bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P222: Vitamin D and Airway Inflammation in Adolescent Asthmatics
Authors: Mansell Douglas , Freishtat Robert
Published: March 2019

Background:
Over 25 million people are afflicted with asthma in the U.S. alone, with a higher incidence among adolescents, especially among the African American and Latino population. There has been a focus on the role of low levels of vitamin D (25(OH)D) and asthma severity. The high prevalence of vitamin D insufficiency has been shown to correlate with the high prevalence of asthma in urban youth. Although underlying mechanisms are not clear, vitamin D may regulate inflammation by increased production of anti - inflammatory compounds (Il-10, cAMP, MKP1). Therefore, the objective of this study is to determine which anti-inflammatory mediators are differentially expressed in asthmatic epithelium when exposed to 25(OH)D in conjunction with dexamethasone. The hypothesis is that low levels of vitamin D will be associated with a more pronounced inflammatory milieu and reduced anti-inflammatory response.

Methods:
Nasal epithelial cells and demographic data were collected as part of the NIMHD R01 grant funded AsthMaP2 project (pediatric asthma cohort study lead by Robert Freishtat M.D) from urban youth between ages six and 20 years of age with physician-diagnosed asthma for >1 year. Cells were cultured for 90 minutes ex vivo with varying levels of Dexamethasone with or without 25(OH)D (6 conditions). mRNA was profiled using Illumina and validated using NanoString. Network and functional analyses were performed using Ingenuity Pathway Analysis. Confirmatory experiments were performed on human asthmatic and non-asthmatic bronchial epithelial cells exposed to 25(OH)D with or without Dex. Intracellular cAMP was measured with ELISA.

Results:
Of 214 AsthMaP2 participants, 53% were male and (97%) had persistent asthma. The mean (SE) age=10.9(0.4) years, BMI percentile for age=72.1(3)%, and serum 25(OH)D=19.5(0.9) ng/mL. Whole transcriptome analyses of nasal epithelial cells (n=7) showed 34 transcripts differentially expressed in all exposure conditions (p≤0.01). Pathways analysis identified cAMP signaling as a top activated pathway impacted by 25(OH)D. Intracellular cAMP levels were 10-fold higher in asthmatic (n=3) vs. non-asthmatic (n=3) tracheal bronchial epithelial cells at baseline (p=0.009). While this difference persisted through 15 minutes of exposure to 25(OH)D with or without DEX, there were no significant changes in intracellular cAMP from baseline in response to exposure conditions.

Conclusions:
The average level of 25(OH)D among both asthmatics and non-asthmatics were deficient. While data show that cAMP is constitutively expressed higher in asthmatics in comparison to non-asthmatics, manipulations of vitamin D level did not alter cAMP levels. Additional experiments using a larger sample size are required to further test the proposed effects of vitamin D, with special focus on cAMP as a transient mediator of inflammation regulation in asthmatic airways.
Abstract P224: Chili Pepper Intake and Risk of Total and Cardiovascular Mortality in Italian Adults: Prospective Findings From the Moli-Sani Study
Authors: Bonaccio Marialaura , Di Castelnuovo Augusto , Costanzo Simona , Ruggiero Emilia , De Curtis Amalia , Persichillo Mariarosaria , Cerletti Chiara , Donati Maria Benedetta , de Gaetano Giovanni , Iacoviello Licia ,   Moli-Sani Study Investigators
Published: March 2019

Introduction:
Chili pepper, along with other spices, is an integral part of a traditional Mediterranean diet (MD). Yet there is paucity of epidemiological data on the association between chili pepper intake and mortality risk, with lack of studies from Mediterranean populations.

Hypothesis:
We assessed the hypothesis of an association between chili pepper consumption and total and cardiovascular (CVD) risk of death in a large sample of the Italian general population, and tested different biological mediators of the association.

Methods:
Longitudinal analysis on 22,811 men and women aged≥35 years enrolled in the Moli-sani Study cohort, Italy (2005-2010). Chili pepper intake was estimated by the EPIC food frequency questionnaire and categorized as none/rare consumption, up to 2 times/week, 2-4 and > 4 times/week. Multivariable hazard ratios (HR) with 95% confidence intervals (95%CI) were calculated by multivariable Cox regression and competing risk models.

Results:
Over a median follow up of 8.2 years, a total of 1,236 deaths were ascertained, of which 444 from CVD. Multivariable risk estimates for all-cause and CVD mortality among participants in the regular (>4 times/week) relative to the none-rare intake were, respectively, 0.77 (0.66-0.90) and 0.66 (0.50-0.86). Regular intake also lowered ischemic heart disease (0.55;0.35-0.87) and cerebrovascular death risks (0.39;0.20-0.76). Traditional CVD risk factors (e.g. blood cholesterol, triglycerides) only marginally account for such associations (Table).

Conclusions:
In a large Mediterranean population, regular consumption of chili pepper is associated with lower risk of total and CVD death independent of adherence to MD. Known biomarkers only marginally accounted for the association of chili pepper intake with total mortality.
Abstract P226: Changes of Blood Pressure and Urinary Sodium Over 18 Years in Rural China: Results From the INTERMAP China Prospective Study
Authors: Yan Li , Carter Ellison , Fu Yu , Xie Gaoqiang , Xie Wuxiang , Kelly Frank , Elliott Paul , Yang Xudong , Ezzati Majid , Baumgartner Jill , Zhao Liancheng , Wu Yangfeng , Chan Queenie
Published: March 2019

Background:
Tremendous dietary pattern changes could be a driver of the increasing burden of high blood pressure (BP) in developing countries. However, data on nutrition transitions and associated BP changes are scarce.

