Evidence mapPaperPMID 41532525Full record

Observational studyJournal of the American Heart Association2026

Association of Higher Dietary Omega-3 Fatty Acid Intake With Cardiovascular-Kidney-Metabolic Syndrome Stage Severity and Mortality in US Adults: A Cross-Sectional and Prospective Cohort Analysis of NHANES 1999 to 2018.

Li-Ling Zhang, Xian-Guan Zhu, Jing Chen, Pei Nie, Jing-Cheng Shi, Zhen Zhang, Yuan-Xi Zheng, Rui Qiao, Liang-Chuan Chen

Abstract readObservational Study
In one paragraph

Observational study in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Li-Ling ZhangDepartment of Cardiology Anqing Municipal Hospital Anqing China.ORCID 0009-0000-1715-7141
Xian-Guan ZhuDepartment of Cardiology Anqing Municipal Hospital Anqing China.ORCID 0000-0001-9480-8120
Jing ChenDepartment of Cardiology Anqing Municipal Hospital Anqing China.
Pei NieDepartment of Cardiology Anqing Municipal Hospital Anqing China.
Jing-Cheng ShiDepartment of Cardiology Anqing Municipal Hospital Anqing China.
Zhen ZhangDepartment of Cardiology Anqing Municipal Hospital Anqing China.
Yuan-Xi ZhengDepartment of Cardiology Anqing Municipal Hospital Anqing China.
Rui QiaoDepartment of Cardiology Anqing Municipal Hospital Anqing China.
Liang-Chuan ChenDepartment of Cardiology Anqing Municipal Hospital Anqing China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular-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.

methodsThis 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.

resultsEach 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.

conclusionsHigher n-3 PUFA intake is associated with less severe CKM stage and linked to lower mortality in an L-shaped, threshold-dependent manner.

Indexed as

Cardiovascular DiseasesDietFatty Acids, Omega-3Kidney DiseasesMetabolic SyndromeAdultCross-Sectional StudiesEatingFemaleHumansLongitudinal StudiesMaleMiddle AgedNutrition SurveysOdds RatioProspective StudiesFatty Acids, Omega-3biological agingcardiovascular‐kidney‐metabolic syndromeestimating glucose disposal ratemortalityNHANESomega‐3 fatty acids

Identifiers

PMID41532525
PMCPMC12919523

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.