背景:在美国,不良的心血管-肾脏代谢(CKM)健康与过早死亡和高发病率相关。不良社会状况在生命过程中对心脏代谢疾病有显著影响。我们旨在研究美国成年人中社会风险状况(SRP)与CKM多重性之间的关联。
结果:我们使用了1999年至2018年国家健康与营养检查调查的数据。CKM综合征的定义是亚临床或临床心血管疾病的共存,慢性肾病,和代谢紊乱。我们根据不同形式的CKM综合征的不同临床严重程度,将参与者分为4个CKM阶段。我们计算了积极的SRP措施的总和,包括受雇者,高收入水平,粮食安全,高学历,私人保险,拥有一所房子,结了婚,作为SRP得分,并按四分位数将其分为4个级别:低(0-2),中下(3-4),中上(5-6),高(7-8)共有18373名美国成年人,20至79岁,包括在我们的分析中。有2567名(9.4%)SRP得分较低的参与者。大多数单独的SRP措施和组合的SRP评分与CKM分期相关。与高SRP得分水平相比,低SRP水平与CKM1期的几率较高相关(优势比[OR],1.34[95%CI,1.06-1.70]),CKM阶段2(或,2.03[95%CI,1.59-2.58]),CKM阶段3(或,5.28[95%CI,3.29-8.47]),和CKM阶段4(或,5.97[95%CI,4.20-8.49])。
结论:累积的社会劣势,用较高的SRP负担表示,与CKM多发病的几率较高有关,独立于人口和生活方式因素。
BACKGROUND: Poor cardiovascular-kidney-metabolic (CKM) health is associated with premature mortality and excess morbidity in the United States. Adverse social conditions have a prominent impact on cardiometabolic diseases during the life course. We aim to examine the association between social risk profile (SRP) and CKM multimorbidity among US adults.
RESULTS: We used data from the National Health and Nutrition Examination Survey from 1999 to 2018. The definition of CKM syndrome is the coexistence of subclinical or clinical cardiovascular disease, chronic kidney disease, and metabolic disorders. We classified participants by 4 CKM stages according to the different clinical severity of different forms of CKM syndrome. We calculated the summed number of positive SRP measures, including employed, high-income level, food secure, high education attainment, private insurance, owning a house, and married, as SRP scores and classified them into 4 levels by quartiles: low (0-2), lower-middle (3-4), upper-middle (5-6), and high (7-8). A total of 18 373 US adults, aged 20 to 79 years, were included in our analyses. There were 2567 (9.4%) participants with low SRP score level. Most individual SRP measures and a combined SRP score were associated with CKM stages. Compared with high SRP score level, low SRP level was associated with higher odds of having CKM stage 1 (odds ratio [OR], 1.34 [95% CI, 1.06-1.70]), CKM stage 2 (OR, 2.03 [95% CI, 1.59-2.58]), CKM stage 3 (OR, 5.28 [95% CI, 3.29-8.47]), and CKM stage 4 (OR, 5.97 [95% CI, 4.20-8.49]).
CONCLUSIONS: Cumulative social disadvantage, denoted by higher SRP burden, was associated with higher odds of CKM multimorbidity, independent of demographic and lifestyle factors.