Objective:
To explore BP changes and sodium (Na) consumption over 18 years in China.

Methods:
International Collaborative Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP) enrolled 839 men and women aged 40-59 years from three geographically diverse regions (Beijing, Shanxi in the north and Guangxi in the south) in 1997. INTERMAP China Prospective (ICP) Study followed up these three populations in 2015-2016. Seated BP were measured at least twice following at least 5 minutes of rest, using a random zero sphygmomanometer for the INTERMAP (baseline) and an oscillometric device (Omron HEM-907) for the ICP (follow-up). When calculating BP changes, baseline values were converted using equations developed in a calibration study. Timed 24-hr urine samples were collected at baseline and follow-up using the same protocol. Urinary Na and creatinine (Cr) were measured by emission flame photometry method at baseline and ion-selective electrode method at follow-up. BP and dietary Na changes over time were compared using student t test.

Results:
Systolic BP increased considerably in all three sites; largest increment in Guangxi (18.6, 95% CI: 16.0-21.1 mm Hg, P<0.001) and smallest in Beijing (9.1, 6.3-11.8 mm Hg, P<0.001) (Table 1). Level of urinary Na was almost double in north (Beijing and Shanxi) than south (Guangxi) at follow-up (P<0.001), similar as baseline. On average, participants consumed 10.8 (4.7) and 11.8 (4.7) grams of salt at Beijing and Shanxi and 6.3 (3.0) grams of salt at Guangxi at follow-up, though a trend of reduction in Na/Cr (-3.7, 95% CI: -4.7- -2.6, P<0.001) overall was documented.

Conclusions:
Systolic BP levels increased considerably in this cohort between 1997 and 2015 in rural China. Na consumption might have a declining trend, but still at a very high level at northern China.
Abstract P231: Sugar-Sweetened Beverage Consumption is Associated with Higher Circulating Ceramide Concentrations in the Framingham Offspring Cohort
Authors: Walker Maura E , Xanthakis Vanessa , Moore Lynn L , Ramachandran Vasan , Jacques Paul F
Published: March 2019

Introduction:
Ceramides are a class of sphingolipid that have been implicated in the pathogenesis of cardiometabolic diseases, and their circulating concentrations may be affected by foods that can alter hepatic lipid metabolism. We hypothesized that sugar-sweetened beverage (SSB) consumption may influence plasma concentrations of three ceramide species.

Methods:
Framingham Offspring cohort participants (N=2142; mean age, 65 years; 57% women) were categorized based on SSB consumption, as non-consumers (0 to < 1 serving/month), occasional consumers (1 serving/month to <1 serving/week), frequent consumers (1 serving/week to <1 serving/day), and daily consumers (≥1 serving/day). Plasma ceramide concentrations were assayed using a validated LC-MS/MS protocol. Multivariable linear regression models related frequency of SSB consumption to plasma ceramide concentrations (C16:0, C22:0, and C24:0), and to ceramide ratios (C22:0/C16:0 and C24:0/C16:0). Models adjusted for age, sex, smoking status, use of lipid-lowering medication, total energy, alcohol, diet quality, physical activity, and BMI. We explored if the SSB effects were modified by use of lipid-lowering medication, BMI (< 25 vs ≥ 25), or diabetes status (pre-diabetic/diabetic vs non-diabetic). Analyses were repeated using mean cumulative SSB consumption reflective of usual intake over 14 years.

Results:
Approximately 49% of participants were non-consumers, 20% occasional consumers, 25% frequent consumers, and 6% daily consumers, of SSBs. On average daily SSB consumers were younger, more likely to be men, more likely to smoke, had a lower diet quality, and were slightly more physically active (P

trend

<0.05). Concentrations (LS mean [95% CI] μg/mL) of the C16:0 ceramide were 0.163 [0.161, 0.166] for non-consumers and 0.169 [0.163, 0.175] for daily consumers (P

trend

<0.05). Concentrations of the C22:0 ceramide were 0.601 [0.599, 0.620] for non-consumers and 0.634 [0.604, 0.664] for daily consumers (P

trend

<0.05). There were no statistically significant associations between SSB consumption and plasma concentrations of the C24:0 ceramide or with ceramide ratios (C22:0/C16:0 and C24:0/C16:0). None of the interactions evaluated were statistically significant. Results of analyses using mean cumulative SSB consumption were similar but additionally indicated a significant positive association with concentrations of the C24:0 ceramide; concentrations were 2.252 [2.193, 2.312] for non-consumers and 2.428 [2.313, 2.542] for daily consumers (P

trend

<0.05).

Conclusion:
In our cross-sectional community-based sample of middle-aged adults, SSB consumption was positively associated with plasma concentrations of several ceramide species but not with ceramide ratios. This study may help to elucidate mechanisms mediating the association between SSB consumption and higher risk of cardiometabolic diseases.
Abstract P233: Correlations Between Grocery Purchase Quality Index Scores and Healthy Eating Index Scores Vary by Demographics and Shopping Habits
Authors: Parker Haley W , Thorndike Anne N , Vadiveloo Maya
Published: March 2019

Introduction:
The Grocery Purchase Quality Index (GPQI) is a new, objective diet quality index that assesses adherence of household grocery purchases to the US Dietary Guidelines. Currently, little is known about the correlation between the GPQI and other common diet quality metrics like the Healthy Eating Index (HEI), and whether shopper characteristics (e.g., demographics, shopping habits) influence the strength of this correlation and the utility of the GPQI as a tool for tracking diet quality.

Hypothesis:
The GQPI and HEI-2010 will be moderately correlated at baseline in a cohort of shoppers enrolled in a study testing strategies to promote healthier grocery purchases, and these correlations will vary by shopper characteristics.

