Long-term Trends in the Prevalence of Cardiovascular-kidney-metabolic Syndrome in South Korea, 2011-2021: A representative Longitudinal Serial Study

Overview

Journal Lancet Reg Health West Pac

Date 2025 Feb 6

PMID 39911647

Authors

Yesol Yim

Jae E Lee

Yejun Son

Soeun Kim

Hojae Lee

Sooji Lee

Wonwoo Jang

Hanseul Cho

Hayeon Lee

Kyeongmin Lee

Hyesu Jo

Jaeyu Park

Jiyeon Oh

Louis Jacob

Jiseung Kang

Hyunji Sang

Sang Youl Rhee

Dong Keon Yon

Affiliations

Soon will be listed here.

Abstract

Background: The American Heart Association recently introduced a new framework, known as cardiovascular-kidney-metabolic (CKM) syndrome, aimed at the early prevention of cardiovascular disease. However, this syndrome has not been studied extensively outside of the United States. Thus, this study aimed to examine the long-term trends in CKM syndrome and its associated demographic features in South Korea.

Methods: This nationwide, cross-sectional study analyzed data from 61,106 Korean adults aged ≥20 years using the Korea National Health and Nutrition Examination Survey from 2011 to 2021. CKM syndrome was defined using the PREVENT equations, categorizing individuals into five stages (0-4). Age-standardized prevalence rates, annual percent changes (APC), and sociodemographic disparities were analyzed using multinomial logistic regression and Joinpoint regression.

Findings: Among the 61,106 participants (50.4% females [95% CI, 50.0-50.8%] and 49.6% males [95% CI, 49.2-50.0%]), stage 2 CKM syndrome was the most prevalent (43.4% [42.9-43.9]), followed by stages 1 (25.4% [25.0-25.8]), 0 (21.1% [20.7-21.6]), 3 (7.3% [7.0-7.5]), and 4 (2.8% [2.6-2.9]). From 2011 to 2021, advanced stages showed significant increases (APC for stage 4: 3.2%; 95% CI, 1.5-5.2), while stage 0 declined (APC: -1.9%; 95% CI, -3.8 to 0.0). Advanced stages were more common among vulnerable subgroups, including males, older adults, rural residents, smokers, drinkers, individuals with obesity, lower education levels, and lower household incomes.

Interpretation: This is the first study to investigate the long-term prevalence of CKM syndrome based on stages at the national level in an Asian population. Our findings emphasize the urgent need for tailored public health strategies targeting metabolic risk factors, particularly in vulnerable subgroups, to prevent progression to advanced CKM stages.

Funding: National Research Foundation of Korea.

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