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Original article Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021
Sung-Bin Hong3orcid , Ji-Eun Kim2orcid , Seung Seok Han4orcid , Joseph J. Shearer2orcid , Jungnam Joo5orcid , Ji-Yeob Choi1orcid , Véronique L. Roger6orcid
Epidemiol Health 2025;e2025005
DOI: https://doi.org/10.4178/epih.e2025005 [Accepted]
Published online: February 14, 2025
1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
2Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States
3Department of Biology Education, Seoul National University, Seoul, Korea
4Division of Nephrology, Department of Internal Medicine, Seoul, Korea
5Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States
6Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States
Corresponding author:  Ji-Yeob Choi,
Email: miso77@snu.ac.kr
Véronique L. Roger,
Email: miso77@snu.ac.kr
Received: 31 October 2024   • Revised: 24 December 2024   • Accepted: 23 January 2025
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Abstract

OBJECTIVES
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 U.S. adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in South Korea and its association with demographic and socioeconomic status (SES).
METHODS
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3–4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, sex, and SES factors.
RESULTS
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7%–25.8%), stage 1 (19.3%; 95% CI, 18.9%–19.7%), stage 2 (51.6%; 95% CI, 51.1%–52.2%), and stages 3–4 (3.9%; 95% CI, 3.7%–4.0%). The prevalence of stages 2 and 3–4 was higher in men than in women. In addition, stages 3–4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 South Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.

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