Methods:
Data from 224 households recruited from a single medium-sized grocery store were analyzed. Eligible participants were ≥18y, the primary shopper of their household, and did ≥50% of household shopping at store. Participants completed a baseline (Aug-Oct 2018) validated online food frequency questionnaire (FFQ) and a questionnaire about demographics and shopping habits. HEI-2010 scores were calculated from FFQs and GPQI scores were calculated from 2-6 weeks of baseline purchasing data; higher scores reflected healthier diets. Correlations between HEI and GQPI scores (reported as percent of total score) were calculated in SAS 9.4 for the overall sample and by demographic characteristics and shopping habits of interest.

Results:
The sample was predominantly female (90%), older (mean age=55.6±13.7), and higher socioeconomic status (47.9% >college degree, 49.7% household income >$100k). The mean HEI score was 73.0±9.3% out of 100pts, the mean GQPI score was 54.5±11.4% out of 75pts, and the mean BMI was 25.4±4.6. The two scores were moderately correlated in the overall sample (r=0.31, p<0.001); correlations were stronger in men (r=0.52, p=0.02), middle-income ($60-100k) households (r=0.51, p=0.001), and individuals with underweight (n=14, r=0.58, p=0.03), and obesity (r=0.39, p=0.04) and weaker in individuals with normal weight (r=0.28, p=0.003). The GPQI and HEI were not correlated for individuals with overweight (r=0.16) low-income (<$60k) households (r=0.16) or for those who shopped at farmer’s markets within the past month (r=0.15) whereas individuals who shopped at other grocery or superstores (r=0.31-0.35) had correlations similar to the overall sample.

Conclusion:
These findings suggest that food purchasing data reflects the individual diet quality and may be a promising tool for evaluating and monitoring individual-level diet quality. Further research should explore influential demographics and shopping habits on the strength of the correlation between the GQPI and HEI to develop more accurate predictive models using objective household purchasing data as a proxy for individual-level intake.
Abstract P234: Social Coherence and Religious/Spiritual Coping Skills Modify Associations Between Weight-Related Discrimination and Risk of Multi-System Physiological Dysregulation Among US Adults
Authors: Vadiveloo Maya , Mattei Josiemer
Published: March 2019

Background:
Weight discrimination is associated with higher multi-system physiological dysregulation, referred to as allostatic load (AL), which increases cardiovascular risk. While reducing weight discrimination is critical for reducing its negative consequences, it is unclear whether individual-level factors can attenuate associations between weight discrimination and AL. This study examined whether religious and spiritual coping practices as well as beliefs about societal complexity modified the effect of weight discrimination on AL among adults aged 25-75y over 10-years.

Hypothesis:
Individual-level factors may attenuate associations between weight discrimination and AL.

Methods:
Participants from the national Midlife Development in the US (MIDUS) Biomarker Substudy with self-reported information on weight discrimination, individual-level factors, and perceptions about social coherence were analyzed (n=953). Social coherence (i.e. degree to which the world makes sense) and religious/spiritual coping (i.e. seeking religious/spiritual support for comfort and guidance) were assessed via 4 self-reported Likert items at baseline, with higher scores indicative of higher coherence and coping. Self-reported perceived discrimination across 9 scenarios at baseline and 10-years follow-up were summed and averaged to compute long-term discrimination. The proportion of 24 dysregulated biomarkers within 7 systems was summed to compute AL (range 0-7). Interactions between social coherence and religious/spiritual coping were tested using a threshold of p<0.05. Median splits for social coherence, religious/spiritual coping, and weight discrimination were computed and AL ≥3 was deemed high. Estimated relative risks (RR) were obtained from multivariable models adjusted for age, household income, sex and baseline BMI.

Results:
Obesity was present in 41% of the sample, 8% reported weight discrimination, and 19% had high AL. Both social coherence (p=0.048) and religious/spiritual coping (p=0.03) modified associations between weight discrimination and AL. In stratified analyses, participants with high social coherence experienced triple the risk of high AL (RR:3.11; 95% CI: 1.82,5.30) while weight discrimination was not associated with AL among individuals with low social coherence (RR:1.35, 95% CI: 0.71,2.61). Conversely, high religious/spiritual coping attenuated associations between weight discrimination and AL (RR: 0.98, 95% CI: 0.27,3.55), while low religious/spiritual coping was associated with AL (RR: 2.46, 95%CI: 1.61, 3.77).

Conclusions:
Some individual-level factors may modify associations between weight discrimination and high AL. Mindfulness and tools that adjust internalization of societal messages about weight status have the potential to produce beneficial metabolic effects that could improve cardiovascular outcomes.
Abstract P237: Relation of Egg Intake to Blood Pressure: The International Study on Macro/Micronutrients and Blood Pressure (INTERMAP)
Authors: Vu Thanh-Huyen T , Van Horn Linda , Chan Queenie , Daviglus Martha L , Stamler Jeremiah
Published: March 2019

Background:
Data regarding associations of egg intake, a major source of dietary cholesterol, with blood pressure (BP) are limited, especially from large, diverse population samples, and findings have been inconsistent.

Methods:
Associations between egg intake and BP were examined using data on 4680 men and women, aged 40-59 years, between 1996 and 1999, from the INTERMAP study that included 17 population samples in the United States (US), United Kingdom (UK), China and Japan. Data were collected from four 24-hour dietary recalls, 2 timed 24-hour urine collections and 8 BP measurements. Egg intake was calculated as amount consumed per day using the Nutrient Data Software for Research (University of Minnesota, USA). Multivariable linear regression models were used to estimate differences in BP per 2-SD of egg intake (50.71g/day). Country-specific regression coefficients were pooled, weighted by inverse of their variance to estimate overall association.

