Reproductive Risk Factors and Prevalence of Cardiovascular-Kidney-Metabolic Syndrome among Young Women

Theresa Boyer; Allison W. Peng; Michael Fang; Timothy Chow; Amelia S. Wallace; Wendy Bennett; Erin D. Michos; Chiadi E. Ndumele; Elizabeth Selvin; Anum S. Minhas

doi:10.1016/j.ajpc.2026.101432

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Reproductive Risk Factors and Prevalence of Cardiovascular-Kidney-Metabolic Syndrome among Young Women

Journal article

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Reproductive Risk Factors and Prevalence of Cardiovascular-Kidney-Metabolic Syndrome among Young Women

Theresa Boyer, Allison W. Peng, Michael Fang, Timothy Chow, Amelia S. Wallace, Wendy Bennett, Erin D. Michos, Chiadi E. Ndumele, Elizabeth Selvin and Anum S. Minhas

American journal of preventive cardiology, Vol.26, 101432

04/2026

DOI: 10.1016/j.ajpc.2026.101432

PMID: 41630962

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Abstract

Introduction Cardiovascular-Kidney-Metabolic (CKM) syndrome provides a framework for early cardiometabolic and kidney dysfunction. While reproductive risk factors are associated with cardiovascular disease, their relationship to CKM syndrome stages remains unclear. We estimated CKM prevalence among reproductive-aged US women and evaluated associations with reproductive risk factors. Methods Using the National Health and Nutrition Examination Survey (2013-2020), we included 3,917 non-pregnant women aged 20-49 years. Reproductive risk factors included early menarche (≤10 years), infertility, gestational diabetes, delivery of a large-for-gestational-age neonate, and grand multiparity (≥ 5 births). CKM stages were classified as stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (metabolic risk factors or chronic kidney disease), stage 3 (subclinical cardiovascular disease), stage 4 (clinical cardiovascular disease). Adjusted prevalence ratios (aPRs) for CKM stage ≥ 2 were estimated using Poisson regression accounting for sociodemographic and behavioral factors. Results Approximately 34.7% (95% CI: 32.3, 37.1) of women reported at least one reproductive risk factor. Overall, 55.1% (95% CI: 52.9, 57.3) were classified as CKM stage ≥ 2. Women with reproductive risk factors were more likely to be in higher CKM stages. Significant associations with CKM stage ≥ 2 were observed for gestational diabetes (aPR, 1.25; 95% CI: 1.13, 1.39) and infertility (aPR, 1.14; 95% CI: 1.04, 1.26). Conclusion CKM syndrome is highly prevalent among reproductive-aged women in the US. Histories of gestational diabetes and infertility were associated with higher CKM stages. Incorporating reproductive factors into clinical tools could support targeted prevention of CKM progression and future CVD.

Cardiovascular-kidney-metabolic syndrome

Reproductive history

Gestational diabetes

Infertility

Cardiometabolic health

Women's health

Details

Title: Subtitle: Reproductive Risk Factors and Prevalence of Cardiovascular-Kidney-Metabolic Syndrome among Young Women
Creators: Theresa Boyer
Allison W. Peng
Michael Fang
Timothy Chow
Amelia S. Wallace
Wendy Bennett
Erin D. Michos
Chiadi E. Ndumele
Elizabeth Selvin
Anum S. Minhas
Resource Type: Journal article
Publication Details: American journal of preventive cardiology, Vol.26, 101432
DOI: 10.1016/j.ajpc.2026.101432
PMID: 41630962
ISSN: 2666-6677
eISSN: 2666-6677
Publisher: Elsevier
Grant note: NIH/NHLBI: T32HL007024, K24HL15244, K23HL171886 NIH/NIDDK: K01DK138273, T32DK007732 American Heart Association
Ms. Boyer was supported by NIH/NHLBI T32HL007024. Dr. Fang was supported by NIH/NIDDK K01DK138273. Dr. Chow was supported by NIH/NIDDK T32DK007732. Dr. Selvin was supported by NIH/NHLBI grant K24HL15244 and a Merit Award from the American Heart Association. Dr. Minhas was supported by NIH/NHLBI K23HL171886.
Language: English
Electronic publication date: 01/19/2026
Date published: 04/2026
Academic Unit: Internal Medicine
Record Identifier: 9985123702002771

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