{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:17:24Z","timestamp":1790309844945,"version":"4.1.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to evaluate the interaction of risk factors and effects of short-term comprehensive treatment on the staging and components of cardiovascular-kidney-metabolic (CKM) syndrome in patients with type 2 diabetes mellitus (T2DM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 541 patients with T2DM who received comprehensive treatment from November 2023 to December 2024. The study analyzed the baseline clinical characteristics and CKM stage. Of these, 204 patients completed a six-month follow-up, forming a real-world observational study. This study evaluated changes in CKM stage and 10-year cardiovascular disease (CVD) risk scores in patients with CKM stages 2 and 3 after six months of intensive treatment. A multivariate logistic regression was used to analyze the factors influencing the 10-year CVD risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 541 adult patients with T2DM, 83.2% were in CKM stage 2, 11.1% in CKM stage 3, and 5.7% in CKM stage 4. Of the 204 patients who completed a six-month comprehensive intervention, 177 (43.2%) were in CKM stage 2 and 18 (7.3%) were in CKM stage 3, with a significant improvement in CKM stage 3 (4.1%) after the intervention. The 10-year CVD risk score decreased from 8.3% to 5.8% before and after the intervention (P&amp;lt;0.05). Multivariate logistic regression analysis revealed that for every 1% decrease in HbA1C, the 10-year CVD risk decreased by 71.5%[OR = 1.715,95%CI(1.386-2.123. For every 1mmol\/L decrease in TC, the 10-year CVD risk decreased by 70%[OR = 1.700,95%CI(1.070-2.701. For every 1mmHg decrease in systolic blood pressure, the 10-year CVD risk decreased by 5.9%[OR = 1.059,95%CI(1.027-1.090. For every 1mmol\/l increase in HDL-C, the 10-year CVD risk decreased by 4.9%[OR = 0.049,95%CI(0.006-0.442)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Short-term comprehensive treatment can improve the staging of CKM syndrome in T2DM patients and reduce the 10-year CVD risk score; the decrease of SBP, TC and HbA1c and the increase of HDL-C under comprehensive treatment are protective factors for the improvement of the 10-year CVD risk score.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1659340","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:12:04Z","timestamp":1758859924000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of short-term comprehensive treatment on cardiovascular-kidney-metabolic syndrome and its components in patients with type 2 diabetes"],"prefix":"10.3389","volume":"16","author":[{"given":"Li","family":"Gong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruirui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshaung","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"B1","unstructured":""},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0792","article-title":"Risk of all-cause and CHD mortality in women versus men with type 2 diabetes: a systematic review and meta-analysis","volume":"180","author":"Xu","year":"2019","journal-title":"Eur J Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e26180","DOI":"10.7759\/cureus.26180","article-title":"Glycemic control for type 2 diabetes mellitus patients: A systematic review","volume":"14","author":"Bin Rakhis","year":"2022","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001040","article-title":"Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: A scientific statement from the american heart association","volume":"145","author":"Joseph","year":"2022","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12782","article-title":"Diabetes mellitus and risk of new-onset and recurrent heart failure: a systematic review and meta-analysis","volume":"7","author":"Kodama","year":"2020","journal-title":"ESC Heart Fail"},{"key":"B6","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1053\/j.ajkd.2018.06.017","article-title":"Chronic renal insufficiency cohort (CRIC) study investigators. Incident type 2 diabetes among individuals with CKD: findings from the chronic renal insufficiency cohort (CRIC) study","volume":"73","author":"Jepson","year":"2019","journal-title":"Am J Kidney Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1161\/CIR.0000000000001191","article-title":"American heart association. Novel prediction equations for absolute risk assessment of total cardiovascular disease incorporating cardiovascular-kidney-metabolic health: A scientific statement from the american heart association","volume":"148","author":"Khan","year":"2023","journal-title":"Circulation"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001186","article-title":"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","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation"},{"key":"B9","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12933-025-02593-z","article-title":"Correlation between atherogenic index of plasma and cardiovascular disease risk across Cardiovascular-kidney-metabolic syndrome stages 0-3: a nationwide prospective cohort study","volume":"24","author":"Hu","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2024.89670","article-title":"An overview of cardiovascular-kidney-metabolic syndrome","volume":"30","author":"Ferdinand","year":"2024","journal-title":"Am J Manag Care"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2024.118585","article-title":"Association between different stages of cardiovascular-kidney-metabolic syndrome and the risk of all-cause mortality","volume":"397","author":"Li","year":"2024","journal-title":"Atherosclerosis"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2025.100985","article-title":"Association of cardiovascular-kidney-metabolic syndrome with all-cause and cardiovascular mortality: A prospective cohort study","volume":"22","author":"Li","year":"2025","journal-title":"Am