Abstract 4147354: Life’s Essential 8 among adults living with cardiovascular-kidney-metabolic (CKM) syndrome: 2013-2020 National Health and Nutrition Examination Survey

Introduction: Cardiovascular-kidney-metabolic (CKM) syndrome is a multifaceted condition impacting cardiovascular, kidney, and metabolic health. Life’s Essential 8 (LE8), key measures for improving and maintaining cardiovascular health, may predict health outcomes, but its relationship with CKM syndrome is unclear. Objectives: This study aimed to examine LE8 scores within CKM stages 1-4 among the US adult population. Methods: Data from the National Health and Nutrition Examination Survey (NHANES, 2013-2020) were analyzed. CKM was categorized into 4: presence of excess adiposity, prediabetes (stage 1), metabolic risk factors, CKM or CVD risk factors, high-risk kidney disease (stages 2-3), clinical CVD with CKM risk factors (stage 4). Each LE8 factor was scored between 0 and 100 points and categorized into quartiles Q1 (low): 0-38, Q2 (moderate): >38–50.65, Q3 (high): >50.65–63, and Q4 (very high): >72.86. We fitted a weighted generalized linear model adjusting for race/ethnicity, age, gender, education, poverty income ratio, insurance, and employment. Result: We include 9,019 adults with CKM; mean age 50.7(±15) years, 49% female. For stage 1 CKM, high (β =0.98 (95% CI: 0.97–0.99) and very high (β =0.95(95% CI:0.93- 0.97) LE8 quartile were significantly associated with lower risk of CKM, compared to low LE8 quartile (figure). Also, Increasing LE8 scores progressively showed reductions in the risk of stage 2 CKM in high (β =0.96 (95% CI: 0.97–0.99) and very high (β =0.91, 95% CI: 0.97–0.99) LE8 quartiles. Similar to stage 2, increasing LE8 scores significantly reduced the risk of stage 3 CKM in the high (β =0.96 (95% CI: 0.97–0.99) and very high (β =0.91, 95% CI: 0.97–0.99) LE8 quartiles. Greater reduction in CKM stage 4 risk was observed for moderate (β = 0.98, 95% CI: 0.97–0.99), p=0.009; high (β =0.92 (95% CI: 0.89–0.95), and very high (β -0.82, 95%CI:0.75- 0.89), LE8 quartiles. Conclusion: The association between LE8 scores and CKM stages suggests that improving LE8 scores may reduce the prevalence and severity of CKM syndrome among adults. These findings contribute to the importance of early intervention strategies targeting cardiovascular and metabolic health.