Wang Xingye, Xie Hang, Xie Xuegang, Zhang Yushun
Department of Structural Heart Disease, the First Affiliated Hospital of Xi'an Jiaotong University, No.277, Yanta West Road, Xi'an, 710061, Shaanxi, China.
Heliyon. 2024 Jun 5;10(13):e32497. doi: 10.1016/j.heliyon.2024.e32497. eCollection 2024 Jul 15.
The American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH)-Life's Essential 8 (LE8) score. Our objective was to investigate the correlation between levels of CVH, as determined by the LE8 score, and the risk of kidney stones among a representative sample of adults in the United States.
We included data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007-2016 for further analysis. The LE8 score, a comprehensive measurement ranging from 0 to 100, was used to evaluate overall CVH and classified into three categories: low (0-49), moderate (50-79), and high (80-100) CVH. Logistic regression was employed to assess the association between the LE8 score and kidney stones. Furthermore, sensitivity analysis was conducted to validate the findings, and the presence of a non-linear relationship was examined using restricted cubic spline (RCS) regression methods.
A total of 19,988 participants were included in this study (weighted mean age, 47.99 years; 95 % confidence interval [CI]: 47.46-48.53 years), with 10,319 being female (weighted percentage, 51.98 %; 95 % CI: 51.26-52.71 %) and 1923 identified as having kidney stones (weighted percentage, 9.95 %; 95 % CI: 9.41-10.53 %). In the fully-adjusted multivariable model, higher LE8 scores were associated with prevalence of self-reported kidney stones (odds ratio [OR] for a 10-unit increase in score, 0.86; 95 % CI: 0.82-0.91), presenting a linear dose-response relationship. Compared to the low CVH group, participants in the moderate and high CVH groups exhibited a lower prevalence of kidney stones (OR = 0.80; 95 % CI: 0.69-0.92; OR = 0.54; 95 % CI: 0.43-0.69, respectively). Similar trends were observed when assessing the association between health behavior scores and kidney stones. Moreover, the negative correlation between the LE8 score and the prevalence of kidney stones was markedly more pronounced in various stratified analyses.
Our study suggests that a higher level of CVH, as assessed by the LE8 metrics, is independently associated with a lower prevalence of self-reported kidney stones in a linear relationship. Further research, particularly through longitudinal or intervention studies, is required to establish whether actively promoting optimal CVH levels can effectively reduce the incidence of kidney stones.
美国心脏协会最近发布了一种用于评估心血管健康（CVH）的更新算法——生命基本8要素（LE8）评分。我们的目的是在美国成年人的代表性样本中，研究由LE8评分确定的CVH水平与肾结石风险之间的相关性。
我们纳入了2007年至2016年期间美国国家健康与营养检查调查（NHANES）的数据进行进一步分析。LE8评分是一种范围从0到100的综合测量指标，用于评估整体CVH，并分为三类：低（0 - 49）、中（50 - 79）和高（80 - 100）CVH。采用逻辑回归评估LE8评分与肾结石之间的关联。此外，进行了敏感性分析以验证研究结果，并使用受限立方样条（RCS）回归方法检查非线性关系的存在。
本研究共纳入19988名参与者（加权平均年龄47.99岁；95%置信区间[CI]：47.46 - 48.53岁），其中10319名女性（加权百分比51.98%；95% CI：51.26 - 52.71%），1923名被确定患有肾结石（加权百分比9.95%；95% CI：9.41 - 10.53%）。在完全调整的多变量模型中，较高的LE8评分与自我报告的肾结石患病率相关（评分每增加10个单位的优势比[OR]为0.86；95% CI：0.82 - 0.91），呈现线性剂量反应关系。与低CVH组相比，中、高CVH组的参与者肾结石患病率较低（OR分别为0.80；95% CI：0.69 - 0.92；OR为0.54；95% CI：0.43 - 0.69）。在评估健康行为评分与肾结石之间的关联时也观察到了类似趋势。此外，在各种分层分析中，LE8评分与肾结石患病率之间的负相关明显更为显著。
我们的研究表明，以LE8指标评估的较高CVH水平与自我报告的肾结石较低患病率呈线性关系且独立相关。需要进一步的研究，特别是通过纵向或干预研究，来确定积极促进最佳CVH水平是否能有效降低肾结石的发病率。
