Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, Guangdong, China.
The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
PLoS One. 2024 Nov 22;19(11):e0314152. doi: 10.1371/journal.pone.0314152. eCollection 2024.
Life's Essential 8 (LE8) is the American Heart Association (AHA)'s recently updated assessment of cardiovascular health (CVH). Metabolic syndrome (MetS) is one of the most common chronic noncommunicable diseases associated with CVH impairment and an increased risk of mortality. However, the association of LE8 with all-cause and disease-specific mortality in the MetS population remains unknown. We aimed to explore these associations in a national prospective cohort study from NHANES 2005-2018.
The LE8 was calculated according to the assessment criteria proposed by the AHA, which includes health behavior and health factor domains. LE8 scores were categorized as low CVH (0-49), moderate CVH (50-79), and high CVH (80-100). MetS was assessed according to NCEP-ATP III criteria, and mortality data were obtained through prospective linkage to the National Death Index database.
7839 participants with MetS were included and only 3.5% were in high CVH. In the fully adjusted models, LE8 was negatively associated with both all-cause and cardiovascular disease (CVD) mortality (hazard ratios [HR] and 95% confidence intervals [CI] of 0.978 (0.971,0.984) and 0.972 (0.961,0.984), respectively, both p < 0.0001). Both moderate/high CVH were associated with significantly lower mortality compared to low CVH (both p for trend <0.0001). Health behaviors had a more dominant effect compared to health factors. All-cause and CVD mortality gradually decreased with increasing ideal LE8 metrics. LE8 was not significantly associated with cancer mortality. LE8 and health behaviors were linearly associated with all-cause and CVD mortality, whereas health factors were nonlinearly associated (plateaued after ≥50). Education and chronic kidney disease influenced the association of LE8 with all-cause and CVD mortality, respectively.
LE8 scores were negatively associated with all-cause and CVD mortality in the MetS population, while health behaviors had a dominant role. Adherence to higher CVH contributes to the prevention of excessive all-cause and CVD mortality in the MetS population.
Life's essential 8（LE8）是美国心脏协会（AHA）最近更新的心血管健康（CVH）评估方法。代谢综合征（MetS）是与 CVH 受损和死亡率增加相关的最常见慢性非传染性疾病之一。然而，LE8 与 MetS 人群的全因和特定疾病死亡率之间的关联尚不清楚。我们旨在通过来自 NHANES 2005-2018 的全国前瞻性队列研究来探讨这些关联。
根据 AHA 提出的评估标准计算 LE8，其中包括健康行为和健康因素领域。LE8 评分分为低 CVH（0-49）、中 CVH（50-79）和高 CVH（80-100）。根据 NCEP-ATP III 标准评估 MetS，并通过与国家死亡指数数据库的前瞻性链接获得死亡率数据。
共纳入 7839 例 MetS 患者，仅有 3.5%的患者处于高 CVH 状态。在完全调整的模型中，LE8 与全因和心血管疾病（CVD）死亡率呈负相关（危险比 [HR]和 95%置信区间 [CI]分别为 0.978（0.971，0.984）和 0.972（0.961，0.984），均 p<0.0001）。与低 CVH 相比，中/高 CVH 均与死亡率显著降低相关（趋势 p 值均<0.0001）。健康行为与健康因素相比，具有更主导的作用。随着理想 LE8 指标的增加，全因和 CVD 死亡率逐渐降低。LE8 与癌症死亡率无显著相关性。LE8 和健康行为与全因和 CVD 死亡率呈线性相关，而健康因素呈非线性相关（≥50 后趋于平稳）。教育和慢性肾脏病分别影响 LE8 与全因和 CVD 死亡率的关联。
LE8 评分与 MetS 人群的全因和 CVD 死亡率呈负相关，而健康行为具有主导作用。遵循更高的 CVH 有助于预防 MetS 人群的全因和 CVD 死亡率过高。
