bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract MP12: Association Of Peripheral Neuropathy With Injurious Falls And Fractures In The Atherosclerosis Risk In Communities Study
Authors: Hicks Caitlin W , Wang Dan , Daya Natalie R , Windham B Gwen , Juraschek Stephen P , Matsushita Kuni , Selvin Elizabeth
Published: April 2022

Background:
Peripheral neuropathy (decreased sensation in the foot) as assessed by monofilament testing is associated with all-cause and cardiovascular mortality. We aimed to assess the association of peripheral neuropathy with incident injurious falls and fractures in older adults.

Methods:
All black and white participants in the Atherosclerosis Risk in Communities Study (ARIC) who underwent monofilament testing at visit 6 (2016-2017) were included. Incident injurious falls and fractures were identified based on ICD-9 and -10 codes from active surveillance of all hospitalizations and linkage to Medicare claims. We used Kaplan Meier curves and Cox regression to assess the association of peripheral neuropathy with injurious falls and fractures (combined and as separate outcomes) after adjusting for demographics, diabetes status, and risk factors for falls.

Results:
There were 3,597 ARIC participants (mean age 79.4, SD 4.7 years), of which 1,236 (34.4%) had peripheral neuropathy based on monofilament testing. During a median follow-up of 2.5 years, 371 participants had a documented fall and 475 participants had a documented fracture. The incidence rate (per 1,000 person-years) for incident injurious falls/fracture, falls, and fractures was higher for participants with peripheral neuropathy compared to those without (
Table
). After adjustment, peripheral neuropathy was consistently and independently associated with all outcomes. Further adjustment for cognitive status, medication use, prior fall or fractures, and analyses accounting for the competing risk of death did not substantially change our results.

Conclusions:
Peripheral neuropathy as measured by monofilament testing is associated with incident injurious falls and fracture in older adults. Screening with monofilament testing is inexpensive and simple and may be warranted to identify older adults at high risk for falls.
Abstract MP31: Telehealth Versus Self-directed Lifestyle Intervention To Promote Healthy Blood Pressure: A Randomized Controlled Trial
Authors: Chang Alex R , Yule Christina , Bonaparte Heather , Collins Charlotte , Naylor Allison , Appel Lawrence J , Juraschek Stephen P , Bailey-Davis Lisa
Published: April 2022

Introduction:
Telehealth and web-based applications are increasingly available to promote healthy lifestyle behavior change. However, evidence that these approaches lower blood pressure is limited.

Methods:
We conducted a randomized controlled trial to compare the efficacy of a self-directed vs. a telehealth-delivered dietitian approach using web-based applications in 187 participants (mean age 54.6 y, 52% female) with 24-hour systolic blood pressure (BP) 120-160 mmHg. Participants were recruited in the Geisinger Health System from 1/2019 to 3/2021. Both study arms received personalized recommendations to improve dietary quality based on web-based food frequency questionnaire, and access to an online comprehensive weight management program. The telehealth arm additionally received weekly telephone calls with a dietitian who used motivational interviewing. The primary outcome was 3-month change in 24-hour systolic BP. Secondary outcomes included changes in awake and sleep BP, self-reported physical activity, healthy eating index (HEI)-2015 score, and weight.

Results:
Twenty-four hour systolic BP improved in both the telehealth-dietitian arm (-6.5 mmHg, 95% CI: -8.4, -4.6) and the self-directed arm (-4.9, 95% CI: -7.0, -2.8), with no difference between arms (p=0.3). Participants in the telehealth-dietitian arm had significantly greater decreases in sleep systolic BP (mean -6.9 mmHg vs. -1.5; p=0.004) and diastolic BP (-3.3 mmHg vs. 0.7; p=0.001). The telehealth-dietitian arm tended to have greater improvements in self-reported physical activity, weight loss, and HEI-2015 score (Figure). Participant satisfaction with the intervention was higher in the telehealth-dietitian arm (p=0.004).

