| Title: | Life's Essential 8 and the incidence and progression trajectory of chronic lung diseases: A multistate analysis of a prospective cohort study. |
| Journal: | Chinese Medical Journal |
| Published: | 29 May 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42218565/ |
| DOI: | https://doi.org/10.1097/cm9.0000000000004140 |
Publication 19861
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND: The association of Life's Essential 8 (LE8) with the development of first chronic lung disease (FCLD), progression to chronic lung multimorbidity (CLM), and subsequent mortality remains inconclusive. In addition, the relative importance of individual LE8 components is unclear.</p>
METHODS: We used data from the UK Biobank, including 391,384 participants free of chronic lung diseases (CLDs) at baseline. CLM was defined as the coexistence of two or more CLDs, including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and lung cancer. A multistate model was used to estimate the impact of LE8 score on the dynamic progression of CLDs. Component-specific contributions were assessed using Heller's explained risk.</p>
RESULTS: During a median follow-up of 13.6 years, 27,934 participants developed FCLD, 4174 subsequently developed CLM, and 31,881 died. Higher LE8 scores were consistently associated with lower risks across all transition stages, with hazard ratios (95% confidence intervals) per 10-point increase of 0.75 (0.74-0.76) for transition from baseline to FCLD, 0.85 (0.83-0.87) from FCLD to CLM, 0.85 (0.84-0.86) from baseline to death, 0.92 (0.90-0.94) from FCLD to death, and 0.89 (0.85-0.92) from CLM to death. For CLD subtypes, LE8 scores showed heterogeneous associations with disease-specific transitions, even within the same transition stage. LE8 showed the strongest protective association with COPD incidence (a 36% risk reduction per 10-point increase), whereas its strongest protective association with disease progression was observed for asthma to CLM (a 27% risk reduction per 10-point increase). Among the component of LE8, smoking ranked highest in relative importance across nearly all transitions, while diet emerged as a comparably influential factor for the transition from CLM to death.</p>
CONCLUSIONS: Higher LE8 scores are associated with significant risk reductions for CLDs at all progression stages. Early LE8 optimization, particularly smoking avoidance, offers the greatest potential for CLDs prevention, while post-diagnosis benefits support lifelong adherence.</p>
10 Authors
- Yanqiu Zou
- Li Zhang
- Yanjun Li
- Xin Song
- Yan Su
- Zilan Chen
- Yuqi Pang
- Ye Ju
- Mengyu Fan
- Xia Jiang
1 Application
| Application ID | Title |
|---|---|
| 99713 | Using genetic and phenotypic data to understand putative causal pathways leading to major human noncommunicable diseases. |
Enabling scientific discoveries that improve human health