J Prev Cardiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e016947","DOI":"10.1161\/JAHA.120.016947","article-title":"Metabolic dyslipidemia and cardiovascular outcomes in type 2 diabetes mellitus: findings from the look AHEAD study","volume":"10","author":"Kaze","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1042\/BST20200611","article-title":"Endothelial response to glucose: dysfunction, metabolism, and transport","volume":"49","author":"Clyne","year":"2021","journal-title":"Biochem Soc Trans"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.816400","article-title":"Mechanistic pathogenesis of endothelial dysfunction in diabetic nephropathy and retinopathy","volume":"13","author":"Yang","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2016.05.003","article-title":"Non-alcoholic fatty liver disease and dyslipidemia: An update","volume":"65","author":"Katsiki","year":"2016","journal-title":"Metabolism"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0092-1","article-title":"Diabetic neuropathy","volume":"5","author":"Feldman","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237028","article-title":"Effective strategies and a ten-point plan for cardio-kidney-metabolic health in Croatia: an expert opinion","volume":"13","author":"Reiner","year":"2024","journal-title":"J Clin Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e38073","DOI":"10.7759\/cureus.38073","article-title":"A systematic review of the effects of smoking on the cardiovascular system and general health","volume":"15","author":"Parmar","year":"2023","journal-title":"Cureus"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1159\/000517749","article-title":"Smoking and kidney disease: risk factors, challenges, and preventive strategies","volume":"199","author":"Oliveira Coelho","year":"2021","journal-title":"Contrib Nephrol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/s0168-8227(99)00095-9","article-title":"Systolic hypertension and duration of diabetes mellitus are important determinants of retinopathy and microalbuminuria in young diabetics","volume":"46","author":"Wan Nazaimoon","year":"1999","journal-title":"Diabetes Res Clin Pract"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14348","article-title":"Diabetes duration and glycaemic control as predictors of cardiovascular disease and mortality","volume":"23","author":"Li","year":"2021","journal-title":"Diabetes Obes Metab"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2024.108903","article-title":"Duration of diabetes, glycemic control, and low heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study","volume":"38","author":"Rooney","year":"2024","journal-title":"J Diabetes Complications"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0806470","article-title":"10-year follow-up of intensive glucose control in type 2 diabetes","volume":"359","author":"Holman","year":"2008","journal-title":"N Engl J Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808431","article-title":"Glucose control and vascular complications in veterans with type 2 diabetes","volume":"360","author":"Duckworth","year":"2009","journal-title":"N Engl J Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1038\/s41392-024-01854-9","article-title":"Real-world effectiveness of early insulin therapy on the incidence of cardiovascular events in newly diagnosed type 2 diabetes","volume":"9","author":"Luo","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-015-1325-2","article-title":"Lifestyle interventions in preventing new type 2 diabetes in Asian populations","volume":"11","author":"Modesti","year":"2016","journal-title":"Intern Emerg Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-020-01518-4","article-title":"Comparison and analyses of therapeutic effects between metabolic management center (MMC) and conventional management modes","volume":"57","author":"Wang","year":"2020","journal-title":"Acta Diabetol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.01006.x","article-title":"Comparison of the diagnostic criteria for diabetes mellitus, WHO-1985, ADA-1997 and WHO-1999 in the adult population of Asturias (Spain)","volume":"20","author":"Botas","year":"2003","journal-title":"Diabetes Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.12.2191","article-title":"Correct homeostasis model assessment (HOMA) evaluation uses the computer program","volume":"21","author":"Levy","year":"1998","journal-title":"Diabetes Care"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.6.1487","article-title":"Use and abuse of HOMA modeling","volume":"27","author":"Wallace","year":"2004","journal-title":"Diabetes Care"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn311282-20240920-00430","article-title":"National Metabolic Management Center(MMC) comprehensive management standards for patients with diabetes, hypertension, and hyperlipidemia","volume":"40","year":"2024","journal-title":"Chin J Endocrinol Metab"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.067626","article-title":"Development and validation of the american heart association predicting risk of cardiovascular disease EVENTs (PREVENTTM) equations","volume":"149","author":"Khan","year":"2024","journal-title":"Circulation"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1161\/CIR.0000000000001191","article-title":"Novel prediction equations for absolute risk assessment of total cardiovascular disease incorporating cardiovascular-kidney-metabolic health: A scientific statement from the american heart association","volume":"148","author":"Khan","year":"2023","journal-title":"Circulation"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.102344","article-title":"Cardiovascular-Kidney-Metabolic (CKM) syndrome: A state-of-the-art review","volume":"49","author":"Sebastian","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2024.12.003","article-title":"Prevalence of cardiovascular-kidney-metabolic syndrome