{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:59:53Z","timestamp":1790031593305,"version":"4.0.1"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"The Guangzhou Science and Technology Program","award":["Project No. 2023A04J0625"],"award-info":[{"award-number":["Project No. 2023A04J0625"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc. Diabetol. \u2013 Endocrinol. Rep."],"DOI":"10.1186\/s40842-026-00331-2","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:02:52Z","timestamp":1790028172000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phenotypic age metrics for risk stratification of chronic disease burden and all-cause mortality in adults"],"prefix":"10.1186","volume":"12","author":[{"given":"Zihao","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinru","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhou","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baojia","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longlong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuting","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haimei","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dafu","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengzhi","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutong","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaduo","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingguo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"4","key":"331_CR1","doi-asserted-by":"publisher","first-page":"e057017","DOI":"10.1136\/bmjopen-2021-057017","volume":"12","author":"IS-S Ho","year":"2022","unstructured":"Ho IS-S, Azcoaga-Lorenzo A, Akbari A, Davies J, Hodgins P, Khunti K, Kadam U, Lyons R, McCowan C, Mercer SW, Nirantharakumar K, Guthrie B. Variation in the Estimated Prevalence of Multimorbidity: Systematic Review and Meta-Analysis of 193 International Studies. BMJ Open. 2022;12(4):e057017. https:\/\/doi.org\/10.1136\/bmjopen-2021-057017.","journal-title":"BMJ Open"},{"issue":"5","key":"331_CR2","doi-asserted-by":"publisher","first-page":"e0301485","DOI":"10.1371\/journal.pone.0301485","volume":"19","author":"A Banstola","year":"2024","unstructured":"Banstola A, Anokye N, Pokhrel S. The Economic Burden of Multimorbidity: Protocol for a Systematic Review. PLoS ONE. 2024;19(5):e0301485. https:\/\/doi.org\/10.1371\/journal.pone.0301485.","journal-title":"PLoS ONE"},{"issue":"1","key":"331_CR3","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40842-026-00283-7","volume":"12","author":"G Santulli","year":"2026","unstructured":"Santulli G. Epidemiology of Cardiovascular Disease and Diabetes in 2026: Expanding Prevalence, Escalating Costs, and the Limits of Contemporary Prevention. Cardiovasc Diabetol Endocrinol Rep. 2026;12(1):15. https:\/\/doi.org\/10.1186\/s40842-026-00283-7.","journal-title":"Cardiovasc Diabetol Endocrinol Rep"},{"issue":"1","key":"331_CR4","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s40258-017-0346-6","volume":"16","author":"L Wang","year":"2017","unstructured":"Wang L, Si L, Cocker F, Palmer AJ, Sanderson KA. Systematic Review of Cost-of-Illness Studies of Multimorbidity. Appl Health Econ Health Policy. 