Conclusions:
Among individuals with elevated BP, the telehealth-dietitian intervention did not lower 24-hour systolic BP compared to the self-directed arm over 3 months. However, there were encouraging changes in other outcomes, including reduced sleep systolic and diastolic BP and increased physical activity.
Abstract MP35: Circulating MicroRNA-21 And Cardiovascular Risk Reduction In Response To Weight-loss Diets: The Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) Trial
Authors: Xue Qiaochu , Heianza Yoriko , Li Xiang , Deng Hong-Wen , Rood Jennifer , Bray George , Sacks Frank , Qi Lu
Published: April 2022

Introduction:
MicroRNA-21 (MiR-21) is one of the most highly expressed microRNAs in the cardiovascular system and plays a pivotal role in the pathogenesis of cardiovascular diseases (CVD).

Hypothesis:
We assessed the hypothesis that circulating miR-21 is associated with the change in overall CVD risk and individual cardiovascular risk factors in response to weight-loss diet interventions.

Methods:
Circulating miR-21 was measured at baseline and 6 months in 511 participants with overweight or obesity from the 2-year weight-loss diet intervention study, the POUNDS LOST trial. MiR-21-5p is a mature sequence derived from the 5' end of the miR-21 stem-loop precursor and another mature sequence, miR-21-3p, is derived from the 3' end of miR-21. The primary outcome was the change in the global Framingham Risk Score (FRS), which estimates the 10-year probability of a CVD event. Secondary outcomes were the change in the FRS components including systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, insulin, homeostatic model assessment of insulin resistance, gut microbiota metabolites, and adiposity measures.

Results:
Circulating miR-21-3p levels were positively associated with fasting insulin (
P
=0.011), insulin resistance (
P
=0.008), and triglycerides (
P
=0.003) at baseline. We found that lower pre-intervention expression levels of miR-21-3p and miR-21-5p were related to a greater reduction in FRS (β[SE]=11.020 [5.025],
P
=0.029 and β[SE]=0.023 [0.008],
P
=0.005, respectively) over 6 months. The trajectory of the FRS across the 2-year intervention period differed between the patterns of pre-intervention miR-21 (
P
time*miR-21-3p
=0.002 and
P
time*miR-21-5p
=0.033). Compared to those with a higher level of miR-21, participants with a lower level of miR-21 had a greater decrease in FRS from baseline to 6 months and then increased substantially from 6 months to 2 years. We also found significant interactions between baseline miR-21-5p and dietary fat on change in FRS (
P
fat diets* miR-21-5p
=0.04). Participants with a lower level of baseline miR-21-5p on the low-fat diet group showed a greater reduction of FRS than those on the high-fat diet at 6 months. In addition, a greater decrease in miR-21-3p rather than miR-21-5p was significantly associated with a greater reduction in body weight (P<0.0001), waist circumference (
P
=0.002), and improvement in trimethylamine N-oxide (
P
=0.011) at 6 months. These associations were attenuated at 2 years of the intervention.

Conclusions:
In conclusion, decreased circulating miR-21 levels were related to a significant reduction in overall CVD risk and improvement in individual cardiovascular risk factors in response to dietary weight-loss interventions.
Abstract MP45: Metabolomic Profiling Provides Novel Insights Into The Biochemical Mechanism Of Mental Stress-induced Ischemia
Authors: Almuwaqqat Zakaria , Liu Chang , Moazzami Kasra , Shah Amit J , Sun Yan , Bremner J Douglas , Jones Dean , Vaccarino Viola , Quyyumi Arshed A
Published: April 2022

Introduction:
Mental stress-induced myocardial ischemia (MSI) is a marker of future cardiovascular events. The underlying biochemical mechanisms of this cardiovascular condition are poorly understood. Our objective was to use metabolic profiling to identify biochemical changes associated with mental stress (MS) in patients with stable coronary artery disease (CAD) and investigate differential pathways that are involved in MSI.

Methods:
A total of 110 Individuals with stable CAD who participated in the Mental Stress Ischemia Prognosis Study (MIPS) underwent a standardized mental stress to provoke of myocardial ischemia, detected with single-photon emission tomography. Plasma samples were obtained before and after MS at 45 and 90 minutes and metabolomic profiling was performed using liquid chromatography/mass spectrometry using a confirmed 500 compounds. Metabolomic features and pathways associated with ischemia using metabolome-wide association studies and Mummichog, respectively.

