Association of Cardiovascular‐Kidney‐Syndrome and Brain Macrostructure and Microstructure Injury: A Prospective Cohort Study
Errata to this article were published (Diabetes Obes Metab, Jul 2026 ↗ · Nov 2026 ↗)
Authors' conclusion
Our findings indicate that CKM syndrome severity is associated with abnormalities in brain macrostructure and microstructure. This is evidenced by both progressive white matter microstructural deterioration, which is detectable early, and concomitant, albeit more modest, declines in brain macrostructure. These results underscore the importance of early identification and monitoring of CKM syndrome to help mitigate or delay subsequent decline in brain health.
Study context
- Population
- Community-dwelling adults aged 50–75 years; mean age 61.9 years, 53.6% female3,038 analysed
- Participants
- 3,067 adults
- Exposure
- Cardiovascular-kidney-metabolic (CKM) syndrome stages 0-4
- Outcome
- Brain macrostructure (global/regional volumes, WMHV) and microstructure (DTI metrics) on MRI
Methodological detailscommunity-based, Brain MRI across three waves; adjusted linear regression and linear mixed-effects models
- Community-based
- Brain MRI across three waves; adjusted linear regression and linear mixed-effects models
Main finding
As reported in the abstract
- Cross-sectionally, advanced CKM stages (3-4) associated with reduced total brain, grey matter and cerebral white matter volumes, and increased white matter hyperintensity volume (WMHV)
- Longitudinally, higher baseline CKM stages (particularly Stages 2-3) associated with accelerated declines in these brain volumes and faster WMHV progression
Observational data: associations, not effects.
Further findings
White matter microstructure (diffusion tensor imaging (DTI))
- Stage-dependent progressive white matter microstructural deterioration, from focal alterations in early stages to widespread integrity loss in Stage 4 (reduced fractional anisotropy; elevated mean, axial and radial diffusivities)
Original publication
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