Zhang Yingying, Wang Pingping, Tu Fan, Kang Hao, Fu Chengfeng
Medical Laboratory Center, Affiliated Wuxi Fifth Hospital of Jiangnan University, No. 1215 Guangrui Road, Jiangsu, 214005, China.
Department of Clinical Laboratory, Taizhou Second People's Hospital Affiliated to Yangzhou University, Jiangsu, China.
BMC Public Health. 2024 Dec 18;24(1):3411. doi: 10.1186/s12889-024-20919-6.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to increased all-cause mortality due to metabolic dysfunctions like obesity, diabetes, and cardiovascular diseases. This study examines the association between Life's Essential 8 (LE8) scores and both all-cause and cardiovascular disease (CVD) mortality in MASLD participants.
Data from 5,916 MASLD participants in the NHANES (2005-2018) were analyzed. Associations between LE8 scores and all-cause and CVD mortality were assessed using Cox proportional hazards models, with follow-up until December 31, 2019. Dose-response relationships and survival differences were evaluated using Kaplan-Meier survival curves and Restricted Cubic Spline models.
Over a median follow-up of 7.6 years, moderate and high LE8 scores were associated with 33% (HR: 0.67; 95% CI: 0.56-0.79) and 47% (HR: 0.53; 95% CI: 0.33-0.84) lower risk of all-cause mortality, respectively, compared to low scores. For CVD mortality, the adjusted HRs were 0.56 (95% CI: 0.41-0.78) and 0.35 (95% CI: 0.12-1.0). Higher LE8 scores were significantly associated with reduced cumulative incidence of all-cause and CVD mortality (log-rank P < 0.001). A 10-point increase in health behavior scores, particularly in diet, physical activity, and nicotine exposure, was linked to an 11% reduction in all-cause mortality risk and an 11% reduction in CVD mortality risk. Among health factors, only blood glucose showed a significant association with CVD mortality.
Higher LE8 scores in MASLD patients are associated with lower mortality risk, suggesting the potential value of promoting cardiovascular health in this population. Further research is needed to confirm these associations.
代谢功能障碍相关脂肪性肝病（MASLD）与肥胖、糖尿病和心血管疾病等代谢功能障碍导致的全因死亡率增加有关。本研究探讨了生命基本八项（LE8）评分与MASLD参与者的全因死亡率和心血管疾病（CVD）死亡率之间的关联。
分析了美国国家健康与营养检查调查（NHANES，2005 - 2018年）中5916名MASLD参与者的数据。使用Cox比例风险模型评估LE8评分与全因死亡率和CVD死亡率之间的关联，随访至2019年12月31日。使用Kaplan-Meier生存曲线和受限立方样条模型评估剂量反应关系和生存差异。
在中位随访7.6年期间，与低LE8评分相比，中度和高LE8评分分别使全因死亡率风险降低33%（风险比：0.67；95%置信区间：0.56 - 0.79）和47%（风险比：0.53；95%置信区间：0.33 - 0.84）。对于CVD死亡率，调整后的风险比分别为0.56（95%置信区间：0.41 - 0.78）和0.35（95%置信区间：0.12 - 1.0）。较高的LE8评分与全因死亡率和CVD死亡率的累积发生率降低显著相关（对数秩检验P < 0.001）。健康行为评分每增加10分，特别是在饮食、身体活动和尼古丁暴露方面，与全因死亡率风险降低11%和CVD死亡率风险降低11%相关。在健康因素中，只有血糖与CVD死亡率有显著关联。
MASLD患者中较高的LE8评分与较低的死亡风险相关，提示在该人群中促进心血管健康的潜在价值。需要进一步研究来证实这些关联。
