Abstract
PURPOSE: This study examined the association between the Life's Crucial 9 (LC9) score and kidney stone prevalence in U.S. adults. METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2014, this cross-sectional analysis focused on adult participants with kidney stone onset or recurrence. LC9 scores were divided into four quartiles for analysis. Weighted multivariable logistic regression, restricted cubic spline (RCS) modeling, threshold effect analysis, and subgroup analyses were employed to evaluate the relationship between LC9 scores and kidney stone prevalence. RESULTS: The study included 24,669 participants with an average age of 46.05 ± 0.34 years and a mean LC9 score of 73.76 ± 0.25. The overall prevalence of kidney stones was 8.45%, while the average recurrence rate stood at 2.96%. Importantly, for each one-point increase in the LC9 score, the incidence of kidney stones dropped by 1.2% (95% CI: 0.979 to 0.997, p = 0.014). Compared to the lowest quartile (Q1), the Q4 group exhibited a 0.305-fold higher recurrence rate (95% CI: 0.159 to 0.586, p < 0.001). Interaction analysis showed that race and gout significantly influenced the relationship between the LC9 score and kidney stone risk. Additionally, curve fitting and threshold effect analysis demonstrated a nonlinear association between LC9 scores and kidney stone recurrence, with a breakpoint identified at 72.777. CONCLUSION: An elevated LC9 score correlates with a lower risk of both kidney stone formation and recurrence. Maintaining an optimal LC9 score could be an effective approach for preventing kidney stones.