Serum uric acid is associated with advanced stages in patients with cardiovascular-kidney-metabolic syndrome

BACKGROUND: In 2023, the American Heart Association introduced the cardiovascular-kidney-metabolic (CKM) syndrome to comprehensively assess multimorbidity involving obesity, diabetes, chronic kidney disease, and cardiovascular disease. This study aimed to explore the potential association between serum uric acid (SUA) level and advanced CKM syndrome. METHODS: This cross-sectional study analyzed data from U.S. adults collected in the National Health and Nutrition Examination Survey between 2011 and 2020. Participants were categorized into five CKM syndrome stages based on clinical severity. CKM syndrome stages 3 or 4 were considered advanced. Multivariable weighted Poisson regression with robust error variance were used. RESULTS: The final analysis included 15,839 patients diagnosed with CKM syndrome. Out of the total, 12,975 cases were classified as non-advanced CKM syndrome, and 2,864 cases were classified as advanced CKM syndrome. In the fully adjusted model, patients in the highest SUA quintile had a prevalence ratio of 1.32 (95% confidence interval: 1.14-1.53) for advanced stages compared to those in the lowest quintile, with a 7% increased risk per 1 mg/dL SUA elevation. Moreover, the restricted cubic spline curve indicated a significant increase in the likelihood of advanced stages when SUA level was ≥ 5.5 mg/dL. CONCLUSIONS: In patients with CKM syndrome, elevated SUA levels correlated with a higher prevalence of advanced stages, demonstrating a dose-response relationship. Our data underscore the importance of SUA screening among CKM syndrome patients for identifying individuals at higher risk.