Results:
Of 4680 participants, 50% were women. Daily egg intake was highest among individuals from Japan (mean 37.74, SD 24.3g/day). With adjustment for age, sex, population sample, and average dietary energy intake/day, egg intake was significantly associated with SBP in both the pooled sample and the US sample. With each 2-SD higher egg intake, US mean SBP was significantly higher by 2mmHg (Model 1-Table). The associations remained significant with further adjustment for education level, family history of hypertension, smoking status, and use of dietary supplement (Model 2-Table). With further adjustment for urinary sodium and urinary potassium or BMI, the associations were no longer significant. No association was found for other countries, and for DBP.

Conclusion:
An adverse association between egg intake and SBP was observed in the US but not in other countries. Notably, this association was strongly attenuated by urinary sodium, urinary potassium and BMI. Further research is needed to better understand the relation of egg intake and BP.
Abstract P238: Sociodemographic Factors Associated With Under- and Overweight Among Women of Reproductive Age in Sub-Sahara Africa
Authors: Were Jason , Creed Irena , Stranges Saverio
Published: March 2019

Introduction:
In the last three decades, many countries in SSA have undergone rapid epidemiological and nutritional transitions, with an ever-increasing prevalence of cardio-metabolic conditions. Because of these changes, health care systems in the sub-region are faced with the simultaneous challenge of handling both underweight and overweight related sequelae. There is still limited epidemiological evidence on the drivers of this phenomenon within and across countries in SSA.

Hypotheses:
We assessed the following hypotheses: 1) SSA countries vary in terms of the type and extent of malnutrition; 2) Macro (country level) and micro (individual level) sociodemographic factors are associated with the double burden of malnutrition (i.e. under- and overweight) in SSA.

Methods:
Macro- and micro-level data for 34 SSA countries were acquired from the World Bank data base and Demographic and Health (DHS) surveys respectively. A total of 247,691 eligible participants (women between the age of 15 and 49) from the DHS surveys were analyzed. We first determined malnutrition categories in SSA from country level prevalence estimates of underweight and overweight using statistically defined logic expressions. Second, we used random forest analysis to investigate the association between the malnutrition groups and macro-level variables. Third, we used random forest analysis and multivariable multinomial logistic regression models to investigate the association between micro level variables and the three BMI categories i.e. underweight (BMI <18.5), normal weight (BMI 18.5 to 24.9) and overweight (BMI≥25).

Results:
Out of the 34 countries studied, the prevalence of underweight was greater than 10% in 3 countries, whereas 13 countries had both underweight and overweight prevalence exceeding 10%. Overweight (BMI 25 to 29.9) prevalence exceeded 10% in 7 countries, while the obese (BMI≥30) prevalence was at least 10% in 11 countries. Macro level random forest analysis showed that fertility rate and gross domestic product (GDP) were key correlates of the malnutrition groups found in SSA. However, age, wealth and parity were key correlates of women’s nutritional status at the micro level. Old age and wealth were consistently associated with overweight across all the countries. However, parity was a risk factor for underweight in underweight countries, and a risk factor for overweight in overweight countries.

Conclusion:
In conclusion, we observed consistent cross-sectional associations between measures of fertility, wealth and age and the dual forms of malnutrition (under- and overweight) among women in SSA.
Abstract P241: Snoring is Associated With Obesity Among Middle Aged Slum-Dwelling Women in Mysore India
Authors: Krupp Karl F , Srinivas Arun , Nasir Khurram , Srinivas Vijaya , Bastida Elena
Published: March 2019

Background:
Globally, rates of obesity have trebled in the past four decades. India has more than 9.8 million men and 20 million women classified as obese. While poor diet and sedentary lifestyles are major causes, growing evidence suggests other factors like sleep-disordered-breathing may also be contributors.

Methods:
A cross-sectional survey was carried out between October 2017 and May 2018 among a nonprobability sample of slum-dwelling women, 40 to 64 years of age, in government-designated slums in Mysore, India. In addition to socio-demographics, data were collected on tobacco and alcohol consumption, diet, physical activity, sleep, quality of life, and personal and family history of diagnosed cardiometabolic disorders. Body mass Index (BMI) was calculated using anthropometry. Serum was tested for HbA1c and lipids. Electrocardiography was carried out by a trained medical technician.

Results:
In this sample of slum dwelling women, snoring was associated with obesity. Habitual snorers had more than double the odds (Adjusted Odds Ratio [aOR] 2.05; 95% Confidence Interval [CI]1.26-3.33; p<0.004) of obesity I, and seven times the odds (aOR 7.71; CI: 3.58-16.62; p<0.001) of having obesity II compared to non-snorers after adjustment for age, diabetes, hypertension, hypercholesterolemia, and daytime sleepiness. There was no difference in obesity status among participants reporting abnormal sleep duration, napping, daytime sleepiness, sleep apnea, insomnia, or use of sleep medication.

Conclusion:
The relationship of snoring and obesity has not been well explored. This study among slum-dwelling Indian women, found a significant relationship between snoring and obesity. Future research should explore the underlying mechanisms connecting snoring to BMI.
Abstract P244: Serum Uric Acid Level is A Predictor of Nonalcoholic Fatty Liver Disease in an Apparently Healthy Population
Authors: Baena Cristina P , Martins Grasiele L , Leite Mariana F , Haagsma Ariele B , de Paiva Clara I , Kallaur Guilherme R , Nogueira Andre M , Simao Camila C , Cavalli Camila , Goss Daniele R , Junior Paulo A
Published: March 2019

Background:
Nonalcoholic Fatty Liver Disease (NAFLD) is the most frequent hepatic abnormality in the western countries and commonly asymptomatic. Known risk factors for the disease are obesity, type 2 diabetes, hypertension and dyslipidemia. Serum Uric Acid levels (SUA) has been associated with a variety of cardiometabolic disorders. Yet the relationship between NAFLD and SUA is less known.