2017;16(1):15\u201329. https:\/\/doi.org\/10.1007\/s40258-017-0346-6.","journal-title":"Appl Health Econ Health Policy"},{"issue":"1","key":"331_CR5","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1186\/s12916-022-02427-9","volume":"20","author":"PB Tran","year":"2022","unstructured":"Tran PB, Kazibwe J, Nikolaidis GF, Linnosmaa I, Rijken M, van Olmen J. Costs of Multimorbidity: A Systematic Review and Meta-Analyses. BMC Med. 2022;20(1):234. https:\/\/doi.org\/10.1186\/s12916-022-02427-9.","journal-title":"BMC Med"},{"issue":"1","key":"331_CR6","doi-asserted-by":"publisher","first-page":"e000505","DOI":"10.1136\/bmjgh-2017-000505","volume":"3","author":"G Sum","year":"2018","unstructured":"Sum G, Hone T, Atun R, Millett C, Suhrcke M, Mahal A, Koh GC-H, Lee JT. Multimorbidity and Out-of-Pocket Expenditure on Medicines: A Systematic Review. BMJ Glob Health. 2018;3(1):e000505. https:\/\/doi.org\/10.1136\/bmjgh-2017-000505.","journal-title":"BMJ Glob Health"},{"issue":"702","key":"331_CR7","doi-asserted-by":"publisher","first-page":"e39","DOI":"10.3399\/bjgp20X713897","volume":"71","author":"M Soley-Bori","year":"2020","unstructured":"Soley-Bori M, Ashworth M, Bisquera A, Dodhia H, Lynch R, Wang Y, Fox-Rushby J. Impact of Multimorbidity on Healthcare Costs and Utilisation: A Systematic Review of the UK Literature. Br J Gen Pract. 2020;71(702):e39\u201346. https:\/\/doi.org\/10.3399\/bjgp20X713897.","journal-title":"Br J Gen Pract"},{"issue":"7721","key":"331_CR8","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41586-018-0457-8","volume":"561","author":"L Partridge","year":"2018","unstructured":"Partridge L, Deelen J, Slagboom PE. Facing up to the Global Challenges of Ageing. Nature. 2018;561(7721):45\u201356. https:\/\/doi.org\/10.1038\/s41586-018-0457-8.","journal-title":"Nature"},{"issue":"1","key":"331_CR9","doi-asserted-by":"publisher","first-page":"e70464","DOI":"10.1111\/liv.70464","volume":"46","author":"A Perkin","year":"2025","unstructured":"Perkin A, Armasu SM, Fan WZ, Yalley NN, Yan IK, Ahmed FY, Izquierdo-Sanchez L, Boix L, Rojas A, Banales JM, Reig M, St\u00e5l P, G\u00f3mez MR, Singal AG, Roberts LR, Wangensteen KJ, Berglund A, Patel T, Antwi SO. Association of Epigenetic Aging Biomarkers With Risk of MASLD-Related HCC. Liver Int. 2025;46(1):e70464. https:\/\/doi.org\/10.1111\/liv.70464.","journal-title":"Liver Int"},{"key":"331_CR10","doi-asserted-by":"publisher","unstructured":"Sun Z, Guo X, Wu S, Jia T, Kou C, Bai W. Accelerated biological aging and schizophrenia risk: evidence from the UK Biobank. Schizophr Bull. 2025;sbaf210. https:\/\/doi.org\/10.1093\/schbul\/sbaf210.","DOI":"10.1093\/schbul\/sbaf210"},{"key":"331_CR11","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-025-01990-2","author":"R Hamaya","year":"2025","unstructured":"Hamaya R, Li S, Chen BH, Pereira AC, Rigby N, Zhu H, Ivey KL, Rist PM, Manson JE, Dong Y, Sesso HD. Longitudinal Changes in Epigenetic Measures over 2 Years: Methodological Implications. Geroscience. 2025. https:\/\/doi.org\/10.1007\/s11357-025-01990-2.","journal-title":"Geroscience"},{"issue":"1","key":"331_CR12","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1186\/s13148-025-01976-z","volume":"17","author":"H Liu","year":"2025","unstructured":"Liu H, Yin Z, Chen X, Wang Z. Exploring Causal Relationships between Epigenetic Age Acceleration and Alzheimer\u2019s Disease: A Bidirectional Mendelian Randomization Study. Clin Epigenet. 2025;17(1):164. https:\/\/doi.org\/10.1186\/s13148-025-01976-z.","journal-title":"Clin Epigenet"},{"issue":"1","key":"331_CR13","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s00240-025-01857-3","volume":"53","author":"Z Zhou","year":"2025","unstructured":"Zhou Z, Gong Z, Lu G, Huang B, Wang D. Association between Biological Aging Acceleration and Kidney Stone in Chinese Adults: Exploring the Role of Insulin Resistance. Urolithiasis. 