Results:
The sample involved a subset case-control for (MSI+ vs MSI-). At 45 minutes and 90 minutes, there were significant stress-induced changes in several compounds. There was a significant upregulation of metabolites associated with lipid signaling et (
p
= 0.025,
Inosine diphosphate).
A comparison between the MSI+ and MS- groups showed differential upregulation of DNA methylation metabolites (
p
= .036,
5-Methylcytosine hydrochloride) at 45 minutes and
microbiome-related metabolites at 90 minutes (P=0.041, N, N-dimethyl-1,4-phenylenediamine). Pathway analyses were consistent with the aforementioned findings.

Conclusion:
Upregulation of metabolic pathways involved in DNA methylation and microbial metabolism is differentially associated with MSI. These findings provide novel mechanistic insights into the association between acute mental stress and myocardial ischemia as a marker for cardiovascular vulnerability in patients with CAD
Abstract MP46: Adverse Childhood Experiences Are Linked To Disrupted Sleep And Diurnal Cortisol Concentrations In Young Adult Women.
Authors: Jenkins Nathaniel D , Rogers Emily , Banks Nile , Tomko Patrick , Sciarrillo Christina , Emerson Sam , Taylor Ashlee , Teague Kent
Published: April 2022

Introduction:
Early life psychosocial stress and adversity - referred to as adverse childhood experiences (ACEs) - are highly prevalent, with ~60% of American adults reporting exposure to at least one ACE. ACEs occur during critical developmental periods and are related to cardiovascular morbidity and mortality in a graded, dose-dependent manner. Sleep is an emerging lifestyle behavior that has been associated with cardiometabolic morbidity and mortality, and poor sleep has been associated with ACEs.

Hypothesis:
We hypothesized that ACEs would be associated with disrupted sleep and altered diurnal cortisol slopes in young adult women.

Methods:
Forty-two young adult women (mean ± SD, age = 21 ± 3 y) completed this study. Twenty-eight women reported an ACE score ≥4 and were classified as having moderate to severe ACEs, while 14 women reported an ACE score of 0. Women provided saliva samples collected using the passive drool technique upon waking and 8 h later. Cortisol concentrations were then quantified from the saliva samples by ELISA and diurnal cortisol slopes (DCS) were calculated by expressing the difference between morning and afternoon concentrations relative to the time between sampling (μg/dL/h). The participants also completed the Center for Epidemiologic Studies Depression Scale Revised (CESD-R), from which a composite sleep score (CSS; range = 0 - 12) was created from the three sleep-related items and reverse-scored such that a higher score indicated better sleep. Women also completed the Maltreatment and Abuse Chronology of Exposure Scale, from which a total maltreatment and abuse severity score was calculated (MACE
TSS
). Mann-Whitney tests were used to examine differences in DCS and CSS between those with versus without a history of ACEs. Median values are reported. Spearman correlations were used to examine associations among DCS, CSS, and MACE
TSS
.

Results:
DCS was greater (-0.0396 vs. -0.0661 μg/dl/h;
U
= 94,
p
= 0.01), indicating lower variability, and CSS was lower (5 vs. 7;
U
= 118.5,
p
= 0.04), indicating poorer sleep, in the women with versus without a history of ACEs. Further, MACE
TSS
was related to DCS (ρ = 0.397,
p
= 0.007) and to CSS (ρ = -0.358,
p
= 0.011). The relationship between DCS and CSS (ρ = -0.218,
p
= 0.092) was not significant.

Conclusions:
Our preliminary evidence indicates that ACEs are associated with poorer sleep and disrupted diurnal cortisol patterns. While we are limited by subjective sleep assessments and small sample size, these findings suggest a link between early life psychosocial stress, poor sleep and circadian disruption that could contribute to lifetime cardiometabolic disease risk. Future, large-scale studies are needed to further explore these associations.
Abstract MP57: Objectively-Assessed Sleep Duration And Incident Heart Failure: The Atherosclerosis Risk In Communities Study-Sleep Heart Health Study
Authors: Polanka Brittanny M , Honda Yasuyuki , Mathews Lena , Shah Amil M , Ndumele Chiadi E , Chang Patricia , Punjabi Naresh M , Lutsey Pamela L , Matsushita Kuni
Published: April 2022

Introduction:
Evidence is mixed on short sleep duration and heart failure (HF) risk. Notably, no studies have investigated objectively-assessed sleep duration or controlled for comorbid sleep apnea in this context.

