{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:39:26Z","timestamp":1792431566434,"version":"4.5.0"},"reference-count":51,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2023MH337"],"award-info":[{"award-number":["ZR2023MH337"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370272"],"award-info":[{"award-number":["82370272"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Experimental Gerontology"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.exger.2026.113297","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T21:41:01Z","timestamp":1787521261000},"page":"113297","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Muscle health and cardiovascular risk across stages of Cardiovascular-Kidney-Metabolic syndrome: A prospective cohort study"],"prefix":"10.1016","volume":"224","author":[{"given":"Ying","family":"Hou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongqian","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jixiang","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengqiang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihang","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"21","key":"10.1016\/j.exger.2026.113297_bb0005","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1001\/jama.2024.6892","article-title":"Prevalence of cardiovascular-kidney-metabolic syndrome stages in US adults, 2011\u20132020","volume":"331","author":"Aggarwal","year":"2024","journal-title":"JAMA"},{"key":"10.1016\/j.exger.2026.113297_bb0010","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.17506","article-title":"Agreement and differences between the equations for estimating muscle and bone mass using the anthropometric method in recreational strength trainees","volume":"12","author":"Baglietto","year":"2024","journal-title":"PeerJ"},{"issue":"14","key":"10.1016\/j.exger.2026.113297_bb0015","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.016845","article-title":"Short physical performance battery and incident cardiovascular events among older women","volume":"9","author":"Bellettiere","year":"2020","journal-title":"J. Am. Heart Assoc."},{"issue":"5","key":"10.1016\/j.exger.2026.113297_bb0020","first-page":"465","article-title":"Muscle strength: clinical and prognostic value of hand-grip dynamometry","volume":"18","author":"Bohannon","year":"2015","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"issue":"7382","key":"10.1016\/j.exger.2026.113297_bb0025","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/nature10777","article-title":"A PGC1-\u03b1-dependent myokine that drives brown-fat-like development of white fat and thermogenesis","volume":"481","author":"Bostr\u00f6m","year":"2012","journal-title":"Nature"},{"key":"10.1016\/j.exger.2026.113297_bb0030","article-title":"Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK biobank participants","volume":"361","author":"Celis-Morales","year":"2018","journal-title":"BMJ (Clinical research ed)"},{"key":"10.1016\/j.exger.2026.113297_bb0035","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2020.00022","article-title":"Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease","volume":"7","author":"Chait","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"issue":"11","key":"10.1016\/j.exger.2026.113297_bb0040","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1038\/s43587-025-01004-y","article-title":"A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update","volume":"5","author":"Chen","year":"2025","journal-title":"Nat. Aging"},{"issue":"12","key":"10.1016\/j.exger.2026.113297_bb0045","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1016\/j.cmet.2023.10.015","article-title":"Cardiovascular-kidney-metabolic syndrome: a step toward multidisciplinary and inclusive care","volume":"35","author":"Claudel","year":"2023","journal-title":"Cell Metab."},{"issue":"20","key":"10.1016\/j.exger.2026.113297_bb0050","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1161\/CIRCULATIONAHA.123.064071","article-title":"Sarcopenia and cardiovascular diseases","volume":"147","author":"Damluji","year":"2023","journal-title":"Circulation"},{"issue":"Suppl. 1","key":"10.1016\/j.exger.2026.113297_bb0055","first-page":"S111","article-title":"6. Glycemic goals and hypoglycemia: standards of care in diabetes-2024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"10.1016\/j.exger.2026.113297_bb0060","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2021.659107","article-title":"Reference values for five-repetition chair stand test among middle-aged and elderly community-dwelling Chinese adults","volume":"8","author":"Gao","year":"2021","journal-title":"Front. Med."