2025;53(1):178. https:\/\/doi.org\/10.1007\/s00240-025-01857-3.","journal-title":"Urolithiasis"},{"key":"331_CR14","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.70055","author":"AS Dulai","year":"2025","unstructured":"Dulai AS, Joshi A, Min M, Shi VY, Sivamani RK. Systematic Review of Accelerated Epigenetic Aging in Chronic Inflammatory Dermatology Conditions. Int J Dermatol. 2025. https:\/\/doi.org\/10.1111\/ijd.70055.","journal-title":"Int J Dermatol"},{"issue":"4","key":"331_CR15","doi-asserted-by":"publisher","first-page":"573","DOI":"10.18632\/aging.101414","volume":"10","author":"ME Levine","year":"2018","unstructured":"Levine ME, Lu AT, Quach A, Chen BH, Assimes TL, Bandinelli S, Hou L, Baccarelli AA, Stewart JD, Li Y, Whitsel EA, Wilson JG, Reiner AP, Aviv A, Lohman K, Liu Y, Ferrucci L, Horvath S. An Epigenetic Biomarker of Aging for Lifespan and Healthspan. Aging. 2018;10(4):573\u201391. https:\/\/doi.org\/10.18632\/aging.101414.","journal-title":"Aging"},{"key":"331_CR16","doi-asserted-by":"publisher","first-page":"e73420","DOI":"10.7554\/eLife.73420","volume":"11","author":"DW Belsky","year":"2022","unstructured":"Belsky DW, Caspi A, Corcoran DL, Sugden K, Poulton R, Arseneault L, Baccarelli A, Chamarti K, Gao X, Hannon E, Harrington HL, Houts R, Kothari M, Kwon D, Mill J, Schwartz J, Vokonas P, Wang C, Williams BS, Moffitt TE. DunedinPACE, a DNA Methylation Biomarker of the Pace of Aging. Elife. 2022;11:e73420. https:\/\/doi.org\/10.7554\/eLife.73420.","journal-title":"Elife"},{"issue":"2","key":"331_CR17","doi-asserted-by":"publisher","first-page":"e13080","DOI":"10.1111\/acel.13080","volume":"19","author":"L Ferrucci","year":"2020","unstructured":"Ferrucci L, Gonzalez-Freire M, Fabbri E, Simonsick E, Tanaka T, Moore Z, Salimi S, Sierra F, de Cabo R. Measuring Biological Aging in Humans: A Quest. Aging Cell. 2020;19(2):e13080. https:\/\/doi.org\/10.1111\/acel.13080.","journal-title":"Aging Cell"},{"key":"331_CR18","doi-asserted-by":"publisher","first-page":"171","DOI":"10.3389\/fgene.2020.00171","volume":"11","author":"Y Salameh","year":"2020","unstructured":"Salameh Y, Bejaoui Y, El Hajj NDNA. Methylation Biomarkers in Aging and Age-Related Diseases. Front Genet. 2020;11:171. https:\/\/doi.org\/10.3389\/fgene.2020.00171.","journal-title":"Front Genet"},{"issue":"12","key":"331_CR19","doi-asserted-by":"publisher","first-page":"2378","DOI":"10.1093\/gerona\/glac147","volume":"77","author":"L Cribb","year":"2022","unstructured":"Cribb L, Hodge AM, Yu C, Li SX, English DR, Makalic E, Southey MC, Milne RL, Giles GG, Dugu\u00e9 P-A. Inflammation and Epigenetic Aging Are Largely Independent Markers of Biological Aging and Mortality. J Gerontol Biol Sci Med Sci. 2022;77(12):2378\u201386. https:\/\/doi.org\/10.1093\/gerona\/glac147.","journal-title":"J Gerontol Biol Sci Med Sci"},{"key":"331_CR20","doi-asserted-by":"publisher","unstructured":"Talifu Z, Ren Z, Chen C, Guo S, Wu Y, Li Y, Su B, Zheng X. The association between accelerated biological aging and the physical, psychological, and cognitive multimorbidity and life expectancy: cohort study. Aging Cell. 2025;e70142. https:\/\/doi.org\/10.1111\/acel.70142.","DOI":"10.1111\/acel.70142"},{"issue":"3","key":"331_CR21","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1038\/s44161-024-00438-8","volume":"3","author":"M Jiang","year":"2024","unstructured":"Jiang M, Tian S, Liu S, Wang Y, Guo X, Huang T, Lin X, Belsky DW, Baccarelli AA, Gao X. Accelerated Biological Aging Elevates the Risk of Cardiometabolic Multimorbidity and Mortality. Nat Cardiovasc Res. 2024;3(3):332\u201342. https:\/\/doi.org\/10.1038\/s44161-024-00438-8.","journal-title":"Nat Cardiovasc