Associations of life's crucial 9 and its components with all-cause and cardiovascular mortality in diabetic kidney disease patients.

OBJECTIVE: To assess the associations of life's crucial 9 (LC9) and its components with all-cause and cardiovascular disease (CVD)-related mortality in patients with diabetic kidney disease (DKD). MATERIALS AND METHODS: Records of DKD patients were extracted from the National Health and Nutrition Examination Survey database. The relationships of LC9 scores with all-cause and CVD-related mortality were investigated by weighted univariate and multivariable COX proportional hazard models, with hazard ratios (HRs) and 95% confidence intervals (CIs). The associations were further explored based on different characteristics of DKD patients, including age, sex, CVD, cancer, diabetic retinopathy, and anemia. Random forest models were used to evaluate the importance of LC9 components for all-cause and CVD-related mortality. RESULTS: Among 1,877 DKD patients, 586 died from any cause, and 193 were CVD-related. DKD patients with elevated LC9 scores (≥ 47.778) had lower odds of all-cause and CVD-related mortality, compared to those with LC9 score < 47.778. For per 10-point increase in LC9 score, the risk of all-cause and CVD-related mortality decreased by 0.26 and 0.37 times in DKD patients, respectively. Similar results were found in different characteristics of DKD patients. Physical activity, sleep duration, and BMI were the most important factors for all-cause mortality in DKD patients, followed by depression. For CVD-related mortality risk, sleep duration and depression were of significant importance, followed by dietary quality. CONCLUSION: High LC9 scores were associated with lower odds of all-cause and CVD-related mortality, suggesting that incremental improvements in modifiable factors may be beneficial to the prognosis of DKD patients.