ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1560224
Association between Life's Crucial 9 and Cardiorenal syndrome: the mediating role of weight-adjusted-waist index
Provisionally accepted
- 1Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, Hebei, China
- 2Shandong Second Medical University, Weifang, Shandong Province, China
- 3Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
- 4Beijing Chest Hospital, Capital Medical University, Beijing, Beijing Municipality, China
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Background: Recent studies have indicated a link between cardiovascular well-being, obesity, and Cardiorenal Syndrome (CRS). The impact of excessive body mass on the dynamics between heart health and CRS remains unclear. Life's Crucial 9 (LC9) serves as an innovative parameter for cardiac evaluation, whereas the Weight-Adjusted Waist Index (WWI) offers a nuanced metric for gauging obesity. This investigation explores the association between LC9 and CRS, and examines WWI's potential moderating influence.Methods: Data from the National Health and Nutrition Examination Survey (NHANES) was employed. Subgroup analyses were conducted, restricted cubic spline (RCS) modeling was utilized, and multivariate logistic regression was performed to assess the relationship between LC9 and CRS. Furthermore, we conducted a mediation analysis to investigate the influence of WWI on this relationship.Results: The cohort consisted of 25,379 participants, with 1,172 diagnosed with CRS.In the adjusted logistic regression model, an increase of ten points in LC9 correlated with a 25% reduction in CRS risk (OR = 0.75, 95% CI: 0.68, 0.82). Each incremental unit in WWI corresponded to a 63% increase in the risk of CRS (OR = 1.63, 95% CI:1.46, 1.83). Tertile analysis of LC9 and WWI demonstrated consistent patterns, with significant p-values for trends <0.001. RCS modeling confirmed a significant inverse linear correlation between LC9 and CRS (overall p < 0.001; nonlinear p = 0.307) and a direct linear relationship between WWI and CRS (overall p < 0.001; nonlinear p = 0.814). Mediation analysis revealed that WWI mediated 24.47% of the effect of LC9 on CRS (p < 0.001).The findings indicate a strong inverse relationship between LC9 and CRS, with WWI serving as a partial mediator in this interaction. The findings emphasize the intricate interactions between LC9 and CRS, illustrating the essential function of WWI as a mediator in future research endeavors.
Keywords: cardiorenal syndrome, Life's Crucial 9, Weight-adjusted waist index, National Health and Nutrition Examination Survey, Mediating role
Received: 20 Jan 2025; Accepted: 22 Apr 2025.
Copyright: © 2025 Fu, Liu, Yu, Zhao, Gan, Chen and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huanjie Fu, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, Hebei, China
Eryue Liu, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, Beijing Municipality, China
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