The Association Between Lifestyle Habits of Knowledge Workers and Carotid Atherosclerosis: A Latent Class Study Of 113,262 Chinese

Background Carotid atherosclerosis (CAS) underlies cardiovascular and cerebrovascular diseases and is linked to unhealthy lifestyles. Knowledge workers may face a higher risk of CAS due to certain special living habits, but evidence on CAS among knowledge workers is scarce because prior studies rarely classify lifestyle patterns. To address this gap, this study applies latent class analysis (LCA) to identify lifestyle patterns among 113,262 Chinese knowledge workers and assess their association with CAS risk. Methods This cross-sectional study analyzed data from the Health Management Center Database of a comprehensive Chinese hospital (2017–2024), including 113,262 knowledge workers. Lifestyle factors assessed included nocturnal eating, coffee and sugar-sweetened beverage consumption, smoking, alcohol use, sedentary behavior, and physical activity. CAS was evaluated via ultrasonography. Latent class analysis identified lifestyle patterns, and multivariable logistic regression assessed their associations with CAS risk. Stratified analysis was performed by gender, age, BMI, and marital status. Results The overall CAS prevalence among knowledge workers was 49.0%. Latent class analysis identified four lifestyle categories: basically healthy, mixed class 1, mixed class 2, and unhealthy. Compared to the basically healthy class, mixed class1 had a significantly increased CAS risk ( P < 0.05), while other classes showed inverse associations. Conclusions The findings reveal substantial heterogeneity in lifestyle behaviors among knowledge workers, which are closely associated with CAS risk. These results suggest that targeted interventions addressing specific lifestyle behaviors may help mitigate CAS risk, providing a scientific basis for the development of precise prevention strategies.