Chen Ao-Miao, He Qiu-Yu, Wu Yi-Chuan, Chen Jia-Qi, Ma Xiao-Qin, Hu Ling-Yuan, Wang Ge-Ning-Yue, Wang Zhuo-Tong, Wu Zhi-Yong, Zheng Zong-Ji, Jia Yi-Jie
Southern Medical University, Guangzhou 510515, Guangdong Province, China.
Department of Endocrinology & Metabolism, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
World J Diabetes. 2025 May 15;16(5):102052. doi: 10.4239/wjd.v16.i5.102052.
Patients with prediabetes are at increased risk of developing cardiovascular disease. The Life's Essential 8 (LE8) score, updated by the American Heart Association in 2022, is a tool used to quantify cardiovascular health (CVH). Quantifying healthy living status on the basis of the uniform standard LE8 will be useful for confirming whether health interventions can reduce the risk of death in prediabetic patients.
To investigate the associations between all-cause mortality risk and CVH status (as quantified by the LE8 score) in prediabetic patients.
This study included 5344 participants with prediabetes (age: 52.9 ± 15.8 years; 51.6% men). The LE8 score includes four health indicators and four health behaviors. Cox proportional hazard ratios were calculated for all-cause mortality in the high CVH (LE8 ≥ 80), low CVH (LE8 ≤ 50), and moderate CVH (LE8 50-79) subgroups, and restricted cubic spline analyses were performed. Separate analyses of the associations of all-cause mortality risk with each LE8 component and CVH health behaviors and indicators were also performed.
In the median follow-up period of 8.33 years, 658 deaths occurred. Compared with those among participants with high CVH, the covariate-adjusted HRs (95% confidence intervals) for mortality among participants with moderate and low CVH were 2.55 (1.23-5.31) and 3.92 (1.70-9.02), respectively. There was a linear relationship between an improvement in CVH status and a reduction in all-cause mortality risk (-overall < 0.0001, -nonlinear = 0.7989). Improved CVH health behaviors had a more significant protective effect on patients with prediabetes than did the improvement in CVH health indicators.
High CVH status (as quantified by the LE8 score) is significantly associated with reduced mortality risk in prediabetic adults in the United States.
糖尿病前期患者患心血管疾病的风险增加。美国心脏协会于2022年更新的生命基本8要素（LE8）评分是一种用于量化心血管健康（CVH）的工具。基于统一标准LE8量化健康生活状况，将有助于确定健康干预措施是否能降低糖尿病前期患者的死亡风险。
探讨糖尿病前期患者全因死亡风险与CVH状况（由LE8评分量化）之间的关联。
本研究纳入了5344名糖尿病前期参与者（年龄：52.9±15.8岁；男性占51.6%）。LE8评分包括四项健康指标和四项健康行为。计算高CVH（LE8≥80）、低CVH（LE8≤50）和中度CVH（LE8 50 - 79）亚组全因死亡的Cox比例风险比，并进行限制立方样条分析。还分别分析了全因死亡风险与每个LE8组成部分以及CVH健康行为和指标之间的关联。
在8.33年的中位随访期内，发生了658例死亡。与高CVH参与者相比，中度和低CVH参与者死亡的协变量调整后HR（95%置信区间）分别为2.55（1.23 - 5.31）和3.92（1.70 - 9.02）。CVH状况的改善与全因死亡风险的降低之间存在线性关系（-总体<0.0001，-非线性 = 0.7989）。改善CVH健康行为对糖尿病前期患者的保护作用比改善CVH健康指标更为显著。
在美国，高CVH状况（由LE8评分量化）与糖尿病前期成年人死亡风险降低显著相关。
