, P < 0.001) and cardiovascular mortality (HR = 2.62, 95% CI: 1.79-3.82, P < 0.001). Compared with < 4 h/day, sedentary time > 8 h/day was independently linked to elevated risks of all-cause (HR = 1.71, 95% CI: 1.33-2.19, P < 0.001) and cardiovascular mortality (HR = 2.12, 95% CI: 1.34-3.38, P = 0.005). Joint analyses showed that the group characterized by physical inactivity combined with ≥ 6 h/day sedentary time was associated with the highest risk of all-cause (HR = 2.77, 95% CI: 2.16-3.56, P < 0.001) and cardiovascular mortality (HR = 3.39, 95% CI: 2.13-5.40, P < 0.001). These associations were further supported by RCS analyses and sensitivity analyses. The findings underscore the potential survival advantages associated with enhancing physical activity and reducing sedentary behavior in this high-risk population.

Indexed as

Cardiovascular DiseasesExerciseMetabolic SyndromeSedentary BehaviorAdultAgedFemaleHumansMaleMiddle AgedNutrition SurveysProportional Hazards ModelsProspective StudiesRisk FactorsCardiovascular-kidney-metabolic syndromeMortalityNational health and nutrition examination surveyPhysical activitySedentary behavior

Identifiers

PMID42886390

DOI10.1161/atvbaha.113.300156

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