Chakrabarti Amit K, Drexler Yelena, Swift Samuel, Lash James P, Kaplan Robert C, Perreira Krista M, Mendoza Jair Munoz, Daviglus Martha, Pirzada Amber, Sotres-Alvarez Daniela, Johns Tanya, Elfassy Tali
Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
Clin J Am Soc Nephrol. 2025 Apr 1;20(4):502-511. doi: 10.2215/CJN.0000000656. Epub 2025 Feb 28.
In US Hispanic/Latino adults with CKD, better cardiovascular health is associated with slower eGFR declines and improvements in albumin-to-creatinine ratio over 6 years. These findings support the implementation of a heart healthy lifestyle to delay CKD progression among US Hispanic/Latino adults.
The primary cause of death in CKD is cardiovascular disease. Life's essential 8 (LE8) is an established measure of cardiovascular health (CVH). Our objective was to examine the relationship between CVH (LE8 score) and CKD progression among Hispanic/Latino adults, an understudied but growing population.
The Hispanic Community Health Study/Study of Latinos is a longitudinal cohort of Hispanic/Latino adults aged 18–74 years from four cities in the United States, examined at visit 1 (V1, 2008–2011) and visit 2 (2014–2017). At V1, participants underwent a comprehensive assessment of health behaviors (diet, physical activity, nicotine exposure, and sleep health) and clinical measurements (body mass index, blood lipids, blood glucose, and BP) used to estimate an LE8 score (range: 0–100). We included 1284 participants with CKD at V1, defined as eGFR <60 ml/min per 1.73 m and/or urine albumin-to-creatinine ratio (ACR) ≥30 mg/g. Change in eGFR and log(ACR) was defined as the difference in each measure between V1 and visit 2. To estimate the association between LE8 score with change in eGFR and log(ACR), we used linear regression models adjusted for follow-up time and demographic, socioeconomic, and clinical factors. All analyses accounted for Hispanic Community Health Study/Study of Latinos complex survey design.
Among 1284 Hispanic/Latino participants with CKD at V1, the mean age was 48.6 years (SEM: 0.8), 57.2% were women, and the mean LE8 score was 61.1 (SEM: 0.7). Over an average of 6 years of follow-up, eGFR declined by 5.8 ml/min per 1.73 m and log(ACR) declined by 0.60. From multivariable adjusted models, for each 10-unit higher LE8 score, eGFR was lower by 0.97 ml/min per 1.73 m less (95% confidence interval, −1.93 to −0.02) and log(ACR) was lower by an additional 0.15 (95% confidence interval, 0.05 to 0.25).
Among diverse US Hispanic/Latino adults with CKD, higher LE8 score (better CVH) was associated with a slower decline in eGFR and lower albuminuria over 6 years.
在美国患有慢性肾脏病（CKD）的西班牙裔/拉丁裔成年人中，更好的心血管健康与6年内估算肾小球滤过率（eGFR）下降较慢以及白蛋白与肌酐比值改善有关。这些发现支持实施有益心脏健康的生活方式，以延缓美国西班牙裔/拉丁裔成年人CKD的进展。
CKD的主要死因是心血管疾病。生命基本八项（LE8）是一种既定的心血管健康（CVH）衡量指标。我们的目标是研究CVH（LE8评分）与西班牙裔/拉丁裔成年人CKD进展之间的关系，这是一个研究较少但数量不断增长的人群。
西班牙裔社区健康研究/拉丁裔研究是一项针对来自美国四个城市、年龄在18 - 74岁的西班牙裔/拉丁裔成年人的纵向队列研究，在第1次访视（V1，2008 - 2011年）和第2次访视（2014 - 2017年）时进行检查。在V1时，参与者接受了对健康行为（饮食、身体活动、尼古丁暴露和睡眠健康）以及用于估算LE8评分（范围：0 - 100）的临床测量（体重指数、血脂、血糖和血压）的全面评估。我们纳入了1284名在V1时患有CKD的参与者，定义为eGFR<60 ml/（min·1.73 m²）和/或尿白蛋白与肌酐比值（ACR）≥30 mg/g。eGFR和log（ACR）的变化定义为每次测量在V1和第2次访视之间的差异。为了估计LE8评分与eGFR和log（ACR）变化之间的关联，我们使用了针对随访时间以及人口统计学、社会经济和临床因素进行调整的线性回归模型。所有分析都考虑了西班牙裔社区健康研究/拉丁裔研究的复杂调查设计。
在1284名V1时患有CKD的西班牙裔/拉丁裔参与者中，平均年龄为48.6岁（标准误：0.8），57.2%为女性，平均LE8评分为61.1（标准误：0.7）。在平均6年的随访中，eGFR每1.73 m²下降5.8 ml/min，log（ACR）下降0.60。从多变量调整模型来看，LE8评分每高10分，eGFR每1.73 m²降低0.97 ml/min（95%置信区间，−1.93至−0.02），log（ACR）额外降低0.15（95%置信区间，0.05至0.25）。
在美国不同的患有CKD的西班牙裔/拉丁裔成年人中，较高的LE8评分（更好的CVH）与6年内eGFR下降较慢和蛋白尿较低有关。
