Cardiovascular-Kidney-Metabolic Health: Insights from Wearables and Blood Biomarkers

TL;DR

This study integrates wearable data and blood biomarkers to identify early, system-specific health impairments in CKM syndrome, highlighting the potential for targeted early interventions.

Contribution

It introduces a normalized deviance score to detect subclinical heterogeneity and demonstrates wearable features as predictors of organ system decline.

Findings

29.0% of cohort showed significant health impairments

Cardiovascular deviation was most prevalent at 13.3%

Step count, Active Zone Minutes, resting heart rate are key predictors

Abstract

Cardiovascular-Kidney-Metabolic (CKM) syndrome represents a growing public health crisis, yet the subclinical heterogeneity of its component systems remains underexplored. Early detection of physiological deviation is critical for preventing irreversible organ damage and mortality. Here, we characterize the prevalence and interplay of CKM impairment in a US cohort (N=841) by integrating continuous wearable data with clinical biomarkers. We assessed cardiovascular, kidney via clinical biomarkers, namely Chol/HDL, eGFR, as well as metabolic health risk through Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). We show that while metabolic and cardiovascular disruptions are significantly associated (r=0.26, p<0.001), early-stage kidney impairment manifests independently. Utilizing a normalized deviance score, we identified significant health impairments in 29.0% of the cohort. Cardiovascular deviation was the most prevalent singular phenotype (13.3%), followed by metabolic (9.1%) and renal (6.25%) deviations, with dual metabolic-cardiovascular impairment occurring in only 2.2% of participants. These findings suggest that high system-specific deviance may serve as an indicator for accelerated physiological aging within the respective organ system. Furthermore, feature ablation analysis revealed that step count, Active Zone Minutes, and resting heart rate are the most potent wearable-derived predictors of cardiovascular and metabolic decline. These findings underscore the necessity of a multi-system subtyping approach, demonstrating that wearable-derived phenotypes can facilitate the early, targeted interventions required to manage the complex landscape of CKM syndrome.