The Evolving Role of High‐Sensitivity C‐Reactive Protein for Mortality Prediction Across the Spectrum of Cardiovascular–Kidney–Metabolic Syndrome
Authors' conclusion
The association of hsCRP with mortality diminishes with CKM syndrome progression, suggesting a shift from inflammation-driven risk in early stages to complex multiorgan dysfunction in late stages.
Study context
- Population
- Participants of the Kailuan Study, across cardiovascular-kidney-metabolic (CKM) syndrome stages 0–413,960 deaths
- Participants
- 86,829 participants
- Exposure
- High-sensitivity C-reactive protein (hsCRP) and all-cause mortality by CKM stage
- Outcome
- All-cause mortality
- Follow-up
- Median 16.01 years
Methodological detailsstratified by AHA-defined CKM stages (0-4), multivariable Cox models
- Stratified by AHA-defined CKM stages (0-4)
- Multivariable Cox models
Main finding
As reported in the abstract
All-cause mortality per unit increase in ln(hsCRP), adjusted HR by CKM stage
| Group | aHR per ln(hsCRP) (95% CI) |
|---|---|
| Stage 0 | 1.11 (1.03-1.20) |
| Stage 1 | 1.14 (1.07-1.21) |
| Stage 2 | 1.08 (1.06-1.10) |
| Stage 3 | 1.05 (1.03-1.07) |
| Stage 4 | 1.04 (1.00-1.08) |
aHR per ln(hsCRP) (95% CI)
Stage 01.11 (1.03-1.20)
Stage 11.14 (1.07-1.21)
Stage 21.08 (1.06-1.10)
Stage 31.05 (1.03-1.07)
Stage 41.04 (1.00-1.08)
- Association attenuated progressively with advancing CKM stage (p for interaction)
- P for interaction < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Stage 0 | Stage 4 |
|---|---|---|
| All-cause mortality, hsCRP ≥2 vs <2 mg/L, by CKM stage | ||
| HR (CI) | 1.51 (1.15-1.98) | 1.07 (0.97-1.19) |
All-cause mortality, hsCRP ≥2 vs <2 mg/L, by CKM stage
- Declining mortality risks from Stage 0 to Stage 4
Restricted cubic splines
- Steep risk curves in early stages, plateau in advanced stages
Sensitivity analyses
- Sensitivity analyses supported robustness
Original publication
The Evolving Role of High‐Sensitivity C‐Reactive Protein for Mortality Prediction Across the Spectrum of Cardiovascular–Kidney–Metabolic Syndrome. Diabetes Obes Metab. Published 10 May 2026. doi:10.
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