Factors associated with the transition from health to disease for type 2 diabetes, cardiovascular disease and kidney dysfunction: A NAKO-IMMEDIATE analysis
- 1Max-Delbruck-Centrum fur Molekulare Medizin in der Helmholtz-Gemeinschaft
Abstract
BackgroundCardio-kidney-metabolic (CKM) diseases share risk factors, but their shared and distinct risk factors for disease progression remain unclear. We examined whether classical risk factors predict baseline CKM indicators and their longitudinal changes in a population-based German National Cohort (NAKO) sample.
MethodsIn 2,650 NAKO-IMMEDIATE participants selected for deep-phenotyping, baseline values and 5-year changes in -- glycated hemoglobin (HbA1c), systolic blood pressure (SBP), pulse wave velocity (PWV), and estimated glomerular filtration rate (eGFR) were linearly regressed on age, sex, education, alcohol and tobacco consumption, body mass index (BMI), and residuals of BMI-adjusted waist circumference (WC) with mutual adjustment.
ResultsBaseline values for HbA1c were 34.6{+/-}5.8 mmol/mol, for PWV 8.3{+/-}1.5 m/s, for SBP 128.0{+/-}15.7 mmHg and for eGFR 96.0{+/-}14.6 ml/min/1.73 m{superscript 2}. Cross-sectionally, all risk factors were associated with one or more of the CKM indicators, with age and BMI being associated with all four indicators. Over 5 years, HbA1c (1.2{+/-}4.2 mmol/mol), PWV (0.5{+/-}1.2 m/s) and SBP (0.6{+/-} 14.2 mmHg) increased, whereas eGFR (-2.3{+/-}9.5 ml/min/1.73 m{superscript 2}) decreased. Age (0.03 m/s per 5 year, 95% CI 0.01, 0.06 m/s) was associated with higher and BMI (-0.02 m/s per 1kg/m2, -0.03, -0.01) with lower PWV changes. No other risk factors were associated with CKM indicator changes.
ConclusionClassical risk factors were more frequently related to baseline CKM indicators than to their 5-year changes. Within longitudinal analyses, only age and BMI were related to PWV 5-year changes.
Clinical PerspectiveO_LIIt is well established that classical risk factors are associated with cardio-kidney and metabolic (CKM) diseases whereas their associations with longitudinal changes in CKM indicators are less well understood. C_LIO_LIThis study examines to what extent age, sex, education, alcohol and tobacco consumption, BMI and waist circumference are associated with glycated hemoglobin, systolic blood pressure, pulse wave velocity and estimated glomerular filtration rate at baseline and their 5-year changes. C_LIO_LIOnly age and BMI were associated with changes in PWV, while other longitudinal associations were non-significant, suggesting that classical CKM risk factors have greater utility for assessing cross-sectional CKM function than for predicting prospective changes in CKM function in the general population. C_LI
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BibTeX
@misc{chiappe2026factors,
title = {{Factors associated with the transition from health to disease for type 2 diabetes, cardiovascular disease and kidney dysfunction: A NAKO-IMMEDIATE analysis}},
author = {S. Gonzalez Chiappe and K. Nimptsch and I. Moreno Velasquez and M. Bouka and H. Becher and M. Dörr and M. Leitzmann and H. Volzke and S. Schipf and S. N. Willich and T. Keil and P. Sekula and K. H. Greiser and J. Tanoey and C. Frick and A. Peters and J. Six-Merker and G. Maskarinec and T. Pischon},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.01.26364547},
url = {https://www.medrxiv.org/content/10.64898/2026.10.01.26364547v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Factors associated with the transition from health to disease for type 2 diabetes, cardiovascular disease and kidney dysfunction: A NAKO-IMMEDIATE analysis
AU - S. Gonzalez Chiappe
AU - K. Nimptsch
AU - I. Moreno Velasquez
AU - M. Bouka
AU - H. Becher
AU - M. Dörr
AU - M. Leitzmann
AU - H. Volzke
AU - S. Schipf
AU - S. N. Willich
AU - T. Keil
AU - P. Sekula
AU - K. H. Greiser
AU - J. Tanoey
AU - C. Frick
AU - A. Peters
AU - J. Six-Merker
AU - G. Maskarinec
AU - T. Pischon
PY - 2026
DA - 2026/10/01
PB - medRxiv
DO - 10.64898/2026.10.01.26364547
UR - https://www.medrxiv.org/content/10.64898/2026.10.01.26364547v1
AB - BackgroundCardio-kidney-metabolic (CKM) diseases share risk factors, but their shared and distinct risk factors for disease progression remain unclear. We examined whether classical risk factors predict baseline CKM indicators and their longitudinal changes in a population-based German National Cohort (NAKO) sample. MethodsIn 2,650 NAKO-IMMEDIATE participants selected for deep-phenotyping, baseline values and 5-year changes in -- glycated hemoglobin (HbA1c), systolic blood pressure (SBP), pulse wave velocity (PWV), and estimated glomerular filtration rate (eGFR) were linearly regressed on age, sex, education, alcohol and tobacco consumption, body mass index (BMI), and residuals of BMI-adjusted waist circumference (WC) with mutual adjustment. ResultsBaseline values for HbA1c were 34.6{+/-}5.8 mmol/mol, for PWV 8.3{+/-}1.5 m/s, for SBP 128.0{+/-}15.7 mmHg and for eGFR 96.0{+/-}14.6 ml/min/1.73 m{superscript 2}. Cross-sectionally, all risk factors were associated with one or more of the CKM indicators, with age and BMI being associated with all four indicators. Over 5 years, HbA1c (1.2{+/-}4.2 mmol/mol), PWV (0.5{+/-}1.2 m/s) and SBP (0.6{+/-} 14.2 mmHg) increased, whereas eGFR (-2.3{+/-}9.5 ml/min/1.73 m{superscript 2}) decreased. Age (0.03 m/s per 5 year, 95% CI 0.01, 0.06 m/s) was associated with higher and BMI (-0.02 m/s per 1kg/m2, -0.03, -0.01) with lower PWV changes. No other risk factors were associated with CKM indicator changes. ConclusionClassical risk factors were more frequently related to baseline CKM indicators than to their 5-year changes. Within longitudinal analyses, only age and BMI were related to PWV 5-year changes. Clinical PerspectiveO_LIIt is well established that classical risk factors are associated with cardio-kidney and metabolic (CKM) diseases whereas their associations with longitudinal changes in CKM indicators are less well understood. C_LIO_LIThis study examines to what extent age, sex, education, alcohol and tobacco consumption, BMI and waist circumference are associated with glycated hemoglobin, systolic blood pressure, pulse wave velocity and estimated glomerular filtration rate at baseline and their 5-year changes. C_LIO_LIOnly age and BMI were associated with changes in PWV, while other longitudinal associations were non-significant, suggesting that classical CKM risk factors have greater utility for assessing cross-sectional CKM function than for predicting prospective changes in CKM function in the general population. C_LI
ER -