Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes

Nature Medicine, Год журнала: 2024, Номер 30(12), С. 3758 - 3764

Опубликована: Сен. 1, 2024

Язык: Английский

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Sacrificing patient care for prevention: distortion of the role of general practice

BMJ, Год журнала: 2025, Номер unknown, С. e080811 - e080811

Опубликована: Янв. 21, 2025

Expansion of preventive clinical recommendations in primary care has had the unintended consequence destabilising this foundation healthcare system, argue Minna Johansson and colleagues

Язык: Английский

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Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages by Social Determinants of Health

JAMA Network Open, Год журнала: 2024, Номер 7(11), С. e2445309 - e2445309

Опубликована: Ноя. 18, 2024

Importance Cardiovascular-kidney-metabolic (CKM) syndrome—a novel, multistage, multisystem disorder as defined by the American Heart Association—is highly prevalent in US. However, prevalence of CKM stages social determinants health (SDOH) remains unclear. Objective To investigate whether varies SDOH US adults. Design, Setting, and Participants This cross-sectional study used data from National Health Nutrition Examination Survey (1999-2018) included a nationally representative sample adults aged 30 to 79 years through complex, multistage probability sampling. Data were analyzed April 1 June 15, 2024. Exposures The exposures 5 (ie, 0-4) reflecting progressive pathophysiology, with advanced (stages 3 or 4) nonadvanced 0, 1, 2) disease. based on risk factors for metabolic syndrome, cardiovascular disease, chronic kidney Main Outcome Measures main outcome was age-standardized across SDOH, including education, marital status, family income, food security, insurance, employment, home ownership, care access. Results Among 29 722 participants (weighted mean [SE] age, 50.8 [0.1] years; weighted 50.7% male), 0 4 13.6% (95% CI, 13.0%-14.3%), 29.9% 29.1%-30.7%), 43.7% 42.9%-44.5%), 4.7% 4.4%-5.0%), 8.1% 7.6%-8.5%), respectively. Significant differences observed all unfavorable interest compared their favorable counterparts, unemployment (18.8% [95% 17.7%-20.1%] vs 11.4% 11.0%-11.9%]), low income (16.1% 15.4%-16.8%] 10.1% 9.5%-10.7%]), insecurity (18.3% 17.1%-19.6%] 11.7% 11.2%-12.2%]) associated an increased likelihood stages. 2 more likely have (age-standardized prevalence, 15.8% 15.2%-16.5%] 10.5% 9.9%-11.1%] <2 SDOH). Living rented (15.9% 14.7%-17.0%] 9.3% 8.7%-9.9%] owning home) not living partner (13.2% 12.3%-14.3%] 9.2% 8.5%-9.8%] partner) female but male participants. Conclusions Relevance In this study, disparities particularly notable sex differences, These findings highlight need address inequities syndrome targeted interventions.

Язык: Английский

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Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages Among Middle-Aged and Older Adults in China

JACC Asia, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

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Animal Models for Studying Developmental Origins of Cardiovascular–Kidney–Metabolic Syndrome

Biomedicines, Год журнала: 2025, Номер 13(2), С. 452 - 452

Опубликована: Фев. 12, 2025

Cardiovascular-kidney-metabolic syndrome (CKMS) has become a significant global health challenge. Since CKMS often originates early in life, as outlined by the developmental origins of and disease (DOHaD) concept, prevention is more effective strategy than treatment. Various animal models, classified environmental exposures or mechanisms, are used to explore CKMS. However, no single model can fully replicate all aspects its clinical stages, limiting advancement preventive therapeutic strategies. This review aims assist researchers comparing strengths limitations common models programming studies highlighting key considerations for selecting suitable models.

Язык: Английский

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Association between estimated glucose disposal rate and prediction of cardiovascular disease risk among individuals with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study

Diabetology & Metabolic Syndrome, Год журнала: 2025, Номер 17(1)

Опубликована: Фев. 14, 2025

Insulin resistance is a crucial factor in the development of cardiovascular diseases (CVD), yet relationship between estimated glucose disposal rate (eGDR), an index reflecting insulin resistance, and risk new-onset CVD among individuals with cardiovascular-kidney-metabolic (CKM) syndrome stage 0–3 remains underexplored, large-scale prospective cohort studies are needed to clarify this relationship. All data for study were extracted from China Health Retirement Longitudinal Study (CHARLS). The primary outcome was incidence (including heart (HD) stroke) during follow-up period (from 2013 2020). Multivariable logistic regression models applied elucidate eGDR developing CVD. restricted cubic splines (RCS), mediation analysis, stratified analyses also employed. This included 6752 participants, whom 1495 (22%) developed Odds ratios 95% confidence intervals lowest level (<7.37 mg/kg/min) highest (≥ 11.16 1.00 (reference), 0.81 (0.68, 0.96), 0.72 (0.58, 0.88), 0.74 0.94) respectively, occurrence CVD; (0.67,0.97), (0.57,0.90), 0.75 (0.58,0.97) HD; 0.91 (0.74,1.12), 0.80 (0.62,1.04), 0.71 (0.52,0.97) stroke after adjusting all potential covariates. RCS analysis discovered approximately inverse "L" correlation HD across CKM stages (All P overall < 0.001, nonlinear = 0.005), while there negative linear (P 0.026, 0.098). Furthermore, proportions mediated through BMI 41.98%, 43.05%, 43.23% CVD, stroke, respectively. No significant interactions found. novel indicator 0–3, serving as partial mediator association risk. Addressing may represent viable strategy reducing population.

