bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P226: Improved Insulin Sensitivity with a Healthy Low Fat or a Healthy Low Carbohydrate Weight Loss Diet: A Twelve Month Randomized Trial
Authors: Trepanowski John F , Gardner Christopher D
Published: March 2022

Background:
The abilities of healthy low fat (HLF) and healthy low carbohydrate (HLC) weight loss diets to improve insulin sensitivity over the long term are not well understood.

Objective:
To examine whether HLF and HLC weight loss diets improve insulin sensitivity over 12 months, and to determine if either diet is superior for these improvements.

Methods:
Healthy adults without diabetes, aged 18-50 years, BMI between 28 and 40 kg/m
2
, were randomized to HLF or HLC for 12 months (n = 609). Health educators delivered the interventions in 22 1-hr group classes. Dietary intake was assessed by three 24-hour recalls per time point. Glucose and insulin were measured at times 0, 30, 60, and 120 min during a 75-g oral glucose tolerance test. Indices of hepatic insulin sensitivity (homeostasis model assessment of insulin resistance; HOMA) and whole-body insulin sensitivity (Matsuda index and the plasma concentration ratio of triglyceride to HDL-cholesterol; TG/HDL-C) were measured. Data were collected at baseline and 12 months. Statistical analyses were performed on study completers.

Results:
Complete data were available for n = 193 for HLF, and n = 197 for HLC. BMI and all indices of insulin sensitivity were similar between groups at baseline (p > 0.25 for all). Macronutrient distributions at 12 months were 48% vs. 30% carbohydrate, 29% vs. 45% fat, and 21% vs. 23% protein for HLF and HLC, respectively. Changes in BMI (mean ± SEM) were similar between groups (HLF: 33.38 ± 0.28 to 31.48 ± 0.29; HLC: 33.01 ± 0.25 to 30.69 ± 0.28; p = 0.11). Improvements within each group were observed for HOMA (HLF: 3.81 ± 0.17 to 3.16 ± 0.12; HLC: 3.60 ± 0.13 to 3.00 ± 0.12), Matsuda index (HLF: 3.13 ± 0.14 to 3.92 ± 0.18; HLC: 3.10 ± 0.12 to 3.86 ± 0.14), and TG/HDL-C (HLF: 3.16 ± 0.17 to 2.74 ± 0.14; HLC: 2.91 ± 0.15 to 2.09 ± 0.14) (p < 0.001 for all). The improvement in TG/HDL-C was greater for HLC (p = 0.013), while the improvements in HOMA and Matsuda index did not differ significantly between groups (p > 0.75 for both).

Conclusions:
All indices of insulin sensitivity were improved with both diets after 12 months. Neither diet was superior for improving HOMA. The HLC diet was more effective for improving TG/HDL-C, but not the Matsuda index.
Abstract P231: Cumulative Body Mass Index and Incident Prediabetes Over 30 Years of Follow Up: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Schreiner Pamela J , Bae Sejong , Allen Norrina , Liu Kiang , Reis Jared P , Wu Colin O , Ingram Katherine H , Lloyd-Jones Donald M , Lewis Cora E , Rana Jamal S
Published: March 2022

Introduction:
Higher body mass index (BMI) is associated with incident prediabetes, but whether the association is related to higher BMI or duration is unclear.

Methods:
We examined cumulative BMI (cBMI) in 4227 black and white men and women, ages 18-30 years at baseline, who were free of prediabetes and diabetes at baseline and did not transition directly from normoglycemia to diabetes. cBMI was a time-varying measure defined as the BMI at a given study visit multiplied by the time until the next available BMI measurement, summed across exams. Prediabetes was defined as fasting glucose of 100-125 mg/dL, 2-hour oral glucose tolerance of 140-199 mg/dL, or HbA1c of 5.7-6.4%. Proportional hazards regression was used to estimate hazard ratios for incident prediabetes across tertiles of cBMI over a maximum of 30 years, without and with adjustment for lifestyle and demographic variables.

Results:
Over an average of 20.4 years of follow up (range 7 to 30 years), there were 2406 incident prediabetes events (56.9% of the sample). Incident events were observed in each cBMI tertile across the full range of follow-up time. In crude models (Table), the hazard ratios for the second and third tertiles of cBMI were statistically significantly and positively associated with incident prediabetes relative to the first tertile. Multivariable adjustment attenuated the associations such that only the third cBMI tertile remained statistically significant, with an 83% higher rate of prediabetes compared to those in the first tertile. These associations did not differ by race, sex or age.

Conclusions:
Cumulative BMI, a measure capturing both BMI level and duration, was strongly associated with prediabetes only when a relatively high threshold was reached. These results suggest that a high cumulative burden over a wide range of BMI values and persistence from young adulthood is associated with prediabetes by middle age, allowing primary prevention before middle age and progression to frank diabetes.
Abstract P239: Clinical Risk Factors Related to Biological versus Chronological Heart Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Zmora Rachel , Schreiner Pamela J , Appiah Duke , Lloyd-Jones Donald M , Rana Jamal S , Lewis Cora E
Published: March 2022

Introduction:
Recent analysis of BRFSS data used the non-laboratory-based Framingham 10-year cardiovascular (CVD) risk calculator to derive biological heart age in older adults. . This calculator utilizes cardiovascular disease (CVD) risk factors sex, age, BMI, systolic blood pressure (SBP), diabetes status, smoking status and antihypertensive medication use. We examined which risk factors drove differences between biological and chronological heart age in young adults.

