| アブストラクト | AIMS: Cardiovascular-kidney-metabolic (CKM) syndrome is a novel disease concept; however, sex differences in its progression remain uncertain. This study aimed to quantify the risk of cardiovascular disease (CVD) events across CKM stages and to explore sex differences in this association. METHODS AND RESULTS: We included 1 332 436 individuals (581 423 males and 751 013 females) from the DeSC database between 2014 and 2023 who had no prior CVD (i.e. CKM Stage 4). CKM stages were categorized as follows: Stage 0 (no CKM risk factors); Stage 1 (excess or dysfunctional adiposity); Stage 2 [metabolic risk factors and chronic kidney diseases (CKD)], and Stage 3 (subclinical CVD). We used Cox models to examine the association of CKM stages with the risk of CVD events (newly developed CKM Stage 4), including myocardial infarction, stroke, heart failure, atrial fibrillation, and peripheral artery disease. The progression from CKM Stages 0 to 3 showed a dose-dependent increase in adjusted hazard ratios (HR) for developing CVD events, with the highest risk at Stage 3 [1.85 (95% CI: 1.80-1.90)]. A similar pattern was observed in both males and females. However, the magnitude of associations for CKM stages 1-3 differed between the sexes: HR by Stage 1, 1.12 (1.04-1.21) vs. 1.12 (1.07-1.16); by Stage 2, 1.78 (1.69-1.88) vs. 1.43 (1.39-1.48); by Stage 3, 1.99 (1.89-2.10) vs. 1.82 (1.76-1.88); and P-for-interaction values were 0.87, < 0.001, and 0.005, respectively. CONCLUSION: In this large nationwide cohort, CKM stage progression was associated with higher CVD risk in both sexes, with modest sex-specific differences. These findings highlight the value of CKM staging for early risk assessment, regardless of sex. |
|---|
| 投稿者 | Taya, Satoshi; Ejiri, Kentaro; Kaneko, Hidehiro; Suzuki, Yuta; Miyoshi, Toru; Mizuno, Atsushi; Ko, Toshiyuki; Jimba, Takahiro; Azegami, Tatsuhiko; Okada, Akira; Fujiu, Katsuhito; Takeda, Norifumi; Morita, Hiroyuki; Hayashi, Kaori; Node, Koichi; Nangaku, Masaomi; Yasunaga, Hideo; Takeda, Norihiko; Yuasa, Shinsuke |
|---|
| 組織名 | Department of Cardiovascular Medicine, Okayama University Graduate School of;Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 7008558, Japan.;Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, 1138655,;Japan.;Department of Advanced Cardiology, The University of Tokyo, Tokyo, 1138655,;Center for Outcomes Research and Economic Evaluation for Health, National;Institute of Public Health, Saitama, 3510197, Japan.;Department of Cardiology, Medical Quality Management Office, QI Center, St.;Luke's International Hospital, Tokyo, 1048560, Japan.;Division of Nephrology, Endocrinology, and Metabolism, Department of Internal;Medicine, Keio University School of Medicine, Tokyo, 1608582, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, Tokyo, 1138655, Japan.;Department of Integrative Physiology, Institute of Science Tokyo, Tokyo, 1138510,;Department of Cardiovascular Medicine, Saga University, Saga, 8498501, Japan.;Division of Nephrology and Endocrinology, The University of Tokyo Graduate School;of Medicine, Tokyo, 1138655, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, 1138655, Japan. |
|---|
