Liu Jiang, Yang Chuang, Cheng Wenke, Li Daidi
Department of Cardiology, Yingtan People's Hospital, Yingtan, Jiangxi Province, China.
Department of Cardiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Front Nutr. 2025 Jul 16;12:1598659. doi: 10.3389/fnut.2025.1598659. eCollection 2025.
Cardiometabolic multimorbidity (CMM) refers to the co-occurrence of two or more cardiometabolic diseases (CMDs), including coronary artery disease (CAD), stroke, and type 2 diabetes mellitus (T2DM), posing a substantial public health concern. Although Life's Essential 8 (LE8), a cardiovascular health (CVH) metric incorporating behavioural and metabolic factors, has been developed, its relationship with CMM remains unexplored. This study examines the independent and combined effects of LE8, insulin resistance (IR) and C-reactive protein (CRP) on CMM risk.
In this prospective cohort study, 304,568 UK Biobank participants without CMM at baseline were followed. The association between LE8 and CMM risk was assessed using Cox proportional hazards models, and dose-response relationships were evaluated using restricted cubic splines. Mediation analyses were conducted to determine the roles of triglyceride-glucose index (TyG, an IR indicator) and CRP in mediating the LE8-CMM association.
Over a 14.2-year follow-up, 5,441 participants developed CMM. Higher LE8 scores were significantly associated with reduced CMM risk (hazard ratio [HR] per 10-point increase: 0.65; 95% confidence interval [CI]: 0.63-0.67). Accelerated failure time models indicated that increased LE8 scores delayed CMM onset by up to 47.3 months. Mediation analyses showed that TyG and CRP accounted for 18.8 and 2.9% of LE8's protective effect on CMM, respectively.
Maintaining high LE8 scores is associated with a lower risk of developing CMM, partially mediated by reductions in IR and inflammation. Promoting CVH and addressing metabolic and inflammatory factors may help prevent CMM and reduce its burden on public health.
心脏代谢多重疾病（CMM）是指两种或更多种心脏代谢疾病（CMD）同时出现，包括冠状动脉疾病（CAD）、中风和2型糖尿病（T2DM），这引起了重大的公共卫生关注。尽管已经开发了一种纳入行为和代谢因素的心血管健康（CVH）指标——生命基本8要素（LE8），但其与CMM的关系仍未得到探索。本研究考察了LE8、胰岛素抵抗（IR）和C反应蛋白（CRP）对CMM风险的独立和联合影响。
在这项前瞻性队列研究中，对304,568名基线时无CMM的英国生物银行参与者进行了随访。使用Cox比例风险模型评估LE8与CMM风险之间的关联，并使用受限立方样条评估剂量反应关系。进行中介分析以确定甘油三酯-葡萄糖指数（TyG，一种IR指标）和CRP在介导LE8与CMM关联中的作用。
在14.2年的随访期间，5441名参与者发生了CMM。较高的LE8得分与降低的CMM风险显著相关（每增加10分的风险比[HR]：0.65；95%置信区间[CI]：0.63 - 0.67）。加速失效时间模型表明，LE8得分的增加使CMM发病延迟长达47.3个月。中介分析表明，TyG和CRP分别占LE8对CMM保护作用的18.8%和2.9%。
维持较高的LE8得分与发生CMM的较低风险相关，部分通过IR和炎症的降低介导。促进CVH并解决代谢和炎症因素可能有助于预防CMM并减轻其对公共卫生的负担。