Methods:
CARDIA examined 2674 black and white men and women who attended Year 10 (mean age 34) and Year 25 (mean age 49) exams and had complete data for heart age components. Biological heart age was calculated using the non-laboratory-based Framingham 10-year CVD risk calculator. Heart age difference was defined as the difference between biological and chronological heart age, with higher values representing poorer heart age. Heart age difference was categorized into three levels, ≤-5 years, -5 to +5 years, or ≥+5 years. Differences between levels were assessed using linear regression, with heart age difference coded as an indicator variable referenced against a heart age difference of -5 and +5 years.

Results:
Race, smoking status, BMI and SBP were statistically significantly different from the reference in those whose heart age differences were lower (≤ -5) and higher (≥ 5) at exam years 10 and 25. Sex differed from the reference only in the lower heart age difference groups at both exams. Diabetes status differed from the reference only in the higher heart age difference groups at both exams.

Conclusions:
Most risk factors driving biological heart age, including race, smoking status, diabetes status, antihypertensive medication use, BMI and SBP, drive both favorable and unfavorable heart age differences at years 10 and 25 with the notable exceptions of female sex with favorable and diabetes with unfavorable heart age difference. This suggests that risk factor management at both younger and older ages impacts vascular aging.
Abstract P243: Retinal Microvascular Findings and Future Risk of Peripheral Artery Disease: the Atherosclerosis Risk in Communities (ARIC) Study
Authors: YANG CHAO , Kwak Lucia , Ballew Shoshana H , Jaar Bernard , Deal Jennifer A , Folsom Aaron R , Heiss Gerardo , Sharrett A. Richey , Selvin Elizabeth , Sabanayagam Charumathi , Coresh Josef , Matsushita Kunihiro
Published: March 2022

Introduction:
Lower-extremity peripheral artery disease (PAD) is often considered as a subtype of macrovascular disease. For the development of critical limb ischemia (CLI), a severe form of PAD, microvascular disease is indicated to play a crucial role by impairing collateral formation and wound healing. However, the contribution of microvascular disease to the development of PAD has not been systematically evaluated in a large cohort study.

Hypothesis:
Microvascular disease, as represented by retinal findings, will be associated with future PAD risk, and its association will be stronger for CLI.

Methods:
Retinal photographs were taken at the 3
rd
examination (1993-1995) of the ARIC Study. We investigated 9390 participants free of clinical history of PAD and quantified the associations of each retinal finding with PAD risk using Cox models. PAD was defined as hospitalizations with PAD diagnosis (ICD-9: 440.2x, 440.3, 440.4) or leg revascularization (38.18, 39.25, 39.29, 39.50). Of PAD cases, those with ulcer (707.1), gangrene (785.4) or leg amputation (84.1x) were considered CLI.

Results:
During a median follow-up of 19 years, 304 participants developed PAD, of which 92 were considered CLI. Retinal hemorrhages, exudates, microaneurysms and any retinopathy demonstrated independent associations with PAD (Table) beyond potential confounders including diabetes, while generalized arteriolar narrowing did not. These significant retinal findings were more strongly associated with CLI than with PAD (HR range 3.1-6.5 vs. 2.2-3.3, with all p-values for difference in HR from seemingly unrelated regression <0.05 except soft exudates). Also, these retinal findings tended to have stronger associations with PAD outcomes among persons with diabetes than those without.

Conclusions:
Retinal hemorrhages, exudates, microaneurysms and any retinopathy were independently associated with PAD, especially its severe form, CLI. Our results suggest the importance of microvascular wall fragility/permeability in the development of PAD.
Abstract P261: HIV-positive Individuals With Undetectable Viral Loads Have suPAR Levels Comparable to HIV-negative Individuals
Authors: Topel Matthew L , Hayek Salim H , Wadhwani Shikha , Moran Caitlin , Staloch Dustin A , Wei Changli , Reiser Jochen , Ofotokun Ighovwerha , Quyyumi Arshed A
Published: March 2022

Introduction:
Individuals with poorly-controlled HIV have high levels of plasma soluble urokinase plasminogen activator receptor (suPAR), a marker of immune activation associated with all-cause mortality, incident myocardial infarction and HIV-associated nephropathy in HIV-positive individuals. Data is conflicting regarding the effect of viral suppression on suPAR levels in HIV-positive individuals, or how these levels compare to individuals without HIV.

Hypothesis:
HIV-positive individuals with undetectable viral loads (VLs) will have similar levels of suPAR compared to individuals without HIV.

Methods:
Plasma suPAR was measured by ELISA in 273HIV-positive (70% Black [n=167], age 42 ± 8 years, 86% female [n=240], 56% detectable viral load [n=150]) and 276 HIV-negative (63% Black [n=169], age 40 ± 9 years, 96% female [n=265]) outpatients. Demographics, medical history and laboratory samples were collected.

Results:
Compared to HIV-negative individuals, HIV-positive subjects were older (p=0.01), less likely to be female (p<0.001), had lower body mass index (28 ± 7 vs. 30 ± 8 kg/m
2
, p<0.001) and worse renal function (eGFR 92 ± 19 vs. 97 ± 20 mL/min/1.73 m
2
, p=0.004).

Median suPAR level was similar for HIV-negative and HIV-positive subjects with undetectable VLs (2436 [1908, 3380] vs. 2667 [1966, 4034] pg/mL, p=0.256), and both were significantly lower compared to HIV-positive subjects with detectable VLs (4252 [3099, 5369] pg/mL, p<0.001).

Within HIV-positive subjects, a detectable viral load was an independent predictor for high suPAR (OR 2.37 [95% CI 1.07-5.25], p=0.03) after controlling for age, race, sex, body mass, smoking history, hypertension, diabetes, eGFR and CD4+ count.

