Poster #89: Christian Alvarado M.S.

Cardiometabolic–Kidney-Metabolic Syndrome and Accelerated Biological Aging in U.S. Adults

Christian Alvarado, MS; Banushree J Nehru, MBBS, MPH; Tarang Parekh, PhD, MBBS; 1. Center For Bioinformatics and Computational Biology, College of Engineering, University of Delaware, DE, USA 2. Department of Epidemiology, College of Health Sciences, University of Delaware, DE, USA

Cardiovascular–kidney–metabolic(CKM) syndrome reflects a continuum of cardiometabolic risk, yet its relationship with biological aging remains incompletely understood. Phenotypic Age provides an integrated biomarker-based measure of biological aging that may capture early physiologic deterioration beyond chronological age. Objective: To evaluate the association between CKM stage and biological age acceleration in a nationally representative sample of U.S. adults. We hypothesized that higher CKM stage would be associated with greater biological age acceleration. Methods: We analyzed 6,263 adults from NHANES 2017-2023. CKM stage(0-4) was defined using AHA-adapted criteria incorporating adiposity, metabolic risk factors, chronic kidney disease, and cardiovascular disease. Phenotypic Age was calculated using 9 clinical biomarkers and chronological age. Biological age acceleration was defined as the deviation of Phenotypic Age from expected values based on chronological age(survey-weighted residuals). Survey-weighted linear regression models adjusted for sociodemographic factors. Results: The weighted prevalence of CKM stage 3 and 4 was 9.6% and 9.0%, respectively. Mean biological age increased across CKM stages, and age acceleration shifted from negative in early stages to positive in advanced stages, indicating individuals with higher CKM burden appear biologically older than expected for their age. Compared with stage 0, adjusted biological age acceleration was higher for stage 1(β=2.34 years), stage 2(β=3.78 years), stage 3(β=7.42 years), and stage 4(β=7.94 years) (all p<0.001). Conclusion: CKM burden is strongly associated with accelerated biological aging. These findings suggest that CKM staging can identify individuals experiencing premature physiologic aging, highlighting opportunities for early prevention and risk reduction to improve long-term public health outcomes.