Diabetes Research and Clinical Practice · Mar 23, 2026

Cardiovascular-kidney-metabolic syndrome stages, stage transitions, and risk of cardiovascular disease and mortality: The Tehran Lipid and Glucose Study

By Masrouri S, Ebrahimi N, Hasanpour A et al.

AIMS: To evaluate the prevalence of cardiovascular-kidney-metabolic syndrome (CKM) and its association with cardiovascular disease (CVD) risk across CKM stages in a Middle Eastern population. METHODS: We analyzed data from 7770 CVD-free adults aged 30-79 years. Multivariable Cox models assessed associations of CKM with incident CVD, coronary heart disease (CHD), myocardial infarction (MI), stroke, and CVD mortality. We also evaluated the impact of CKM stage transitions over approximately 3 years on cardiovascular endpoints. RESULTS: Baseline prevalence of CKM stages 0-3 was 11.2%, 12.0%, 72.8%, and 4.0%, respectively. Over a median 19.9 years of follow-up, 1450 CVD events occurred, including 338 CVD deaths. Compared with stage 0, the HRs (95% CIs) for CVD were 2.03 (1.59-2.58) for stage 2 and 2.76 (2.05-3.73) for stage 3; similar associations were observed for CHD, stroke, and MI. For CVD mortality, stage 3 conferred a risk of 2.61 (1.53-4.45). Each 1-stage progression in CKM over ∼ 3 years was associated with 1.40-2.01 times significantly greater risk of endpoints, except for MI. CONCLUSIONS: Nearly 77% of participants were classified in poor CKM stages (2-3), strongly associated with excess cardiovascular risk. These findings highlight the importance of early CKM detection and targeted interventions.

doi.org/10.1016/j.diabres.2026.113223PubMed 41881362Biomarkers