Res"},{"key":"331_CR22","doi-asserted-by":"publisher","unstructured":"Revised Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery (STROCSS) guideline: an update for the age of Artificial Intelligence - Premier Science. https:\/\/doi.org\/10.70389\/PJS.100081","DOI":"10.70389\/PJS.100081"},{"issue":"4","key":"331_CR23","doi-asserted-by":"publisher","first-page":"573","DOI":"10.18632\/aging.101414","volume":"10","author":"ME Levine","year":"2018","unstructured":"Levine ME, Lu AT, Quach A, Chen BH, Assimes TL, Bandinelli S, Hou L, Baccarelli AA, Stewart JD, Li Y, Whitsel EA, Wilson JG, Reiner AP, Aviv A, Lohman K, Liu Y, Ferrucci L, Horvath S. An Epigenetic Biomarker of Aging for Lifespan and Healthspan. Aging-us. 2018;10(4):573\u201391. https:\/\/doi.org\/10.18632\/aging.101414.","journal-title":"Aging-us"},{"key":"331_CR24","doi-asserted-by":"publisher","DOI":"10.1038\/s41576-022-00511-7","author":"J Rutledge","year":"2022","unstructured":"Rutledge J, Oh H, Wyss-Coray T. Measuring biological age using omics data. Nat Rev Genet. 2022;23(12):715\u201327. https:\/\/doi.org\/10.1038\/s41576-022-00511-7."},{"issue":"2","key":"331_CR25","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1002\/ehf2.14947","volume":"12","author":"Z Fang","year":"2025","unstructured":"Fang Z, Raza U, Song J, Lu J, Yao S, Liu X, Zhang W, Li S. Systemic Aging Fuels Heart Failure: Molecular Mechanisms and Therapeutic Avenues. ESC Heart Fail. 2025;12(2):1059\u201380. https:\/\/doi.org\/10.1002\/ehf2.14947.","journal-title":"ESC Heart Fail"},{"issue":"7","key":"331_CR26","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1038\/s43587-022-00248-2","volume":"2","author":"AT Higgins-Chen","year":"2022","unstructured":"Higgins-Chen AT, Thrush KL, Wang Y, Minteer CJ, Kuo P-L, Wang M, Niimi P, Sturm G, Lin J, Moore AZ, Bandinelli S, Vinkers CH, Vermetten E, Rutten BPF, Geuze E, Okhuijsen-Pfeifer C, van der Horst MZ, Schreiter S, Gutwinski S, Luykx JJ, Picard M, Ferrucci L, Crimmins EM, Boks MP, H\u00e4gg S, Hu-Seliger TT, Levine ME. A Computational Solution for Bolstering Reliability of Epigenetic Clocks: Implications for Clinical Trials and Longitudinal Tracking. Nat Aging. 2022;2(7):644\u201361. https:\/\/doi.org\/10.1038\/s43587-022-00248-2.","journal-title":"Nat Aging"},{"key":"331_CR27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.maturitas.2016.04.014","volume":"93","author":"A Dawson","year":"2016","unstructured":"Dawson A, Dennison E. Measuring the Musculoskeletal Aging Phenotype. Maturitas. 2016;93:13\u20137. https:\/\/doi.org\/10.1016\/j.maturitas.2016.04.014.","journal-title":"Maturitas"},{"issue":"1","key":"331_CR28","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1038\/s41572-022-00376-4","volume":"8","author":"ST Skou","year":"2022","unstructured":"Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, Boyd CM, Pati S, Mtenga S, Smith SM, Multimorbidity. Nat Rev Dis Primers. 2022;8(1):48. https:\/\/doi.org\/10.1038\/s41572-022-00376-4.","journal-title":"Nat Rev Dis Primers"},{"issue":"8","key":"331_CR29","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/j.jamda.2015.03.013","volume":"16","author":"E Fabbri","year":"2015","unstructured":"Fabbri E, Zoli M, Gonzalez-Freire M, Salive ME, Studenski SA, Ferrucci L. Aging and Multimorbidity: New Tasks, Priorities, and Frontiers for Integrated Gerontological and Clinical Research. J Am Med Dir Assoc. 