{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:14:49Z","timestamp":1789172089154,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72104061"],"award-info":[{"award-number":["72104061"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"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>Background<\/jats:title>\n                    <jats:p>\n                      The effects of exposure to fine particulate matter (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ) constituents on the dynamic progression of cardiovascular\u2010kidney\u2010metabolic (CKM) syndrome remain unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Based on the Guangzhou Older Longitudinal Dynamic Health (GOLD\u2010Health) cohort, we included 41\u2009175 individuals at CKM stage 0\u20131, 266\u2009016 at stage 2, and 206\u2009692 at stage 3, classified according to American Heart Association guidelines. Individual\u2010level exposures to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      and its five constituents\u2014black carbon (BC), organic matter (OM), sulphate (SO\n                      <jats:sub>4<\/jats:sub>\n                      <jats:sup>2\u2212<\/jats:sup>\n                      ), nitrate (NO\n                      <jats:sub>3<\/jats:sub>\n                      <jats:sup>\u2212<\/jats:sup>\n                      ) and ammonium (NH\n                      <jats:sub>4<\/jats:sub>\n                      <jats:sup>+<\/jats:sup>\n                      )\u2014were estimated at geocoded residential addresses using bilinear interpolation. Multi\u2010state models and accelerated failure time (AFT) models were applied to evaluate associations with dynamic CKM progression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During 1.49 million person\u2010years of follow\u2010up, we documented 26\u2009089 transitions from stage 0\u20131 to stage 2, 125\u2009456 to stage 3, 18\u2009561 to stage 4, and 39\u2009614 deaths. Exposure to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      and all five constituents was significantly associated with CKM stage transitions, with effect estimates varying across stages. The transition from stage 3 to stage 4 showed the greatest risk, with a highest hazard ratio of 1.562 (95% CI: 1.548\u20131.577). AFT models further indicated that higher exposure levels were associated with accelerated CKM progression, with OM exhibiting the strongest effects across most transitions; for example, each standard deviation increase in OM exposure was associated with a 22.1% acceleration in transition time from stage 2 to stage 3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Targeted mitigation of PM\n                      <jats:sub>2.5<\/jats:sub>\n                      constituents, particularly organic matter, may help slow CKM progression and reduce the associated disease burden.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70953","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:13:21Z","timestamp":1780647201000},"page":"7443-7456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of\n                    <scp>\n                      PM\n                      <sub>2<\/sub>\n                    <\/scp>\n                    <sub>.5<\/sub>\n                    and Its Constituents With the Dynamic and Accelerated Progression of Cardiovascular\u2010Kidney\u2010Metabolic Syndrome: The Gold\u2010Health Cohort"],"prefix":"10.1111","volume":"28","author":[{"given":"Hui","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Basic Public Health Services Guangzhou Center for Disease Control and Prevention (Guangzhou Health Supervision Institute)  Guangzhou China"},{"name":"Institute of Public Health Guangzhou Medical University &amp; Guangzhou 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