Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021

Sung-Bin Hong; Ji-Eun Kim; Seung Seok Han; Joseph J. Shearer; Jungnam Joo; Ji-Yeob Choi; Véronique  L. Roger

doi:10.4178/epih.e2025005

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Original Article Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021: Sung-Bin Hong¹ , Ji-Eun Kim^2,3 , Seung Seok Han⁴ , Joseph J. Shearer² , Jungnam Joo⁵ , Ji-Yeob Choi^6,7,8,9 , Véronique L. Roger²; Epidemiol Health 2025;47e2025005-0
DOI: https://doi.org/10.4178/epih.e2025005
Published online: February 14, 2025

¹Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
²Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
³Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
⁴Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine Seoul, Korea
⁵Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
⁶Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
⁷BK21Plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea
⁸Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
⁹Cancer Research Institute, Seoul National University, Seoul, Korea

Corresponding author: Ji-Yeob Choi,
Email: miso77@snu.ac.kr
Véronique L. Roger,
Email: veronique.roger@nih.gov

Received: 31 October 2024 • Accepted: 23 January 2025

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Abstract

OBJECTIVES
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).
METHODS
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.
RESULTS
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.

Keywords: Cardiovascular diseases; Chronic kidney diseases; Metabolic syndrome; Socioeconomic status; Pandemic

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