Rising Prevalence of Cardiovascular-Kidney-Metabolic (CKM) Syndrome in China, 2010-2019: National Cross-Sectional Surveys

BackgroundCardio-kidney-metabolic (CKM) syndrome is defined as a systemic disorder characterized by pathophysiological interactions among metabolic risk factors, chronic kidney disease, and the cardiovascular system, leading to multiorgan dysfunction and a high rate of adverse cardiovascular outcomes. However, the prevalence of CKM syndrome among adults in China is unknown. ObjectivesThe aim of this study was to assess the prevalence of CKM syndrome and its stages in mainland China. MethodsThis cross-sectional study included two nationally representative data from 41 088 participants aged 18 and older from the China National Survey of Chronic Kidney Disease (CNSCKD) conducted from September 2009 to September 2010 and 171 462 adults from the sixth China Chronic Disease and Risk Factor Surveillance (CCDRFS) conducted from August 2018 to June 2019. CKM syndrome stages were identified in accordance with the 2023 American Heart Association Presidential Advisory on CKM Health. Prevalence estimates were weighted to represent the Chinese adult population accounting for the complex sampling design. The prevalence of advanced CKM syndrome was compared among subgroups using log-binomial regression with age and sex adjusted. Weighted multivariable logistic regression models for advanced CKM syndrome were analyzed with relevant covariates. ResultsThe weighted prevalence of CKM syndrome and its advanced stages among adults in mainland China were 77.1% (95% confidence interval, 76.1% to 78.0%) and 6.3% (5.9% to 6.7%) in 2010, and 83.7% (83.2% to 84.2%) and 10.1% (9.9% to 10.4%) in 2019. Among all CKM syndrome stages, stage 2 had the highest prevalence, accounting for 50% of the population in both 2010 and 2019. The prevalence of CKM syndrome have increased across all age groups, especially the 18-39 age group. The increase was greater in men than women across all age groups. Factors independently associated with advanced CKM syndrome were age, sex, area of residence, education level, smoking status, alcohol consumption, diet, and physical activity. ConclusionsThe prevalence of CKM syndrome in China is high and has increased significantly over the past decade, emphasizing the urgent need to develop comprehensive and equitable prevention and management strategies.