Correlation between overall lifestyle score and advanced stages among patients with cardiovascular-kidney-metabolic syndrome: NHANES 2011-2020.

BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome, a new multistage disorder recently introduced by the American Heart Association, underscores the intricate connection between cardiovascular, renal, and metabolic diseases. Since maintaining a healthy lifestyle is a reliable way to promote regression of CKM stages, we aimed to examine the associations between overall lifestyle scores and advanced CKM stages in affected patients. METHODS: This cross-sectional study used nationally representative data from five National Health and Nutrition Examination Survey cycles (2011-2020) among adults aged 20 years or older. The overall lifestyle score was constructed based on four factors: never smoking, no heavy drinking, sufficient leisure-time physical activity, and a healthy diet. Participants were divided into five CKM stages (0-4) based on the clinical severity, with stages 3 and 4 considered advanced. Multivariable weighted logistic regression was used to explore the relationship between overall lifestyle score and advanced CKM stages. RESULTS: A total of 18,664 patients with CKM syndrome were included in the final analysis, of whom 3073 were classified as having advanced CKM syndrome, and 15,591 were not. After adjusting for potential confounders, compared with participants with an unfavorable overall lifestyle score (0-1 healthy lifestyle factors), patients with CKM syndrome with intermediate (2 healthy lifestyle factors) and favorable (3-4 healthy lifestyle factors) overall lifestyle scores had a 31% and 44% lower risk of being in advanced stages, respectively. Further subgroup and sensitivity analyses yielded consistent results. CONCLUSIONS: Patients with CKM syndrome who had a favorable and intermediate overall lifestyle score were significantly less likely to be in advanced stages of the disease.