Department of Gastroenterology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian Province, China.
Department of Radiology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian Province, China.
Endocr Pract. 2024 Nov;30(11):1089-1096. doi: 10.1016/j.eprac.2024.08.015. Epub 2024 Sep 4.
This study evaluates the relationship between the Life's Essential 8 (LE8) scoring system and all-cause and cause-specific mortality among obese individuals using National Health and Nutrition Examination Survey data.
Data from 9143 obese participants (BMI ≥30 kg/m) collected between 2005 and 2018 were analyzed. Participants were categorized based on their LE8 scores: low cardiovascular health (Low CVH, n = 2264), moderate cardiovascular health (Moderate CVH, n = 6541), and high cardiovascular health (High CVH, n = 338). Associations between LE8 scores and mortality were assessed using Kaplan-Meier survival analysis and Cox proportional hazards models.
Over a median follow-up of 7.3 years, there were 867 all-cause deaths (9.5%), including 246 cardiovascular disease (CVD) deaths (2.7%) and 621 non-CVD deaths (6.8%). In multivariable Cox regression analysis, compared to the Low CVH group, the Moderate CVH group had an adjusted hazard ratio (HR) for all-cause mortality of 0.63 (95% CI: 0.55-0.72), and the High CVH group had an HR of 0.25 (95% CI: 0.10-0.60). For CVD mortality, the HRs were 0.61 (95% CI: 0.47-0.78) for Moderate CVH and 0.19 (95% CI: 0.03-1.38) for High CVH. For non-CVD mortality, the HRs were 0.64 (95% CI: 0.54-0.75) for Moderate CVH and 0.27 (95% CI: 0.10-0.72) for High CVH. Each 10-point increase in LE8 score was associated with a 20% reduction in all-cause mortality (P < .001), 21% reduction in CVD mortality (P < .001), and 20% reduction in non-CVD mortality (P < .001).
Higher LE8 scores are significantly associated with lower rates of all-cause, CVD, and non-CVD mortality among obese individuals. These findings support the LE8 scoring system as an effective predictor of health status and mortality risk.
本研究利用美国国家健康与营养调查（NHANES）数据评估生活必需 8 项评分系统（LE8）与肥胖个体全因死亡率和死因特异性死亡率之间的关系。
分析了 2005 年至 2018 年间收集的 9143 名肥胖参与者（BMI≥30kg/m2）的数据。根据 LE8 评分将参与者分为低心血管健康（低 CVH，n=2264）、中心血管健康（中 CVH，n=6541）和高心血管健康（高 CVH，n=338）。使用 Kaplan-Meier 生存分析和 Cox 比例风险模型评估 LE8 评分与死亡率之间的关联。
在中位随访 7.3 年期间，共有 867 例全因死亡（9.5%），其中包括 246 例心血管疾病（CVD）死亡（2.7%）和 621 例非 CVD 死亡（6.8%）。多变量 Cox 回归分析显示，与低 CVH 组相比，中 CVH 组全因死亡率的校正风险比（HR）为 0.63（95%CI：0.55-0.72），高 CVH 组为 0.25（95%CI：0.10-0.60）。对于 CVD 死亡率，中 CVH 的 HR 为 0.61（95%CI：0.47-0.78），高 CVH 的 HR 为 0.19（95%CI：0.03-1.38）。对于非 CVD 死亡率，中 CVH 的 HR 为 0.64（95%CI：0.54-0.75），高 CVH 的 HR 为 0.27（95%CI：0.10-0.72）。LE8 评分每增加 10 分，全因死亡率降低 20%（P<.001），CVD 死亡率降低 21%（P<.001），非 CVD 死亡率降低 20%（P<.001）。
LE8 评分较高与肥胖个体全因、CVD 和非 CVD 死亡率降低显著相关。这些发现支持 LE8 评分系统作为健康状况和死亡风险的有效预测指标。
