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Binational component-wise association between cardiovascular-kidney-metabolic syndrome and life's essential 8 in
Yoon Lee1,2, Taelim Choi2,3, Jeongseon Oh2,3
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
Insights
Higher Life
Area of Science:
- Cardiovascular-kidney-metabolic (CKM) syndrome research
- Public health and epidemiology
- Health behavior and risk factor analysis
Background:
- The American Heart Association (AHA) recommends integrating cardiovascular-kidney-metabolic (CKM) syndrome and Life's Essential 8 (LE8) score.
- Limited research exists on the association between CKM syndrome and LE8 scores.
- This study addresses this gap using binational data.
Purpose of the Study:
- To analyze the component-wise association between CKM syndrome and LE8 scores.
- To investigate differences in this association between South Korea and the US.
- To inform targeted public health interventions for CKM syndrome.
Main Methods:
- Binational study using Korea National Health and Nutrition Examination Surveys (2013-2020) and US National Health and Nutrition Examination Surveys (2013-2020).
- Included adults aged 30-79 years.
- Weighted logistic regression analyzed associations between LE8 scores and CKM syndrome prevalence, adjusting for covariates.
Main Results:
- Higher LE8 scores were consistently linked to lower CKM syndrome prevalence in both countries.
- In Korea, health factors primarily drove the association; in the US, health behaviors were more prominent.
- The protective effect of LE8 scores was strongest in younger adults (30-44 years).
Conclusions:
- Country-specific intervention strategies are crucial for reducing CKM syndrome burden.
- Findings support the development of targeted public health initiatives for CKM syndrome.
- LE8 score components show differential associations with CKM syndrome by country.
Abstract:
Although the American Heart Association (AHA) has emphasized the integration of cardiovascular-kidney-metabolic (CKM) syndrome and life's essential 8 (LE8) score, research on their association remains limited. To address this gap, this study analyzed the component-wise association between CKM syndrome and LE8 scores using nationally representative data from South Korea and the US. This binational study included adults aged 30 to 79 years from the Korea National Health and Nutrition Examination Surveys 2013 to 2020 and the US National Health and Nutrition Examination Surveys 2013 to 2020. CKM stages and LE8 scores were defined according to AHA criteria. LE8 scores encompass 4 health behaviors (diet, physical activity, nicotine exposure, and sleep) and 4 health factors (body mass index, blood lipids, blood glucose, and blood pressure). All analyses accounted for the complex survey design through appropriate sampling weights, stratification, and clustering methods. Associations between LE8 scores and the prevalence of CKM syndrome were assessed using weighted logistic regression adjusted for age, sex, household income, education level, and alcohol consumption. We included 8150 Koreans, the Korea National Health and Nutrition Examination Survey (61.30% female), and 5859 American participants (National Health and Nutrition Examination Survey; 44.80% female) aged 30 to 79. Higher LE8 scores were consistently associated with a lower prevalence of CKM syndrome in both Korea and the US. In Korea, component-wise association was primarily explained by health factor scores (weighted odds ratio [wOR], 0.09; 95% confidence interval, 0.06-0.14), whereas in the US, health behavior scores reported a distinct association (0.30; 0.17-0.52). Among all age groups, the protective association between LE8 scores and CKM syndrome was most pronounced in adults aged 30 to 44 years, with wORs of 0.89 (0.85-0.93) in Korea and 0.93 (0.91-0.95) in the US. This binational study highlights the importance of country-specific intervention strategies in reducing the burden of CKM syndrome. The findings of this study may provide a basis for designing targeted public health interventions aimed at CKM syndrome.
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