Young Adults With CKM Syndrome Show Early Vascular Injury: Study
According to a new study, young adults with cardiovascular-kidney-metabolic (CKM) syndrome showed evidence of early carotid artery injury, indicating that vascular damage may begin at a young age. They also had a greater burden of cardiovascular risk factors, reflected by lower American Heart Association Life’s Essential 8 scores, highlighting the importance of early risk-factor identification and prevention. The study was published in Circulation: Population Health and Outcomes by Vaishanavi K. and colleagues.
In order to determine the prevalence and structural determinants of CKM syndrome, 1,283 individuals from the FF-CHAYA study, a cohort of young adults with an average age of 22.9 ± 0.7 years (54.4% females) were assessed. CKM stages were classified based on recognized diagnostic guidelines for the American Heart Association, which included Stage 0 (absence of CKM risk factors), Stage 1 (excess adiposity), Stage 2 (metabolic risk factors such as hypertriglyceridemia, hypertension, or diabetes), and Stage 3 (subclinical cardiovascular disease or end-stage chronic kidney disease).
The measurement of cardiovascular health status was precisely determined by the AHA Life’s Essential 8 score, a comprehensive measure encompassing dietary patterns, physical activity levels, sleep status, smoking habits, body mass index, blood glycemia, blood lipids, and blood pressure. Measurement of structural vascular injury was directly assessed via non-invasive high-resolution carotid ultrasonography by assessing mean-mean carotid intima-medial thickness (cIMT), mean-maximum cIMT, and plaque gray scale median.
Key findings:
- Stage 0 (no risk factors) was present in 20.7% of participants, Stage 1 (excess adiposity) in 40.2%, Stage 2 (metabolic risk factors) in 36.2%, and Stage 3 (subclinical CVD or advanced kidney disease) in 2.8%.
- Compared to Stage 0, participants in advanced CKM stages exhibited significantly lower cardiovascular health scores (adjusted β: −7.6 [95% CI, −9.4 to −5.8] for Stage 1; −13.9 [95% CI, −15.7 to −12.0] for Stage 2; −13.2 [95% CI, −17.4 to −9.0] for Stage 3).
- Mean-maximum carotid intima-medial thickness was significantly higher across CKM stages relative to Stage 0, showing an increase of 0.014 mm (95% CI, 0.005–0.020) for Stage 1, 0.020 mm (95% CI, 0.017–0.035) for Stage 2, and 0.100 mm (95% CI, 0.085–0.128) for Stage 3.
- Advanced CKM stages were consistently associated with significantly higher mean-mean cIMT and reduced gray scale median, indicating greater structural arterial wall thickness and altered tissue echogenicity.
In summary, the correlation between the advanced stage of CKM among young adults and the low cardiovascular scores as well as markers of subclinical arterial disease is very significant. The identification of structural damage to carotid arteries in patients with an average age of 23 years proves that the cardiometabolic risk factors cause damage to the vasculature at an early age.
Reference:
Krishnan, V., Ning, H., Notterman, D. A., Goldman, N., Khan, S. S., Shah, N. S., Allen, N. B., & Lloyd-Jones, D. M. (2026). Association Between Cardiovascular-Kidney-Metabolic Health and Early Arterial Injury in Young Adults in the United States: The Future of Families–Cardiovascular Health Among Young Adults Study. Circulation: Population Health and Outcomes. https://doi.org/10.1161/circoutcomes.125.013042
