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Life’s Essential 8 and osteoporosis in adults aged 50 years or older: data from the National Health and Nutrition Examination Survey

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Abstract

Summary

In this cross-sectional study, we examined the association between Life’s Essential 8 (LE8) and bone mineral density (BMD) as well as osteoporosis risk among adults aged 50 and over. The findings of this study revealed that higher LE8 scores were associated with higher BMD and reduced osteoporosis risk.

Purpose

The objective of the present study was to evaluate the association between Life’s Essential 8 (LE8) and bone mineral density (BMD), as well as osteoporosis risk, in adults aged 50 years or over.

Methods

This cross-sectional study recruited individuals who were 50 years old or older from the National Health and Nutrition Examination Survey. LE8 scores were evaluated and calculated according to the scoring algorithm based on the American Heart Association recommendations, which were further categorized into health behaviors (LE8-HB) and health factors (LE8-HF) scores. Furthermore, the present study utilized multivariate linear regression models to examine the correlations between BMD and LE8 scores. In addition, ordinal logistic regression models were employed to determine the associations between the risk of osteoporosis (normal BMD, osteopenia, and osteoporosis) and LE8 scores.

Results

The final analysis included a total of 2910 participants, whose mean age was 64.49 ± 9.28 years. LE8 and LE8-HF scores exhibited a negative association with BMD and a positive association with osteoporosis risk in unadjusted models. Nevertheless, after adjustment for covariates, LE8 and LE8-HB scores exhibited a positive association with BMD and a negative association with osteoporosis risk, regardless of age, sex, or menopausal status.

Conclusions

Scoring systems based on multiple lifestyle and behavior factors, similar to LE8, have the potential to become a novel option and be used for osteoporosis risk assessment.

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Data availability

All data were extracted from NHANES database. The detailed information was provided on the NHANES website (URL: https://www.cdc.gov/nchs/nhanes/index.htm).

Abbreviations

ALT:

Alanine aminotransferase

ANOVA:

Analysis of variance

AST:

Aspartate aminotransferase

BMD:

Bone mineral density

BMI:

Body mass index

CI:

Confidence interval

CVD:

Cardiovascular disease

CVH:

Cardiovascular health

FBG:

Fasting blood glucose

FN:

Femoral neck

HB:

Health behavior

HbA1c:

Hemoglobin A1c

HDL:

High-density lipoprotein

HDL-C:

High-density lipoprotein cholesterol

HEI:

Healthy Eating Index

HF:

Health factor

LE8:

Life’s Essential 8

NCHS:

National Center for Health Statistics

NHANES:

National Health and Nutrition Examination Survey

OR:

Odds ratio

OST:

Osteoporosis Self-Assessment Tool

SCORE:

Simple Calculated Osteoporosis Risk Estimation

SD:

Standard deviation

TC:

Total cholesterol

VIF:

Variance inflation factor

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Funding

This study was supported by the National Natural Science Foundation of Chongqing (CSTB2022NSCQ-MSX0792).

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Authors and Affiliations

  1. Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Yuchen Tang, Wei Dong, Guanyin Jiang, Qiufu Wang, Jie Hao & Zhenming Hu

  2. Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Chongqing, China

    Yuchen Tang, Guanyin Jiang, Qiufu Wang & Zhenming Hu

  3. Department of Spinal Surgery, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing, China

    Wei Dong

  4. Department of Rehabilitation Medicine, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, China

    Jieliang Shen

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  1. Yuchen Tang
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Correspondence to Jie Hao or Zhenming Hu.

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Ethics approval

The ethics review board of the National Center for Health Statistics has approved the NHANES (URL: https://www.cdc.gov/nchs/nhanes/irba98.htm).

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Informed consent was obtained from all study participants. The detailed information was provided on the NHANES website (URL: https://www.cdc.gov/nchs/nhanes/index.htm).

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Not applicable.

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Yuchen Tang and Wei Dong contributed equally to this work.

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Tang, Y., Dong, W., Shen, J. et al. Life’s Essential 8 and osteoporosis in adults aged 50 years or older: data from the National Health and Nutrition Examination Survey. Arch Osteoporos 19, 13 (2024). https://doi.org/10.1007/s11657-024-01368-5

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