Supplemental Material for: Life’s Simple 7 and Kidney Health: Evidence from a Large Cross-Sectional Study in the Hakka Population of Southern China

Résumé fourni par la source

Introduction: Optimal cardiovascular health (CVH), assessed by Life’s Simple 7 (LS7) developed by the American Heart Association, has been associated with reduced cardiovascular morbidity and mortality. However, the relationship between comprehensive CVH and kidney health, particularly in Chinese populations, remains insufficiently characterized. Methods: We conducted a cross-sectional analysis among adults aged ≥18 years participating in a community-based health survey in southern China in 2024. CVH was evaluated using LS7 metrics, including smoking status, physical activity, diet, body mass index, blood pressure, total cholesterol, and fasting glucose. The total LS7 score (range, 0–14) was categorized as inadequate, average, or optimal. Three CKD-related outcomes were defined for this baseline analysis: CKD-eGFR, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m²; CKD-UACR, defined as urine albumin-to-creatinine ratio (UACR) ≥30 mg/g; and CKD-Total, defined as either CKD-eGFR, CKD-UACR, or a documented history of chronic kidney disease (CKD). Associations were examined using multivariable logistic and linear regression models adjusted for potential confounders, with nonlinear relationships assessed using restricted cubic splines. Results: Among 8,889 participants, 1,132 (12.7%) met the CKD-Total criteria. Compared with inadequate CVH, average (odds ratio [OR] = 0.48; 95% CI, 0.39–0.59) and optimal CVH (OR = 0.19; 95% CI, 0.14–0.25) were associated with progressively lower odds of CKD-Total (P for trend <0.001). Health factors, particularly blood pressure, body mass index, blood glucose, and blood lipids, demonstrated stronger associations with CKD-Total than health behaviors. Each 1-point increase in the LS7 score was associated with a lower log-transformed UACR (β = −0.11; 95% CI, −0.12 to −0.10) and higher eGFR (β = 0.22; 95% CI, 0.08–0.35). These inverse associations were consistent across subgroups and were most pronounced among younger adults (20–39 years; P for interaction = 0.012). Conclusions: Better cardiovascular health, as assessed by LS7, was linearly and inversely associated with CKD-Total. These findings suggest that LS7 may be a simple and integrative tool for identifying individuals with an unfavorable kidney health profile in community and primary care settings.

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