Cardiovascular–Kidney–Metabolic Syndrome Age Derived From Routine Health Checkup and Claims Data ― Large-Scale Epidemiological Study ―
Abstract
BACKGROUND: The cardiovascular-kidney-metabolic (CKM) framework emphasizes the interplay of metabolic, renal, and cardiovascular abnormalities in cardiovascular disease risk. We aimed to develop a CKM syndrome age algorithm using routinely collected health checkup and claims data in Japan. METHODS AND RESULTS: We conducted a cohort study of 376,612 men and 478,853 women aged 20-79 years in the DeSC database. Flexible parametric survival models were developed for 5 incident cardiovascular outcomes corresponding to CKM syndrome stage 4 (i.e., heart failure, myocardial infarction, atrial fibrillation, stroke, and peripheral arterial disease) and a composite outcome comprising these 5 outcomes. The models used available CKM-related variables obtained from health checkups and administrative claims data. Model performance was assessed using bootstrap internal validation. CKM syndrome age was defined as the age at which a hypothetical same-sex individual with an optimal CKM risk profile would have the same predicted 5-year risk as the participant. The developed prediction models showed acceptable discrimination across the 6 outcomes, with optimism-corrected Harrell's C-index ranging from 0.694 to 0.724 in men and from 0.653 to 0.716 in women. CKM syndrome age showed higher discrimination than chronological age alone across all outcomes and both sexes. CONCLUSIONS: CKM syndrome age may serve as an intuitive tool for communicating integrated cardiovascular risk beyond chronological age in health checkup settings.
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BibTeX
@article{suzuki2026cardiovascularkidneymetabolic,
title = {{Cardiovascular–Kidney–Metabolic Syndrome Age Derived From Routine Health Checkup and Claims Data ― Large-Scale Epidemiological Study ―}},
author = {Yuta Suzuki and Hidehiro Kaneko and Masachika Nishikawa and Akira Okada and Toshiyuki Ko and Takahiro Jimba and Atsushi Mizuno and Katsuhito Fujiu and Norifumi Takeda and Hiroyuki Morita and Tatsuhiko Azegami and Kaori Hayashi and Koichi Node and Hideo Yasunaga and Norihiko Takeda},
journal = {Circulation Journal},
year = {2026},
month = sep,
doi = {10.1253/circj.cj-26-0498},
url = {https://www.jstage.jst.go.jp/article/circj/90/10/90_CJ-26-0498/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Cardiovascular–Kidney–Metabolic Syndrome Age Derived From Routine Health Checkup and Claims Data ― Large-Scale Epidemiological Study ―
AU - Yuta Suzuki
AU - Hidehiro Kaneko
AU - Masachika Nishikawa
AU - Akira Okada
AU - Toshiyuki Ko
AU - Takahiro Jimba
AU - Atsushi Mizuno
AU - Katsuhito Fujiu
AU - Norifumi Takeda
AU - Hiroyuki Morita
AU - Tatsuhiko Azegami
AU - Kaori Hayashi
AU - Koichi Node
AU - Hideo Yasunaga
AU - Norihiko Takeda
PY - 2026
DA - 2026/09/25
JO - Circulation Journal
DO - 10.1253/circj.cj-26-0498
UR - https://www.jstage.jst.go.jp/article/circj/90/10/90_CJ-26-0498/_article
AB - BACKGROUND: The cardiovascular-kidney-metabolic (CKM) framework emphasizes the interplay of metabolic, renal, and cardiovascular abnormalities in cardiovascular disease risk. We aimed to develop a CKM syndrome age algorithm using routinely collected health checkup and claims data in Japan. METHODS AND RESULTS: We conducted a cohort study of 376,612 men and 478,853 women aged 20-79 years in the DeSC database. Flexible parametric survival models were developed for 5 incident cardiovascular outcomes corresponding to CKM syndrome stage 4 (i.e., heart failure, myocardial infarction, atrial fibrillation, stroke, and peripheral arterial disease) and a composite outcome comprising these 5 outcomes. The models used available CKM-related variables obtained from health checkups and administrative claims data. Model performance was assessed using bootstrap internal validation. CKM syndrome age was defined as the age at which a hypothetical same-sex individual with an optimal CKM risk profile would have the same predicted 5-year risk as the participant. The developed prediction models showed acceptable discrimination across the 6 outcomes, with optimism-corrected Harrell's C-index ranging from 0.694 to 0.724 in men and from 0.653 to 0.716 in women. CKM syndrome age showed higher discrimination than chronological age alone across all outcomes and both sexes. CONCLUSIONS: CKM syndrome age may serve as an intuitive tool for communicating integrated cardiovascular risk beyond chronological age in health checkup settings.
SN - 1347-4820
SN - 1346-9843
ER -