He Panpan, Li Huan, Liu Mengyi, Ye Ziliang, Zhou Chun, Zhang Yanjun, Yang Sisi, Zhang Yuanyuan, Qin Xianhui
Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, Guangdong 510515, China.
Chin Med J (Engl). 2025 Aug 5;138(15):1835-1842. doi: 10.1097/CM9.0000000000003491. Epub 2025 Apr 14.
The American Heart Association recently released a new cardiovascular health (CVH) metric, Life's Essential 8 (LE8), for health promotion. However, the association between LE8 scores and the risk of chronic kidney disease (CKD) remains uncertain. We aimed to explore the association of LE8 scores with new-onset CKD and examine whether socioeconomic deprivation and genetic risk modify this association.
A total of 286,908 participants from UK Biobank and without prior CKD were included between 2006 and 2010. CVH was categorized using LE8 scores: low (LE8 scores <50), moderate (LE8 scores ≥50 but <80), and high (LE8 scores ≥80). The study outcome was new-onset CKD, ascertained by data linkage with primary care, hospital inpatient, and death data. Cox proportional hazard regression models were used to investigate the association between CVH categories and new-onset CKD.
During a median follow-up of 12.5 years, 8857 (3.1%) participants developed new-onset CKD. Compared to the low CVH group, the moderate (adjusted hazards ratio [HR], 0.50; 95% confidence interval [CI]: 0.47-0.53) and high CVH (adjusted HR, 0.31; 95% CI: 0.27-0.34) groups had a significantly lower risk of developing new-onset CKD. The population-attributable risk associated with high vs. intermediate or low CVH scores was 40.3%. Participants who were least deprived ( vs. most deprived; adjusted HR, 0.75; 95% CI: 0.71-0.79) and with low genetic risk of CKD ( vs. high genetic risk; adjusted HR, 0.89; 95% CI: 0.85-0.94) had a significantly lower risk of developing new-onset CKD. However, socioeconomic deprivation and genetic risks of CKD did not significantly modify the relationship between LE8 scores and new-onset CKD (both P -interaction >0.05).
Achieving a higher LE8 score was associated with a lower risk of developing new-onset CKD, regardless of socioeconomic deprivation and genetic risks of CKD.
美国心脏协会最近发布了一项新的心血管健康（CVH）指标，即生命八大要素（LE8），用于促进健康。然而，LE8评分与慢性肾脏病（CKD）风险之间的关联仍不确定。我们旨在探讨LE8评分与新发CKD的关联，并研究社会经济剥夺和遗传风险是否会改变这种关联。
2006年至2010年间，英国生物银行共纳入了286,908名无CKD病史的参与者。使用LE8评分对CVH进行分类：低（LE8评分<50）、中（LE8评分≥50但<80）和高（LE8评分≥80）。研究结局为新发CKD，通过与初级保健、医院住院和死亡数据的关联来确定。使用Cox比例风险回归模型研究CVH类别与新发CKD之间的关联。
在中位随访12.5年期间，8857名（3.1%）参与者发生了新发CKD。与低CVH组相比，中（调整后风险比[HR]，0.50；95%置信区间[CI]：0.47-0.53）和高CVH（调整后HR，0.31；95%CI：0.27-0.34）组发生新发CKD的风险显著较低。与高CVH评分相比，中或低CVH评分的人群归因风险为40.3%。社会经济剥夺程度最低（与最高相比；调整后HR，0.75；95%CI：0.71-0.79）且CKD遗传风险较低（与高遗传风险相比；调整后HR，0.89；95%CI：0.85-0.94）的参与者发生新发CKD的风险显著较低。然而，社会经济剥夺和CKD遗传风险并未显著改变LE8评分与新发CKD之间的关系（两者P交互作用>0.05）。
无论社会经济剥夺和CKD遗传风险如何，获得更高的LE8评分与新发CKD风险较低相关。
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