NMR metabolomics for cardiovascular-kidney-metabolic risk stratification in an integrated healthcare system

Metabolomic profiling predicts future disease in population cohorts, but its value in real-world healthcare remains uncertain. We profiled 250 nuclear magnetic resonance (NMR) biomarkers in 54,933 participants from a diverse integrated US healthcare system linked to longitudinal electronic health records, evaluating nine cardiovascular-kidney-metabolic disease endpoints. Adding NMR to standard-of-care predictors improved discrimination for nearly all endpoints, with the largest gains for type 2 diabetes, chronic kidney disease and metabolic dysfunction-associated steatotic liver disease. Beyon

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