C反应蛋白、生命必需的八项指标与美国成年人死亡率之间的关联：基于2005 - 2010年美国国家健康和营养检查调查（NHANES）数据分析的见解

Association between C-reactive protein, Life's Essential 8, and mortality in American adults: Insights from NHANES 2005-2010 data analysis.

作者信息

Li Xin, Zhu Yongxin, Yan Tingting, Fang Jie, Xu Xin, Xu Xiaodong

机构信息

Department of Cardiovascular Diseases, The People's Hospital of Chizhou, Chizhou 247100, China.

出版信息

Exp Gerontol. 2024 Oct 15;196:112590. doi: 10.1016/j.exger.2024.112590. Epub 2024 Sep 21.

DOI:10.1016/j.exger.2024.112590

PMID:39307250

Abstract

OBJECTIVE

To evaluate the independent, mediating, interactive, and associated effects of C-reactive protein (CRP) and Life's Essential 8 (LE8) on all-cause and cardiovascular mortality.

METHODS

Utilizing data from 10,043 participants in the NHANES 2005-2010, we employed Cox proportional hazards regression models and causal mediation analysis to investigate the joint and interactive effects of Life's Essential 8 (LE8) and C-reactive protein (CRP) on mortality risk.

RESULTS

During an average follow-up of 137.10 months, there were 1591 all-cause deaths and 485 cardiovascular deaths. Weighted linear regression showed that for patients with low cardiovascular health (CVH), the adjusted β was -0.22 (95 % CI: -0.27 to -0.17) for moderate cardiovascular health (CVH) and -0.36 (95 % CI: -0.43 to -0.30) for high cardiovascular health (CVH). Mediation analysis revealed that C-reactive protein (CRP) mediated 10.43 % of all-cause mortality and 9.20 % of cardiovascular mortality for moderate cardiovascular health (CVH) compared to low cardiovascular health (CVH), and 9.95 % and 8.32 % respectively for high cardiovascular health (CVH) compared to low cardiovascular health (CVH). No significant multiplicative or additive interactions between Life's Essential 8 (LE8) and C-reactive protein (CRP) were found in all-cause mortality or cardiovascular mortality. Individuals with high cardiovascular health (CVH) and the first quartile of C-reactive protein (CRP) had HRs of 0.30 (95 % CI 0.18-0.48) for all-cause mortality and 0.31 (95 % CI 0.13-0.74) for cardiovascular mortality compared to those with low cardiovascular health (CVH) and the fourth quartile of C-reactive protein (CRP).

CONCLUSION

These findings suggest that CRP could significantly influence the relationship between cardiovascular health (CVH) and mortality. Interventions that target both lifestyle factors and CRP levels may improve cardiovascular health and potentially lower mortality risks.

摘要

目的

评估C反应蛋白（CRP）和生命必需的8要素（LE8）对全因死亡率和心血管死亡率的独立、中介、交互及关联效应。

方法

利用2005 - 2010年美国国家健康与营养检查调查（NHANES）中10,043名参与者的数据，我们采用Cox比例风险回归模型和因果中介分析来研究生命必需的8要素（LE8）和C反应蛋白（CRP）对死亡风险的联合及交互效应。

结果

在平均137.10个月的随访期间，有1591例全因死亡和485例心血管死亡。加权线性回归显示，对于心血管健康（CVH）状况较差的患者，中等心血管健康（CVH）的调整β值为 -0.22（95%置信区间：-0.27至 -0.17），高心血管健康（CVH）的调整β值为 -0.36（95%置信区间：-0.43至 -0.30）。中介分析表明，与心血管健康（CVH）状况较差相比，中等心血管健康（CVH）时C反应蛋白（CRP）介导了10.43%的全因死亡率和9.20%的心血管死亡率，高心血管健康（CVH）时分别为9.95%和8.32%。在全因死亡率或心血管死亡率方面，未发现生命必需的8要素（LE8）和C反应蛋白（CRP）之间存在显著的乘法或加法交互作用。与心血管健康（CVH）状况较差且C反应蛋白（CRP）处于第四四分位数的个体相比，心血管健康（CVH）状况良好且C反应蛋白（CRP）处于第一四分位数的个体全因死亡率的风险比（HR）为0.30（95%置信区间0.18 - 0.48），心血管死亡率的风险比（HR）为0.31（95%置信区间0.13 - 0.74）。