{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:12:56Z","timestamp":1791274376885,"version":"4.1.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:sec id=\"jah310949-sec-0001\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Risk factors for atherosclerotic cardiovascular disease begin in youth. Knowledge of the prevalence of cardio\u2010kidney\u2010metabolic (CKM) syndrome in adolescents and its risk factors is critical to understanding the cause of atherosclerotic cardiovascular disease risk burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310949-sec-0002\" xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a cross\u2010sectional analysis of the 2017 to 2020 US National Health and Nutrition Examination Survey data and determined the prevalence of each CKM stage in adolescents aged 12 to 18\u2009years. We then assessed the relationship between the family income\u2010to\u2010poverty ratio, health insurance, routine health care access, food security, health behaviors, and CKM stage. We quantified associations between social factors, behaviors, and CKM stages using generalized linear and logistic models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310949-sec-0003\" xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Of the 1774 surveyed US adolescents, representing 30\u2009327\u2009145, 56% (95% CI, 52\u201360) had CKM stage 0, 37% (95% CI, 33\u201340) had CKM stage 1, and 7% (95% CI, 5\u20139) had CKM stage 2. According to sex, race, ethnicity, and age\u2010adjusted analyses, a ratio of income\u2010to\u2010poverty level &gt;1.85, having health insurance, and food security were associated with a 32% (odds ratio [OR[, 0.68 [95% CI, 0.52\u20130.89]), 40% (OR, 0.60 [95% CI, 0.37\u20130.99]), and 45% (OR, 0.55 [95% CI, 0.41\u20130.73]) lower odds of CKM stage 1 to 2, respectively. After adjustment for all sociodemographic factors, only food security was associated with 40% lower odds of CKM stage 1 to 2 (OR, 0.60 [95% CI, 0.44\u20130.82]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310949-sec-0004\" xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In adolescents, CKM stages 1 to 2 are strongly associated with food insecurity. Improved access to healthy food and policies to address food security may help prevent higher CKM stages beginning in adolescence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.040269","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T05:41:09Z","timestamp":1747287669000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Prevalence of Cardiovascular\u2010Kidney\u2010Metabolic Stages in US Adolescents and Relationship to Social Determinants of Health"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7528-1586","authenticated-orcid":false,"given":"Carissa M.","family":"Baker\u2010Smith","sequence":"first","affiliation":[{"name":"Nemours Children\u2019s Health","place":["Wilmington"]},{"name":"Nemours Children\u2019s Health","place":["Wilmington"]},{"name":"Sidney Kimmel Medical College of Thomas Jefferson University","place":["Philadelphia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4416-0180","authenticated-orcid":false,"given":"Abigail M.","family":"Gauen","sequence":"additional","affiliation":[{"name":"Northwestern University","place":["Chicago"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0156-1219","authenticated-orcid":false,"given":"Lucia C.","family":"Petito","sequence":"additional","affiliation":[{"name":"Northwestern University","place":["Chicago"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0643-1859","authenticated-orcid":false,"given":"Sadiya S.","family":"Khan","sequence":"additional","affiliation":[{"name":"Northwestern University","place":["Chicago"]},{"name":"Northwestern University","place":["Chicago"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-4384","authenticated-orcid":false,"given":"Norrina B.","family":"Allen","sequence":"additional","affiliation":[{"name":"Northwestern University","place":["Chicago"]},{"name":"Northwestern University","place":["Chicago"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001186"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001184"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001078"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.319811"},{"key":"e_1_3_1_6_2","unstructured":"Disparities NIoMHaH . 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