Oxidative stress and inflammation link Life's Essential 8 with adverse cardiovascular events in adults with diabetes mellitus: NHANES 2011-2018.

Background: The American Heart Association has modified Life's Essential 8 (LE8) as a new algorithm for evaluating cardiovascular health (CVH). However, the relationship between LE8 and cardiovascular disease (CVD) incidence among diabetic patients, and the potential effect of oxidative stress and inflammation within these associations remain to be elucidated.

Methods: Three thousand eight hundred twenty-eight diabetic patients were selected from the National Health and Nutrition Examination Survey (NHANES). The weighted logistic regression was employed to examine the association between LE8 with CVD, and the quantitative relationship was investigated with a restricted cubic spline (RCS). Mediation analyses explored the mediating role of oxidative stress and inflammation in the above relationship.

Results: In the 3828 diabetic patients, a total of 977 people were diagnosed with CVD, and the LE8 was significantly and linearly negatively associated with CVD incidence. After all covariates were adjusted, the medium CVH group had a 25% lower risk of CVD (OR: 0.75, 95% CI: 0.58, 0.95) than the low CVH group, and the high CVH group had a 66% lower risk (OR: 0.34, 95% CI: 0.12, 0.94). Furthermore, oxidative stress and inflammation explained 11.57% and 10.89% of the connection, respectively (P<0.05).

Conclusion: Elevated LE8 is negatively associated with adverse cardiovascular events in diabetes mellitus and the association appeared to be partially mediated through oxidative stress and inflammation pathways. Those results indicate the necessity of maintaining at least moderate cardiovascular health and the LE8 help make lifestyle self-management more targeted for diabetes patients.