Race/ethnicity-specific association between the American Heart Association’s new Life’s Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: Evidence from NHANES 2005–2018

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-02-01 DOI:10.1016/j.jocn.2024.111005

Nuo Xu , Xiaowen Lu , Cheng Luo , Junchen Chen

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引用次数: 0

Abstract

Background

The Life’s Essential 8 (LE8) is a recently introduced assessment of cardiovascular health (CVH) by the American Heart Association (AHA). Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease and is associated with an increased risk of stroke. We aimed to explore the association of LE8 with stroke in NAFLD using a national cross-sectional study.

Methods

Eligible participants with NAFLD aged 20–85 years in NHANES 2005–2018 were included. LE8 was assessed according to AHA criteria and categorized into metabolic and behavioral factors. US Fatty Liver Index (USFLI) ≥ 30 and exclusion of other chronic liver diseases suggested NAFLD. Stroke was diagnosed according to self-report on standardized questionnaires.

Results

After adjusting for all confounders, each point increase in LE8, LE8 metabolic factors, and LE8 behavioral factors was associated with a 4.4 %, 1.8 %, and 2.5 % reduction in stroke prevalence in NAFLD, respectively. Both moderate and high CVH assessed by LE8 and LE8 behavioral factors were associated with reduced odds of stroke compared with low CVH. Stroke prevalence declined progressively with increasing number of ideal LE8 components, with the lowest odds of stroke at 3 + ideal LE8 components for both LE8 metabolic and behavioral factors. Restricted cubic spline suggested dose–response associations. Race/ethnicity was a significant effect modifier, and this association was present only among non-Hispanic white population and other Hispanic population. FLI as a diagnostic indicator of NAFLD yielded generally consistent results.

Conclusions

Higher LE8 score, especially LE8 behavioral factors, was associated with reduced prevalence of stroke in NAFLD, especially among non-Hispanic white population and other Hispanic population. The odds of stroke declined progressively with increased ideal LE8 component number. These findings underscore the preventive value of adherence to high CVH for stroke prevention in NAFLD.

查看原文本刊更多论文

美国心脏协会的新生命基本标准8与美国非酒精性脂肪性肝病成年人中风之间的种族/民族特异性关联：来自NHANES 2005-2018的证据

背景：生命必需8 （LE8）是美国心脏协会（AHA）最近推出的心血管健康（CVH）评估。非酒精性脂肪性肝病（NAFLD）是目前最常见的慢性肝病，与卒中风险增加有关。我们的目的是通过一项全国性的横断面研究来探讨LE8与NAFLD卒中的关系。方法：纳入NHANES 2005-2018中年龄在20-85岁的NAFLD患者。LE8根据美国心脏协会的标准进行评估，并分为代谢和行为因素。美国脂肪肝指数(USFLI)≥30，排除其他慢性肝病提示NAFLD。卒中诊断依据标准化问卷自述。结果：在对所有混杂因素进行调整后，LE8、LE8代谢因素和LE8行为因素每增加一个点，NAFLD卒中患病率分别降低4.4%、1.8%和2.5%。与低CVH相比，LE8和LE8行为因素评估的中度和高CVH与卒中几率降低相关。随着理想LE8含量的增加，卒中患病率逐渐下降，在LE8代谢和行为因素中，理想LE8含量为3 +时卒中发生率最低。受限三次样条提示剂量-反应关联。种族/民族是显著的影响调节因素，这种关联仅存在于非西班牙裔白人和其他西班牙裔人群中。FLI作为NAFLD的诊断指标，结果基本一致。结论：较高的LE8评分，尤其是LE8行为因素，与NAFLD卒中患病率降低相关，尤其是在非西班牙裔白人人群和其他西班牙裔人群中。随着理想LE8成分数的增加，脑卒中的几率逐渐下降。这些发现强调了NAFLD患者坚持高CVH预防卒中的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.