Hypothesis:
We assessed the hypothesis that there is an association between SUA levels with NAFLD in an apparently healthy population in Brazil. Materials and

Methods:
A cross-sectional study was conducted among 2.660 adult Brazilians who underwent to a medical check-up at Marcelino Champagnat Hospital in Curitiba/PR. Sociodemographic, anthropometric and laboratory evaluations were conducted, including abdominal ultrasonography. NAFLD was diagnosed by abdominal ultrasound, with evidence of contrast between the liver and renal parenchyma. Individuals with history of significant alcohol consumption (intake superior to 140g/week for men and 70g/week for women) or using hipouricemic medications were excluded from the analysis. Binary logistic regression models were built to test the impact of SUA levels on NAFLD by sex. Adjustments were subsequently made by age, fasting glucose, body mass index, hypertension, dyslipidemia and smoking status to test the independence of SUA in association with NAFLD.

Results:
We included 1.329 men (46.1±8.5 years) and 351 women (46.3±8.2 years) in the final analysis. Prevalence of NAFLD were 35.6% and 38.7% for men and women, respectively (p<0.001). Mean SUA levels were significantly higher in subjects with NAFLD (6.52±1.30mg/dL vs 5.51±1.41 mg/dL) in men and ( 6.36±1.34 mg/dL vs 5.53 ±1.28 mg/dL) in women (p<0.001 for both). Crude models for NAFLD by unit of SUA yielded OR of 1.69 (CI 95% 1.53-1.86) and 1.61 (CI 95% 1.33-1.94) for men and women, respectively. Fully adjusted models showed OR of 1.43 (CI 95% 1.27-1.62) and 1.48 (CI 95% 1.17-1.88), for men and women, respectively.

Conclusion:
SUA levels are independently associated with NAFLD in an apparently healthy population. Future studies should explore the benefits of lowering SUA levels on NAFLD prevention and potential mechanisms of this association.
Abstract P246: Fish Oil Supplementation During Early Life Improves Metabolic Health in Diet Induced Obesity
Authors: Ramalingam Latha , Menikdewella Kalhara , Scoggin Shane , Moustaid-Moussa Naima
Published: March 2019

Objective:
Obesity is global epidemic and a complex disease that increases the risk for cardiovascular and metabolic disorders. Over half of American women of child bearing age are either obese or overweight, putting their offspring at high risk for childhood obesity and comorbidity. Hence, maternal programming through diet is critical for prevention of obesity and its metabolic complications in the offspring. Fish oil (FO), rich in very long chain omega 3 polyunsaturated fatty acids exert various health benefits such as reduced serum triglycerides, inflammation and insulin resistance. However, it remains unclear whether maternal and/or post-natal consumption of FO protects offspring from adverse effects of consuming high fat (HF) diet.

Methods:
Female mice were fed low fat diets (LF, control diet), HF diets supplemented without (HF) or with FO for 8 weeks pre-pregnancy through lactation, and bred to low fat fed male mice. After weaning, male and female offspring from HF or FO dams were either continued on their respective diets (HF-HF and FO-FO) or switched to the other diet (HF->FO and FO->HF) and compared to LF. Serum, adipose tissue, and other tissues were collected at the end of the feeding period for further analyses.

Results:
HF fed mice of both sexes had significantly higher body weight and were insulin resistant compared to LF mice. Male offspring who continued on FO during pregnancy and early life (FO-FO) demonstrated significantly higher glucose clearance and insulin sensitivity compared to offspring that were switched to HF (FO-HF) (P<0.05). However, no differences were observed between pups born to HF fed dams. Interestingly, in the female offspring, all groups that received FO either during pregnancy or early life (FO-FO, FO-HF, HF-FO) demonstrated better glucose tolerance than HF-HF groups. Furthermore, adiposity and inflammation was significantly lower in all pups that received fish oil either during pregnancy or early life (FO-FO, FO-HF, HF-FO) compared to HF fed mice in both male and female pups.

Conclusions:
Supplementation of FO during pregnancy and early life is more beneficial than treating with FO either during pregnancy or in neonatally.
Abstract P248: Increased Arterial Stiffness Measures in Morbidly Obese Patients After Bariatric Surgery
Authors: Wang Frances , Yang Chao , Tanaka Hirofumi , Coresh Josef , Ndumele Chiadi , Matsushita Kunihiro
Published: March 2019

Introduction:
The association between obesity and arterial stiffness is complex and has been reported to be modified by age, with a positive association in older adults and an inverse association in younger adults. Additionally, several diet and exercise-based programs have demonstrated conflicting results regarding changes in arterial stiffness before and after weight reduction. However, few have explored arterial stiffness outcomes in bariatric surgery patients.

Objective:
To characterize changes in arterial stiffness after bariatric surgery.

Methods:
In 72 morbidly obese patients, we evaluated two measures of arterial stiffness, cardio-ankle vascular index (CAVI) and heart-ankle pulse wave velocity (haPWV), ~1 month prior to and 6 and 12 months after bariatric surgery. Arterial stiffness measures were assessed twice at each visit and averages were reported. Paired t-tests were used to evaluate the significance of changes after bariatric surgery.