Conclusions:
In conclusion,HIV-positive individuals with undetectable VLs have similar levels of suPAR compared to those without HIV. Lower suPAR levels may account for the lower incidence of cardiovascular events and HIV nephropathy in patients with well-controlled HIV.
Abstract P262: HIV/HCV Co-infection and the Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis
Authors: Osibogun Olatokunbo , Ogunmoroti Oluseye , Michos Erin D , Olubajo Babatunde , Nasir Khurram , Madhivanan Purnima , Maziak Wasim
Published: March 2022

Introduction:
With improved antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (HIV) has increased. However, these individuals are now more susceptible to developing cardiovascular diseases (CVD). Prior studies examining the association between HIV and hepatitis C virus (HCV) co-infection and the risk of CVD, compared to HIV mono-infection, have differed in their conclusions. We conducted a systematic review and meta-analysis to clarify and quantify the association between HIV/HCV co-infection and CVD risk. We hypothesized that CVD risk will be synergistically increased by the persistent inflammatory responses of both viruses.

Methods:
We searched EMBASE, CINAHL, Google Scholar, PubMed, and Web of science from inception to October 2016 to identify studies on HIV/HCV co-infection and CVD, defined as coronary artery disease, congestive heart failure and stroke. The search was supplemented with a review of the reference list of articles. We used a random-effects model to abstract and pool data on the hazard ratios (HRs) for CVD. Hazard ratios were adjusted for traditional CVD risk factors.

Results:
Among the 280 articles reviewed, 4 cohort studies met the inclusion criteria with a total of 33,723 participants. Of these, 8,109 (24%) were HIV/HCV coinfected, 18,958 (56%) were HIV monoinfected while 6,656 (20%) comprised HCV monoinfected, HIV uninfected, and HIV/HBV coinfected participants. Pooled adjusted HRs for the association between HIV/HCV co-infection and CVD was 1.24 (95% CI 1.07-1.40) compared to HIV mono-infection. Test for homogeneity was not statistically significant [I
2
= 0.0%, P=0.397] (Figure).

Conclusion:
We found a consistent positive association showing that individuals with HIV/HCV coinfection had an increased CVD risk compared to those with HIV monoinfection. However, more research is needed to further examine this association, determine potential underlying mechanisms and evaluate whether treatment for HIV and HCV infections can reduce CVD outcomes.
Abstract P271: Association Between Nitric Oxide Synthase Gene Polymorphism (
Glu298Asp
) and Blood Pressure in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Wei Jingkai , Graff Misa , Steffen Lyn M , North Kari E , Zheng Yan , Heiss Gerardo
Published: March 2022

Introduction:
Endothelial NO synthase (
eNOS
) gene polymorphism at position 894 (G>T,
Glu298Asp
) resulting in a T allele is related to higher blood pressure (BP) levels, but the association of
Glu298Asp
and temporal increase in BP in adulthood has not been studied, nor is it known whether the association between
Glu298Asp
and BP is modified by habitual intake of fruits and vegetables, an abundant source of nitrate for conversion to NO.

Hypothesis:
We hypothesized that homozygous (TT) or heterozygous genotype (GT) status of
Glu298Asp
is associated with BP increase over a course of 9 years among black and white adults, compared to normal genotype (GG). Further, the association is amplified by higher habitual intake of fruits and vegetables.

Methods:
Among 9488 white (mean age: 54.3 years, 47.0% men) and 2861 black members of the ARIC cohort (mean age: 53.4 years, 37.2% men) at baseline (1987-1989), genotyping of the
NOS3
Glu298Asp
polymorphism (rs1799983) was conducted using the TaqMan assay (Applied Biosystems, Foster City, CA, USA). The rs1799983 levels 1.5-2, 0.5-1.49, <0.5 were categorized as TT, GT, GG, respectively. We used the average of repeated sitting blood pressure at 4 cohort examinations through 1996-1998. Average intake of vegetables and fruit was calculated from food frequency questionnaires at exams 1 and 3, and analyzed as quartiles. A diet score without fruit and vegetables intake was created using principal component analysis. Mixed models were used to estimate the association between
NOS3
G894T
(TT or GT vs. GG) with level and change of SBP and DBP, adjusting for age, sex, genotypes, BMI, smoking status, diabetes, and physical activity. The analysis was also conducted within each quartile of vegetables and fruit intake, with further adjustment for the diet score without fruit and vegetables intake.

Results:
The genotypes of TT, GT and GG of
Glu298Asp
were present in 800 (8.4%), 4057 (42.8%), 4631 (48.8%) white participants, and 26 (0.9%), 510 (17.8%), 2335 (81.3%) black participants. Among whites with the genotype GT/TT, DBP increased 2.46 mmHg (95% CI: 0.02, 4.90) over 9 years compared to GG participants. The interaction between
Glu298Asp
and intake of fruit and vegetables was not statistically significant. There was no statistically significant association between GT/TT and SBP, nor with 9-year change of SBP or DBP among black participants.

Conclusion:
Carrier status of the GT/TT genotypes of
Glu298Asp
is associated with higher level of DBP among white adults, but not with SBP over a course of 9 years compared to the GG genotype of
Glu298Asp
. There is no interaction found between
Glu298Asp
and intake of fruit and vegetables in association with SBP or DBP.
Abstract P283: Changes in Sugar-sweetened and Diet Soda Consumption in Relation to Weight and Waist Circumference Change in a Cohort of Mexican Women
Authors: Stern Dalia , Middaugh Nicole , Rice Megan , López-Ridaura Ruy , Willett Walter , Lajous Martin
Published: March 2022

Introduction:
Obesity is associated with an increased risk of many NCDs, including cardiovascular diseases. Consumption of soda has been linked to weight gain. Mexico is the second largest consumer of soda in the world and close to 70% of Mexican women are overweight or obese.

Hypothesis:
We hypothesize that increase consumption of sugar-sweetened soda willbe associated with increases in weight and weight circumference.

