Zhang Yuan, Ning Ning, Fan Xiaoting, Huang Rong, Ye Yan, He Yue, Ma Yanan, Jin Lina
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China.
Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Liaoning, Shenyang, China.
Prev Med. 2023 Dec;177:107763. doi: 10.1016/j.ypmed.2023.107763. Epub 2023 Nov 7.
Chronic kidney disease (CKD), an age-related condition, is closely associated with cardiovascular disease. We aimed to examine the age-dependent interaction between Life's Essential 8 (LE8), the updated measurement of cardiovascular health (CVH), and CKD in the United States.
The cross-sectional study involved 25,529 participants from National Health and Nutrition Examination Survey in 2007-2018. Multivariate logistic regressions were used to estimate the age-dependent interaction between LE8 and CKD, and restricted cubic spline regressions were used to analyze the dose-response relationships between LE8 and CKD among adults and all age subgroups.
Overall, 2934 (9.3%), 17,278 (66.2%), and 5317 (24.5%) participants had low, moderate, and high CVH, separately. After adjusting for the potential covariates, LE8 was negatively associated with CKD [odds ratio (OR) for per 1 standard deviation (SD) increase and 95%CI, 0.71 (0.67, 0.75)], with a nonlinear dose-response relationship (P for nonlinearity = 0.001). The inversed association was stronger among participants aged 65 and older (0.65 (0.59, 0.71)) compared to youngers [20-39 years, 0.63 (0.59, 0.58), 40-64 years, 0.63 (0.59, 0.58)] (P for interaction = 0.002).
CVH, as measured by the LE8 score, was negatively associated with the presence of CKD in non-linear fashions, more pronounced in participants aged 65 and older compared to younger age groups.
慢性肾脏病（CKD）是一种与年龄相关的疾病，与心血管疾病密切相关。我们旨在研究美国生命基本要素8项（LE8，心血管健康（CVH）的更新指标）与CKD之间的年龄依赖性相互作用。
这项横断面研究纳入了2007 - 2018年美国国家健康与营养检查调查的25529名参与者。采用多变量逻辑回归来估计LE8与CKD之间的年龄依赖性相互作用，并使用受限立方样条回归分析成年人及所有年龄亚组中LE8与CKD之间的剂量反应关系。
总体而言，分别有2934名（9.3%）、17278名（66.2%）和5317名（24.5%）参与者的心血管健康水平低、中、高。在调整潜在协变量后，LE8与CKD呈负相关[每增加1个标准差（SD）的比值比（OR）及95%置信区间为0.71（0.67，0.75）]，且存在非线性剂量反应关系（非线性P值 = 0.001）。与年轻人[20 - 39岁，0.63（0.59，0.58）；40 - 64岁，0.63（0.59，0.58）]相比，65岁及以上参与者的这种负相关更强[0.65（0.59，0.71）]（相互作用P值 = 0.002）。
以LE8评分衡量的心血管健康与CKD的存在呈非线性负相关，在65岁及以上参与者中比年轻年龄组更明显。