Objective:
To examine the independent associations of objective short sleep duration with incident HF, accounting for sleep apnea.

Methods:
We studied ARIC-SHHS study participants free of HF at visit 4 (1996-98). Sleep duration was measured by at-home polysomnography (PSG) and defined as: 7 to <9 hours (reference), 6 to <7 hours, 5 to <6 hours, and <5 hours. The apnea-hypopnea index (AHI; defined as: <5, 5 to <15, 15 to <30, and ≥30), a measure of sleep apnea, was also measured by at-home PSG. Cox proportional hazards models, with progressive adjustment for comorbidities and AHI, were used to evaluate the association of sleep duration with incident HF (hospitalizations or deaths with HF diagnosis).

Results:
We included 1,056 participants (mean age 62 years, 50% female, 99% White). During a median follow-up of 22 years, there were 211 HF events. Participants with sleep duration <5 hours had a higher risk of incident HF in unadjusted and age-sex-adjusted models, with corresponding hazard ratios of 2.44 (95%
CI
: 1.40-4.26) and 1.88 (95%
CI
: 1.07-3.29) (
Table
). However, further adjustment for clinical factors attenuated the results. The associations for sleep duration appeared more evident when we restricted our analysis to participants without prevalent cardiovascular disease (
Table
). The AHI was not a significant predictor of incident HF in the presence of sleep duration.

Conclusions:
Objectively-assessed short sleep duration <5 hours was modestly associated with HF risk. Our study suggests the need and value of larger studies exploring objectively-assessed sleep duration in terms of HF risk. Importantly, sleep duration may be objectively measured without PSG, using wearable devices.
Abstract MP67: Pre-pregnancy Cardiovascular Health And Stress Related To Severe Maternal Morbidity In Black And White Women
Authors: Catov Janet M , Sun Baiyang , Gunderson Erica P , Bryan Samantha , Bertolet Marnie , Lewis Cora E , Lane-cordova Abbi , Khan Sadiya , Beck Stacy
Published: April 2022

Introduction:
Severe maternal morbidity (SMM), unexpected complications of pregnancy with substantial consequences, are high in the U.S., contribute to maternal mortality, and racial disparities persist. Cardiovascular and psychosocial factors contribute to SMM, but pre-pregnancy risks are rarely studied.

Hypothesis:
Poor cardiovascular health (CVH) and adverse psychosocial stress before pregnancy contribute to SMM and racial disparities.

Methods:
Among 1,392 women in CARDIA (51% Black) with 2,372 post-enrollment births we characterized SMM using established criteria via delivery records (n=660 births) and self-reported hospitalizations <6-weeks postpartum (hemorrhage, sepsis, cardiomyopathy, hysterectomy) and up to 1 year post-delivery (depression, domestic violence, overdose, cardiovascular). CVH before pregnancy was quantified (BP, BMI, smoking, glucose, cholesterol, diet, activity; lower score adverse) and stress was assessed at baseline as stressful life events (higher score adverse). Self-reported adverse pregnancy outcomes (APOs) were hypertensive disorders of pregnancy, preterm birth and gestational diabetes. Generalized linear mixed models related CVH and stress to risk of SMM birth, adjusted for race, age, education, parity, APOs; non-SMM births were the referent and models were stratified by race.

Results:
We identified 45 SMM births (1.9%; 1.7% Black, 1.9% White); 39% at delivery and 61% post-delivery. CVH was lower and stress was higher before SMM births (9.4 [2.3] vs. 10.4 [1.9] and 8.5 [4.7] vs. 7.0 [4.1], respectively, p<0.01). Black but not White women with SMM were more likely to have poor pre-pregnancy CVH (p<0.01; Figure). Higher stress was related to SMM in Black and White women (adjusted OR per SD 1.22 [95% CI 0.92, 1.61]. Better CVH was associated with lower SMM risk in Black but not White women (0.61 [0.48, 0.78] vs. 0.93 [0.72, 1.20]).

