Associations Between the Inflammation Burden Index and Cardiovascular–Kidney–Metabolic Syndrome: A Cross-Sectional Study Based upon the NHANES Database
TL;DR
Elevated IBI holds promise for identifying individuals at high risk for advanced CKM syndrome as a composite inflammatory index that integrates multiple inflammatory cells and acute-phase proteins.
Abstract
Background: Cardiovascular–kidney–metabolic (CKM) syndrome is a systemic disorder manifested as the interconnected dysregulation of cardiovascular disease, chronic kidney disease, and metabolic abnormalities. Systemic inflammation was identified as an important contributor to CKM syndrome. Based on data from the National Health and Nutrition Examination Survey (NHANES), this research sought to explore associations between the inflammation burden index (IBI) and the risk of CKM syndrome (specifically stages 3–4). Methods: This research used data from six NHANES cycles (1999–2010). CKM stages were constructed based on the American Heart Association recommendations, with stages 3–4 classified as advanced CKM syndrome. Weighted multivariable logistic regression was used to investigate associations between IBI and CKM stages 3–4. Restricted cubic splines were employed to evaluate potential nonlinear relationships. Subgroup analyses stratified by age, sex, and body mass index were performed. Moreover, sensitivity analyses were conducted. Results: In total, 13,830 participants were included. Among them, 3322 were in CKM stages 3–4. In the fully adjusted model, IBI was positively associated with the risk of CKM stages 3–4 [odds ratio (OR) = 1.026, 95% confidence interval (CI): 1.008–1.044, P = 0.005]. In the sensitivity model excluding patients with hypertension and diabetes (Model 4), the association remained significant (OR = 1.030, 95% CI: 1.014–1.047, P < 0.001). RCS analyses further indicated a significant nonlinear dose–response relationship between IBI and the risk of CKM stages 3–4 (P for nonlinearity <0.001). This association remained reliable in subgroup and sensitivity analyses. Conclusions: Elevated IBI is independently associated with a higher risk of CKM syndrome. As a composite inflammatory index that integrates multiple inflammatory cells and acute-phase proteins, IBI holds promise for identifying individuals at high risk for advanced CKM syndrome.