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Background/objectives <p>Cardiovascular-Kidney-Metabolic (CKM) syndrome reflects the interconnected nature of cardiovascular, renal, and metabolic dysfunction. Sarcopenia, or the loss of skeletal muscle mass, is linked to adverse outcomes in chronic diseases, but its role within the CKM framework remains poorly defined. This study aimed to investigate the association between sarcopenia, CKM syndrome severity, and mortality risk.</p> Methods <p>This study analyzed data from 5,925 adults (aged ≥ 20 years) across eight NHANES cycles (1999–2006, 2011–2018). Sarcopenia was defined using FNIH criteria based on DXA-derived muscle mass. CKM syndrome staging followed the AHA classification. Multinomial and ordinal logistic regression examined the relationship between sarcopenia and CKM stage. Cox proportional hazards models evaluated the impact of sarcopenia on all-cause, cardiovascular (CVD), and non-CVD mortality. Sensitivity analysis was performed to confirm robustness.</p> Results <p>During a mean follow-up of 125.47 (0.94) months, 851 deaths occurred. Sarcopenia was significantly associated with increased odds of advanced CKM stages: (OR: 2.236, 95% CI: 1.594–3.135), stage 3 (OR: 3.332, 95% CI: 2.001–5.548) and stage 4 (OR: 3.495, 95% CI: 2.157–5.662), compared to Stage 1. Sarcopenia also predicted higher mortality risks in patients with CKM stage 1–4: all-cause mortality (HR: 1.527, 95% CI: 1.274–1.831), CVD mortality (HR: 1.903, 95% CI: 1.299–2.788) and non-CVD mortality (HR: 1.407, 95% CI: 1.124–1.762).</p> Conclusion <p>Sarcopenia is strongly linked to CKM syndrome severity and is a predictor of mortality across CKM stages. These findings suggest that assessing and managing sarcopenia could offer a valuable strategy to mitigate disease progression and improve survival in individuals with CKM syndrome.</p>

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Sarcopenia (defined by low muscle mass) as a predictor of disease progression and mortality in cardiovascular-kidney-metabolic syndrome

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月14日

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  • Diar Zooravar

摘要

Background/objectives

Cardiovascular-Kidney-Metabolic (CKM) syndrome reflects the interconnected nature of cardiovascular, renal, and metabolic dysfunction. Sarcopenia, or the loss of skeletal muscle mass, is linked to adverse outcomes in chronic diseases, but its role within the CKM framework remains poorly defined. This study aimed to investigate the association between sarcopenia, CKM syndrome severity, and mortality risk.

Methods

This study analyzed data from 5,925 adults (aged ≥ 20 years) across eight NHANES cycles (1999–2006, 2011–2018). Sarcopenia was defined using FNIH criteria based on DXA-derived muscle mass. CKM syndrome staging followed the AHA classification. Multinomial and ordinal logistic regression examined the relationship between sarcopenia and CKM stage. Cox proportional hazards models evaluated the impact of sarcopenia on all-cause, cardiovascular (CVD), and non-CVD mortality. Sensitivity analysis was performed to confirm robustness.

Results

During a mean follow-up of 125.47 (0.94) months, 851 deaths occurred. Sarcopenia was significantly associated with increased odds of advanced CKM stages: (OR: 2.236, 95% CI: 1.594–3.135), stage 3 (OR: 3.332, 95% CI: 2.001–5.548) and stage 4 (OR: 3.495, 95% CI: 2.157–5.662), compared to Stage 1. Sarcopenia also predicted higher mortality risks in patients with CKM stage 1–4: all-cause mortality (HR: 1.527, 95% CI: 1.274–1.831), CVD mortality (HR: 1.903, 95% CI: 1.299–2.788) and non-CVD mortality (HR: 1.407, 95% CI: 1.124–1.762).

Conclusion

Sarcopenia is strongly linked to CKM syndrome severity and is a predictor of mortality across CKM stages. These findings suggest that assessing and managing sarcopenia could offer a valuable strategy to mitigate disease progression and improve survival in individuals with CKM syndrome.