Healthy Lifestyle, Metabolic Signature, and Risk of Cardiovascular Diseases: A Population-Based Study

Q: What are the key findings of this study?

A healthy lifestyle-related metabolic signature was associated with a lower risk of incident cardiovascular diseases, with a hazard ratio of 0.83 per standard deviation increase.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular Diseases (n=161018). Intervention: Healthy lifestyle-related metabolic signature vs. Lower metabolic signature score (per standard deviation increase). Primary outcome: Incident cardiovascular diseases (CVD) (HR 0.83, 95% CI 0.81, 0.84, p=<0.001).

Q: What question did this study set out to answer?

To evaluate the potential metabolic mechanisms mediating the association between a healthy lifestyle and the risk of developing cardiovascular diseases.

Yuhua Wang; Fei Tian; Zhengmin Qian; Shanshan Ran; Jingyi Zhang; Chongjian Wang; Lan Chen; Dashan Zheng; Michael G. Vaughn; Maya Tabet; Hualiang Lin

doi:10.3390/nu16203553

October 19, 2024NutrientsOpen Access

Healthy Lifestyle, Metabolic Signature, and Risk of Cardiovascular Diseases: A Population-Based Study

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Key result

Healthy lifestyle metabolic signature linked to ~17% lower incident CVD risk per SD.

HR 0.83
95% CI 0.81, 0.84
P<0.001
n=161,018

Figures

Why the study?

Does a healthy lifestyle-related metabolic signature correlate with a reduced risk of incident cardiovascular diseases in CVD-free individuals?

Key Points

To evaluate the potential metabolic mechanisms mediating the association between a healthy lifestyle and the risk of developing cardiovascular diseases.
Analyzed prospective data from 161,018 cardiovascular disease-free participants in the UK Biobank over 13 years of follow-up.
Derived a 123-metabolite healthy lifestyle signature using elastic net regression.
Assessed incident cardiovascular disease risk, mediation effects, and potential causality using Cox proportional hazards models and Mendelian randomization.
Over 13 years of follow-up with 17,030 incident CVD cases, each standard deviation increase in the metabolic signature was associated with reduced CVD (HR 0.83, 95% CI: 0.81, 0.84), ischemic heart disease (HR 0.83, 95% CI: 0.81, 0.84), stroke (HR 0.86, 95% CI: 0.83, 0.90), myocardial infarction (HR 0.86, 95% CI: 0.82, 0.89), and heart failure (HR 0.75, 95% CI: 0.72, 0.77).
The metabolic signature mediated 20% of the protective association between a healthy lifestyle score and CVD risk.
Mendelian randomization analysis demonstrated a potential causal association between the healthy lifestyle metabolic signature and stroke.

Study Design

Type

Cohort (n=161,018)

Multicenter

Yes

Structured PICO

Does a healthy lifestyle-related metabolic signature correlate with a reduced risk of incident cardiovascular diseases in CVD-free individuals?

P

Population

161,018 CVD-free adults aged 37 to 73 years from the UK Biobank, followed for a median of 13 years to assess the association between a healthy lifestyle-related metabolic signature and incident cardiovascular diseases.

E

Exposure

Healthy lifestyle-related metabolic signature (comprising 123 metabolites)

O

Outcome

Incident cardiovascular diseases (CVDs)hard clinical

Main Result

Hazard Ratio: 0.83 (95% CI 0.81–0.84)

p-value: p=<0.001

Limitations

Lifestyle data were self-reported on five traits at baseline, and participants might have changed their lifestyle over the course of the follow-up.
The overall healthy lifestyle score was unweighted, which may not accurately reflect the independent contributions of different behaviors.
Multicollinearity may mislead interpretations of the results.
The main analysis was not replicated in an external cohort.
Only a proportion of metabolites were identified using the Nightingale Health platform.
The study's participants were from European backgrounds, restricting the applicability of the results to other groups.

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Implication

A healthy lifestyle-related metabolic signature is inversely associated with incident cardiovascular diseases and partially mediates the cardiovascular benefits of a healthy lifestyle.

Abstract

BACKGROUND: Although healthy lifestyle has been linked with a reduced risk of cardiovascular diseases (CVDs), the potential metabolic mechanism underlying this association remains unknown. METHODS: We included 161,018 CVD-free participants from the UK Biobank. Elastic net regression was utilized to generate a healthy lifestyle-related metabolic signature. The Cox proportional hazards model was applied to investigate associations of lifestyle-related metabolic signature with incident CVDs, and mediation analysis was conducted to evaluate the potential mediating role of metabolic profile on the healthy lifestyle-CVD association. Mendelian randomization (MR) analysis was conducted to detect the causality. RESULTS: During 13 years of follow-up, 17,030 participants developed incident CVDs. A healthy lifestyle-related metabolic signature comprising 123 metabolites was established, and it was inversely associated with CVDs. The hazard ratio (HR) was 0.83 (95% confidence interval [CI]: 0.81, 0.84) for CVD, 0.83 (95% CI: 0.81, 0.84) for ischemic heart disease (IHD), 0.86 (95% CI: 0.83, 0.90) for stroke, 0.86 (95% CI: 0.82, 0.89) for myocardial infarction (MI), and 0.75 (95% CI: 0.72, 0.77) for heart failure (HF) per standard deviation increase in the metabolic signature. The metabolic signature accounted for 20% of the association between healthy lifestyle score and CVD. Moreover, MR showed a potential causal association between the metabolic signature and stroke. CONCLUSIONS: Our study revealed a potential link between a healthy lifestyle, metabolic signatures, and CVD. This connection suggests that identifying an individual's metabolic status and implementing lifestyle modifications may provide novel insights into the prevention of CVD.

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Cite This Study

Wang et al. (2024) conducted a cohort in Cardiovascular Diseases (n=161,018). Healthy lifestyle-related metabolic signature vs. Lower metabolic signature score (per standard deviation increase) was evaluated on Incident cardiovascular diseases (CVD) (HR 0.83, 95% CI 0.81, 0.84, p=<0.001). A healthy lifestyle-related metabolic signature was associated with a lower risk of incident cardiovascular diseases, with a hazard ratio of 0.83 per standard deviation increase.

synapsesocial.com/papers/69d9e8155e5bcb4e3b8383b1 https://doi.org/10.3390/nu16203553

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Healthy Lifestyle, Metabolic Signature, and Risk of Cardiovascular Diseases: A Population-Based Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Healthy Lifestyle, Metabolic Signature, and Risk of Cardiovascular Diseases: A Population-Based Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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