Methods:
We evaluated changes in soda consumption and short-term weight and waist circumference gain in the Mexican Techers Cohort. A subsample of 11,218 participants reported reproductive history, lifestyle factors, and medical conditions and responded to a 137-item semi-quantitative food-frequency questionnaire (FFQ) at baseline in 2006 and at follow-up in 2008. Participants self-reported height and weight and were provided a measuring tape and instructions to assess their waist circumference. We used multivariable linear regression to estimate the impact of 2-year change in sugar-sweetened and diet soda consumption on change in weight and waist circumference, adjusting for potential confounders.

Results:
In multivariable analyses, each additional sugar-sweetened soda serving/day was associated with 0.95 kg (95% CI 0.71, 1.20) increase in weight and 0.94 cm (95% CI 0.48, 1.39) increase in waist circumference over the two-year study period. Changes in diet soda consumption were not associated with changes in weight or waist circumference.

Conclusions:
An increase in sugar-sweetened soda consumption was associated to short-term weight gain in Mexican women. Accumulated over time, even modest weight gain may have important health implications. Our results underscore the urgent need to rapidly reduce sugar-sweetened beverage consumption in this population.
Abstract P286: Egg Consumption is Associated With Cardiovascular Disease Risk Factors in the Coronary Artery Risk Development in Young Adults Study
Authors: Meyer Katie A
Published: March 2022

Objective:
The role of eggs in cardiovascular disease risk remains uncertain. Studies implicate a metabolite of choline , trimethylamine N-oxide (TMAO), in the development of cardiovascular disease (CVD). We tested the association between egg consumption and CVD risk factors over 20 years of follow-up.

Methods:
Study participants were from the CARDIA Study, a multicenter cohort of black and white Americans established in 1985/86 (baseline n=5,115; ages 18-30). Egg consumption was calculated from reported intake on a diet history at baseline and years 7 and 20 of follow-up. Eggs were categorized as: ≤1.0, 1.1-3.5, 3.6-6.9, and ≥7 per week. CVD risk factors were assessed at each exam, including blood pressure, lipids, and insulin resistance (defined by homeostatic model assessment, HOMA-IR). Multivariable-adjusted fixed effects (within-subject) regression models quantified prospective associations between time-varying egg consumption and CVD risk factors.

Results:
In the regression (Table), 7+ eggs per week was negatively associated with systolic and diastolic blood pressure and >3.5 eggs per week was positively associated with HDL-C. Total cholesterol and LDL-C were positively associated with low-to-moderate consumption, but not with higher consumption.

Conclusion:
At higher levels of intake, eggs were negatively associated with blood pressure and positively associated with HDL-C; at low-to-moderate levels, eggs were positively associated with total cholesterol and LDL-C. P
Abstract P294: The Chinese Great Famine and Major Depression Disorder: the CHARLS study
Authors: Shen Luqi , Huang Cheng , Li Changwei
Published: March 2022

Objectives:
To estimate the prevalence of major depression and experience severe famine during the Chinese Great Famine in middle-aged and older Chinese population, and to evaluate the impact of famine experience on risk of major depression in late adulthood.

Methods:
We estimated the prevalence of major depression and severe famine in participants of the China Health and Retirement Longitudinal Study (CHARLS). CHARLS surveyed a representative sample of 17,708 middle-aged and older Chinese adults. SAS PROCFREQ procedure was applied to estimate famine and depression prevalence taking into account the survey design and responding rate. Depression was measured using Center for Epidemiological Studies Depression Scale (CES-D) short form. Famine was based on self-report, and was categorized into none, slight, moderate, and severe. We evaluated famine experience and major depression risk in late adulthood in cohorts of different development stages when famine occurred, using logistic regression adjusting for important demographic, socioeconomic, biomedical, and chronic comorbidities. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) are presented.

Results:
A total of 11.60% of the middle-aged and older Chinese adults experienced severe famine in 1959-1961. Famine significantly increased risk of major depression in late adulthood among those who experienced famine during fetal, mid-childhood, young teens, and adulthood. Compared to those who did not experience famine, those with severe famine experience were 3.00 (95% CI: 1.53-5.89), 1.94 (95% CI: 1.39-2.71), 1.89 (95% CI: 1.15-3.10), and 2.32 (95% CI: 1.62-3.32) times more likely to have major depression in late adulthood among the fetal, mid-childhood, young teens, and adulthood cohorts, respectively. Even adjusting for all variables, there are still significant trends between famine severity and risk of major depression. However, famine experience was not associated with late adulthood depression risk among infant, toddler, preschool, or teenagers cohorts.

Conclusion:
More than 11.6% of the Chinese population experienced severe famine. Exposure to famine during fetal, mid-childhood, young teens, and adulthood stages increased risk of depression in late adulthood.
Abstract P295: Dietary Pattern Mediates the Association Between Education Level and Metabolic Syndrome in Korean Adults
Authors: Kwak SoYoung , Jo Garam , Cho Yoonsu , Shin Min-Jeong
Published: March 2022

Introduction:
Emerging evidences have inconsistently reported that dietary components mediate the relationship between low socioeconomic status (SES) and higher cardiometabolic risk, but the findings are limited in Korean.

Hypothesis:
We tested the hypothesis whether the education level as a proxy for SES is associated with the prevalence of metabolic syndrome and this association is mediated by dietary pattern.

Methods:
We used nationally representative data from the Korea National Health and Nutritional Examination Survey (2008-2011) for cross-sectional analyses (Total number of subjects=22 607, 30-64 yrs). Dietary data were assessed using food frequency questionnaire including 63 food items and were categorized into seven food groups based on the Korea nutrient database. Metabolic syndrome was defined using revised National Cholesterol Education Program criteria. The possible mediating effect of dietary components (fruit, vegetable, red meat, milk, and soft-drink) on the association between education level and metabolic syndrome was tested using a multiple mediation model.

