Adherence to Life's Essential 8 is associated with reduced all-cause and cause-specific mortality in individuals with metabolic dysfunction-associated steatotic liver disease: evidence from NHANES 2005-2018

Abstract

The American Heart Association updated the cardiovascular health (CVH) assessment tool, the Life's Essential 8 (LE8). Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease worldwide and is associated with excessive mortality risk. 10050 participants with MASLD were included from NHANES 2005–2018. LE8 was assessed by combining 4 health behaviors and 4 health factors, with 0–49 being low CVH, 50–79 being moderate CVH, and 80–100 being high CVH. In the fully adjusted model, each point increase in the LE8 score was associated with a 2.7%, 2.7%, and 1.6% decrease in all-cause, CVD, and cancer mortality risk, respectively, in people with MASLD. Compared to low CVH, being in moderate/high CVH was negatively associated with most mortality outcomes, while health factors lost significant association with cancer mortality. Most of the associations showed dose-response associations, except for health factors and all-cause mortality and LE8 and CVD mortality. Race/ethnicity and income-poverty ratio significantly influenced the association between LE8 and all-cause mortality.LE8 was associated with significantly lower all-cause, CVD, and cancer mortality in people with MASLD. Assessment of CVH by LE8 may contribute to targeted healthy lifestyle and factor modification to prevent excess mortality in MASLD.