Impact of Lung Function and COPD on the Prevalence and Mortality of CKM Syndrome: Evidence from a Cross-Sectional Study

Chronic obstructive pulmonary disease (COPD) and cardiovascular-kidney-metabolic (CKM) syndrome are major public health concerns, yet their interrelationship remains under-explored. This study investigates the impact of lung function and COPD on the prevalence and mortality of CKM syndrome using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2012. A cross-sectional analysis of 5569 adults was conducted, defining CKM stages per the 2023 American Heart Association framework. Lung function was assessed <i>via</i> prebronchodilator spirometry, with COPD classified using GOLD criteria. Advanced CKM syndrome (stages 3–4) was the primary outcome. Associations were evaluated using survey-weighted logistic regression, restricted cubic splines (RCS), and cox proportional hazards models. Among participants, 10.7% had advanced CKM syndrome. COPD was significantly associated with advanced CKM(adjusted OR = 1.52 [1.11, 2.09]), with escalating risks across GOLD stages (GOLD stage II: OR = 2.13 [1.21, 3.74]; GOLD stage III–IV: OR = 4.38 [1.06, 18.02]). Pre-COPD conditions, including preserved ratio impaired spirometry (PRISm) (OR = 2.62 [1.66, 4.14]) and chronic bronchitis (OR = 2.60 [1.50, 4.53]), also showed significant associations. COPD increased all-cause mortality (HR = 1.40 [1.04, 1.89]) and cardiovascular-related mortality (HR = 1.81 [1.04, 3.14]) in individuals aged ≥50 with advanced CKM. COPD is strongly associated with advanced CKM syndrome and increased mortality. These findings highlight the systemic impact of lung health on CKM progression and outcomes, emphasizing the need for integrated screening and management strategies targeting both pulmonary and cardiometabolic health, especially in older adults.