Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2025; 17(2): 97741
Published online Feb 27, 2025. doi: 10.4254/wjh.v17.i2.97741
Association of Life’s Essential 8 and Life’s Simple 7 with metabolic-associated fatty liver disease in the United States
Wei Fu, Guo-Bin Cheng, Jun-Long Zhao, Lin-Ya Lv, Yao Ding
Wei Fu, Department of Gastroenterology, The 925th of PLA Hospital, Guiyang 550009, Guizhou Province, China
Guo-Bin Cheng, Lin-Ya Lv, Yao Ding, Department of Gastroenterology, 925th Hospital of PLA Joint Logistics Support Force, Guiyang 550009, Guizhou Province, China
Jun-Long Zhao, State Key Laboratory of Cancer Biology, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Co-first authors: Wei Fu and Guo-Bin Cheng.
Author contributions: Fu W, Zhao JL, Cheng GB, Lyu LY, and Ding Y made substantial contributions to the conception, study design, data collection, analysis, and interpretation, as well as participated in drafting, revising, or critically reviewing the article. All authors have approved the final version to be published, have reached an agreement on the journal for submission, and have agreed to be accountable for all aspects of the research.
Supported by The Science Foundation of 925th Hospital, No. 2023[3] and No. 2022[3/4]; and The Guizhou Provincial Health Commission Science and Technology Fund, No. gzwkj2023-135. The design, data collection, analysis, and interpretation of the study were all conducted independently of the funding agencies. The decision to publish, the study design, data collecting and analysis, and manuscript preparation were carried out independently of the funders.
Institutional review board statement: The study was supported by the Chinese 925th PLA Hospital, which also granted ethical approval.
Informed consent statement: The requirement for obtaining informed consent was waived by the Ethics Committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The data that support the findings of this study are available on the National Health and Nutrition Examination Survey (NHANES) official website. Researchers interested in accessing these data can obtain them directly from the NHANES website without requesting the corresponding author. The NHANES dataset is publicly accessible and does not require special permissions or ethical clearances for use. For access to specific datasets or restricted data that are not freely available to the public, researchers can follow the application procedures provided on the NHANES website under the “Research Data Center” section.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Fu, MD, Chief Physician, Deputy Director, Director, Doctor, Department of Gastroenterology, The 925th of PLA, No. 67 Huanghelu, Guiyang 550009, Guizhou Province, China. fmmufw@foxmail.com
Received: June 7, 2024
Revised: October 30, 2024
Accepted: January 15, 2025
Published online: February 27, 2025
Processing time: 257 Days and 23 Hours
Abstract
BACKGROUND

Cardiovascular health (CVH) plays a crucial role in overall health, but its association with metabolic-associated fatty liver disease (MAFLD) remains unclear.

AIM

To investigate the relationship between CVH, measured using Life’s Essential 8 (LE8) and Life’s Simple 7 (LS7), and the prevalence of MAFLD.

METHODS

This cross-sectional study had a sample of 2234 individuals, representing approximately 120 million individuals in the United States. Baseline parameters were compared between the LE8 and LS7 groups. Logistic regression models were used to evaluate the relationship between LE8, LS7, and MAFLD, while taking into account confounding factors. The investigation employed restricted cubic splines to investigate non-linear associations. Subgroup analyses and sensitivity studies were performed to evaluate the strength and reliability of the results.

RESULTS

Higher LE8 and LS7 scores were significantly associated with a decreased risk of MAFLD, even after controlling for demographic, socioeconomic, and clinical variables. This association demonstrated a non-linear pattern, with the most dramatic risk reduction observed at higher CVH levels. Individual CVH components, notably healthy behaviors and factors, exhibited strong relationships with MAFLD. Subgroup analyses indicated consistent relationships across several demographics. Sensitivity tests utilizing other MAFLD definitions validated the robustness of the findings.

CONCLUSION

Higher adherence to CVH criteria, as indicated by LE8 and LS7 scores, is associated with a significantly lower risk of MAFLD. These results emphasize the need to advance CVH to control and avoid MAFLD.

Keywords: Cardiovascular health; Life’s Essential 8; Life’s Simple 7; Metabolic-associated fatty liver disease; National Health And Nutrition Examination Survey

Core Tip: Higher adherence to cardiovascular health (CVH) metrics, assessed using Life’s Essential 8 and Life’s Simple 7, is strongly associated with a reduced risk of metabolic-associated fatty liver disease (MAFLD). This large cross-sectional study demonstrates a non-linear relationship, with the most significant risk reduction observed at higher CVH levels, emphasizing the importance of promoting CVH for the prevention and management of MAFLD.