Associations between Life's Essential 8 and abdominal aortic calcification among US Adults: a cross-sectional study

Quanjun Liu; Hong Xiang; Shuhua Chen; Jie Ouyang; Huiqin Liu; Jing Zhang; Yanfei Chai; Peng Gao; Xiao Zhang; Jianing Fan; Xinru Zheng; Hongwei Lu

doi:10.1186/s12889-024-18622-7

Associations between Life's Essential 8 and abdominal aortic calcification among US Adults: a cross-sectional study

BMC Public Health. 2024 Apr 19;24(1):1090. doi: 10.1186/s12889-024-18622-7.

Authors

Quanjun Liu^#^{1

2}, Hong Xiang^#³, Shuhua Chen⁴, Jie Ouyang^{1

2}, Huiqin Liu^{1

2}, Jing Zhang^{1

2}, Yanfei Chai¹, Peng Gao^{1

2}, Xiao Zhang⁴, Jianing Fan^{1

2}, Xinru Zheng^{1

2}, Hongwei Lu^{5

6

7}

Affiliations

¹ Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China.
² Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China.
³ Center for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.
⁴ Department of Biochemistry, School of Life Sciences of Central, South University, Changsha, China.
⁵ Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China. hongweilu@csu.edu.cn.
⁶ Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China. hongweilu@csu.edu.cn.
⁷ Center for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China. hongweilu@csu.edu.cn.

^# Contributed equally.

Abstract

Background: Cardiovascular health (CVH) and abdominal aortic calcification (AAC) are closely linked to cardiovascular disease (CVD) and related mortality. However, the relationship between CVH metrics via Life's Essential 8 (LE8) and AAC remains unexplored.

Methods: The study analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cohort, which included adults aged 40 or above. The research used the LE8 algorithm to evaluate CVH. Semi-quantitative AAC-24 scoring techniques were employed to assess AAC, categorized into no calcification, mild to moderate calcification, and severe calcification.

Results: The primary analysis involved 2,478 participants. Following adjustments for multiple factors, the LE8 score exhibited a significant association with ACC risk (Mild-moderate ACC: 0.87, 95% CI: 0.81,0.93; Severe ACC: 0.77, 95% CI: 0.69,0.87, all P < 0.001), indicating an almost linear dose-response relationship. Compared to the low CVH group, the moderate CVH group showed lower odds ratios (OR) for mild-moderate and severe calcification (OR = 0.78, 95% CI: 0.61-0.99, P = 0.041; OR = 0.68, 95% CI: 0.46-0.99, P = 0.047, respectively). Moreover, the high CVH group demonstrated even lower ORs for mild-moderate and severe calcification (OR = 0.46, 95% CI: 0.31, 0.69, P < 0.001; OR = 0.29, 95% CI: 0.14, 0.59, P = 0.001, respectively). Interactions were found between chronic kidney disease (CKD) condition, history of CVD, marital status and CVH metrics to ACC. Participants without CKD exhibited a more pronounced negative association between the CVH metric and both mild-moderate and severe ACC. Those lacking a history of CVD, and never married/widowed/divorced/separated showed a stronger negative association between the CVH metric and severe ACC.

Conclusions: The novel CVH metrics demonstrated an inverse correlation with the risk of AAC. These findings suggest that embracing improved CVH levels may assist in alleviating the burden of ACC.

Keywords: Abdominal aortic calcification; Cardiovascular disease; Cardiovascular health; Life’s Essential 8; NHANES.

MeSH terms

Adult
Cardiovascular Diseases*
Cross-Sectional Studies
Humans
Nutrition Surveys
Renal Insufficiency, Chronic*
Research Design
Risk Factors
United States / epidemiology