COPD was significantly associated with advanced cardiovascular-kidney-metabolic syndrome (adjusted OR 1.52; 95% CI 1.11-2.09) and increased all-cause mortality.
Cross-Sectional (n=5,569)
Does COPD increase the prevalence of advanced CKM syndrome and mortality in adults?
COPD and impaired lung function are strongly associated with a higher prevalence of advanced cardiovascular-kidney-metabolic (CKM) syndrome and increased all-cause and cardiovascular mortality.
Effect estimate: OR 1.52 (95% CI 1.11-2.09)
Abstract Background Chronic obstructive pulmonary disease (COPD) and cardiovascular-kidney-metabolic (CKM) syndrome are major public health concerns, yet their interrelationship remains under-explored. This study investigates the impact of lung function and COPD on the prevalence and mortality of CKM syndrome using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. Methods A cross-sectional analysis of 5,569 adults was conducted, defining CKM stages per the 2023 American Heart Association framework. Lung function was assessed via prebronchodilator spirometry, with COPD classified using GOLD criteria. Advanced CKM syndrome (stages 3-4) was the primary outcome. Associations were evaluated using survey-weighted logistic regression, restricted cubic splines (RCS), and Cox proportional hazards models. Preserved ratio impaired spirometry (PRISm) and self-reported chronic bronchitis were evaluated as pre-COPD conditions. Associations were evaluated using survey-weighted logistic regression, restricted cubic splines (RCS), and Cox proportional hazards models. Results Among participants, 10.7% had advanced CKM syndrome. Participants with advanced CKM were significantly older (62.11 vs. 43.67 years, P 0.001), more likely male (60.5% vs. 47.43%, P 0.001), and had lower income, education, higher smoking rates, and elevated BMI (all P 0.001). Lung function was markedly impaired in the advanced CKM group, with lower FEV1, FVC, and higher prevalence of COPD, emphysema, and chronic bronchitis (all P 0.001). COPD was significantly associated with advanced CKM (adjusted OR = 1.52 1.11, 2.09), with escalating risks across GOLD stages (GOLD stage II: OR = 2.13 1.21, 3.74; GOLD stage III-IV: OR = 4.38 1.06, 18.02). Pre-COPD conditions, including PRISm (OR = 2.62 1.66, 4.14) and chronic bronchitis (OR = 2.60 1.50, 4.53), also showed significant associations. RCS revealed a linear relationship between FEV1 and advanced CKM, and a non-linear association with FEV1% predicted, plateauing beyond 96%. Subgroup analyses showed consistent associations across age, sex, BMI, race, income, education, and smoking (all P-interaction 0.05). Sensitivity analysis using LLN criteria confirmed robustness. In mortality follow-up among those with CKM syndrome, COPD increased all-cause mortality (HR = 1.52 1.18, 1.96, P = 0.001) and showed a trend for CVD mortality (HR = 1.51 0.90, 2.55, P = 0.122). Among individuals aged ≥50 years, COPD significantly increased all-cause (HR = 1.40 1.04, 1.89, P = 0.028) and cardiovascular-related mortality (HR = 1.81 1.04, 3.14, P = 0.037). Kaplan-Meier curves confirmed higher GOLD stages were associated with increased all-cause and CVD mortality (log-rank P 0.001). Conclusion COPD is strongly associated with advanced CKM syndrome and increased mortality, particularly in older adults. These findings highlight the systemic impact of lung health on CKM progression, emphasizing the need for integrated screening and management targeting both pulmonary and cardiometabolic health. This abstract is funded by: Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0506003)
Tang et al. (Fri,) conducted a cross-sectional in Cardiovascular-kidney-metabolic (CKM) syndrome and COPD (n=5,569). COPD vs. No COPD was evaluated on Advanced CKM syndrome (stages 3-4) (OR 1.52, 95% CI 1.11-2.09). COPD was significantly associated with advanced cardiovascular-kidney-metabolic syndrome (adjusted OR 1.52; 95% CI 1.11-2.09) and increased all-cause mortality.