Yunxia Xie,1,* Keqing Shen,2,* Jingping Xu,3 Lusha Li,2 Liying Chen2 

1Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 3Sanjiang Street Community Health Service Centre, Jinhua City, Zhejiang, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Liying Chen, Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, 310016, People’s Republic of China, Email 3197020@zju.edu.cn

Purpose: Fatigue is common in many chronic diseases. The aim of this cross-sectional study was to investigate the association between fatigue and cardiovascular–kidney–metabolic syndrome (CKM) in Chinese asymptomatic individuals undergoing routine health screenings and to explore the mediating role of inflammation.
Patients and Methods: The data of 4349 individuals were included in this cross-sectional study. Fatigue was measured with the Fatigue Severity Scale (FSS). The association between fatigue and the severity of CKM syndrome was evaluated via logistic regression analysis. The mediating role of inflammation in fatigue and advanced CKM syndrome was explored using mediation analysis.
Results: A total of 4349 participants were included in this study, and 2120 (48.7%) experienced fatigue. Fatigue was associated with a greater risk of developing advanced CKM syndrome (OR 2.597, 95% CI 1.323– 5.097, p < 0.05). However, there was no significant correlation with the risk of developing early CKM syndrome. Further analyses stratified by age revealed that the association between fatigue and advanced CKM syndrome was more pronounced in those aged < 60 years (OR 3.008, 95% CI 1.263– 7.163, p < 0.05). The white blood cell count and neutrophil count had a mediating effect in the association between fatigue and advanced CKM syndrome, with mediation rates of 7.2% and 6.3%, respectively.
Conclusion: Fatigue is significantly associated with the increased risk of advanced CKM syndrome, especially in young and middle-aged adults. The cause of this association may be that white blood cell count and neutrophil count play a partial role in this relationship.

Keywords: cardiovascular–kidney–metabolic syndrome, fatigue, inflammation, mediating effect