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Life's Crucial 9 and NAFLD from association to SHAP-interpreted machine learning predictions.

作者信息

Xi Jianxin, Chen Yuguo, Jie Chen, Law Jason Chi Shing, Fan Zhongqi, Lv Guoyue

机构信息

Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, No.1 Xinmin Street, Chaoyang District, Changchun City, Jilin Province, China.

Department of Radiology, The First Hospital of Jilin University, Jilin, China.

出版信息

Sci Rep. 2025 Mar 18;15(1):9384. doi: 10.1038/s41598-025-92777-0.


DOI:10.1038/s41598-025-92777-0
PMID:40102489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11920226/
Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Cardiovascular disease (CVD) and NAFLD share multiple common risk factors. Life's Crucial 9 (LC9), a novel indicator for comprehensive assessment of cardiovascular health (CVH), has not yet been studied in terms of its association with or predictive value for NAFLD. This study analyzed data from 10,197 participants in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The association between LC9 and NAFLD was assessed using weighted logistic regression, while weighted Cox proportional hazards models were applied to evaluate the relationship between LC9 and all-cause mortality among NAFLD patients. Restricted cubic spline (RCS) analysis was conducted to explore dose-response relationships, and Kaplan-Meier survival curves were utilized to examine differences in survival outcomes. Machine learning (ML) approaches were employed to construct predictive models, with the optimal model further interpreted using SHapley Additive exPlanations (SHAP). An increase of 10 points in LC9 was negatively associated with the risk of NAFLD (model 3: OR = 0.39, 95% CI = 0.36 - 0.42, P < 0.001) and all-cause mortality in NAFLD patients (model 3: HR = 0.78, 95% CI = 0.67 - 0.91, P < 0.001). A non-linear relationship was observed between LC9 and NAFLD (P < 0.0001 for nonlinearity). Among the eight ML models, the Support Vector Machine (SVM) demonstrated the best predictive performance (AUC = 0.873). SHAP analysis indicated that LC9 was the most significant predictor in the model. LC9 demonstrated a nonlinear negative association with NAFLD and a linear negative association with all-cause mortality in NAFLD patients. Maintaining a higher LC9 score may reduce the risk of NAFLD and all-cause mortality among NAFLD patients. The predictive model developed using Support Vector Machine (SVM) exhibited strong clinical predictive value, with LC9 being the most critical factor in the model, facilitating self-risk assessment and targeted intervention.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/b5f0f38fe8ec/41598_2025_92777_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/c098865d9f9e/41598_2025_92777_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/83feb11280f5/41598_2025_92777_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/619fcba56fe7/41598_2025_92777_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/e60d3699ac86/41598_2025_92777_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/0e73d4a217ab/41598_2025_92777_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/b5f0f38fe8ec/41598_2025_92777_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/c098865d9f9e/41598_2025_92777_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/83feb11280f5/41598_2025_92777_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/619fcba56fe7/41598_2025_92777_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/e60d3699ac86/41598_2025_92777_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/0e73d4a217ab/41598_2025_92777_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7392/11920226/b5f0f38fe8ec/41598_2025_92777_Fig6_HTML.jpg

相似文献

[1]
Life's Crucial 9 and NAFLD from association to SHAP-interpreted machine learning predictions.

Sci Rep. 2025-3-18

[2]
Association between life's crucial 9 and lung health: a population-based study.

BMC Pulm Med. 2025-5-3

[3]
The association between life's crucial 9 and all-cause, cancer-specific and cardiovascular mortality in US cancer survivors: a cohort study of NHANES.

BMC Cancer. 2025-4-30

[4]
Comparative Discrimination of Life's Simple 7, Life's Essential 8, and Life's Crucial 9: Evaluating the impact of added complexity on mortality prediction.

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[5]
Association of Life's Crucial 9 with all-cause and cardiovascular mortality in stroke survivors and predictive value for mortality compared with Life's Essential 8: evidence from NHANES 2005-2018.

Front Neurol. 2025-3-17

[6]
Association of the "life's crucial 9" cardiovascular health with all-cause and cardiovascular disease mortality: a national cohort study.

Arch Public Health. 2025-4-28

[7]
The correlation between Life's essential 8 and cardiovascular disease and mortality in individuals with nonalcoholic fatty liver disease: a cross-sectional study.

Sci Rep. 2024-10-14

[8]
Predictive Value of Life's Crucial 9 for Cardiovascular and All-Cause Mortality: A Prospective Cohort Study From the NHANES 2007 to 2018.

J Am Heart Assoc. 2024-10-15

[9]
Estimated glucose disposal rate mediates the association between Life's Crucial 9 and congestive heart failure: a population-based study.

Front Endocrinol (Lausanne). 2025-4-3

[10]
Higher Life's Crucial 9 protects against infertility among U.S. women aged 18-45 years.

Front Endocrinol (Lausanne). 2025-1-30

本文引用的文献

[1]
Life's essential 8 and mortality in US adults with metabolic dysfunction-associated steatotic liver disease.

BMC Public Health. 2024-12-18

[2]
The correlation between Life's essential 8 and cardiovascular disease and mortality in individuals with nonalcoholic fatty liver disease: a cross-sectional study.

Sci Rep. 2024-10-14

[3]
Predictive Value of Life's Crucial 9 for Cardiovascular and All-Cause Mortality: A Prospective Cohort Study From the NHANES 2007 to 2018.

J Am Heart Assoc. 2024-10-15

[4]
Dietaryindex: a user-friendly and versatile R package for standardizing dietary pattern analysis in epidemiological and clinical studies.

Am J Clin Nutr. 2024-11

[5]
Association of triglyceride glucose-related parameters with all-cause mortality and cardiovascular disease in NAFLD patients: NHANES 1999-2018.

Cardiovasc Diabetol. 2024-7-18

[6]
Cumulative exposure to AHA Life's Essential 8 is associated with nonalcoholic fatty liver disease: a large cohort study.

Nutr Metab (Lond). 2024-6-27

[7]
Air pollution, life's essential 8, and risk of severe non-alcoholic fatty liver disease among individuals with type 2 diabetes.

BMC Public Health. 2024-5-20

[8]
Strengthening the Pillars of Cardiovascular Health: Psychological Health is a Crucial Component.

Circulation. 2024-2-27

[9]
Depression and NAFLD risk: A meta-analysis and Mendelian randomization study.

J Affect Disord. 2024-5-1

[10]
Depressive Symptoms and Mortality Among US Adults.

JAMA Netw Open. 2023-10-2

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