},{"issue":"3","key":"10.1016\/j.exger.2026.113297_bb0065","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1017\/S0029665124007559","article-title":"Exploring the association between sarcopenic obesity and cardiovascular risk: a summary of findings from longitudinal studies and potential mechanisms","volume":"84","author":"Guan","year":"2025","journal-title":"Proc. Nutr. Soc."},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0070","doi-asserted-by":"crossref","DOI":"10.1002\/jcsm.13726","article-title":"Device-measured physical activity, sedentary behaviour and risk of chronic kidney diseases across levels of grip strength","volume":"16","author":"He","year":"2025","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"10.1016\/j.exger.2026.113297_bb0075","doi-asserted-by":"crossref","DOI":"10.1016\/j.archger.2019.103937","article-title":"Effect of relative handgrip strength on cardiovascular disease among Korean adults aged 45 years and older: results from the Korean Longitudinal Study of Aging (2006\u20132016)","volume":"86","author":"Jang","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"issue":"4","key":"10.1016\/j.exger.2026.113297_bb0080","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1161\/CIRCRESAHA.121.319902","article-title":"Sex differences in myocardial and vascular aging","volume":"130","author":"Ji","year":"2022","journal-title":"Circ. Res."},{"issue":"8","key":"10.1016\/j.exger.2026.113297_bb0085","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.jacc.2023.12.019","article-title":"Sex differences in association of physical activity with all-cause and cardiovascular mortality","volume":"83","author":"Ji","year":"2024","journal-title":"J. Am. Coll. Cardiol."},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0090","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1161\/ATVBAHA.124.321629","article-title":"Sex differences in cardiovascular-kidney-metabolic syndrome: 30-year US trends and mortality risks-brief report","volume":"45","author":"Ji","year":"2025","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"issue":"24","key":"10.1016\/j.exger.2026.113297_bb0095","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1161\/CIR.0000000000001191","article-title":"Novel prediction equations for absolute risk assessment of total cardiovascular disease incorporating cardiovascular-kidney-metabolic health: a scientific statement from the American Heart Association","volume":"148","author":"Khan","year":"2023","journal-title":"Circulation"},{"issue":"6","key":"10.1016\/j.exger.2026.113297_bb0100","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1161\/CIRCULATIONAHA.123.067626","article-title":"Development and validation of the American Heart Association\u2019s PREVENT equations","volume":"149","author":"Khan","year":"2024","journal-title":"Circulation"},{"issue":"3\u20134","key":"10.1016\/j.exger.2026.113297_bb0105","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1080\/07853890.2020.1748220","article-title":"Handgrip strength is inversely associated with fatal cardiovascular and all-cause mortality events","volume":"52","author":"Laukkanen","year":"2020","journal-title":"Ann. Med."},{"issue":"6","key":"10.1016\/j.exger.2026.113297_bb0110","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.amepre.2015.10.022","article-title":"Associations of relative handgrip strength and cardiovascular disease biomarkers in U.S. adults, 2011\u20132012","volume":"50","author":"Lawman","year":"2016","journal-title":"Am. J. Prev. Med."},{"issue":"9990","key":"10.1016\/j.exger.2026.113297_bb0115","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S0140-6736(14)62000-6","article-title":"Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study","volume":"386","author":"Leong","year":"2015","journal-title":"Lancet (London, England)"},{"issue":"4","key":"10.1016\/j.exger.2026.113297_bb0120","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1053\/j.ajkd.2010.02.337","article-title":"Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions","volume":"55","author":"Levey","year":"2010","journal-title":"Am. J. Kidney Dis."},{"issue":"6","key":"10.1016\/j.exger.2026.113297_bb0125","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jshs.2020.10.005","article-title":"The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension: findings from the Prospective Urban Rural Epidemiology China study","volume":"10","author":"Liu","year":"2021","journal-title":"J. Sport Health Sci."