Cardiovascular disease (CVD) and chronic kidney disease (CKD), along with diabetes mellitus (DM), are all major global chronic non-communicable diseases. These three conditions are interconnected and often coexist, forming what is known as cardiorenal metabolic (CRM) syndrome, which has become a serious health issue in modern society.

Using diabetes as an entry point, this study explores the impact of CKM syndrome as a common disease mechanism on hospitalization resource utilization.

A cross-sectional study was conducted using front-page medical record data from patients hospitalized with a principal diagnosis of diabetes mellitus (DM) at a tertiary general hospital in L City between 2020 and 2024. According to the presence of CVD and CKD, patients were classified into four groups: DM without chronic complications, DM with CVD, DM with CKD, and CKM syndrome. Age, length of hospital stay, number of hospitalizations, and hospitalization costs (total inpatient costs, medical service fees, examination and testing fees, medication costs, consumable costs) were compared among the groups. Categorical data were compared using the chi-square test. Non-normally distributed continuous variables were expressed as M (P₂₅, P₇₅) and compared using the Kruskal-Wallis H test; pairwise comparisons were adjusted using the Bonferroni method.

A total of 8 765 patients with DM were included, comprising 3 289 patients with CKM syndrome (37.5%), 3 049 with DM and CVD (34.8%), and 1 616 with DM and CKD (18.4%). Significant differences were observed among the four groups in sex, age, length of hospital stay, number of hospitalizations, total hospitalization costs, medical service costs, examination and laboratory costs, medication costs, and medical consumable costs (all P<0.05). The proportion of patients with CKM syndrome exceeded 40% in all age groups aged 40 and above; the percentage of CKM syndrome patients hospitalized more than 3 times was higher than that of DM patients without chronic complications and DM patients with CVD (P<0.008 3). The median total hospitalization cost for CKM syndrome patients was 6 105.27 (4 674.75, 7 803.20) yuan, which was higher than that for patients with DM without chronic complications and patients with DM and CKD (all P<0.008 3).

Patients with CKM syndrome account for a high proportion of hospitalized DM patients, with a higher prevalence among those aged 40 and above, and they experience a significant economic burden during hospitalization. Early screening, tiered diagnosis and treatment, and comprehensive management should be strengthened to reduce healthcare burden and improve prognosis.

心血管疾病（CVD）和慢性肾脏疾病（CKD）与糖尿病（DM）均为全球重要的慢性非传染性疾病，三者相互关联且常共存，称为心血管-肾脏-代谢（CKM）综合征，其已经成为现代社会严重的健康问题。

以DM为切入点探讨CKM综合征作为共同发病机制疾病对住院资源的消耗情况。

采用横断面研究设计，收集L市三级综合医院2020—2024年主要诊断为DM住院患者的病案首页资料。根据是否合并CVD和CKD，将患者分为DM不伴慢性并发症、DM伴CVD、DM伴CKD及CKM综合征4组。比较各组患者的年龄、实际住院天数、住院次数及住院费用（住院总费用、医务性费用、检查检验费用、药费、耗材费）。计数资料组间比较采用χ²检验；非正态分布计量资料以M（P₂₅，P₇₅）表示，多组间比较采用Kruskal-Wallis H检验，两两比较采用Bonferroni法校正。

共纳入8 765例DM患者，其中CKM综合征患者3 289例（37.5%），DM伴CVD患者3 049例（34.8%），DM伴CKD患者1 616例（18.4%）。不同类型DM患者的性别、年龄、实际住院天数、住院次数及住院总费用、医务性费用、检查检验费用、药费和耗材费比较，差异均有统计学意义（P<0.05）。CKM综合征患者在40岁及以上各年龄组中的构成比均超过40%；CKM综合征患者中住院次数>3次者所占比例高于DM不伴慢性并发症患者和DM伴CVD患者（P<0.008 3）。CKM综合征患者住院总费用中位数为6 105.27（4 674.75，7 803.20）元，高于DM不伴慢性并发症患者和DM伴CKD患者（P<0.008 3）。

CKM综合征患者在DM住院患者中占比较高，40岁及以上患者中CKM综合征构成比较高，住院经济负担较重。应加强早期筛查、分级诊疗和综合管理，以减轻医疗负担并改善预后。