摘要Objective Cardiovascular-kidney-metabolic(CKM)syndrome involves complicated interactions among cardiovascular integ-rity,metabolic disorders,and chronic kidney disease,significantly impacting global morbidity and mortality.This study aimed to investigate the effect of an inflammatory diet on CKM syndrome progression.Methods This study included 10,387 adults aged 20 years and older with complete data on CKM syndrome diagnosis and dietary inflammatory index(DII)scores.The DII score was derived on the basis of a 2-day dietary recall interview,and CKM syndrome stages were categorized according to clinical criteria.Multinomial logistic regression,restricted cubic spline(RCS)model,and mediation analysis were used to assess the associations between food components,DII scores,and CKM syndrome stages.Results A higher DII score was significantly associated with advanced CKM syndrome stages,with odds ratios increas-ing from 1.35(1.10,1.65)to 3.76(2.76,5.12)as the DII score rose from the 1st quartile to the 4th quartile(all P＜0.05).The RCS model presented a linear relationship between the DII score and the CKM stage.Mediation analysis revealed that biological age acceleration partially mediated the association between DII score and CKM syndrome,accounting for 21.43％-40.00％of the effect.Conclusions Inflammatory diets are associated with increased risk and progression of CKM syndrome.Biological age acceleration is a critical mediating factor,highlighting the importance of dietary interventions in managing CKM syndrome and its associated complications.Future research should focus on longitudinal studies to confirm these findings and explore additional mechanisms through which dietary patterns influence CKM syndrome.