},{"issue":"12","key":"10.1016\/j.exger.2026.113297_bb0130","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1038\/s41366-025-01909-z","article-title":"Sarcopenic obesity and risk of cardio-cerebrovascular disease and mortality: a systematic review and meta-analysis","volume":"49","author":"Luo","year":"2005","journal-title":"Int. J. Obes. (Lond)"},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0135","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s40520-025-03209-y","article-title":"Sex- and age-stratified relative handgrip strength and risk of eight chronic diseases in middle-aged and older adults: evidence from a national aging cohort study in China","volume":"37","author":"Nan","year":"2025","journal-title":"Aging Clin. Exp. Res."},{"issue":"20","key":"10.1016\/j.exger.2026.113297_bb0140","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1161\/CIR.0000000000001186","article-title":"A synopsis of the evidence for the science and clinical management of Cardiovascular-Kidney-Metabolic (CKM) syndrome: a scientific statement from the American Heart Association","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation"},{"issue":"20","key":"10.1016\/j.exger.2026.113297_bb0145","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1161\/CIR.0000000000001184","article-title":"Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation"},{"issue":"11","key":"10.1016\/j.exger.2026.113297_bb0150","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/heartjnl-2018-313816","article-title":"Grip strength predicts cardiac adverse events in patients with cardiac disorders: an individual patient pooled meta-analysis","volume":"105","author":"Pavasini","year":"2019","journal-title":"Heart"},{"issue":"4","key":"10.1016\/j.exger.2026.113297_bb0155","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1152\/physrev.90100.2007","article-title":"Muscle as an endocrine organ: focus on muscle-derived interleukin-6","volume":"88","author":"Pedersen","year":"2008","journal-title":"Physiol. Rev."},{"issue":"5","key":"10.1016\/j.exger.2026.113297_bb0160","doi-asserted-by":"crossref","first-page":"E453","DOI":"10.1152\/ajpendo.00553.2012","article-title":"Cross-talk between skeletal muscle and immune cells: muscle-derived mediators and metabolic implications","volume":"304","author":"Pillon","year":"2013","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"issue":"12","key":"10.1016\/j.exger.2026.113297_bb0165","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.clnu.2024.10.022","article-title":"Joint associations of handgrip strength and physical activity with incident cardiovascular disease and overall mortality in the UK Biobank","volume":"43","author":"Polo-L\u00f3pez","year":"2024","journal-title":"Clin. Nutr."},{"key":"10.1016\/j.exger.2026.113297_bb0170","doi-asserted-by":"crossref","DOI":"10.1016\/j.maturitas.2025.108248","article-title":"Association of chair stand performance with all-cause and cardiovascular mortality in older adults with hypertension: a 28-country study","volume":"196","author":"Polo-L\u00f3pez","year":"2025","journal-title":"Maturitas"},{"key":"10.1016\/j.exger.2026.113297_bb0175","doi-asserted-by":"crossref","DOI":"10.1177\/1179546818771894","article-title":"Associations of grip strength and change in grip strength with all-cause and cardiovascular mortality in a European older population","volume":"12","author":"Prasitsiriphon","year":"2018","journal-title":"Clin. Med. Insights Cardiol."},{"issue":"3","key":"10.1016\/j.exger.2026.113297_bb0180","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1152\/physrev.1997.77.3.731","article-title":"Cellular energy utilization and molecular origin of standard metabolic rate in mammals","volume":"77","author":"Rolfe","year":"1997","journal-title":"Physiol. Rev."},{"issue":"4","key":"10.1016\/j.exger.2026.113297_bb0185","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/apha.12246","article-title":"Adipose tissue and its role in organ crosstalk","volume":"210","author":"Romacho","year":"2014","journal-title":"Acta Physiol (Oxf.)"},{"issue":"12 Pt 1","key":"10.1016\/j.exger.2026.113297_bb0190","article-title":"Vascular aging, cardiovascular-kidney-metabolic syndrome, and cardiovascular risk: the northern Shanghai study","volume":"4","author":"Shi","year":"2025","journal-title":"JACC Adv."},{"key":"10.1016\/j.exger.2026.113297_bb0195","doi-asserted-by":"crossref","DOI":"10.1016\/j.archger.2025.106023","article-title":"Handgrip strength as a predictor of new-onset cardiovascular disease: insights from the Korean genome and epidemiology study (KoGES) cohort","volume":"139","author":"Song","year":"2025","journal-title":"Arch. Gerontol. Geriatr."},{"issue":"3","key":"10.1016\/j.exger.2026.113297_bb0200","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.jshs.2020.06.009","article-title":"Handgrip strength and health outcomes: umbrella review of systematic reviews with meta-analyses of observational studies","volume":"10","author":"Soysal","year":"2021","journal-title":"J. Sport Health Sci."