Huang Miao, Fu Ru, Zhao Xiexiong, Liu Tao, Li Xiaogang, Jiang Weihong
Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.
Eur J Prev Cardiol. 2025 Apr 26. doi: 10.1093/eurjpc/zwaf247.
To evaluate the impact of Life's Essential 8 (LE8) on the onset and progression trajectory of cardiometabolic multimorbidity (CMM).
This prospective study included 240,346 participants (median age, 57 years) free of CMDs at baseline from the UK Biobank. LE8 scores were divided into low, moderate, and high cardiovascular health (CVH) groups at baseline, with higher LE8 scores representing better CVH. CMM was defined as the coexistence of two or three cardiometabolic diseases, including type 2 diabetes (T2D), ischemic heart disease, and stroke. Multi-state model was applied to explore the role of LE8 level in each transition stage of CMM trajectory. During a median follow-up of 14.01 years, 29,551 participants developed first cardiometabolic disease (FCMD), 3,183 developed CMM, and 15,763 died. LE8 scores were significantly associated with an increased risk of transition from health to FCMD or to death, with adjusted HRs (CIs) for high CVH levels of 0.22 (0.20-0.23) and 0.23 (0.21-0.25), respectively. Similar associations were observed in the transitions from FCMD to CMM (HRs: 0.41; 95% CIs: 0.34-0.50) and from FCMD to death (HRs: 0.82; 95% CIs: 0.68-0.98). CVH levels had an impact on disease-specific transitions except from stroke and T2D to death and from CMM to death.
This study revealed that LE8 may influence the progression of CMM trajectory. Our results highlight that managing behavior and health factors of LE8 is an important way to mitigate the progression of CMM trajectory.
评估生命必需的8项指标（LE8）对心脏代谢多重疾病（CMM）发病及进展轨迹的影响。
这项前瞻性研究纳入了英国生物银行中240346名基线时无慢性疾病的参与者（中位年龄57岁）。基线时LE8评分被分为低、中、高心血管健康（CVH）组，LE8评分越高代表CVH越好。CMM被定义为两种或三种心脏代谢疾病并存，包括2型糖尿病（T2D）、缺血性心脏病和中风。应用多状态模型来探究LE8水平在CMM轨迹各转变阶段中的作用。在中位随访14.01年期间，29551名参与者患上了首发心脏代谢疾病（FCMD），3183名发展为CMM，15763名死亡。LE8评分与从健康状态转变为FCMD或死亡的风险增加显著相关，高CVH水平的调整后风险比（HRs）（95%置信区间）分别为0.22（0.20 - 0.23）和0.23（0.21 - 0.25）。在从FCMD到CMM（HRs：0.41；95%置信区间：0.34 - 0.50）以及从FCMD到死亡（HRs：0.82；95%置信区间：0.68 - 0.98）的转变中也观察到了类似的关联。CVH水平对特定疾病的转变有影响，但中风和T2D到死亡以及CMM到死亡的转变除外。
本研究表明LE8可能影响CMM轨迹的进展。我们的结果强调，管理LE8的行为和健康因素是减轻CMM轨迹进展的重要途径。