Results:
The mean age of our study sample was 44.5 years (SD 11.2), and 72.2% were female. Average BMI substantially decreased after bariatric surgery (from 47.1 to 34.8 kg/m
2
). Similarly, systolic blood pressure declined after surgery (from a mean of 143.0 to 131.7 mmHg) whereas diastolic blood pressure did not significantly differ. Both arterial stiffness measures, CAVI and haPWV, were significantly elevated after bariatric surgery (Figure, p<0.001). CAVI increased from baseline by an average of 0.64 (95% confidence interval [CI]: 0.42-0.87) at 6-month follow-up and 0.80 (95% CI: 0.53-1.07) 1 year after surgery. A similar pattern was observed for haPWV.

Conclusions:
Despite favorable changes in body weight and blood pressure, arterial stiffness measures were elevated after bariatric surgery. Although this observation is in line with an inverse association between obesity and arterial stiffness in younger adults, future studies are necessary to explore the underlying mechanisms and clinical implications of increased arterial stiffness after bariatric surgery.
Abstract P252: Stress Echocardiography in Assessment of Symptoms in Obese Patients
Authors: Windish Stephanie , Smart Steven
Published: March 2019

Introduction:
Obesity and obesity related illness continues to be an epidemic in the United States and worldwide. Obesity carries substantial risk of cardiovascular disease (CVD), and symptoms (shortness of breath, decreased exercise tolerance, etc) related to CVD can be nonspecific. Stress testing may identify the cause of these symptoms in obese patients (body mass index (BMI) > 30.) Stress echocardiography has evolved to be capable of comprehensive hemodynamic assessment as well as functional and myocardial perfusion analysis and may be ideal for symptom evaluation in the obese.

Methods:
1,615 consecutive patients (52% women, age 61±41 yrs, BMI 28±6) underwent stress perfusion ECHO (treadmill in 913, supine bike in 623 and dobutamine in 79 patients) between 2012 and 2014. Imaging included contrast/perfusion imaging and multi-method assessment of regional and global left and right heart systolic and diastolic function, left ventricular (LV) volumes, quantitative valve function, left and right heart pressures, peak/mean pulmonary artery pressures, pulmonary vascular resistance, and LV mass. Standard statistical methods were used.

Results:
Of the 1,615 patients analyzed, 516 (32%) were obese patients (BMI 36±5) and in the obese group females were 48% (vs 53% in non-obese). Both groups underwent similar stress modalities (58% vs 56% treadmill, 6% vs 4% dobutamine, and 36% vs 40% bike). Diabetes (21% vs 10%) and hypertension (57% vs 44%) were more common in obese (p< 0.05).

LV mass is disproportionately higher (113±30 vs 97±33 gm/M2) in obese patients (P< 0.01). Additionally, obese patients had statistically significant findings (p< 0.01) of LV hypertrophy (62% vs 26%), diastolic dysfunction (65% vs 44%), and at least moderate pulmonary hypertension (48% vs 34%). Overall, abnormal tests were more common in obese (83% vs 59%, p<0.01). Multiple abnormalities were more common (p<0.01): 1-3 abnormalities (13% vs 16%) and > 4 abnormalities (70% vs 43%).

Unexpectedly, the data showed no statistically significant difference between obese and non-obese in the incidence of ischemia (10% vs 11%), myocardial infarction (5% vs 4%), and cardiomyopathy (6% vs 5%).

Conclusions:
Comparative analysis of the data from stress ECHO revealed obese patients had disproportionally higher LV mass index/LV hypertrophy. Stress testing provoked worse diastolic dysfunction and much worse pulmonary vascular dysfunction in the obese patients. The triad of LV hypertrophy/diastolic dysfunction/pulmonary vascular disease with provoked moderate to severe pulmonary hypertension was the main cause of symptoms in obese patients. Hemodynamic stress ECHO is the ideal modality for evaluation of nonspecific symptoms of CVD in obese patients, as it can classify the cause of symptoms and the extent of pathology. Thereby, it may be the ideal test to guide treatment.
Abstract P255: Central Fat Distribution and Metabolic Health in Normoglycemic Young Women
Authors: Ingram Katherine H , Amason Janeen S
Published: March 2019

Purpose:
The purpose of this pilot study is to test the hypothesis that fat distribution, rather than overall obesity, is strongly related to insulin sensitivity in young, normoglycemic women.

Methods:
Thirty-eight non-diabetic young women completed the study (ages 20.7 ±2.8 years; BMI 27.6 ±3.6; 44% Caucasian (17 of 38). Matsuda Insulin Sensitivity Index was calculated from plasma glucose and insulin at 0, 30, 60, and 90 minutes after ingestion of 75g glucose, using established formula, to estimate whole body insulin sensitivity. Whole body and regional adipose tissue was assessed via DXA, abdominal ultrasound of intra-abdominal and pre-peritoneal adipose depots, circumference measures, and skinfold measures. ANOVA was used to assess mean differences among tertiles of Matsuda Index. Partial correlations were controlled for age and race, then additionally controlled for DXA percent body fat to assess associations of fat distribution independent of overall obesity.

