BMC Cardiovascular Disorders· 2026Q2
Bidirectional transitions of cardiovascular-kidney-metabolic syndrome states in middle-aged and older adults: evidence from a nationwide cohort study
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- Q2SCImago
- 2026year
Short summary
In a nationwide Chinese cohort (n=6,388, age ≥45), the Cardiovascular-Kidney-Metabolic (CKM) syndrome states showed bidirectional transitions, with a 70.5% 4-year probability of progressing from non-CKM to light CKM, but only a 2.7% probability of regressing from light CKM to non-CKM.
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Key points
- A 4-year probability of 70.5% exists for progressing from non-CKM to light CKM in adults aged ≥45.
- Regression from light CKM to non-CKM occurred with only a 2.7% 4-year probability.
- Individuals with advanced CKM had a 15.0% 4-year mortality risk.
- Age, sex, urban/rural residence, activities of daily living, and depressive symptoms were key determinants of CKM state transitions.
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Abstract
Abstract Background Cardiovascular–Kidney–Metabolic (CKM) syndrome is a systemic condition from the interplay among metabolic risk factors, chronic kidney disease (CKD), and cardiovascular system. This study aimed to characterize bidirectional transition patterns between CKM states and identify their determinants. Methods and results We included community-dwelling adults ≥45 years from national China Health and Retirement Longitudinal Study (CHARLS), with CKM state assessments in 2011 and 2015. Multi-state Markov models (MSM) estimated transition intensities/probabilities among non-CKM (stage 0), light CKM (stages 1,2), advanced CKM (stages 3,4), death, and factors for transitions.A total of 6,388 participants were analyzed (53.80% female; mean age 59.41±9.02 years; mean follow-up 3.86±0.51 years). Baseline: 412 (6.45%) non-CKM, 4,605 (72.09%) light CKM, 1,371 (21.46%) advanced CKM. Follow-up: 1,675 transitions (1,077 progressing, 171 regressing, 427 death). Four-year probabilities: non-CKM→light CKM (70.5%); light CKM→non-CKM (2.7%), light CKM→advanced CKM (16.7%); advanced CKM→light CKM (3.4%), advanced CKM→death (15.0%). Age, sex, urban/rural residence, activities of daily living (ADL), depressive symptoms were key determinants. Conclusion This national cohort delineated CKM state bidirectional transitions, revealed progression-regression asymmetry and state-specific determinants, providing evidence for prevention-oriented, risk-stratified CKM management in middle-aged/older adults.
The authors' abstract, as published at the source. BMC Cardiovascular Disorders, 2026 · DOI ↗
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Field: Endocrinology, Diabetes and Metabolism
Endocrinology, Diabetes and MetabolismMedicine