},{"issue":"12","key":"10.1016\/j.exger.2026.113297_bb0205","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1161\/CIRCRESAHA.111.262493","article-title":"Adipose tissue biology and cardiomyopathy: translational implications","volume":"111","author":"Turer","year":"2012","journal-title":"Circ. Res."},{"key":"10.1016\/j.exger.2026.113297_bb0210","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajpc.2025.101060","article-title":"Sarcopenia and cardiovascular disease among adults with cardiovascular-kidney-metabolic syndrome stages 0\u20133: a prospective cohort study","volume":"23","author":"Wei","year":"2025","journal-title":"Am. J. Prev. Cardiol."},{"issue":"6","key":"10.1016\/j.exger.2026.113297_bb0215","doi-asserted-by":"crossref","first-page":"551.e517","DOI":"10.1016\/j.jamda.2017.03.011","article-title":"Association of grip strength with risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations: a meta-analysis of prospective cohort studies","volume":"18","author":"Wu","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"10.1016\/j.exger.2026.113297_bb0220","doi-asserted-by":"crossref","DOI":"10.3389\/fnut.2023.1183973","article-title":"The association of handgrip strength with all-cause and cardiovascular mortality: results from the National Health and nutrition examination survey database prospective cohort study with propensity score matching","volume":"10","author":"Xiong","year":"2023","journal-title":"Front. Nutr."},{"issue":"22","key":"10.1016\/j.exger.2026.113297_bb0225","doi-asserted-by":"crossref","DOI":"10.3390\/jcm14228148","article-title":"Research progress on the association between sarcopenic obesity and atherosclerosis: current status and challenges","volume":"14","author":"Yang","year":"2025","journal-title":"J. Clin. Med."},{"issue":"7","key":"10.1016\/j.exger.2026.113297_bb0230","doi-asserted-by":"crossref","DOI":"10.1093\/ptj\/pzab101","article-title":"Physical activity, sedentary behavior, and skeletal muscle strength in patients with chronic kidney disease: an isotemporal substitution approach","volume":"101","author":"Yoshioka","year":"2021","journal-title":"Phys. Ther."},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0235","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s40520-024-02856-x","article-title":"Association of handgrip strength and risk of cardiovascular disease: a population-based cohort study","volume":"36","author":"Zhang","year":"2024","journal-title":"Aging Clin. Exp. Res."},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0240","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1186\/s12933-025-02960-w","article-title":"The relationship between C-reactive protein-triglyceride-glucose index and cardiovascular disease: insights from the China health and retirement longitudinal study (CHARLS)","volume":"24","author":"Zhang","year":"2025","journal-title":"Cardiovasc. Diabetol."},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0245","doi-asserted-by":"crossref","DOI":"10.1080\/13685538.2025.2534558","article-title":"Relationship of prolonged sit-to-stand test duration and cardiovascular disease risk in middle-aged and older adults: evidence from CHARLS","volume":"28","author":"Zhang","year":"2025","journal-title":"Aging Male"},{"issue":"1","key":"10.1016\/j.exger.2026.113297_bb0250","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int. J. Epidemiol."},{"issue":"7","key":"10.1016\/j.exger.2026.113297_bb0255","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.jacasi.2025.04.007","article-title":"Prevalence and mortality of cardiovascular-kidney-metabolic syndrome in China: a nationwide population-based study","volume":"5","author":"Zheng","year":"2025","journal-title":"JACC Asia"}],"container-title":["Experimental Gerontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0531556526002767?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0531556526002767?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:44:21Z","timestamp":1792428261000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0531556526002767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":51,"alternative-id":["S0531556526002767"],"URL":"https:\/\/doi.org\/10.1016\/j.exger.2026.113297","relation":{},"ISSN":["0531-5565"],"issn-type":[{"value":"0531-5565","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Muscle health and cardiovascular risk across stages of Cardiovascular-Kidney-Metabolic syndrome: A prospective cohort study","name":"articletitle","label":"Article Title"},{"value":"Experimental Gerontology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.exger.2026.113297","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"113297"}}