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AHA Life’s Essential 8 and new-onset CKD: a prospective cohort study from the UK Biobank

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A Correction to this article was published on 20 March 2024

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Abstract

Background

The AHA has recently introduced a novel metric, Life's Essential 8, to assess cardiovascular health (CVH). Nevertheless, the association between varying levels of LE8 and the propensity for CKD is still unclear from a large prospective cohort. Our objective is to meticulously examine the relationship between LE8 and its associated susceptibilities to CKD.

Methods

A total of 251,825 participants free of CKD from the UK Biobank were included. Cardiovascular health was scored using LE8 and categorized as low, moderate, and high. Cox proportional hazard models were employed to evaluate the associations of LE8 scores with new-onset CKD. The genetic risk score for CKD was calculated by a weighted method.

Results

Over a median follow-up of 12.8 years, we meticulously documented 10,124 incident cases of CKD. Remarkably, an increased LE8 score correlated with a significant reduction of risk in new-onset CKD (high LE8 score vs. low LE8 score: HR = 0.300, 95% CI 0.270–0.330, p < 0.001; median LE8 score vs. low LE8 score: HR = 0.531, 95% CI 0.487–0.580, p < 0.001). This strong LE8–CKD association remained robust in extensive subgroup assessments and sensitivity analysis. Additionally, these noteworthy associations between LE8 scores and CKD remained unaffected by genetic predispositions to CKD.

Conclusions

An elevated degree of CVH, as delineated by the discerning metric LE8, exhibited a pronounced and statistically significant correlation with a marked reduction in the likelihood of CKD occurrence.

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Change history

Abbreviations

AHA:

American Heart Association

BMI:

Body mass Index

BP:

Blood pressure

CI:

Confidence interval

CKD:

Chronic kidney disease

CRP:

C-reactive protein

CVH:

Cardiovascular health

CVD:

Cardiovascular disease

DASH:

Dietary Approaches to Stop Hypertension

DBP:

Diastolic blood pressure

eGFR:

Estimated glomerular filtration rate

HbA1c:

Hemoglobin A1c

HDL:

High-density lipoprotein

HR:

Hazard ratio

LE8:

Life’s Essential 8

LDL:

Low-density lipoprotein

LS7:

Life’s Simple 7

Non-HDL-C:

Non-high-density lipoprotein cholesterol

NSAIDS:

Nonsteroidal anti-inflammatory drugs

PAF:

Population attributable fraction

SBP:

Systolic blood pressure

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Acknowledgements

We would like to express our gratitude to all the participants of the UK Biobank study for their valuable contributions. We also extend our appreciation to the individuals involved in the establishment and maintenance of the UK Biobank study.

Funding

This work was supported by grants from National Natural Science Foundation of China (82070237, 82270254); Guangzhou Regenerative Medicine and Health Guangdong Laboratory (2019GZR110406004); Guangzhou Key Laboratory of Molecular Mechanism and Translation in Major Cardiovascular Disease (202102010007), the Guangdong Basic and Applied Basic Research Foundation (2020A1515011237) and National Natural Science Foundation of China (82271609, 81970200); National Natural Science Foundation of China (82100369), Natural Science Foundation of Guangdong Province of China (2023A1515010310), Guangdong Basic and Applied Basic Research Foundation (2019A1515110129).

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Author notes

  1. Yong-Xiang Ruan, Mao-Xiong Wu, and Jing-Wei have contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang W. Rd, Guangzhou, 510120, China

    Yong-Xiang Ruan, Mao-Xiong Wu, Jing-Wei Gao, Da-Chuan Guo, Yang-Wei Cai, Ze-Gui Huang, Wan-Bing He, Yang-Xin Chen, Jing-Feng Wang & Hai-Feng Zhang

  2. Guangzhou Key Laboratory of Molecular Mechanisms of Major Cardiovascular Disease, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China

    Yong-Xiang Ruan, Mao-Xiong Wu, Jing-Wei Gao, Da-Chuan Guo, Yang-Wei Cai, Ze-Gui Huang, Wan-Bing He, Yang-Xin Chen, Jing-Feng Wang & Hai-Feng Zhang

  3. Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China

    Yong-Xiang Ruan, Mao-Xiong Wu, Jing-Wei Gao, Da-Chuan Guo, Yang-Wei Cai, Ze-Gui Huang, Wan-Bing He, Yang-Xin Chen, Jing-Feng Wang & Hai-Feng Zhang

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Contributions

Y-XR performed the analyses and wrote the original manuscript. M-XW, J-WG, D-CG and Y-WC facilitated access to UKB data and advised on analyses. Z-GH and W-BH advised on analyses. H-FZ, Y-XC and J-FW facilitated access to UKB data, conceptualized the study, provided supervision and contributed to writing the original manuscript. All authors contributed to review and editing of the final manuscript. All authors approved the final manuscript.

Corresponding authors

Correspondence to Yang-Xin Chen, Jing-Feng Wang or Hai-Feng Zhang.

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Conflict of interest

All the authors declare no competing interests. The authors have no relevant financial or non-financial interests to disclose. The authors had full responsibility for data collection, data interpretation, and writing of the report.

Ethical standards

Informed consents were obtained from all participants, and the study was approved by the North West Multi-Centre Research Ethics Committee (11/NW/0382). The present work was conducted under the approval and access to data provided by the UK Biobank, with application number 91090.

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The original online version of this article was revised: In the original publication, the equally contribution text has appeared as “Huang, Wan-Bing He, and Yang-Xin Chen have contributed equally to this work”. However, the text should read as below: Yong-Xiang Ruan, Mao-Xiong Wu, and Jing-Wei Gao have contributed equally to this work.

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Ruan, YX., Wu, MX., Gao, JW. et al. AHA Life’s Essential 8 and new-onset CKD: a prospective cohort study from the UK Biobank. Clin Exp Nephrol 28, 325–336 (2024). https://doi.org/10.1007/s10157-023-02440-z

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