International journal of cardiology · 2026
Diverging trajectories of cardiorenal protection: From early benefit to late attenuation with multifactorial target achievement across cardiovascular kidney-metabolic syndrome stages.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Cai Lu, Liang Baiyi, Zhou Shiyu, Xiao Huaying, Hu Ying, Ma Hong
Аннотация
BACKGROUND: The extent to which achieving multiple metabolic treatment targets confers sustained cardiorenal protection across all stages of cardiovascular - kidney - metabolic (CKM) syndrome remains uncertain.
METHODS: This multicenter retrospective study used data from the China Renal Data System (CRDS) to investigate the association between achieving multiple metabolic targets (blood pressure, fasting blood glucose, LDL-C control) and cardiorenal outcomes across stages of CKM syndrome.
RESULTS: The proportion of patients meeting all three metabolic targets decreased markedly with advancing CKM stage. Kaplan-Meier curves showed increasing risks of cardiovascular-renal events and mortality across higher stages (P < 0.001). After adjustment, higher metabolic scores were linked to lower risks: for cardiovascular-renal outcomes, HR 0.82 (95% CI 0.77-0.87) for score 1, 0.72 (0.68-0.77) for score 2, and 0.65 (0.57-0.73) for score 3. Stratified analysis showed significant risk reduction in early CKM stages but not in advanced stages. Restricted cubic spline models indicated nonlinear associations between LDL-C and both outcomes, and between FBG, systolic BP, and mortality, after full adjustment (all P < 0.05).
CONCLUSIONS: The findings underscore the need for stage-specific management strategies in CKM syndrome.
METHODS: This multicenter retrospective study used data from the China Renal Data System (CRDS) to investigate the association between achieving multiple metabolic targets (blood pressure, fasting blood glucose, LDL-C control) and cardiorenal outcomes across stages of CKM syndrome.
RESULTS: The proportion of patients meeting all three metabolic targets decreased markedly with advancing CKM stage. Kaplan-Meier curves showed increasing risks of cardiovascular-renal events and mortality across higher stages (P < 0.001). After adjustment, higher metabolic scores were linked to lower risks: for cardiovascular-renal outcomes, HR 0.82 (95% CI 0.77-0.87) for score 1, 0.72 (0.68-0.77) for score 2, and 0.65 (0.57-0.73) for score 3. Stratified analysis showed significant risk reduction in early CKM stages but not in advanced stages. Restricted cubic spline models indicated nonlinear associations between LDL-C and both outcomes, and between FBG, systolic BP, and mortality, after full adjustment (all P < 0.05).
CONCLUSIONS: The findings underscore the need for stage-specific management strategies in CKM syndrome.