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Association of physical activity and sedentary behavior with stages of cardiovascular–kidney–metabolic syndrome among U.S. adults: NHANES 2007–2020

Year: 2025

Type: article

Abstract: Background: Cardiovascular-kidney-metabolic (CKM) syndrome, newly defined by the American Heart Association, integrates metabolic risk factors, chronic kidney disease, and cardiovascular dysfunction. Although clinically important, evidence-based prevention strategies remain limited. This study examined associations of moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) with CKM stage in a representative U.S. adult sample. Methods: We used survey-weighted multinomial logistic regression and restricted cubic splines (RCS). MVPA was classified as 0, 1-149, and ≥ 150 min/week; SB as <5, 5-8, and ≥ 8 h/day; CKM was staged 0-4 (stage 0 as reference). Predefined subgroups were age (20-59 vs 60-79 years), sex (female vs male) and PIR (high >3.49; medium >1.49-<3.49; low ≤1.49). Results: Compared with individuals reporting no MVPA, those achieving ≥150 min/week had approximately 33 % lower odds of CKM stage 1 (OR 0.67, 95 % CI 0.46-0.97), 44 % lower odds of stage 2 (OR 0.56, 95 % CI 0.38-0.83), 92 % lower odds of stage 3 (OR 0.09, 95 % CI 0.02-0.32), and 65 % lower odds of stage 4 (OR 0.35, 95 % CI 0.19-0.63). Subgroup analyses by age, sex, poverty-income ratio, and SB indicated that the protective impact of MVPA was evident across age and socioeconomic subgroups, with relatively stronger associations among younger adults and benefits at both low and high socioeconomic strata. By contrast, SB showed weaker independent associations with CKM severity after full adjustment. Conclusions: Greater MVPA was associated with lower odds of advanced CKM stage. These findings highlight the role of physical activity in CKM prevention and support public health strategies to reduce lifestyle-related risks.

Source: American Heart Journal Plus Cardiology Research and Practice

DOI: 10.1016/j.ahjo.2025.100639

Authors: Shuo Pang, Yuxi Dongye, Yingwei Bi, Jianbo Wang

Institutions: First Affiliated Hospital of Dalian Medical University, Jinan Third People's Hospital

Language: English

Topic: Physical Activity and Health

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,810