Conclusion:
Poor pre-pregnancy CVH is associated with risk of SMM in Black women, and stress may be associated with SMM risk regardless of race.
Abstract P002: A Pilot Study To Evaluate The Development And Implementation Of A Virtual Nutrition Education Program In Older Veterans
Authors: Parker Elizabeth A , Cassatt Sarah , Giffuni Jamie , Ortmeyer Heidi , KATZEL LESLIE , Addison Odessa
Published: April 2022

Despite evidence to support cardiovascular disease prevention and disability management, <50% of older adults consume healthy diets. The aim of this project was to determine the feasibility of developing and implementing a 14-week virtual group nutrition education intervention paired with produce delivery in older Veterans with mobility challenges and significant medical multimorbidity participating in an exercise and health promotion program (Gerofit). The nutrition education included content relevant to healthy aging, guided by the social cognitive theory framework (SCT) and included focus on self-regulation skills that includes goal setting, overcoming barriers and identifying triggers that cause less optimal dietary choices. To encourage participation in the virtual group setting, sessions included an interactive activity and discussion questions. Each week participants also received a bag of local produce with recipe suggestions. Sixteen participants were enrolled in the program; twelve participants elected to attend the once-weekly nutrition program. On average participants attended 9.3 sessions and expressed a high level of satisfaction with the program. One participant commented, “I really enjoyed participating in the nutrition class…and look forward to being included in future on-line events…The fresh produce boxes added greatly to the class in that there was an opportunity to revisit familiar items and to introduce new produce into my diet.” Despite the generally positive feedback from participants regarding the virtual nutrition education classes, a few expressed concerns about the fresh produce given their limited knowledge of food preparation, basic cooking skills, and/or inability to prepare these foods due to physical or environmental limitations (amputated limbs; inadequate kitchen resources in assisted living facility). These physical/environmental barriers prohibited them from being able to prepare and consume the produce, which may have negated benefits of providing produce to these individuals. However, follow up dietary data collection is ongoing. Future studies are needed to evaluate barriers related to food preparation and how incorporating physical/environmental adaptations into nutrition education programs may be a strategy to improve dietary intake among older adults with mobility challenges and medical multimorbidity.
Abstract P007: Liver Biomarkers And Brain Health: The Atherosclerosis Risk In Communities (aric) Study
Authors: Lu Yifei , Lu Yifei , Pike James R , Hughes Timothy M , Hoogeveen Ron C , Heiss Gerardo M , Palta Priya
Published: April 2022

Introduction:
Animal studies and emerging population data link liver function and integrity to brain health, although mostly based on cross-sectional estimates. We reported that low liver transaminases are associated with risk of dementia, but prospective studies on liver biomarkers and altered brain morphology are lacking.

Methods:
We studied 1,596 participants of the Atherosclerosis Risk in Communities (ARIC) Study cohort examined in 1996-98 (mean age: 62 years, 59% female, 27% Black) free of chronic liver disease, cirrhosis, and stroke, and with alanine aminotransferase (ALT) to aspartate aminotransferase (AST) ratio ≤2. Brain magnetic resonance imaging (MRI) scans were performed in 2011-13, at the time of re-examination. Serum transaminases (ALT, AST) and gamma-glutamyl transferase (GGT) at baseline were analyzed as sex-specific quintiles, with the first quintile further subdivided into a <10
th
and 10
th
-20
th
percentiles to allow for nonlinear associations at low biomarker levels. Brain MRI markers were measured with 3 Tesla MRI. Multinomial logistic and linear regressions were used, adjusted for demographics and APOE-ε4.

Results:
Monotonic associations were observed between higher GGT levels and smaller cortical volume and temporal lobe volume meta regions of interest
(Figure)
. The lowest GGT levels were associated with smaller volumes of white matter hyperintensities. In contrast, associations of transaminases with brain morphological measures were inconclusive.

