{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:13:48Z","timestamp":1789172028338,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>High\u2010sensitivity C\u2010reactive protein (hsCRP) is central to cardiovascular\u2013kidney\u2013metabolic (CKM) syndrome pathogenesis, but its prognostic value across progressive CKM stages remains uncertain. We aimed to evaluate the stage\u2010specific associations between hsCRP and mortality in CKM syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this prospective analysis of 86\u2009829 participants from the Kailuan Study, we evaluated hsCRP's association with all\u2010cause mortality stratified by AHA\u2010defined CKM stages (0\u20134). Multivariable Cox models assessed hazard ratios (HRs) for mortality per unit increase in ln(hsCRP) and by dichotomised hsCRP (&lt;\u20092 vs. \u2265\u20092\u2009mg\/L).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a median follow\u2010up of 16.01\u2009years, 13\u2009960 deaths occurred. HsCRP levels were associated with higher mortality across all stages, but the association progressively attenuated with advancing CKM stages. Adjusted HRs per ln(hsCRP) were 1.11 (95% CI: 1.03\u20131.20) in Stage 0, 1.14 (1.07\u20131.21) in Stage 1, 1.08 (1.06\u20131.10) in Stage 2, 1.05 (1.03\u20131.07) in Stage 3 and 1.04 (1.00\u20131.08) in Stage 4 (\n                      <jats:italic>p<\/jats:italic>\n                      for interaction &lt;\u20090.001). Similarly, dichotomised hsCRP showed declining mortality risks from Stage 0 (HR: 1.51, 1.15\u20131.98) to Stage 4 (HR: 1.07, 0.97\u20131.19). Restricted cubic splines confirmed this gradient, with early stages displaying steep risk curves that plateaued in advanced stages. Sensitivity analyses supported robustness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The association of hsCRP with mortality diminishes with CKM syndrome progression, suggesting a shift from inflammation\u2010driven risk in early stages to complex multiorgan dysfunction in late stages. These findings advocate for stage\u2010specific risk assessment, with hsCRP retaining utility in early CKM management but requiring integrated approaches in advanced disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70843","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:49:41Z","timestamp":1778460581000},"page":"6630-6638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Evolving Role of High\u2010Sensitivity C\u2010Reactive Protein for Mortality Prediction Across the Spectrum of Cardiovascular\u2013Kidney\u2013Metabolic Syndrome"],"prefix":"10.1111","volume":"28","author":[{"given":"Jing","family":"Li","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Beijing Neurosurgical Institute Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"Department of Clinical Epidemiology and Clinical Trial Capital Medical University  Beijing China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuohua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kailuan General Hospital, North China University of Science and Technology  Tangshan Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Beijing Neurosurgical Institute Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"Department of Clinical Epidemiology and Clinical Trial Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1719-0598","authenticated-orcid":false,"given":"Xue","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Beijing Neurosurgical Institute Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"Department of Clinical Epidemiology and Clinical Trial Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6021-1905","authenticated-orcid":false,"given":"Yuxiang","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Capital Medical University  Beijing 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