Results:
Education levels had direct and indirect effects via dietary consumption patterns on the prevalence of metabolic syndrome. Higher education level was directly associated with lower prevalence of metabolic syndrome (Odds ratio [OR]: 0.854, 95% Confidence Intervals [CIs]: 0.817-0.894). Regarding the medicating effect of dietary patterns, higher education level was indirectly associated with decreased prevalence of metabolic syndrome by high in fruit intake (OR: 0.983, 95% CIs: 0.947-0.992), red meat intake (OR: 0.991, 95% CIs: 0.985-0.996), milk intake (OR: 0.994, 95% CIs: 0.992-0.998), and by low in soft-drink intake (OR: 0.995, 95% CIs: 0.992-0.998). Gender modified the association between education level and metabolic syndrome prevalence. In women, there was significant inverse relationship between education level and the prevalence of metabolic syndrome with significant mediating effect of dietary pattern on metabolic syndrome. Conversely, mediating effect of dietary pattern was not observed in men.

Conclusions:
In conclusion, there was inverse association between education level and prevalence of metabolic syndrome, which is partially explained by specific dietary components in Korean adults. Our results provide information for establishing dietary guideline and nutrition policy to prevent and manage metabolic syndrome.
Abstract P308: Physical Activity is Associated With Lower Atherosclerotic Risk and Arterial Stiffness in Youth
Authors: Wittekind Samuel G , Edwards Nicholas M , Khoury Philip R , McCoy Connie E , Kimball Thomas R , Urbina Elaine M
Published: March 2022

Introduction:
The prevalence of cardiovascular (CV) risk factors in young people has increased related to the pediatric obesity epidemic. An association between physical activity (PA) and target organ damage has been firmly established in adults, and such damage confers increased CV event risk. There is an urgent need to implement prevention strategies for CV disease in youth. Promoting PA holds promise in this regard. However, in order to be a useful marker, PA needs to be quantified accurately and feasibly in the clinical setting, and its relationship to preclinical CV disease in youth needs to be understood.

Objective:
We aimed to 1) examine the relationship between a subjective measure of PA and an objective measure in a young cohort, 2) determine the association of PA and other CV risk factors, and 3) test the hypothesis that PA is an independent determinant of target organ damage.

Methods:
Adolescents and young adults were recruited from an ongoing study of the effects of risk factors on CV aging. At baseline adolescents with type 2 diabetes mellitus were matched by age, sex, and race to lean and obese control subjects without diabetes. These analyses were performed at 5 years follow-up on 249 subjects (mean age 22 ± 3.9 years). PA was measured with the International Physical Activity Questionnaire (IPAQ) and the Actical accelerometer. Target organ damage was assessed with echocardiography and vascular structure and function testing. Subjects were stratified into tertiles of average PA with the lean group as the standard. Differences in endpoints by PA tertile were tested by analysis of variance and χ2 tests. General linear models were constructed and used to test for independent associations.

Results:
Responses to the IPAQ differed greatly from objective accelerometry. There was a weak trend toward increased CV risk factors and target organ damage in those with the lowest IPAQ scores. When subjects were stratified into tertiles of by accelerometry the less active subjects had significantly worse CV risk profiles as indicated by higher Pathobiological Determinants of Atherosclerosis in Youth (PDAY) scores, and more signs of target organ damage including stiffer arteries as indicated by greater carotid-femoral pulse wave velocities. These differences did not reach statistical significance when adjusted for metabolic variables.

Conclusion:
PA is associated with CV risk factor clustering and target organ damage in young people. Measuring PA in this population is feasible, but has limitations. This study confirms the utility of PA in predicting the presence of target organ damage. Our study is the first to demonstrate a negative, cross-sectional relationship between PA and PDAY score. Future opportunities for research include examining the contribution of different levels of PA on CV aging as well as the effect of increasing PA over time.
Abstract P316: Reproductive Factors Associated With Subclinical Vascular Measures at Late Midlife: SWAN
Authors: Cortes Yamnia I , Catov Janet , Brooks Maria , Isasi Carmen , Jackson Elizabeth A , Harlow Sioban , Matthews Karen , Thurston Rebecca , Barinas-Mitchell Emma
Published: March 2022

Background:
Sex-specific features, including adverse pregnancy outcomes (i.e., gestational hypertension, preeclampsia, gestational diabetes), have been associated with increased risk for CVD. However, there is limited research characterizing these associations with menopause features or with subclinical vascular measures at late midlife, when CVD risk increases.

Objective:
To evaluate associations between reproductive factors (i.e. gestational hypertension, preeclampsia, and gestational diabetes) with validated and reliable markers of subclinical vascular damage and remodeling; carotid intima-media thickness (cIMT), adventitial diameter (cAD), carotid plaque presence, and brachial-ankle pulse wave velocity (baPWV).

Methods:
A cross-sectional analysis was conducted with 1454 women (50% white, 31% black, 6% Hispanic, 13% Chinese) from the Study of Women’s Health Across the Nation (SWAN). Women were included if they completed a detailed reproductive history questionnaire and had a carotid ultrasound at visit 12 or 13. baPWV was performed at the same follow-up visit. Associations between reproductive history and subclinical CVD were tested using linear and logistic regression models adjusting for demographics and traditional CVD risk factors (age, site, race/ethnicity, financial strain, BMI, SBP, LDL-c, HDL-c, HOMA-IR). Additional models were adjusted for sex hormone levels and number of births.

