The influence of Life's Essential 8 on the link between socioeconomic status and depression in adults: a mediation analysis.
Individuals with low socioeconomic status (SES) are at a higher risk of developing depression. However, evidence on the role of cardiovascular health (CVH) in this chain is sparse and limited. The purpose of this research was to assess the mediating role of Life's Essential 8 (LE8), a recently updated measurement of CVH, in the association between SES and depression according to a nationally representative sample of adults.
Data was drawn from the National Health and Nutrition Examination Survey (NHANES) in 2013-2018. Multivariate logistic regression analysis was applied to analyze the association of SES (measured via the ratio of family income to poverty (FIPR), occupation, educational level, and health insurance) and LE8 with clinically relevant depression (CRD) (evaluated using the Patient Health Questionnaire (PHQ-9)). Multiple linear regression analysis was performed to analyze the correlation between SES and LE8. Mediation analysis was carried out to explore the mediating effect of LE8 on the association between SES and CRD. Moreover, these associations were still analyzed by sex, age, and race.
A total of 4745 participants with complete PHQ-9 surveys and values to calculated LE8 and SES were included. In the fully adjusted model, individuals with high SES had a significantly higher risk of CRD (odds ratio = 0.21; 95% confidence interval: 0.136 to 0.325, P < 0.01) compared with those with low SES. Moreover, LE8 was estimated to mediate 22.13% of the total association between SES and CRD, and the mediating effect of LE8 varied in different sex and age groups. However, the mediating effect of LE8 in this chain was significant in different sex, age, and racial subgroups except for Mexican American (MA) individuals.
The results of our study suggest that LE8 could mediate the association between SES and CRD. Additionally, the mediating effect of LE8 in this chain could be influenced by the race of participants.
Zhang H
,Zhang L
,Li J
,Xiang H
,Liu Y
,Gao C
,Sun X
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《BMC Psychiatry》
Associations between Life's Essential 8 and liver function: a cross-sectional study.
Life's Essential 8 (LE8) score, developed by the American Heart Association, assesses cardiovascular health using eight components: diet, physical activity, nicotine exposure, sleep health, body mass index, lipids, blood glucose, and blood pressure. Liver function is a critical indicator of overall health, with impairments linked to numerous chronic diseases. While the LE8 score has been extensively studied in relation to cardiovascular outcomes, its association with liver function remains underexplored. Understanding this relationship is crucial for integrating cardiovascular and hepatic health management, particularly given the shared metabolic pathways underlying these systems. This study aims to examine the relationship between LE8 scores and liver function indicators in a large cohort, addressing a critical gap in understanding the interplay between cardiovascular and liver health.
Data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) were used in this cross-sectional study. The study included 21,873 participants, stratified into low (0-49), moderate (50-79), and high (80-100) LE8 score categories. The relationship between LE8 scores and liver function markers, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and ALT/AST ratio, was evaluated using multivariable linear regression, smoothed curve fitting, threshold effect analysis, and weighted quantile sum (WQS) regression. Subgroup analyses were performed based on sex and age to assess potential interactions.
Higher LE8 scores were significantly associated with improved liver function, particularly highlighted by two major findings. First, nonlinear associations were observed between LE8 scores and liver function parameters, including ALT and ALT/AST ratio, with stronger effects beyond specific thresholds (ALT: 50.625, ALT/AST: 61.875). Second, subgroup analyses revealed that these associations were more pronounced in younger participants (<60 years), suggesting age-specific differences in the relationship. These age-related differences might be attributed to variations in metabolic function or differences in the severity of cardiovascular and liver-related risk factors between younger and older individuals. WQS regression identified body mass index, blood pressure, blood glucose, and nicotine exposure as the strongest contributors to liver function markers. These findings underscore the potential of LE8 scores as a comprehensive indicator for liver health, particularly in younger populations.
This study suggests that LE8 scores is associated with improved liver function. Clinicians and public health practitioners could consider integrating LE8 scores into routine assessments to help identify individuals at risk for liver dysfunction, particularly among younger populations. Further research should explore whether interventions targeting cardiovascular health could also improve liver function outcomes.
Liang Q
,Zou M
,Peng Z
《Frontiers in Nutrition》
The impact of Life's Essentials 8 on sarcopenia prevalence among adults in the United States.
Sarcopenia is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health (CVH), with the presence of sarcopenia among US adults.
This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2005-2006 and 2011-2018, and included adults aged 20 years or older. LE8 score was measured according to American Heart Association definitions. Sarcopenia was measured according to the National Institutes of Health definition, the ratio of appendicular skeletal muscle mass (ASM) to body mass index (BMI). Multivariable logistic and restricted cubic spline models were used to assess the associations between LE8 and sarcopenia.
Among the 11,078 participants, 1021 (9.22 %) were diagnosed with sarcopenia. After adjusting for potential confounders, higher LE8, health behavior and health factors scores were associated with reduced odds ratios (OR) of sarcopenia (OR for per 10 scores increase in LE8, 0.65; 95 % CI 0.61-0.70; OR for per 10 scores increase in health behaviors score, 0.90; 95 % CI 0.84-0.97; OR for per 10 scores increase in health factors score, 0.67; 95 % CI 0.63-0.71). A non-linear dose-response relationship was observed between LE8 scores, health factors scores, and sarcopenia. The inversed association between LE8 score and sarcopenia was significantly stronger among males and participants with a high school education or above.
LE8 was negatively associated with the prevalence of sarcopenia in a nonlinear fashion. Promoting adherence to optimal CVH levels may benefit to reduce the risk of sarcopenia.
Zhang G
,Fu J
,Zhang H
,Xu X
,Cao Z
... -
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Association between Life's essential 8 and stress urinary incontinence in women from the National Health and nutrition examination survey 2005-2018: A cross-sectional study.
Stress urinary incontinence (SUI) may be associated with cardiovascular disease. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with SUI in women.
The study adopted a cross-sectional design with national scope, incorporating 9332 women aged 20 and above, selected from the National Health and Nutrition Examination Survey dataset from 2005 to 2018. The LE8 metric, which varies from 0 to 100, was evaluated based on the criteria set by the American Heart Association. SUI was determined based on self-report. To evaluate these correlations, we employed models with multivariable logistic variables and a restricted cubic spline.
In the cross-sectional study, a total of 9332 participants were included (weighted average age, 52.23 years), and 4274 had SUI (weighted percentage, 48.64%). Considering potential confounders, it was found that higher LE8 scores were associated with lower odds of SUI (odds ratio [OR] for each 10-point increase was 0.83; 95% confidence interval [CI], 0.80-0.87). Compared to participants with lower LE8 scores, those with higher LE8 scores had a 57% lower probability of developing SUI. There was a statistically significant association between LE8 score and SUI among participants who were middle-aged, non-Hispanic white, had higher levels of education and income, and were living with a partner.
According to this study, there was an association between increase in Life's Essential 8 and reduction in SUI risk. Therefore, promoting optimal CVH may associate with reducing SUI in women.
Xu X
,Wu H
,Xu X
,Liu R
... -
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