ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1684478
This article is part of the Research TopicCardiovascular Risks in Cardiovascular-Kidney-Metabolic Syndrome: Mechanisms and TherapiesView all 8 articles
Association between arterial stiffness index and incidence of stroke in individuals with cardiovascular-kidney-metabolic syndrome: insights from the UK Biobank
Provisionally accepted
Pengfei Chen*
Chen Chen
Zhuye Gao
Lixiao ZhangTianyu Wang
Hou Ailin
Wenxi 余
Jianpeng Du
Fu Changgeng*
Dazhuo Shi*Ming Guo- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Background: The association between arterial stiffness index and incidence of stroke in individuals with cardiovascular kidney-metabolic (CKM) syndrome remains unclear. Methods: Participants with CKM syndrome stages 0-3 from the UK Biobank cohort were included in this study. The primary outcome was the incidence of new-onset stroke. We used Cox proportional hazards models to assess the association between arterial stiffness index (ASI) and incidence of stroke, estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) models were used to assess potential nonlinear associations. Subgroup analyses were conducted stratified by CKM stages. Results: This study included 37,339 individuals, with CKM stages 0 (13.0%), 1 (17.6%), 2 (62.1%), and 3 (7.3%). During a median follow-up of 12.3 years, a total stroke incidence occurred in 1,855 (5.0%) participants. After fully adjusted, participants in the highest ASI quartile had a 43% higher risk of stroke incidence compared to the lowest quartile (HR 1.43; 95% CI: 1.25–1.64, P < 0.001). Each unit increase in log-transformed ASI was associated with a 39% risk of stroke incidence (HR 1.39; 95% CI: 1.21–1.59, P < 0.001). The RCS models demonstrated a linear association between ASI and stroke incidence. Subgroup analyses suggested stronger associations of ASI with stroke incidence in participants at earlier CKM stages (0–2), while no significant association was observed in stage 3. Conclusions: Higher ASI is associated with an increased risk of stroke incidence in individuals with CKM syndrome. These findings provided a new highlight on ASI for predicting incidence of stroke in the CKM population.
Keywords: Stroke, cardiovascular-kidney-metabolic syndrome, UK Biobank, Arterial stiffness index, cohort study
Received: 12 Aug 2025; Accepted: 10 Oct 2025.
Copyright: © 2025 Chen, Chen, Gao, Zhang, Wang, Ailin, 余, Du, Changgeng, Shi and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Pengfei Chen, 815677131@qq.com
Fu Changgeng, fucgbs@163.com
Dazhuo Shi, shidztcm@163.com
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