Results:
Women were on average 60 years old and mostly postmenopausal (94%). Two hundred fifty-six women (18%) were nulliparous. Approximately 10% of parous women had a self-reported history of gestational hypertension or preeclampsia, and 4% reported gestational diabetes. Among parous women, gestational hypertension was associated with higher mean cIMT (β±SE=0.053±0.015mm; P=0.0003) and preeclampsia was associated with higher odds of plaque (OR=1.7; 95% CI: 1.1, 2.6; P=0.01) in fully adjusted models. History of gestational diabetes was related to higher baPWV (β±SE=64.6±28.4cm/s; P=0.009). Associations between adverse pregnancy outcomes and subclinical vascular measures remained significant after adjusting for baseline estradiol and number of births. Compared to nulliparous women, parity≥3 was associated with higher cAD (β±SE=0.10±0.05mm; P=0.02) when controlling for demographics, but not after adjustment for CVD risk factors. Age at menarche, age at menopause, hormone ever use, and bilateral oophorectomy were not associated with subclinical vascular measures at late midlife.

Conclusions:
Adverse pregnancy outcomes (i.e., gestational hypertension, preeclampsia, and gestational diabetes) converge to put women at excess risk for CVD, but may affect the vasculature through distinct pathways. Further studies are necessary to assess the joint effects of early and late midlife reproductive factors on future CVD.
Abstract P327: Migraine and Cardiovascular Risk Profile in a Sample of Hong Kong Chinese Women
Authors: Xie Yao Jie , Ho Suzanne C. , Loke Alice Yuen
Published: March 2022

Background:
Migraine has been found to be a risk marker for several cardiovascular diseases (CVDs). Some studies have shown that migraineurs had unfavorable cardiovascular risk profile, which might partially explain the mechanisms that link migraine to CVD. But the results are still controversial. The relevant study in Chinese population was lacking. The aim of this study was to evaluate the cardiovascular risk profile in a sample of Hong Kong Chinese women with and without migraine.

Methods:
Three rounds of mail surveys were conducted among Chinese female nurses aged 35 to 65 years in Hong Kong. In total 1253 nurses were enrolled in analysis. Information on traditional CVD risk factors, including body mass index (BMI), blood pressure (BP), hypercholesterolemia, diabetes mellitus (DM), smoking, alcohol drinking, physical activity, and family history of CVD, together with the physician-diagnosed migraine, was collected by a self-administered questionnaire. The self-reported anthropometric variables and BP have been validated in a pilot study.

Results:
The overall prevalence of physician-diagnosed migraine was 7.9%. Women with migraine had higher systolic and diastolic BP than those without migraine (118.2 mmHg vs. 113.1 mmHg, 73.8 mmHg vs. 70.0 mmHg; both P<0.001). More than half of the migraineurs (57.3%) had the family history of CVD, which was higher than non-migraineurs (33.0%, P<0.001). Compared with non-migraineurs, the migraineurs were more likely to have hypertension (OR: 2.00, 95% CI: 1.14-3.51), high cholesterol (OR: 1.70, 95% CI: 1.02-2.85), and family history of CVD (OR: 2.72, 95% CI: 1.78-4.15). There were no statistically significant differences regarding obesity, smoking, alcohol drinking, physical activity, and DM between migraineurs and non-migraineurs (all P>0.05). In the logistic regression analysis, after adjustment for age and BMI, the odds of having hypertension in migraineurs were 105% greater than in non-migraineurs (OR: 2.05, 95% CI: 1.08-3.91; P<0.05), and strengthened in those with family history of CVD (OR: 2.81, 95% CI: 1.27-6.21; P<0.05); however, the association between migraine and high cholesterol were eliminated (P>0.05).

Conclusion:
We did not find an overall worse cardiovascular risk profile among Chinese women with migraine. While family history of CVD and hypertension were significantly associated with migraine. Further prospective studies with larger sample size are needed in Chinese population.
Abstract P332: Self-perceived Psychological Factors and Their Impact on Ideal Cardiovascular Health by Gender: the Baptist Health South Florida (BHSF) Employee Study
Authors: Mathews Lena , Ogunmoroti Oluseyi , Blumenthal Roger S , Utuama Ovie , Rouseff Maribeth , Das Sankalp , Veledar Emir , Feldman Theodore , Agatston Arthur , Nasir Khurram , Michos Erin D
Published: March 2022

Introduction:
Psychological factors including stress are associated with adverse cardiovascular (CV) disease outcomes. Gender differences exist in both the perception of stress and the magnitude of the stress response. We hypothesize that self-perceived psychological stressors would have a greater impact on women compared to men as measured by the American Heart Association Life’s Simple Seven (LS7) health metrics.

Methods:
This was a cross-sectional study conducted among employees of BHSF. The LS7 metrics (smoking, physical activity, diet, body mass index, blood pressure, cholesterol and glucose) were each scored as ideal (2), intermediate (1), or poor (0), with composite scores ranging from 0 to 14. Total scores were categorized as optimal (11-14), average (9-10) and inadequate (0-8). We used multinomial logistic regression to compare psychological factors obtained by questionnaire (self-perceived stress, life satisfaction, hopelessness, sadness, depression, anxiety) with the LS7 score (inadequate score served as reference). The model was stratified by gender and adjusted for age, ethnicity, and education level.

Results:
Of the 9,056 participants, 74% were female, 17% white, 57% Hispanic, 16% black, with a mean age of 43±12 years. Self-perceived adverse psychological factors were associated with being less likely to achieve adequate and optimal LS7 scores (Table). For example both women and men, respectively, with self-perceived stress were less likely to have optimal LS7 metrics [OR 0.47 (95% CI 0.40-0.56) vs. 0.50 (0.36-0.69)]. There were some interactions by gender (P <0.05), but the results were qualitatively similar in both men and women.

