AI Insight
This study analyzed data from 62,888 US adults across 1999-2023 to assess cardiovascular-kidney-metabolic (CKM) syndrome, a framework integrating obesity, metabolic risk, kidney dysfunction, and cardiovascular disease. In 2021-2023, 87.9% of adults had at least stage 1 CKM syndrome and 62.0% had stages 2-4, with modest increases in overall CKM prevalence over two decades but no significant change in advanced stages. Projections suggest that population aging alone could increase the number of adults with stages 2-4 from 164.8 million in 2023 to 193.7 million by 2050, though broad risk factor improvements could reduce this to 147.7 million.
Why it matters
The findings reveal that CKM syndrome affects the vast majority of US adults and that the absolute burden of care will likely increase substantially due to population aging unless preventive interventions successfully reduce risk factors. This has major implications for healthcare resource planning and the urgency of implementing population-level prevention strategies targeting obesity, diabetes, and related metabolic conditions.
⚠️ Preprint – Noch nicht peer-reviewed
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Background Cardiovascular-kidney-metabolic (CKM) syndrome integrates adiposity, metabolic risk, kidney dysfunction, and cardiovascular disease in a prevention-oriented framework. National estimates across 1999-2023 NHANES and future burden remain limited. Methods We analyzed US adults aged 20 years from 11 NHANES cycles, 1999-2000 through August 2021-August 2023. CKM stage 0-4 was assigned using harmonized examination, laboratory, medication, and questionnaire data. Prevalence was survey-weighted and standardized to the 2010 US Census adult population. Decade trends used survey-weighted logistic regression adjusted for age, sex, and race and ethnicity. Exploratory 2040 and 2050 projections combined NHANES prevalence models with US Census projections under population-aging-only, trend-continuation, and risk-improvement scenarios. Results Among 62,890 eligible adults, 62,888 had sufficient CKM data. In 2021-2023, age-standardized prevalence was 87.9% (95% CI, 86.5%-89.4%) for CKM stage 1 and 62.0% (95% CI, 60.1%-63.8%) for stages 2-4. Stage 2 accounted for 50.1% (95% CI, 48.2%-51.9%) and stages 3-4 for 11.9% (95% CI, 11.0%-12.7%). From 1999-2000 to 2021-2023, any CKM increased by 4.6 percentage points (95% CI, 2.4 to 6.9; P<0.001), whereas stages 2-4 changed by 2.1 percentage points (95% CI, 5.1 to 0.8; P=0.156). In adjusted decade models, any CKM increased (OR, 1.28; 95% CI, 1.19-1.38; P<0.001), while stages 2-4 showed no significant linear trend (OR, 0.95; 95% CI, 0.89-1.01; P=0.084). Excess adiposity and diabetes increased, dyslipidemia declined, and hypertension, chronic kidney disease, and clinical cardiovascular disease were stable. With population aging alone, projected stages 2-4 burden rose from 164.8 million adults in 2023 to 193.7 million in 2050; under risk improvement, it was 147.7 million. Conclusions CKM syndrome remained highly prevalent among US adults. Although later stages did not increase significantly, population aging may expand the absolute care burden unless broad risk improvement occurs.