Zhu Jinqi, Tao Ran, Zhao Sue
Department of Respiratory and Critical Care Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
Department of Cardiovascular Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
Front Nutr. 2025 Jun 17;12:1603875. doi: 10.3389/fnut.2025.1603875. eCollection 2025.
Research indicates that Life's Essential 8 (LE8) has health-promoting effects for many diseases, yet few studies have explored its association with asthma patients. This research aimed to investigate the relationships between LE8 and all-cause mortality in asthma patients.
We conducted a retrospective cohort analysis of seven cycles of data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). The impact of LE8, which includes four health behaviors (diet, physical activity, smoking, and sleep) and four health factors (BMI, lipids, blood glucose, and blood pressure), on asthma mortality was analyzed using multivariate Cox proportional hazards models. Dose-response relationships between these indicators and mortality were examined using restricted cubic spline (RCS) analysis. Subgroup analyses and interaction tests were performed to verify the stability of the results.
The study included 3,321 asthma patients aged 20 or older, with a median follow-up of 91.03 months, during which 331 patients died. Each one-unit increase in LE8 score was associated with a 1.4% reduction in all-cause mortality risk (HR = 0.986, 95% CI: 0.974-0.998; < 0.001). Patients with scores ≥80 had a 58.8% lower mortality risk than those with scores <50 (HR = 0.412, 95% CI: 0.203-0.837, = 0.014). Each one-point increase in health behavior score was linked to a 1.3% decrease in mortality risk (HR = 0.987, 95% CI: 0.982-0.992; < 0.001). Participants with optimal health behaviors (scores ≥80) had a 53.8% lower mortality risk than those with poor scores (<50; HR = 0.462, 95% CI: 0.275-0.777; = 0.004). RCS analysis revealed linear associations of LE8 and health behavior scores with mortality, while the relationship between health factor scores and mortality was non-linear, with mortality risk decreasing as scores increased above 80. Subgroup analyses showed stable associations between exposure variables and mortality, particularly strong protective associations in high-income groups.
Optimized LE8, health behavior scores, and health factor scores above 80 are associated with reduced all-cause mortality risk in asthma patients, supporting ideal cardiovascular health as an intervention strategy to lower asthma mortality.
研究表明，生命基本要素8项指标（LE8）对多种疾病具有促进健康的作用，但很少有研究探讨其与哮喘患者的关联。本研究旨在调查LE8与哮喘患者全因死亡率之间的关系。
我们对2005 - 2018年美国国家健康与营养检查调查（NHANES）七个周期的数据进行了回顾性队列分析。使用多变量Cox比例风险模型分析了LE8（包括四项健康行为：饮食、身体活动、吸烟和睡眠，以及四项健康因素：体重指数、血脂、血糖和血压）对哮喘死亡率的影响。使用受限立方样条（RCS）分析检查这些指标与死亡率之间的剂量反应关系。进行亚组分析和交互作用检验以验证结果的稳定性。
该研究纳入了3321名年龄在20岁及以上的哮喘患者，中位随访时间为91.03个月，在此期间有331名患者死亡。LE8评分每增加一个单位，全因死亡风险降低1.4%（风险比[HR]=0.986，95%置信区间[CI]：0.974 - 0.998；P<0.001）。评分≥80的患者的死亡风险比评分<50的患者低58.8%（HR=0.412，95%CI：0.203 - 0.837，P=0.014）。健康行为评分每增加一分，死亡风险降低1.3%（HR=0.987，95%CI：0.982 - 0.992；P<0.001）。健康行为最佳（评分≥80）的参与者的死亡风险比评分差（<50）的参与者低53.8%（HR=0.462，95%CI：0.275 - 0.777；P=0.004）。RCS分析显示LE8和健康行为评分与死亡率呈线性关联，而健康因素评分与死亡率的关系是非线性的，当评分高于80时死亡风险降低。亚组分析显示暴露变量与死亡率之间存在稳定的关联，在高收入群体中尤其有强烈的保护关联。
优化后的LE8、健康行为评分以及高于80的健康因素评分与哮喘患者全因死亡风险降低相关，支持将理想的心血管健康作为降低哮喘死亡率的干预策略。
