{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:11Z","timestamp":1782496511085,"version":"3.54.5"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Key Projects of the Zhejiang Provincial Natural Science Foundation","award":["No.LZ25H020001"],"award-info":[{"award-number":["No.LZ25H020001"]}]},{"name":"Joint TCM Science & Technology Projects of National Demonstration Zones for Comprehensive TCM Reform","award":["GZY-KJS-ZJ-2025-022"],"award-info":[{"award-number":["GZY-KJS-ZJ-2025-022"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.81971688"],"award-info":[{"award-number":["No.81971688"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Research Fund of Zhejiang Provincial Education Department","award":["No.Y202457057"],"award-info":[{"award-number":["No.Y202457057"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular\u2013kidney\u2013metabolic (CKM) syndrome is strongly associated with cardiovascular disease (CVD) and mortality. Stages 0\u20133 represent a key preclinical window for early intervention. Retinal optical coherence tomography (OCT) enables non-invasive evaluation of systemic microcirculation, but its prognostic value for CVD in CKM 0\u20133 remains undetermined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective study of 40,516 UK Biobank participants with CKM syndrome stages 0\u20133 who had retinal OCT. Cox regression, trend tests, and predictive metrics (NRI, IDI, AUC) were used to evaluate associations and incremental prognostic value of retinal structural markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline thinner retinal nerve fiber layer (RNFL) and macular thickness were independently associated with higher risks of incident CVD, coronary heart disease, all-cause mortality, and cardiovascular mortality over a subsequent median 14.6-year follow-up (all P\u2009&lt;\u20090.001). Significant linear dose\u2013response relationships were observed. Adding these markers to traditional risk models improved risk classification and discrimination (all P\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thinner RNFL and macular thickness are independent predictors of adverse cardiovascular outcomes in CKM 0\u20133. Integrating these OCT-derived biomarkers improves risk stratification, supporting a non-invasive approach for early cardiovascular risk assessment in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0351945","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:40:25Z","timestamp":1782495625000},"page":"e0351945","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between optical coherence tomography\u2013quantified retinal features and cardiovascular risk in cardiovascular\u2013kidney\u2013metabolic syndrome stages 0\u20133: An analysis of a prospective UK biobank cohort"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4387-0868","authenticated-orcid":true,"given":"Chenhao","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sixiang","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingru","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6228-5783","authenticated-orcid":true,"given":"Shudong","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"issue":"20","key":"pone.0351945.ref001","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1161\/CIR.0000000000001186","article-title":"A 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