Conclusions:
GGT levels measured in late mid-life are associated vascular sequelae on brain MRI among older adults. As a potent regulator of antioxidant capacity and a predictor of atherosclerosis, GGT may point to vascular pathways that influence brain health. The lack of association between low transaminases and brain MRI findings suggests non-vascular pathways for their association with incident dementia. A deeper understanding of the links between hepatic metabolic dysregulation and brain health is warranted.
Abstract P030: Traditional Cardiovascular Risk Factors Are Associated With Being Hypertensive At Rheumatoid Arthritis Diagnosis: Results From The Canadian Early Arthritis Cohort
Authors: Hadwen Brook , Stranges Saverio , Klar Neil , Bykerk Vivian , Bartlett Susan , Bessette Louis , Boire Gilles , Hazlewood Glen , Hitchon Carol , Keystone Edward , Kuriya Bindee , Pope Janet , Thorne Carter , Tin Diane , Valois Marie-France , Schieir Orit , Barra Lillian ,   on behalf of CATCH Investigators
Published: April 2022

Introduction:
Rheumatoid arthritis (RA) is an autoimmune disease causing chronic inflammation of the joints. RA patients have increased risk of hypertension (HTN). The aim of this study was to determine prevalence of HTN at RA diagnosis as well as demographic, behavioral, and clinical characteristics associated with HTN.

Hypothesis:
We assessed the hypothesis that a large proportion of RA patients are hypertensive at RA diagnosis and that worse disease activity is associated with HTN.

Methods:
Data from the Canadian Early Arthritis Cohort was used. This is an inception cohort of RA patients across Canada. Data on HTN was collected according to patient/physician-report or use of anti-hypertensive drugs. Prevalence of HTN was calculated. A multivariate logistic regression model was built using likelihood ratio test for the total sample and while stratifying by sex, including variables on age, race, BMI, education, smoking, alcohol, disease activity and comorbidities.

Results:
The sample included 2052 RA patients. Mean(±SD) for age was 55(14) years and RA symptom duration 5.6(2.9) months, 71% (1438 of 2028) were female and 85% (1709 of 2010) were Caucasian. HTN was reported in 26% (537 of 2052) of subjects, 23% (327 of 1438) of females and 35% (205 of 590) of men. All results of logistic regression are in table 1. In multivariable analysis for the total sample, older age, overweight and obese BMI, diabetes and hyperlipidemia were associated with HTN. For females, excess alcohol consumption was also associated with HTN. In males, only older age, diabetes and hyperlipidemia were associated with HTN.

Conclusions:
One in four RA patients were hypertensive at RA diagnosis. Traditional risk factors that have been found in the general population were also associated with HTN in RA patients at diagnosis. Whether other characteristics are associated with HTN later in the RA disease course will be explored in further analysis.
Abstract P067: Elite Female Athlete’S Heart Of Asians: The Chief Heart Study
Authors: Lin Gen-min , Liu Pang-yen , Ac Lima Joao A , LAVIE Carl J
Published: April 2022

Background:
Women have been reported with smaller cardiac size and blood volume in response to intensive physical training compared to men. However, adaptive cardiac characteristics to exercises have been rarely compared between elite and non-elite female athletes particularly among Asian athletes.

Methods:
This study included 177 women, aged 18-34 years, under a standard 6-month military training course in Taiwan. In 2020, all attended a 3000-meter run to assess endurance capacity, and 89 were randomly selected to complete a 2-minute push-up test to assess muscular strength. Elite athletes were those whose performance fell one standard deviation above the mean (16%) of each exercise modality. Cardiac characteristics evaluated by a 12-lead electro-cardiography (ECG) and transthoracic echocardiography were compared between elite and non-elite female athletes. Multiple logistic regression analysis was used to determine the predictors of elite female athletes’s cardiac adaptation to endurance versus strength exercise.

Results:
Compared to non-elite controls, elite female endurance athletes had greater QRS duration (92.12±10.35 ms vs. 87.26±9.89 ms, p =0.01) and higher prevalence of right axis deviation (34.9% vs. 11.1%, p <0.001). There were no differences in any echocardiographic variables, i.e. left ventricular mass index and diastolic function. Greater QRS duration, right axis deviation and lower systolic blood pressure levels were independent predictors of elite endurance athletes [odds ratios (OR) and 95% confidence intervals: 1.05 (1.01-1.09), 2.91 (1.12-7.59) and 0.93 (0.88-0.98), respectively]. In contrast, elite female strength athletes had greater right ventricular outflow tract (RVOT) (28.06±3.57 mm vs. 25.38± 3.61 mm, p =0.007), while demonstrated no differences in ECG variables. Greater RVOT was the only predictor of elite strength athletes [OR: 1.26 (1.05-1.50)].

