心脏代谢性单病患者心血管健康指数与心脏代谢性共病的关系研究

Association of cardiovascular health index and cardiometabolic multimorbidity in patients with single cardiometabolic disease

摘要:

目的 基于健康生活八要素（LE8），探讨心脏代谢性疾病（CMD）单病人群心血管健康指数与心脏代谢性共病（CMM）发病风险之间的关联。方法 基于英国生物银行（UKB）前瞻性队列研究，纳入20 472例参与者，根据LE8评分将其分为3组：理想组（LE8总分≥ 80分）、中等组（LE8总分50～< 80分）和较低组（LE8总分< 50分）。采用Kaplan-Meier生存曲线分析不同组别的CMM累积发病率，并通过Cox比例风险回归模型探讨不同组别与CMM发病风险的关联。结果 在中位随访时间为13.6年的观察中，共记录了新发CMM 490例。其中，较低组146例（4.46%），中等组336例（2.13%），理想组8例（0.57%）。Kaplan-Meier分析显示，较低组CMM累积发病率最高，中等组次之，理想组最低（P <0.05）。在校正年龄、性别、种族、汤森剥夺指数、学历、饮酒频率、抑郁症及CMD家族史后，Cox比例风险回归分析结果表明，与较低组相比，中等组［H^R=0.438（95% CI：0.359，0.535）］和理想组［H^R=0.124（95% CI：0.061，0.254）］的风险依然降低（P <0.05）。结论 在CMD单病人群中，较高的LE8评分与CMM风险降低显著相关。

Abstract:

Objective To investigate the association between the cardiovascular health index based on Life's Essential 8 (LE8) and the risk of cardiometabolic multimorbidity (CMM) in individuals with single cardiometabolic disease (CMD).Methods The study, based on the UK Biobank prospective cohort, included 20,472 participants divided into three groups according to their LE8 scores: the ideal group (LE8 score ≥ 80), moderate group (50 ≤ LE8 score <80), and lower group (LE8 score < 50). Kaplan-Meier survival analysis was used to estimate the cumulative incidence of CMM across different groups, and Cox proportional hazards regression was employed to examine the association between group classification and the risk of developing CMM.Results During a median follow-up period of 13.6 years, 490 new cases of CMM were recorded. Among these, 146 cases (4.46%) were in the lower group, 336 cases (2.13%) in the moderate group, and 8 cases (0.57%) in the ideal group. Kaplan-Meier analysis indicated that the cumulative incidence of CMM was highest in the lower group, followed by the moderate group, and lowest in the ideal group (P < 0.05). After adjusting for covariates such as age, sex, ethnicity, Townsend deprivation index, education level, alcohol consumption, depression, and family history of cardiometabolic disease, Cox proportional hazards regression analysis showed that, compared with the lower group, the risk of CMM was significantly lower in the moderate group [H^R = 0.438 (95% CI: 0.359, 0.535) ] and the ideal group [H^R = 0.124 (95% CI: 0.061, 0.254) ](P < 0.05).Conclusion In participants with single CMD, increased LE8 scores are significantly correlated with a decreased risk of CMM.