CKM and isolated hemihyperplasia: However, evidence on the relationship between DII and intermediate-to-high-risk cardiovascular-kidney-metabolic syndrome (IH-CKM) is limited.<h4>Objective</h4>This study aimed to evaluate the association between DII and IH-CKM and to explore the relationship between DII and all-cause mortality risk in individuals with and without IH-CKM.<h4>Methods</h4>We conducted a cross-sectional and cohort analysis using data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES).