Inflammatory Markers Mediate the Association Between Cardiovascular Health and Chronic Inflammatory Airway Diseases: A Cross-Sectional Study on the Population Aged 50 Years and Above From NHANES 2013-2018.

Abstract

Objective: This cross-sectional study collected data from participants in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018, aiming to investigate the association between cardiovascular health (CVH) and chronic inflammatory airway diseases (CIADs). Methods: Single-factor and multiple-factor logistic regression analyses were used to explore the relationship between CVH levels assessed based on Life's Essential 8 (LE8) scores and CIAD. Subgroup and interaction analyses were conducted and restricted cubic splines (RCSs) were used to evaluate the linear or nonlinear relationship between LE8 scores and CIAD. Mediation analysis was conducted to investigate the mediating role of inflammatory markers between CVH levels and CIAD. Results: A total of 5736 participants were included in this study. When participants with high CVH levels (LE8 scores: 80-100) were used as the reference standard, the average risk of CIAD increased by 1.78 times in participants with moderate CVH (odds ratio (OR) = 1.78, 95% confidence interval (CI) (1.25, 2.51)) and the risk of CIAD in participants with low CVH increased by 2.45 times (OR = 2.45, 95% CI (1.53, 3.94)). Subgroup analysis indicates that older age and comorbidities are significantly associated with CIAD and there is no interaction between various covariates and CVH levels. RCS showed a negative linear relationship between LE8 scores and CIAD. Mediation analysis results revealed that neutrophil (NEU) count and Systemic Immune-Inflammation (SII) Index significantly mediated the relationship between CVH and CIAD. Conclusion: Moderate and low levels of CVH pose a threat for developing CIAD, with inflammatory factors playing a major mediating role in this association.