Results:
ANOVA revealed a higher waist circumference (83.8 ±7.8cm vs. 75.6 ±7.2), waist/hip ratio (0.777 ±0.48 vs. 0.716 ±0.05 ), waist/height ratio (0.524 ±0.028 vs. 0.468 ±0.043), ultrasound intra-abdominal thickness (3.57 ±1.3 vs. 2.48 ±1.1) in the least insulin-sensitive tertile, when compared to the most insulin-sensitive tertile, while age, BMI, and other measures of adiposity were comparable among the three groups. Partial correlations controlled for age and race revealed strong negative relationships between Matsuda Index and measures of upper-body and central adiposity, including waist circumference (
r
=-.416,
p
<0.05), waist/hip ratio (
r
= -0.500,
p
<0.01), waist/height ratio (
r
=-0.431,
p
<0.05), IAAT (
r
= -0.412,
p
<0.05), PPAT (
r
=-0.381,
p
<0.05), but not BMI (
r
= -0.173,
p
=ns) or overall percent fat (
r
=-0.132
, p
=ns). When further controlled for percent body fat, correlations persisted between Matsuda and waist circumference (
r
=-.433,
p
<0.05), waist/hip ratio (
r
=-0.488,
p
<0.01), waist/height ratio (r= -.470,
p
<0.01), intra-abdominal fat thickness (
r
=-0.394,
p
<0.05) and pre-peritoneal fat thickness (
r
=-0.361,
p
=0.05).

Conclusions:
Central and upper-body fat distribution, independent of overall obesity, is strongly associated with metabolic health in young non-diabetic women. These data underscore the clinical utility of central adiposity as an marker of metabolic health.
Abstract P257: Acute Type A Aortic Dissection: Post-Repair Quality of Life and Its Association With Post-Traumatic Stress Disorder, Exercise and Sexual Activity
Authors: Pasadyn Selena R , Roselli Eric , Artis Amanda , Hurley Karen , Blackstone Eugene
Published: March 2019

Introduction:
Aortic dissection (AD) classically presents with abrupt onset of symptoms immediately followed by major emergency surgery. This can be physically and mentally traumatic. Little is known about the post-repair Quality of Life (QOL) of patients and its association with exercise, post-traumatic stress disorder (PTSD), and sexual activity. Our objective was to describe these associations.

Methods:
There were 295 identified patients who survived acute type A aortic dissection repair. All were surveyed and 132 responded. Included was the Veterans RAND 12-item Health Survey (VR-12). Also included was a validated screening tool to identify PTSD (PC-PTSD) and questions about exercise and sexual activity. The VR-12 produces physical and mental health QOL summary scores (PCS and MCS) that are standardized using a T-score metric with mean of 50±10. Wilcoxon signed rank tests were used to test if median PCS and MCS scores were equal to 50. Kruskal-Wallis tests were used to test for associations between QOL and PTSD, post-AD exercise status, and limited sexual activity. Hodges-Lehmann (HL) estimates of the location shifts between the two groups and their 95% CIs are also provided as (HL [lower CI, upper CI]). Skewed distributions are presented as median [15
th
, 85
th
] percentiles.

Results:
Median PCS (40.1 [25.9, 51.2]) was significantly lower than 50 (P<.0001). There was no statistical difference between median MCS (54.6 [33.9, 61.4]) and 50 (P=0.2454). The median PCS QOL score was significantly lower in AD patients who screened positive for PTSD than those who did not (HL: -9.3 [-14.0,-4.1], p=0.0008). The same was true for the median MCS score (HL: -17.0 [-23.1,-10.0], p<.0001). The median PCS QOL score was significantly higher in AD patients who were exercisers than those who were not (HL: 6.8 [2.4, 11.1], p=.0015). The same was true for the median MCS score (HL: 4.2 [1.0, 7.8], p=.0095). The median PCS QOL score was significantly lower in AD patients experiencing limited sexual activity after their dissection than those who did not (HL: -8.0 [-12.6, -4.3], p=.0002). The same was true for the median MCS score (HL: -5.5 [-10.5,-1.8], p=.0026).

Conclusions:
The traumatic and debilitating nature of AD and its emergency repair results in lower physical, but not mental, QOL scores than the general population. Lower physical and mental scores are also associated with PTSD, non-exercisers and limited sexual activity in this population. To promote physical and mental QOL in these patients, physicians should investigate and treat PTSD, encourage exercise, and promote resumption of sexual activity when safe.
Abstract P258: Novel Dual-task Balance Challenge to Prevent Falls in Older Adults With Cardiovascular Disease Risk Factors
Authors: Taylor-Piliae Ruth E , Hsu Chiu-Hsieh (Paul) , Toosizadeh Nima , Mohler Jane
Published: March 2019

Background:
Fall injuries are responsible for significant health care utilization, disability, loss of independence, and high costs among community-dwelling older adults with cardiovascular disease risk factors (CVD-RF). A Matter of Balance (MOB) is a national community-based fall prevention program, which focuses on cognitive restructuring to manage concerns about falling, but does not include a balance-training component. We hypothesize if MOB added to a dual-task balance challenge (DTBC) comprising weight transfer using fixed and random ordering of ankle reaching tasks, while simultaneously challenging attention—would lead to reduced fall risk.

Objectives:
To assess participants’ acceptance and satisfaction with the 4-week MOB and MOB plus DTBC interventions, safety and adherence, and examine changes in fall risk (balance, gait, and fear of falling) post-intervention.

Methods:
A single-blind, two-group, randomized pilot study, among community-dwelling older adults with CVD-RF at high fall risk. MOB classes were 2-hours, 2x/week for 4 weeks, with 15 minutes of social time. MOB+DTBC classes followed the same curriculum with 15 minutes of ankle reaching tasks while simultaneously challenging attention. Acceptability and satisfaction were obtained by self-report, study staff monitored safety and adherence during class. Balance and gait were objectively assessed using LEGSys™ (BioSensics, LLC), while the Falls Efficacy Scale International (FES-I) assessed fear of falling. We used t-tests for continuous variables and Fisher’s exact test for categorical variables.

