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Association between Life's Simple 7 and life's essential 8 with all-cause and cardiovascular mortality in cardiovascular-kidney-metabolic syndrome population

Yin, Shan ; Yan, Shuang ; Yang, Zhenzhen ; Zhu, Pingyu ; Tang, Tielong and Borné, Yan LU (2026) In Diabetes Research and Clinical Practice 231.
Abstract

Aims: This study compares the associations of Life's Simple 7 (LS7) and Life's Essential 8 (LE8) with all-cause and cardiovascular mortality in cardiovascular-kidney-metabolic (CKM) syndrome populations. Methods: This cohort study analyzed 11,487 participants aged ≥20 years with CKM syndrome from NHANES 2005–2018. Participants were categorized into non-advanced (stages 0–2) and advanced (stages 3–4) CKM stages. LS7 and LE8 scores were calculated, and Cox proportional hazards models were used to assess mortality associations. Time-dependent ROC analysis compared LS7 and LE8’s predictive performance. Results: During a median follow-up of 91 months, 1167 all-cause deaths and 360 cardiovascular deaths occurred. Both LS7 and LE8 showed... (More)

Aims: This study compares the associations of Life's Simple 7 (LS7) and Life's Essential 8 (LE8) with all-cause and cardiovascular mortality in cardiovascular-kidney-metabolic (CKM) syndrome populations. Methods: This cohort study analyzed 11,487 participants aged ≥20 years with CKM syndrome from NHANES 2005–2018. Participants were categorized into non-advanced (stages 0–2) and advanced (stages 3–4) CKM stages. LS7 and LE8 scores were calculated, and Cox proportional hazards models were used to assess mortality associations. Time-dependent ROC analysis compared LS7 and LE8’s predictive performance. Results: During a median follow-up of 91 months, 1167 all-cause deaths and 360 cardiovascular deaths occurred. Both LS7 and LE8 showed strong negative associations with mortality. In fully adjusted models for the entire CKM population, high versus low CVH groups demonstrated significant risk reductions: LE8 (HR 0.63 for all-cause; HR 0.53 for cardiovascular mortality) and LS7 (HR 0.69; HR 0.59). Similar protective associations were observed in non-advanced CKM stages but not in advanced stages. Both metrics had comparable predictive ability with similar AUC values. Conclusion: LS7 and LE8 demonstrate comparable predictive ability for mortality outcomes in CKM syndrome, particularly in non-advanced stages. LS7’s simplicity makes it favorable for clinical and public health practice.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular health, Cardiovascular-kidney-metabolic syndrome, Comparison, Mortality
in
Diabetes Research and Clinical Practice
volume
231
article number
113064
publisher
Elsevier
external identifiers
  • scopus:105025523763
  • pmid:41435969
ISSN
0168-8227
DOI
10.1016/j.diabres.2025.113064
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 Elsevier B.V.
id
4fd6a168-0de9-4bd3-bb2a-f1ec181b4ba0
date added to LUP
2026-02-03 12:00:28
date last changed
2026-02-03 13:34:20
@article{4fd6a168-0de9-4bd3-bb2a-f1ec181b4ba0,
  abstract     = {{<p>Aims: This study compares the associations of Life's Simple 7 (LS7) and Life's Essential 8 (LE8) with all-cause and cardiovascular mortality in cardiovascular-kidney-metabolic (CKM) syndrome populations. Methods: This cohort study analyzed 11,487 participants aged ≥20 years with CKM syndrome from NHANES 2005–2018. Participants were categorized into non-advanced (stages 0–2) and advanced (stages 3–4) CKM stages. LS7 and LE8 scores were calculated, and Cox proportional hazards models were used to assess mortality associations. Time-dependent ROC analysis compared LS7 and LE8’s predictive performance. Results: During a median follow-up of 91 months, 1167 all-cause deaths and 360 cardiovascular deaths occurred. Both LS7 and LE8 showed strong negative associations with mortality. In fully adjusted models for the entire CKM population, high versus low CVH groups demonstrated significant risk reductions: LE8 (HR 0.63 for all-cause; HR 0.53 for cardiovascular mortality) and LS7 (HR 0.69; HR 0.59). Similar protective associations were observed in non-advanced CKM stages but not in advanced stages. Both metrics had comparable predictive ability with similar AUC values. Conclusion: LS7 and LE8 demonstrate comparable predictive ability for mortality outcomes in CKM syndrome, particularly in non-advanced stages. LS7’s simplicity makes it favorable for clinical and public health practice.</p>}},
  author       = {{Yin, Shan and Yan, Shuang and Yang, Zhenzhen and Zhu, Pingyu and Tang, Tielong and Borné, Yan}},
  issn         = {{0168-8227}},
  keywords     = {{Cardiovascular health; Cardiovascular-kidney-metabolic syndrome; Comparison; Mortality}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Diabetes Research and Clinical Practice}},
  title        = {{Association between Life's Simple 7 and life's essential 8 with all-cause and cardiovascular mortality in cardiovascular-kidney-metabolic syndrome population}},
  url          = {{http://dx.doi.org/10.1016/j.diabres.2025.113064}},
  doi          = {{10.1016/j.diabres.2025.113064}},
  volume       = {{231}},
  year         = {{2026}},
}