Endocrine Abstracts

JOINT1669

Background: Cardiovascular-kidney-metabolic (CKM) syndrome is a newly defined condition involving metabolic risk factors, chronic kidney disease, and cardiovascular disease (CVD), which significantly increases the risk of mortality. While a healthy lifestyle has been shown to improve health outcomes in the general population, its impact on CKM patients remains unclear. This study investigated the association of a healthy lifestyle with all-cause and CVD mortality in CKM patients.

Methods: We analyzed 79, 350 CKM patients from the UK Biobank (2006-2010, follow-up until 2021) and 9, 823 CKM patients from NHANES (2007-2018). The CKM patients were categorized into stages 0-4, with stages 3 and 4 classified as advanced CKM. A healthy lifestyle score (0-7 points) was created based on seven factors: no current smoking, moderate drinking, healthy diet, regular physical activity, adequate sleep, low sedentary behavior and appropriate social connection. Primary outcomes were all-cause and CVD mortality from linked health records and death registries. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality risk.

Results: During follow-up, the UK Biobank recorded 7, 299 all-cause deaths and 1, 685 CVD deaths, and NHANES reported 833 all-cause deaths and 266 CVD deaths. Cox regression models showed that higher lifestyle scores were associated with reduced risks of all-cause (HR: 0.82, 95% CI: 0.80-0.83) and CVD mortality (HR: 0.81, 95% CI: 0.77-0.84) in the UK Biobank. In NHANES, higher scores were associated with 18% (95% CI: 0.78-0.87) and 15% (95% CI: 0.77-0.94) lower risks of all-cause and CVD mortality, respectively. Regular physical activity and low sedentary behavior were beneficial for the risk of all-cause and CVD mortality in both databases (P < 0.05). Compared with participants with advanced CKM syndrome and unfavorable lifestyle (0-2 points), those with non-advanced CKM syndrome and favorable lifestyle (6-7 points) had the lowest risk of all-cause and CVD mortality. In the UK Biobank, the HRs were 0.23 (95% CI: 0.20-0.26) and 0.13 (95% CI: 0.10-0.17), respectively; In NHANES, the HRs were 0.22 (95% CI: 0.11-0.41) and 0.25 (95% CI: 0.08-0.80), respectively.

Conclusion: We found that adherence to a healthy lifestyle was significantly associated with a reduced risk of mortality in patients with CKM syndrome, with more pronounced benefits observed in the early stages. These findings highlight the potential benefits of promoting a healthy lifestyle to improve long-term survival in patients with CKM syndrome.