Results:
At high fall risk older adults (n=16, mean age=74±8 years), mainly retired (95%, n=15), women (88%, n=14), with >13 years education (81%, n=13), diabetes (25%, n=4), dyslipidemia (70%, n=12), and hypertension (63%, n=10) completed the study (drop-outs, n=1). Participants reported high levels intervention acceptability and satisfaction (mean score=9±1.3, 1=least, 10=most), no safety issues (0%), with very high adherence rates (>94%), regardless of group assignment. Participants in the MOB group (n=7) had no significant within group changes in fall risk post-intervention (p>0.05). Conversely, participants in the MOB plus DTBC group (n=9) had significant improvements in balance (eyes open test=ankle sway, p=0.02; eyes closed test=hip sway, p=0.03 and center of mass, p=0.01) and gait (fast pace=stride time, p=0.04 and double support, p=0.02), with less fear of falling (p=0.04) post-intervention, when compared to baseline.

Conclusions:
Reducing fall risk factors and preventing falls are essential for older adults with CVD-RF, to ensure that they continue to live safely and independently. The addition of DTBC to the nationally-used standard MOB curriculum may enhance both balance and cognitive function, and lead to reduced fall risk among community-dwelling older adults with CVD-RF.
Abstract P262: Parity and Ideal Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis
Authors: Ogunmoroti Oluseye , Osibogun Olatokunbo , Kolade Olamide , Ying Wendy , Sharma Garima , Vaidya Dhananjay , Michos Erin D
Published: March 2019

Background:
Parity (null or grand multiparity) is associated with an increased cardiovascular disease (CVD) risk through several biological pathways. The American Heart Association’s Life’s Simple 7 (LS7) metrics are a useful framework for the promotion of ideal cardiovascular health (CVH). However, the effects of parity on CVH are uncertain. We examined the association between parity and ideal CVH among an ethnically diverse group of middle to older aged women free of CVD at baseline.

Methods:
We analyzed cross-sectional data of 3,430 women aged 45 to 84 years enrolled in the Multi-Ethnic Study of Atherosclerosis. Parity was self-reported, defined as the total number of live births, and categorized as 0, 1-2, 3, 4 and ≥5. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each categorized into ideal (2 points), intermediate (1 point) and poor (0 points). A total score of 0-8 was considered inadequate; 9-10, average and 11-14, optimal for CVH. The number of metrics in the ideal category was also counted. Multinomial logistic regression was used to examine the association between parity and CVH measured by the score and number of ideal metrics.

Results:
Mean age (SD) was 62 (10) years. Using women with 1-2 live births as reference, for nulliparous women, the odds of having an average CVH score were 38% higher, while for women with a history of 3 and ≥5 live births, the odds of having optimal CVH were 26% and 54% lower, respectively
(Table)
. Additionally, women with ≥5 live births were less likely to achieve 5 ideal metrics [OR 0.39 (0.21-0.69)], with a similar trend for 6-7 ideal metrics [0.41 (0.16-1.07)]. Test for interaction by race/ethnicity was not significant (p=0.3).

Conclusion:
While there was not a strong graded association of parity and CVH scores, our data suggest that women with ≥5 live births are less likely to achieve optimal CVH and greater numbers of ideal metrics. More research will be required to explore the mechanisms by which parity improves or worsens CVH.
Abstract P270: Neighborhood Socioeconomic Status and Sleep Duration Among U.S. Adolescents: Does the Association Differ by Race?
Authors: Saelee Ryan , Gazmararian Julie A , Johnson Dayna A , Suglia Shakira
Published: March 2019

Background:
Short sleep duration is linked to adverse cardiovascular risk factors among adolescents and racial disparities in sleep among this group is well documented. Thus, identifying determinants and its differential impact on sleep duration by race may be important for informing sleep interventions and reducing sleep disparities. Evidence suggests neighborhood socioeconomic status (NSES) may play a role in shorter sleep duration among adolescents, but few studies have examined whether this relationship differs by race. Furthermore, previous studies were limited by sample size, geographic representation to specific U.S. cities and racial/ethnic diversity with mostly non-Hispanic White samples. The purpose of our study was to investigate the association between NSES and short sleep duration and determine if this relationship varies by race among a diverse sample of adolescents.

Methods:
Participants (n=17,746) are from Wave I of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative multi-ethnic study of health behaviors during adolescence and outcomes during adulthood. Sleep duration was self-reported as total hours of sleep at night, and categorized as short (6-13 years: <9 hours, 14-17 years: <8 hours, 18-25 years: <7 hours) vs. normal (6-13 years: 9-11 hours, 14-17 years: 8-10 hours, 18-25 years: 7-9 hours ). NSES was a summary z-score consisting of three census-block measures: unemployment rate, proportion of households with income below poverty level, and public assistance. Participants were categorized as living in low (>median z-score) or high (≤ median z-score) NSES. Log-binomial regression models examined the association between NSES (low vs. high) and short sleep duration and tested for racial differences. Models adjusted for race, sex, age, and highest parental education.

Results:
The study population was 51% female, 66% White, 15% African-American, 12% Hispanic, 4% Asian, 3% other racial group, and mean age was 15.4 years (Standard Error=0.11). The prevalence of short sleep duration was 41% and 48% for low NSES. There was no significant association between NSES and short sleep duration before (Prevalence Ratio (PR):1.02; 95% Confidence Interval (CI): 0.96-1.09) and after adjusting for individual sociodemographic characteristics (PR: 1.00; 95% CI: 0.93-1.06). There was also no significant race-by-NSES interaction (p=0.21).

Conclusion:
Findings suggests NSES is not associated with short sleep duration regardless of race and that other factors may play a larger role in sleep among this sample of adolescents. The inconsistency with findings from prior studies could be due to our inclusion of a larger, racially diverse, and nationally representative sample. Future studies should explore whether other neighborhood and contextual factors influence sleep and if racial differences exist in these relationships.