Background Cardiovascular‐kidney‐metabolic (CKM) syndrome interlinks obesity, diabetes, kidney disease, and cardiovascular dysfunction. Omega‐3 polyunsaturated fatty acids (n‐3 PUFAs) possess anti‐inflammatory and metabolic properties potentially relevant to CKM health, yet their links to disease severity and mortality remain undefined. Methods This cross‐sectional and longitudinal analysis included 27 934 US adults with CKM syndrome from NHANES (National Health and Nutrition Examination Survey) 1999 to 2018. Dietary n‐3 PUFA intake (mg/kg per day) was ascertained from 2 24‐hour recalls. Mortality was ascertained via linkage to the National Death Index through 2019. Cross‐sectional CKM stage was analyzed using weighted ordered logistic regression. Mortality risk was evaluated using Cox models, restricted cubic splines, and weighted quantile sum regression. Results Each 10 mg/kg per day higher n‐3 PUFA intake was associated with 13% lower odds of advanced CKM stage (odds ratio OR, 0.87 95% CI, 0.83–0.91). Over a median 9‐year follow‐up (5150 deaths), a nonlinear, L‐shaped relationship with all‐cause mortality was observed, with a threshold at 22.35 mg/kg per day. Below this point, each 1 mg/kg per day increment was associated with a 1% lower mortality risk (hazard ratio HR, 0.99 95% CI, 0.98–1.00). Participants in the highest versus lowest intake quartile had 48% lower odds of severe CKM stage (OR, 0.52 95% CI, 0.46–0.60) and 25% lower mortality (HR, 0.75 95% CI, 0.61–0.92). Docosapentaenoic acid was the primary n‐3 PUFA species associated with mortality risk. Variation in glucose disposal and biological aging collectively explained 6.7% of the mortality association. Conclusions Higher n‐3 PUFA intake is associated with less severe CKM stage and linked to lower mortality in an L‐shaped, threshold‐dependent manner.
Zhang et al. (Wed,) studied this question.