Table 1_Association of Life’s Essential 8 with the prevalence and mortality of chronic obstructive pulmonary disease.docx

ObjectiveTo study the correlation between Life’s Essential 8 (LE8) and the occurrence of chronic obstructive pulmonary disease (COPD) among US adults, as well as the association between LE8 and all-cause and cardiovascular disease (CVD) mortality among individuals with COPD.
MethodsData from National Health and Nutrition Examination Survey (2005–2018 year) were analyzed. The correlation between LE8 scores and the prevalence of COPD was evaluated using logistic regression models. Additionally, the Cox proportional hazards model was applied to investigate how LE8 scores relate to the risk of mortality from all causes and cardiovascular diseases. To ensure the robustness of the findings, sensitivity analyses and subgroup analyses were performed.
ResultsIn the overall population, an inverse relationship was observed between a 10-point increase in LE8 score and the risk of COPD [OR = 0.78, 95%CI (0.75 ~ 0.82), p < 0.001]. Those diagnosed with COPD experienced a 65% increased rate of all-cause mortality and 5% higher rate of mortality due to cardiovascular diseases compared to the non-COPD group. Within the COPD patient cohort, an inverse relationship was similarly observed between a 10-point increase in the LE8 score and the risk of all-cause mortality [HR = 0.87, 95%CI (0.8 ~ 0.95), p = 0.002]. However, no significant association was found between the LE8 score and CVD mortality [HR = 0.83, 95%CI (0.68 ~ 1.02), p = 0.073]. In further exploration through subgroup analysis, no statistically significant interactions were found, suggesting consistency across different demographic or clinical subgroups.
ConclusionHigher LE8 adherence is linked to lower COPD prevalence and all-cause mortality, yet no clear link to CVD mortality was found. This highlights the need for more extensive research to clarify LE8’s role in CVD outcomes.

研究目的：本研究旨在探讨美国成年人群中生命必需8项指标（Life’s Essential 8，LE8）与慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）发病的相关性，同时分析COPD患者中LE8与全因死亡率、心血管疾病（cardiovascular disease，CVD）死亡率的关联。
研究方法：本研究分析了2005至2018年美国国家健康与营养检查调查（National Health and Nutrition Examination Survey）的数据。采用逻辑回归模型评估LE8评分与COPD患病率的相关性；此外，运用考克斯比例风险模型探究LE8评分与全因死亡、心血管疾病死亡风险的关联。为确保研究结果的稳健性，本研究开展了敏感性分析与亚组分析。
研究结果：在全人群中，LE8评分每升高10分与COPD发病风险呈负相关[比值比（odds ratio，OR）=0.78，95%置信区间（confidence interval，CI）：0.75~0.82，P<0.001]。与非COPD人群相比，确诊COPD的人群全因死亡率升高65%，心血管疾病死亡率升高5%。在COPD患者队列中，LE8评分每升高10分同样与全因死亡风险呈负相关[风险比（hazard ratio，HR）=0.87，95%CI：0.8~0.95，P=0.002]。但未发现LE8评分与CVD死亡率存在显著关联[HR=0.83，95%CI：0.68~1.02，P=0.073]。进一步的亚组分析未发现具有统计学意义的交互作用，提示该结果在不同人口统计学或临床亚组中均保持一致。
研究结论：更高的LE8依从性与更低的COPD患病率和全因死亡率相关，但未发现其与CVD死亡率存在明确关联。本研究结果提示，需要开展更广泛的研究以阐明LE8在心血管疾病结局中的作用。