Tang Rui, Wang Xuan, Li Xiang, Ma Hao, Liang Zhaoxia, Heianza Yoriko, Qi Lu
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Am J Clin Nutr. 2023 Oct;118(4):804-811. doi: 10.1016/j.ajcnut.2023.08.007. Epub 2023 Aug 19.
The American Heart Association recently updated Life's Essential 8 (LE8) score. This amalgamation of health factors, recognized for their individual associations with chronic kidney disease (CKD) risk, provides a robust tool to assess overall cardiovascular health (CVH), which could potentially be extrapolated to predict CKD risk.
This study aimed to investigate the association between levels of CVH, as measured by the LE8 score, and risk of CKD in the UK Biobank.
A total of 147,988 participants free of CKD and cardiovascular disease from the UK Biobank were included in this prospective study. CVH levels were categorized as low (0-49), moderate (50-79), and high (80-100) using LE8 score. An adjusted Cox proportional hazard model was used to investigate the association between LE8 and CKD. The population attributable-risk (PAR) was also calculated.
During a median follow-up of 10 y, 1936 CKD cases were documented. A higher LE8 score was associated with a significant lower risk of CKD (P < 0.001), and a linear dose-response relationship was observed. Similar patterns were also found in the associations of the LE8 behavior and biological subscale scores with CKD. Compared with participants with a low CVH category, participants with a moderate CVH were associated with a 39% lower risk of developing CKD (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.52, 0.72); and those with a high CVH had a 57% lower risk of CKD incidence (HR: 0.43; 95% CI: 0.35, 0.53) after adjustment for covariates. Among 8 distinct metrics of LE8 score, the BMI metric had the highest PAR (24.6%; 95% CI: 18.8, 30.2). Of the total CKD risk, 3.2% (95% CI: 1.4, 5.0) was attributable to inadequate or excessive sleep duration.
High CVH, defined by LE8, is significantly associated with a lower risk of CKD. These results suggest that promoting optimal cardiovascular health may lower the burden of CKD.
美国心脏协会最近更新了生命基本要素8（LE8）评分。这种综合了多种健康因素的评分，因其与慢性肾脏病（CKD）风险的个体关联而受到认可，它提供了一个强大的工具来评估整体心血管健康（CVH），这有可能被外推用于预测CKD风险。
本研究旨在调查在英国生物银行中，用LE8评分衡量的CVH水平与CKD风险之间的关联。
本前瞻性研究纳入了英国生物银行中147,988名无CKD和心血管疾病的参与者。使用LE8评分将CVH水平分为低（0 - 49）、中（50 - 79）和高（80 - 100）三类。采用校正后的Cox比例风险模型来研究LE8与CKD之间的关联。还计算了人群归因风险（PAR）。
在中位随访10年期间，记录了1936例CKD病例。LE8评分越高，CKD风险显著越低（P < 0.001），并且观察到线性剂量反应关系。在LE8行为和生物子量表评分与CKD的关联中也发现了类似模式。与CVH低分组的参与者相比，CVH中等分组的参与者发生CKD的风险降低39%（风险比[HR]：0.61；95%置信区间[CI]：0.52, 0.72）；在调整协变量后，CVH高分组的参与者CKD发病风险降低57%（HR：0.43；95% CI：0.35, 0.53）。在LE8评分的8个不同指标中，体重指数指标的PAR最高（24.6%；95% CI：18.8, 30.2）。在总的CKD风险中，3.2%（95% CI：1.4, 5.0）可归因于睡眠时间不足或过长。
由LE8定义的高CVH与较低的CKD风险显著相关。这些结果表明，促进最佳心血管健康可能会降低CKD的负担。
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