Abstract
BACKGROUND: Circadian syndrome (CircS) has demonstrated a strong association with the occurrence of cardiovascular disease (CVD), as well as chronic kidney disease (CKD). However, the association of CircS with cardiac-kidney events (CKE) or even mortality is unknown. This study was to evaluate whether CircS was related with CKE or all-cause mortality. METHODS: This prospective study analyzed data from 295,378 participants in the UK Biobank (UKB) cohort. CircS was characterized by the components of metabolic syndrome (MetS), along with short sleep and depression. We applied Cox regression analyses to examine the associations between CircS and composite outcome of CKE or all-cause mortality. RESULTS: Among the 295,378 included participants (median age, 58 years; 55.7% female), we find that 28,027 primary outcome events are recorded during a median follow-up of 13.6 years. Findings reveal that CircS (hazard ratio [HR] 1.379; 95% confidence interval [CI] 1.319-1.441) demonstrates a significant positive association with the primary outcome. With the increase in CircS score, the risk of the primary outcome also increases. Among the seven components, depression (HR 1.518; 95% CI 1.426-1.616) emerges as the strongest contributing factor. Furthermore, we also find that CircS is a significant risk factor for CKE (HR 1.143; 95% CI 1.044-1.251) and has a greater impact on CKE with CVD-first and CKE with renal failure. CONCLUSIONS: CircS is strongly linked to increased CKE and all-cause mortality risk, highlighting the need for greater clinical focus on this syndrome. This correlation also provides theoretical support for the cardiovascular-kidney-metabolic syndrome concept.