2015;16(8):640\u20137. https:\/\/doi.org\/10.1016\/j.jamda.2015.03.013.","journal-title":"J Am Med Dir Assoc"},{"issue":"6","key":"331_CR30","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1056\/NEJMra2301292","volume":"391","author":"DH Kim","year":"2024","unstructured":"Kim DH, Rockwood K. Frailty in Older Adults. N Engl J Med. 2024;391(6):538\u201348. https:\/\/doi.org\/10.1056\/NEJMra2301292.","journal-title":"N Engl J Med"},{"issue":"11","key":"331_CR31","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.3390\/nu17111783","volume":"17","author":"Y Tian","year":"2025","unstructured":"Tian Y, Wang J, Zhu T, Li X, Zhang H, Zhao X, Yang X, Luo Y, Tao L, Wu Z, Guo X. Biological Age Acceleration Associated with the Progression Trajectory of Cardio-Renal-Metabolic Multimorbidity: A Prospective Cohort Study. Nutrients. 2025;17(11):1783. https:\/\/doi.org\/10.3390\/nu17111783.","journal-title":"Nutrients"},{"issue":"12","key":"331_CR32","doi-asserted-by":"publisher","first-page":"e1002718","DOI":"10.1371\/journal.pmed.1002718","volume":"15","author":"Z Liu","year":"2018","unstructured":"Liu Z, Kuo P-L, Horvath S, Crimmins E, Ferrucci L, Levine MA. New Aging Measure Captures Morbidity and Mortality Risk across Diverse Subpopulations from NHANES IV: A Cohort Study. PLoS Med. 2018;15(12):e1002718. https:\/\/doi.org\/10.1371\/journal.pmed.1002718.","journal-title":"PLoS Med"},{"issue":"1","key":"331_CR33","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1186\/s12885-025-13760-6","volume":"25","author":"X Liu","year":"2025","unstructured":"Liu X, Wang Y, Huang Y, Lin C, Xu B, Zeng Y, Chen P, Liu X, Huang Y. Association of Phenotypic Age Acceleration with All-Cause and Cause-Specific Mortality among U.S. Cancer Survivors: A Retrospective Cohort Study. BMC Cancer. 2025;25(1):338. https:\/\/doi.org\/10.1186\/s12885-025-13760-6.","journal-title":"BMC Cancer"},{"issue":"1","key":"331_CR34","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1186\/s12933-024-02515-5","volume":"23","author":"F Loria","year":"2024","unstructured":"Loria F, Mone P, Rispoli A, Di Fonzo R, Masarone D, Mancusi C, Correale M, Vitullo A, Granatiero M, Mazzeo P, Mercurio V, Fiore F, Di Sarro E, Falco L, Izzo C, Campanile A, Virtuoso N, Stabile E, Bonanno S, Dattilo G, Tocchetti CG, Santulli G, Vecchione C, Ciccarelli M, Visco V. The Effects of Dapagliflozin in a Real-World Population of HFrEF Patients with Different Hemodynamic Profiles: Worse Is Better. Cardiovasc Diabetol. 2024;23(1):423. https:\/\/doi.org\/10.1186\/s12933-024-02515-5.","journal-title":"Cardiovasc Diabetol"},{"issue":"9","key":"331_CR35","doi-asserted-by":"publisher","first-page":"100632","DOI":"10.1016\/j.lanhl.2024.08.001","volume":"5","author":"P Mone","year":"2024","unstructured":"Mone P, Ciccarelli M, Jankauskas SS, Guerra G, Vecchione C, Visco V, Santulli G. SGLT2 Inhibitors and GLP-1 Receptor Agonists: Which Is the Best Anti-Frailty Drug? Lancet Healthy Longev. 2024;5(9):100632. https:\/\/doi.org\/10.1016\/j.lanhl.2024.08.001.","journal-title":"Lancet Healthy Longev"},{"key":"331_CR36","doi-asserted-by":"publisher","unstructured":"Ndumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, Coresh J, Mathew RO, Baker-Smith CM, Carnethon MR, Despres J-P, Ho JE, Joseph JJ, Kernan WN, Khera A, Kosiborod MN, Lekavich CL, Lewis EF, Lo KB, Ozkan B, Palaniappan LP, Patel SS, Pencina MJ, Powell-Wiley TM, Sperling LS, Virani SS, Wright JT, Rajgopal Singh R, Elkind MSV. American Heart Association. Cardiovascular-kidney-metabolic health: a presidential advisory from the american heart association. Circulation. 