Conclusions:
In an ethnically diverse population, participants with negative self-perceived psychological factors are more likely to have inadequate CV health as measured by LS7. Contrary to our hypothesis, in general, men and women were similarly affected by adverse psychological factors. Addressing psychological stressors may be one mechanism to improve CV health.
Abstract P340: Structural Social Support and Cardiovascular Disease Risk Factors in Hispanic/Latino Adults With Diabetes: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Hernandez Rosalba , Carnethon Mercedes , Giachello Aida L , Penedo Frank J , Wu Donghong , Birnbaum-Weitzman Orit , Espinoza Giacinto Rebeca , Gallo Linda C , Isasi Carmen R , Schneiderman Neil , Teng Yanping , Zeng Donglin , Daviglus Martha L
Published: March 2022

Introduction:
There is mounting evidence linking social support to restorative health processes and favorable cardiovascular risk profiles. However, observational studies have yielded inconsistent findings on the associations of social support networks with cardiovascular health in Hispanic/Latino adults with diabetes. We examined the cross-sectional associations of structural social support and traditional cardiovascular disease (
CVD
) risk factors in a diverse sample of Hispanic/Latino adults with diabetes.

Hypothesis:
Persons with lower indices of social support will have higher odds of adverse CVD risk factors.

Methods:
This analysis included 2,994 adult participants ages 18-74 with diabetes from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL—2008-2011). Select items from the Social Network Inventory were used to assess indices of structural social support, i.e., network size (number of children, parents, and in-laws) and frequency of familial contact. Standardized methods were used to measure diabetes and other CVD risk factors -- abdominal obesity, body mass index, hypertension, hypercholesterolemia, and smoking status. Multivariate regression was used to examine associations of structural support with individual CVD risk factors with demographics, acculturation, physical health, and psychological distress included as covariates.

Results:
There were no significant cross-sectional associations of structural support indices with abdominal obesity, hypertension, hypercholesterolemia, or smoking status. There was a marginally significant (OR: 1.05; 95% CI 1.00-1.12) trend toward higher odds of obesity in participants reporting a larger family unit (including children, parents, and in-laws) (
Table 1
).

Conclusions:
Structural social support was marginally associated with higher odds of obesity in Hispanic/Latino adults with diabetes. Alternate forms of social support should be further explored as potential markers of cardiac risk in Hispanics/Latinos with diabetes.
Abstract P346: Genome-wide Association Study of Chronic Kidney Disease
Authors: Li Changwei , Kelly Tanika N , Zhang Dingding , Shen Luqi , Chen Jing , He Jiang
Published: March 2022

Objectives:
The current study aimed to identify genetic variants influencing chronic kidney disease (CKD) by conducting genome-wide association study (GWAS) among participants from the Atherosclerosis Risk in Communities Study (ARIC) and the Chronic Renal Insufficiency Cohort (CRIC).

Methods:
We conducted a case-control GWAS of CKD, combining data from the ARIC and CRIC studies to generate our discovery stage sample. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m
2
at baseline or during follow-up in each cohort. Logistic regression models were used to test genome-wide SNP effects on CKD, adjusting for age, gender, hypertension, diabetes, and the first 10 principal components, among 3,855 Blacks (1,541 CKD cases) and 10,096 Whites (2,194 CKD cases), separately. SNPs with discovery stage
P
<1.00х10
-5
were evaluated for replication among participants of the Women’s Health Initiative (WHI). We also performed conditional analyses, including the lead SNP in a model with all other significant SNPs in the region, separately, to identify any additional independent variants at each locus.

Results:
We identified 7 and 5 novel loci for Blacks and Whites, respectively. Intergenic variants rs9396438 (ARIC&CRIC
P
=3.38х10
-9
, WHI
P
=4.32х10
-2
, and meta
P
=9.09х10
-9
), rs56687683 (ARIC&CRIC
P
=8.64х10
-11
, WHI
P
=3.58х10
-2
, and meta
P
=7.97х10
-10
), and rs6071452 (ARIC&CRIC
P
=3.02х10
-11
, WHI
P
=4.50х10
-2
, and meta
P
=2.10х10
-10
),
SNX9
variant rs10945790 (ARIC&CRIC
P
=3.67х10
-10
, WHI
P
=2.05х10
-2
, and meta
P
=2.00х10
-10
), and
NXN
variant rs10153287 (ARIC&CRIC
P
=2.32х10
-7
, WHI
P
=1.61х10
-2
, and meta
P
=1.75х10
-8
) were robustly associated with CKD among Blacks. Intergenic variants rs509616 (ARIC&CRIC
P
=2.86х10
-19
, WHI
P
=3.44х10
-2
, and meta
P
=5.97х10
-19
), rs35849486 (ARIC&CRIC
P
=6.66х10
-7
, WHI
P
=1.79х10
-2
, and meta
P
=3.95х10
-8
), rs12508057 (ARIC&CRIC
P
=2.57х10
-9
, WHI
P
=2.45х10
-2
, and meta
P
=2.48х10
-10
), and rs2180911 (ARIC&CRIC
P
=3.75х10
-7
, WHI
P
=1.53х10
-2
, and meta
P
=2.11х10
-8
),
MEGF6
variant rs34852522 (ARIC&CRIC
P
=6.01х10
-7
, WHI
P
=2.30х10
-2
, and meta
P
=4.20х10
-8
),
CAPN8
variant rs34485635 (ARIC&CRIC
P
=9.58х10
-10
, WHI
P
=2.27х10
-2
, and meta
P
=1.01х10
-10
), and
PTPRS
variant rs80125132 (ARIC&CRIC
P
=4.38х10
-7
, WHI
P
=1.74х10
-2
, and meta
P
=3.05х10
-8
) were identified for Whites. Furthermore, conditional analyses at the above loci additionally identified
CAPN8
missense variant rs4072247 (
P
=6.30х10
-8
) at the rs34485635 locus and
NKX3-2
UTR 3-primer variant rs3822226 (
P
=4.08х10
-14
) at the rs12508057 locus for CKD among Whites. Finally, we replicated 9 and 39 loci reported in previous CKD GWAS among Whites and Blacks, respectively.

