Table 1_Sustained high Life’s Essential 8 is associated with lower risk of cerebral small vessel disease: a community-based study.docx

ObjectiveWe aimed to investigate the influence of Life’s Essential 8 (LE8) score trajectories on cerebral small vessel disease (CSVD).
MethodsA total of 1,162 subjects from the Kailuan prospective cohort study were enrolled. The LE8 score trajectories were developed from 2006 to 2021 using trajectory modeling of the SAS procedure Proc Traj. Participants were classified into three trajectory models: low stable group, medium stable group, and high stable group. Magnetic resonance imaging (MRI) was performed at the last follow-up. Ordered logistic regression and binary logistic regression models were employed to analyze the association between LE8 trajectory groups and the total CSVD score. Furthermore, we examined the relationship between LE8 trajectory groups and Various CSVD Lesions: lacunar infarcts, cerebral microbleeds (CMB), white matter hyperintensities (WMH), and enlarged perivascular spaces (EPVS).
Results(1) There is a negative association between sustained high LE8 scores and the risk of CSVD. The odds ratios (OR) for an increased risk of elevated CSVD scores in the medium and high stable groups compared to the low stable group were 0.65 (95% CI: 0.47–0.88) and 0.44 (95% CI: 0.30–0.63), both of which were statistically significant. (2) LE8 had the most significant impact on lacunar infarcts, EPVS and WMH. The ORs for an increased risk of lacunar infarcts in the medium and high stable groups compared to the low stable group were 0.56 (95% CI: 0.37–0.86) and 0.25 (95% CI: 0.14–0.47), respectively. The ORs for an increased risk of BG-EPVS were 0.49 (95% CI: 0.30–0.81) and 0.31 (95% CI: 0.18–0.54), respectively. The ORs for an increased risk of WMH were 0.49 (95% CI: 0.64–1.38) and 0.58 (95% CI: 0.36–0.95), respectively. However, LE8 showed no statistically significant impact on CMB.
ConclusionIn summary, our study revealed that sustained high Life’s Essential 8 scores have a protective effect against cerebral small vessel disease.

研究目的：本研究旨在探究生命必需8项（Life’s Essential 8, LE8）评分轨迹对脑小血管病（cerebral small vessel disease, CSVD）的影响。
研究方法：本研究纳入开滦前瞻性队列研究中的1162名受试者。采用SAS软件Proc Traj过程的轨迹建模方法，构建2006年至2021年期间的LE8评分轨迹。将受试者划分为3个轨迹组别：低稳定组、中稳定组及高稳定组。在末次随访时对所有受试者实施磁共振成像（Magnetic Resonance Imaging, MRI）检查。采用有序logistic回归与二元logistic回归模型，分析LE8轨迹组别与脑小血管病总评分之间的关联。此外，本研究还考察了LE8轨迹组别与各类脑小血管病病变的相关性，具体包括腔隙性脑梗死、脑微出血（cerebral microbleeds, CMB）、脑白质高信号（white matter hyperintensities, WMH）以及扩大的血管周围间隙（enlarged perivascular spaces, EPVS）。
研究结果：(1) 持续较高的LE8评分与脑小血管病发病风险呈负相关。相较于低稳定组，中稳定组与高稳定组的脑小血管病评分升高的风险比（odds ratios, OR）分别为0.65（95%CI：0.47~0.88）与0.44（95%CI：0.30~0.63），二者均具有统计学意义。(2) LE8评分轨迹对腔隙性脑梗死、扩大的血管周围间隙及脑白质高信号的影响最为显著。相较于低稳定组，中稳定组与高稳定组的腔隙性脑梗死发病风险比分别为0.56（95%CI：0.37~0.86）与0.25（95%CI：0.14~0.47）；基底节区扩大的血管周围间隙（BG-EPVS）发病风险比分别为0.49（95%CI：0.30~0.81）与0.31（95%CI：0.18~0.54）；脑白质高信号发病风险比分别为0.49（95%CI：0.64~1.38）与0.58（95%CI：0.36~0.95）。不过，LE8评分轨迹对脑微出血未表现出统计学意义的影响。
研究结论：综上，本研究揭示持续较高的生命必需8项评分对脑小血管病具有保护作用。