2023;148 (20):1606\u20131635. https:\/\/doi.org\/10.1161\/CIR.0000000000001184","DOI":"10.1161\/CIR.0000000000001184"},{"issue":"1","key":"331_CR37","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1161\/CIR.0000000000001221","volume":"150","author":"D Laddu","year":"2024","unstructured":"Laddu D, Neeland IJ, Carnethon M, Stanford FC, Mongraw-Chaffin M, Barone Gibbs B, Ndumele CE, Longenecker CT, Chung ML, Rao G, American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Clinical Cardiology. Cardiovascular Disease; and Council on Cardiovascular and Stroke Nursing. Implementation of Obesity Science Into Clinical Practice: A Scientific Statement From the American Heart Association. Circulation. 2024;150(1):e7\u201319. https:\/\/doi.org\/10.1161\/CIR.0000000000001221. Council on Hypertension; Council on the Kidney in.","journal-title":"Circulation"},{"issue":"20","key":"331_CR38","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1161\/CIR.0000000000001186","volume":"148","author":"CE Ndumele","year":"2023","unstructured":"Ndumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS, Coresh J, Baker-Smith CM, Carnethon MR, Despr\u00e9s J-P, Ho JE, Joseph JJ, Kernan WN, Khera A, Kosiborod MN, Lekavich CL, Lewis EF, Lo KB, Ozkan B, Palaniappan LP, Patel SS, Pencina MJ, Powell-Wiley TM, Sperling LS, Virani SS, Wright JT, Rajgopal Singh R, Elkind MSV, Rangaswami J. American Heart Association. 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. Circulation. 2023;148(20):1636\u201364. https:\/\/doi.org\/10.1161\/CIR.0000000000001186.","journal-title":"Circulation"},{"key":"331_CR39","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf708","author":"M Yang","year":"2025","unstructured":"Yang M, Su C, Chang X, Wang G, Liu J. Data-driven cluster analysis identifies distinct types of cardiovascular-kidney-metabolic syndrome. Eur J Prev Cardiol. 2025;zwaf708. https:\/\/doi.org\/10.1093\/eurjpc\/zwaf708.\u00a0"},{"issue":"1","key":"331_CR40","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s12933-024-02218-x","volume":"23","author":"G Santulli","year":"2024","unstructured":"Santulli G, Visco V, Ciccarelli M, Ferrante MNV, De Masi P, Pansini A, Virtuoso N, Pirone A, Guerra G, Verri V, Macina G, Taurino A, Komici K, Mone P. Frail Hypertensive Older Adults with Prediabetes and Chronic Kidney Disease: Insights on Organ Damage and Cognitive Performance - Preliminary Results from the CARYATID Study. Cardiovasc Diabetol. 2024;23(1):125. https:\/\/doi.org\/10.1186\/s12933-024-02218-x.","journal-title":"Cardiovasc Diabetol"},{"issue":"1","key":"331_CR41","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40842-025-00227-7","volume":"11","author":"J Bianchi","year":"2025","unstructured":"Bianchi J, Duarte FO, Camillo L, Godoy KF. Cluster Analysis Reveals Distinct Inflammatory Phenotypes in Cardiometabolic Disease. Cardiovasc. Diabetol \u2013 Endocrinol Rep. 2025;11(1):15. https:\/\/doi.org\/10.1186\/s40842-025-00227-7. RodolphoJ. M.de A.; Fragelli, B. D. de L.; Esp\u00f3sito, M. C. C.; Branco, L. A.; Speglich, C.; Roscani, M. G.; Pott, H.; Anibal, F. de.","journal-title":"Diabetol \u2013 Endocrinol Rep"},{"issue":"21","key":"331_CR42","doi-asserted-by":"publisher","first-page":"e984","DOI":"10.1161\/CIR.0000000000000973","volume":"143","author":"TM Powell-Wiley","year":"2021","unstructured":"Powell-Wiley TM, Poirier P, Burke LE, Despr\u00e9s J-P, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge M-P, American Heart Association Council on Lifestyle and Cardiometabolic Health. Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143(21):e984\u20131010. https:\/\/doi.org\/10.1161\/CIR.0000000000000973.","journal-title":"Circulation"},{"issue":"4","key":"331_CR43","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/j.cmet.2024.03.002","volume":"36","author":"MC Petersen","year":"2024","unstructured":"Petersen MC, Smith GI, Palacios HH, Farabi SS, Yoshino M, Yoshino J, Cho K, Davila-Roman VG, Shankaran M, Barve RA, Yu J, Stern JH, Patterson BW, Hellerstein MK, Shulman GI, Patti GJ, Klein S. Cardiometabolic Characteristics of People with Metabolically Healthy and Unhealthy Obesity. Cell Metab. 2024;36(4):745\u2013e7615. https:\/\/doi.org\/10.1016\/j.cmet.2024.03.002.","journal-title":"Cell Metab"},{"issue":"1","key":"331_CR44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12933-025-03022-x","volume":"25","author":"G Santulli","year":"2025","unstructured":"Santulli G, Sabatelli G, Wang B, Savino M, Bruno FP, Jankauskas SS, Massaro A, Peluso C, Vicario M, Savino L, Varzideh F, D\u2019Onghia ML, Mone P. Interplay between Frailty and Cardiometabolic Disorders: From Pathophysiology to Clinical Implications. Cardiovasc Diabetol. 2025;25(1):1. https:\/\/doi.org\/10.1186\/s12933-025-03022-x.","journal-title":"Cardiovasc Diabetol"},{"issue":"1","key":"331_CR45","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1186\/s12933-024-02420-x","volume":"23","author":"O Janota","year":"2024","unstructured":"Janota O, Mantovani M, Kwiendacz H, Irlik K, Bucci T, Lam SHM, Huang B, Alam U, Boriani G, Hendel M, Pia\u015bnik J, Olejarz A, W\u0142osowicz A, Pabis P, W\u00f3jcik W, Gumprecht J, Lip GYH, Nabrdalik K. Metabolically Extremely Unhealthy Obese and Non-Obese People with Diabetes and the Risk of Cardiovascular Adverse Events: The Silesia Diabetes - Heart Project. Cardiovasc Diabetol. 2024;23(1):326. https:\/\/doi.org\/10.1186\/s12933-024-02420-x.","journal-title":"Cardiovasc Diabetol"}],"container-title":["Cardiovascular Diabetology \u2013 Endocrinology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40842-026-00331-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40842-026-00331-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40842-026-00331-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:02:53Z","timestamp":1790028173000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40842-026-00331-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["331"],"URL":"https:\/\/doi.org\/10.1186\/s40842-026-00331-2","relation":{"references":[{"id-type":"doi","id":"10.1038\/s41576-022-00511-7","asserted-by":"subject"},{"id-type":"doi","id":"10.1093\/eurjpc\/zwaf708","asserted-by":"subject"}]},"ISSN":["3059-4057"],"issn-type":[{"value":"3059-4057","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"assertion":[{"value":"8 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was based on de-identified, publicly available NHANES data. As a secondary analysis of public-use data, this study was exempt from additional institutional review board approval.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was not required, as the study used publicly available, anonymized data from the NHANES database, and participants\u2019 identities were not disclosed.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Generative AI assistance was used solely for English-language editing and manuscript revision under the full supervision of the authors. All study design decisions, statistical analyses, interpretation of the results, and final approval of the manuscript remained the responsibility of the authors.","order":3,"name":"Ethics","label":"Artificial intelligence (AI) use","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was retrospectively registered prior to submission.","order":4,"name":"Ethics","label":"Registration","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"62"}}