Conclusion:
We robustly identified 12 novel loci in our large-scale case-control GWAS of CKD. In addition, conditional analyses identified additional functional signals at 2 novel loci among Whites.
Abstract P355: Sleep Duration is Associated With the Metabolic Syndrome Independent of Depression Symptoms The Polish Norwegian Study
Authors: Vaidean Georgeta , Manczuk Marta
Published: March 2022

Introduction:
Short- and long sleep durations have emerged as potential cardiovascular risk factors. Yet, the relation with metabolic syndrome (MetSyn) remains uncertain due to potential residual confounding by depression and comorbidities.

Purpose:
To test whether compared to adequate-sleepers, short and/or long- sleepers have higher prevalence of MetSyn, independent of current depression or past psychiatric illnesses.

Methods:
Cross-sectional data of 12754 participants, age 45 to 64 years, in an ongoing cohort study, with structured questionnaires and fasting blood samples. We categorized self-reported sleep duration as short (le 5 h), adequate (6-8 h) or long (ge9 h). Metabolic syndrome was defined based on AHA/NHLBI’s criteria. Depression symptoms were ascertained with a culturally-adapted, 7-item Patient Health Questionnaire. We estimated multivariable-adjusted prevalence ratios using Poisson regression models with robust standard error estimates.

Results:
Compared to adequate sleepers, both short- and long -sleepers were less likely to be men, to drink alcohol, and be current smokers but more likely to have history of cardiovascular diseases and hypertension. Among short-, adequate and long-sleepers the prevalence of self-reported past psychiatric diseases was 2.28%, 1.59% and 8.50% respectively (p =0.0001) and the prevalence of current antidepressant use was 5.09%, 2.52% and 10.26% respectively (p=<0.0001). Similarly, the prevalence of 5 or more depressive symptoms was 39.36%, 22.09% and 26.98% respectively (p =0.0001). The prevalence of MetSyn among short-, adequate and long-sleepers was 45.38%, 38.12% and 49.56% respectively (p =0.0001). Compared to adequate sleepers, the prevalence of MetSyn remained higher among short-sleepers (PR 1.10, 95% CI 1.01-1.19) and among long-sleepers (PR 1.15, 95%CI 1.02-1.30), after adjusting for age, sex, smoking, alcohol, coffee intake, physical activity, education, non-cardiovascular chronic diseases, past psychiatric diseases, current depression symptoms and current antidepressant drugs use. Difficulties with sleep initiation were not associated with MetSyn. In a subgroup analysis restricted to those with BMI 25-29.9 kg/m
2
, compared to adequate sleepers, the prevalence of MetSyn remained higher among short-sleepers (PR 1.16, 95% CI 1.02-1.32) and among long-sleepers (PR 1.29, 95%CI 1.04-1.60) after multivariable adjustment.

Conclusion:
Both short and long sleep duration are associated with the presence of MetSyn, independent of past psychiatric conditions or current depression symptoms or treatment.
Abstract P365: Effects of a Health Partner Intervention on Arterial Health
Authors: Mohamed Kelli Heval , Heinl Robert , Hajjari Jamal , Noreen Samantha , Ko Yi-An , Hammadah Muhammad , Samman-Tahhan Ayman , Sandesara Pratik , Alghamdi Talal , Chivukula Kaavya , Corrigan Frank , Al Mheid Ibhar , Ziegler Thomas , Gibson Greg , Lampl Michelle , Brigham Kenneth , Vaccarino Viola , Martin Greg , Quyyumi Arshed A
Published: March 2022

Introduction:
Lifestyle modification is effective for cardiovascular disease prevention. Whether lifestyle intervention also preserves vascular health is less clear. Our study examined the role of a Health Partner-administered lifestyle intervention on vascular function.

Hypothesis:
Lifestyle intervention improves and preserves vascular function.

Methods:
A total of 711 university employees (48±11 years, 66% women, 22.5% Black) enrolled in a program that promoted healthier lifestyles at Emory University. Participants collaborated with a Health Partner to generate a personalized plan focused on achieving ideal health metrics. Anthropometric, laboratory and vascular function measurements were performed at baseline and at 1-year and 2-years of follow-up. Arterial stiffness was assessed by carotid-femoral pulse wave velocity and radial tonometry-derived central augmentation index. Microvascular function was assessed as digital reactive hyperemia index. Flow-mediated dilation was measured using ultrasound. The sample was divided into individuals within the lowest tertile and those in the upper two tertiles for vascular function at baseline. Paired t-test was used to assess the changes in vascular functions at 1 and 2 years of follow-up compared to baseline.

Results:
At each of the 1-year and 2-year follow-up visits, vascular function improved in the group within the abnormal tertile at baseline. Flow-mediated dilation increased by 1.6% and 2.0% (P<0.001) respectively, pulse wave velocity decreased by 0.85 m/s and 0.93 m/s (P<0.001), central augmentation index was lower by 3.4 and 3.2 (P<0.001), and microvascular function assessed by reactive hyperemia index improved by 0.48 and 0.52 (P<0.001). In those within the upper two tertiles, pulse wave velocity did not significantly change, but flow-mediated dilation and reactive hyperemia index showed significant decline at 2 years of follow up.

Conclusion:
A personalized, goal directed Health Partner intervention was associated with better vascular stiffness, endothelial and microvascular function in those with baseline abnormal values. These effects were evident at 1 year following enrollment and were sustained for 2 years. Whether the impact of Health Partner intervention on vascular function improves long-term morbidity and mortality needs further investigation in a controlled design.