Biological age acceleration and mortality risk among U.S. adults with cardio-kidney-metabolic syndrome, stages 0-3: An NHANES cohort study.
X, C., Y, H., Y, H., Y, L., X, C., Y, W., & X, L. (2026). Biological age acceleration and mortality risk among U.S. adults with cardio-kidney-metabolic syndrome, stages 0-3: An NHANES cohort study.. Medicine. https://doi.org/10.1097/MD.0000000000050450
X C, Y H, Y H, Y L, X C, Y W, et al. Biological age acceleration and mortality risk among U.S. adults with cardio-kidney-metabolic syndrome, stages 0-3: An NHANES cohort study.. Medicine. 2026; doi: 10.1097/MD.0000000000050450
X C, Y H, Y H, et al. Biological age acceleration and mortality risk among U.S. adults with cardio-kidney-metabolic syndrome, stages 0-3: An NHANES cohort study.[J]. Medicine. 2026. DOI: 10.1097/MD.0000000000050450.
@article{x2026,
author = {Chen X and Huang Y and Huang Y and Li Y and Chen X and Wang Y and Liu X},
title = {Biological age acceleration and mortality risk among U.S. adults with cardio-kidney-metabolic syndrome, stages 0-3: An NHANES cohort study.},
journal = {Medicine},
year = {2026},
doi = {10.1097/MD.0000000000050450},
note = {PMID: 42675722},
}
TY - JOUR AU - Chen X AU - Huang Y AU - Huang Y AU - Li Y AU - Chen X AU - Wang Y AU - Liu X TI - Biological age acceleration and mortality risk among U.S. adults with cardio-kidney-metabolic syndrome, stages 0-3: An NHANES cohort study. T2 - Medicine PY - 2026 DO - 10.1097/MD.0000000000050450 AN - PMID:42675722 ER -
This study aims to evaluate the associations of Klemera-Doubal Method Biological Age Acceleration (KDM-BAA) and Phenotypic Age Acceleration (PAA) with all-cause and cause-specific mortality in U.S. adults with Cardio-Kidney-Metabolic (CKM) syndrome stages 0-3 and to establish risk prediction models. Data were obtained from 16,837 participants in NHANES 1999-2010 and 2015-2018, linked to mortality through 2019. Biological age was estimated using KDM-BA and Phenotypic Age algorithms, with residuals defining Biological Age Acceleration (BAA). Cox proportional hazards models were applied, and LASSO-Cox nomograms were developed for mortality prediction. Over a median follow-up of 11.33 years, 10.8% of the weighted population (9.75 million adults) died. After full adjustment for confounders, KDM-BAA positivity increased the risk of all-cause, CVD, and non-CVD mortality by 41%, 74%, and 31%, respectively; PAA positivity showed even larger increases - 103%, 79%, and 112%. Both metrics consistently exhibited a positive association in multiple subgroups and sensitivity analyses. The LASSO-Cox-based nomogram showed favorable discrimination (training AUCs 0.776 and 0.775 at 10 and 20 years; validation AUCs 0.765 and 0.757, respectively) and good calibration, suggesting potential clinical applicability. BAA independently predicts long-term mortality among individuals with CKM stages 0-3. PAA provides superior prognostic value, supporting the importance of monitoring biological aging to guide early intervention and improve long-term outcomes.