Association between cardiovascular-kidney-metabolic syndrome, lifestyle, and all-cause and cause-specific mortality: a prospective cohort study
Abstract
Summary Background Cardiovascular-kidney-metabolic (CKM) syndrome is reported to be associated with increased all-cause and CVD-specific mortality. However, the association between CKM and cancer-specific mortality, as well as the modifying or joint effects of healthy lifestyle on mortality remain unclear. Methods In this prospective cohort study, we enrolled participants aged 37–73 years from the UK Biobank. Individuals with missing data on CKM status, lifestyle factors or potential confounders at baseline (between March 2006 and July 2010) were excluded. Followed-up was conducted until November 30, 2022. CKM stages (0-4) were defined per the American Heart Association criteria. A healthy lifestyle score (adequate physical activity, no current smoking, healthy sleep, and healthy diet) was categorized into unfavourable (0–1), intermediate (2–3), and favourable (4) groups. Outcomes included all-cause and cause-specific mortality (due to cardiovascular disease [CVD], cancer, and other causes). Cox proportional hazards models and Fine–Gray proportional subdistribution hazards models were used to assess associations with all-cause and cause-specific mortality, respectively. Findings A total of 319,291 participants were included. Over a median follow-up of 13.7 years (interquartile ranges 13.0–14.3), 27,267 deaths occurred (5558 CVDs [20.4%], 13,566 cancers [49.8%], 8143 other-causes [29.8%]). Compared with CKM Stage 0, Stages 2–4 were associated with progressively higher risks…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 319,291 participants or records.
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