Язык: Английский

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Role of Oxidative Balance Score in Staging and Mortality Risk of Cardiovascular-Kidney-Metabolic Syndrome: Insights from Traditional and Machine Learning Approaches

Redox Biology, Год журнала: 2025, Номер 81, С. 103588 - 103588

Опубликована: Март 7, 2025

To evaluate the roles of oxidative balance score (OBS) in staging and mortality risk cardiovascular-kidney-metabolic syndrome (CKM). Data this study were from National Health Nutrition Examination Survey 1999-2018. We performed cross-sectional analyses using multinomial logistic regression to investigate relationship between OBS CKM staging. Cox proportional hazards models used assess impact on outcomes patients. Additionally, mediation explore whether mediated relationships specific predictors (Life's Simple 7 [LS7], systemic immune-inflammation index [SII], frailty score) outcomes. Then, machine learning developed classify stages 3/4 predict all-cause mortality, with SHapley Additive exPlanations values interpret contribution components. 21,609 participants included (20,319 CKM, median [IQR] age: 52.0 [38.0-65.0] years, 54.3% male, follow-up: 9.4 [5.3-14.1] years). Lower quartiles associated advanced Moreover, lower related increased risk, compared Q4 (all-cause mortality: Q1: HR 1.31, 95% CI 1.18-1.46, Q2: 1.27, 1.14-1.42, Q3: 1.18, 1.06-1.32; cardiovascular 1.44, 1.16-1.79, 1.39, 1.11-1.74, 1.26, 1.01-1.57; non-cardiovascular 1.12-1.44, 1.23, 1.08-1.40, 1.16, 1.02-1.31), optimal stratification threshold for was 22. (ranging 4.25%-32.85 %) effects SII, LS7, scores light gradient boosting achieved highest performance predicting (area under curve: 0.905) 0.875). Cotinine while magnesium, vitamin B6, physical activity protective. This highlights as a tool emphasizing stress's role management.

Язык: Английский

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Relationship between Moderate Alcohol Consumption and All-Cause Mortality Across Different Stages of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: a cohort study

Research Square (Research Square), Год журнала: 2025, Номер unknown

Опубликована: Янв. 2, 2025

Background The health effects of moderate alcohol consumption remain inconclusive, both in the general population and among individuals with specific diseases. Cardiovascular-Kidney-Metabolic Syndrome (CKM) is a novel concept that involves various conditions. This study aimed to investigate association between all-cause mortality different stages CKM within UK Biobank cohort, validate findings NHANES population. Methods included 112,207 participants from stratified by CKM. Multiple covariates were incorporated regression analyses explore relationship mortality. Additionally, 10,904 cohort analysed, sex, restricted cubic spline (RCS) curves plotted for corroboration. Results Cox results indicated had no protective effect on either males or females. In Biobank, was significantly associated increased mortality, whereas significant found cohort. Among stages, drinking positively correlated females stage II IV, while associations observed other stages. RCS revealed positive correlation genders, indicating absence an "optimal amount," showing greater sensitivity than males. Conclusion While previous studies have suggested potential benefits cardiovascular reduced our across two databases evidence supporting effect. Instead, genders. Therefore, even intake warrants caution, efforts should be made minimize consumption. Trial registration Retrospectively registered. retrospective analysis using data does not involve clinical trials.

Язык: Английский

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Association between the fatty liver index, metabolic dysfunction-associated steatotic liver disease and the risk of kidney stones

Kidney & Blood Pressure Research, Год журнала: 2025, Номер unknown, С. 1 - 25

Опубликована: Янв. 2, 2025

Introduction: This study aimed to investigate the potential association between fatty liver index (FLI), metabolic dysfunction-associated steatotic disease (MASLD), and risk of kidney stones using large-scale population-based data. Methods: employed a cross-sectional design, utilizing data from 2007-2018 National Health Nutrition Examination Survey (NHANES) database. A total 24,342 participants were enrolled in study, status was assessed by calculating FLI. MASLD diagnosed FLI conjunction with cardiometabolic criteria. Data on history obtained self-report. We logistic regression models analyze FLI, MASLD, stone constructed multivariable adjustment control for confounders. Furthermore, we used restricted cubic spline curve dose-response relationship conducted subgroup interaction analyses. Results: The study's results indicate strong correlation increasing quartiles notable rise prevalence stones. Specifically, developing 1.68 times higher among highest quartile compared those lowest. patients exhibited 1.35-fold increased non-MASLD. Subgroup analyses demonstrated that consistent across multiple subgroups. However, significant observed subgroups smoking status, physical activity level, hypertension (interaction P < 0.05). analysis did not yield statistically nonlinear risk. identify inflection point values Conclusion: an suggests these conditions may be pivotal factors Further investigation is required elucidate associations' underlying mechanisms develop efficacious interventions reduce Also, formulating personalized prevention treatment strategies different population paramount.

Язык: Английский

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Cardio-Kidney Metabolic Health in Pediatrics and Primordial Prevention

Cardiology Clinics, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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