stages among middle-aged and older adults in China","volume":"5","author":"Zhang","year":"2025","journal-title":"JACC Asia"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.6892","article-title":"Prevalence of cardiovascular-kidney-metabolic syndrome stages in US adults, 2011-2020","volume":"331","author":"Aggarwal","year":"2024","journal-title":"JAMA"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2024.10.016","article-title":"Prevalence of the cardiovascular-kidney-metabolic syndrome in 3 chinese cohorts","volume":"5","author":"Huang","year":"2025","journal-title":"JACC Asia"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.124.32162","article-title":"Sex differences in cardiovascular-kidney-metabolic syndrome: 30-year US trends and mortality risks-brief report","volume":"45","author":"Ji","year":"2025","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.110022","article-title":"The association of attained age, age at diagnosis, and duration of type 2 diabetes with the long-term risk for major diabetes-related complications","volume":"190","author":"Morton","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2022.101370","article-title":"Smo-king and diabetes interplay: A comprehensive review and joint statement","volume":"48","author":"Durlach","year":"2022","journal-title":"Diabetes Metab"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s40292-022-00542-5","article-title":"HOMA-IR as a predictor of health outcomes in patients with metabolic risk factors: A systematic review and meta-analysis","volume":"29","author":"Gonz\u00e1lez-Gonz\u00e1lez","year":"2022","journal-title":"High Blood Press Cardiovasc Prev"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001186","article-title":"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","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation"},{"key":"B44","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1186\/s12933-024-02371-3","article-title":"Sex-difference of multifactorial intervention on cardiovascular and mortality risk in DKD: post-hoc analysis of a randomised clinical trial","volume":"23","author":"Minutolo","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B45","article-title":"Reduced risk of cardiovascular diseases after bariatric surgery based on the new PREVENT equations","volume":"14","author":"Wang","year":"2025","journal-title":"J Am Heart Assoc"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-21131-2","article-title":"Joint association of the inflammatory marker and cardiovascular-kidney-metabolic syndrome stages with all-cause and cardiovascular disease mortality: a national prospective study","volume":"25","author":"Cao","year":"2025","journal-title":"BMC Public Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e0262885","DOI":"10.1371\/journal.pone.0262885","article-title":"The association between trajectories of risk factors and risk of cardiovascular disease or mortality among patients with diabetes or hypertension: A systematic review","volume":"17","author":"Wang","year":"2022","journal-title":"PloS One"},{"key":"B48","doi-asserted-by":"publisher","first-page":"e032527","DOI":"10.1161\/JAHA.123.032527","article-title":"Trends and disparities in treatment and control of atherosclerotic cardiovascular disease in US adults, 1999 to 2018","volume":"13","author":"Li","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"B49","doi-asserted-by":"publisher","first-page":"e000810","DOI":"10.1136\/bmjdrc-2019-000810","article-title":"ASCVD risk stratification modifies the effect of HbA1c on cardiovascular events among patients with type 2 diabetes mellitus with basic to moderate risk","volume":"8","author":"Zhang","year":"2020","journal-title":"BMJ Open Diabetes Res Care"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2022.100317","article-title":"HbA1c, Coronary atheroma progression and cardiovascular outcomes","volume":"9","author":"Dykun","year":"2022","journal-title":"Am J Prev Cardiol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/s12872-021-01971-1","article-title":"Total cholesterol\/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease: a 17-year follow-up study of women in southern Sweden","volume":"21","author":"Calling","year":"2021","journal-title":"BMC Cardiovasc Disord"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19148272","article-title":"Serum cholesterol levels and risk of cardiovascular death: A systematic review and a dose-response meta-analysis of prospective cohort studies","volume":"19","author":"Jung","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B53","doi-asserted-by":"publisher","first-page":"e002791","DOI":"10.1136\/openhrt-2024-002791","article-title":"Association of blood pressure and left ventricular mass with subclinical coronary atherosclerosis","volume":"12","author":"Loh","year":"2025","journal-title":"Open Heart"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09402","article-title":"Relationship of hypertension to coronary atherosclerosis and cardiac events in patients with coronary computed tomographic angiography","volume":"70","author":"Nakanishi","year":"2017","journal-title":"Hypertension"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0000000000000698","article-title":"Risk of heart disease and stroke among individuals with prehypertension or blood pressure progression: a national population-based cohort study","volume":"29","author":"Jin","year":"2024","journal-title":"Blood Press Monit"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1659340\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:12:06Z","timestamp":1758859926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1659340\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":55,"alternative-id":["10.3389\/fendo.2025.1659340"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1659340","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"article-number":"1659340"}}