Conclusions:
In physically active Asian women, QRS prolongation and right axis deviation in ECG rather than the heart structure and functional changes characterize the elite endurance athletes. However, the right ventricular outflow enlargement documented in elite strength athletes requires further investigations.
Abstract P068: 24-hour Activity Behaviors Are Associated With Covid-19 Prevalence
Authors: Pagan Lassalle Patricia , Bates Lauren C , Halpin Peter F , Kerr Zachary Y , Hanson Erik D , Meyer Michelle L , Stoner Lee
Published: April 2022

Background:
Beneficial 24-hour activity behaviors (i.e., limiting sedentary behavior, physical activity, sleep) are critical for chronic disease prevention, but were altered by the COVID-19 pandemic. Less time in beneficial 24-hour activity behaviors may place individuals at greater risk for contracting COVID-19. Further, some populations may be more impacted than others, with demographic and environmental (rural/urban/suburban) factors influencing access to healthcare and COVID-19 information.

Methods:
In December 2020, we recruited an online convenience sample of 746 adults aged 18 years or older residing in the US. Of the sample, 400 (39±14 years old, 52% female, 15% Hispanic, 78% White, and 28% had or survived cancer) had complete data for our variables of interest. Participants self-reported demographic information, COVID-19 diagnosis (yes/no), total weekday and weekend sedentary behavior (hours/day), moderate to vigorous physical activity (mins per week), sleep (hours/day), and environment (rural/urban/suburban). a) A k-fold cross-validation, machine learning variable selection (glmnet) approach was used to identify which variables were most strongly associated with COVID-19 prevalence, as determined by specifying the tuning parameter, λ, at its minimum value. This approach minimizes the elastic net penalty and optimizes the model fit. b) Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for the strongly associated variables.

Results:
a) The variables most associated with COVID-19 prevalence were total sedentary behavior during weekdays, sleep, biological sex, race, and environment (λ=0.012). b) Holding all other parameters constant, the odds of having COVID-19 were lower for every additional hour of sleep (OR=0.87, 95%CI=0.79, 0.96); identifying as non-white versus white (OR=0.46, 95%CI=0.23, 0.87); living in a rural versus urban area (OR=0.42, 95%CI=0.18, 0.92); and higher for being male versus female (OR=2.79, 95%CI=1.69, 4.67). Non-significant decreases were found for weekday sedentary behavior (OR=0.97; 95%CI=0.92, 1.02) and living in a suburban versus urban areas (OR=0.63, 95%CI=0.38, 1.05).

Conclusion:
Less sleep, identifying as non-white, female, and residing in rural areas were associated with a lower COVID-19 prevalence.
Abstract P069: Temporal Patterns Of Adherence To The Physical Activity Goal In A Mobile Health Weight-loss Trial
Authors: Bizhanova Zhadyra , Sereika Susan M , Kariuki Jacob K , Conroy Margaret B , Rockettewagner Bonny , Brooks Maria M , Cheng Jessica , Beatrice Britney , Burke Lora E
Published: April 2022

Background:
Wearable trackers such as Fitbit may promote physical activity (PA) levels recommended by the US Physical Activity Guidelines. However, there is a lack of evidence on the associations between long-term wearable tracker use and temporal patterns of PA levels. Therefore, we aimed to identify distinct trajectories of the adherence to PA goals using group-based trajectory modeling in a year-long mobile health weight-loss trial.

Method:
PA data were collected within the SMARTER weight-loss trial that recruited adults (i.e., age ≥18 years) from 2018 to 2020 from southwest PA, USA. Healthy adults with body mass index between 27-43 kg/m
2
were randomized to either self-monitoring with daily personalized feedback messages (SM+FB, n=251) or self-monitoring only (SM, n=251) and followed for 52 weeks. Adherence to weekly PA goals, the primary outcome of this analysis, was computed as the percentage of fairly active and very active total minutes per week measured by Fitbit Charge 2™ relative to the minimum PA goal of 150 minutes/week recommended for all study participants. We used group-based trajectory modeling to identify distinct temporal patterns of adherence to weekly PA goals.

Results:
The sample (N = 502) was mostly female (n=399, 79%), white (n=423, 82%) with a mean age of 45.0 ± 14.4 years. Among the models considered, the five-group trajectory model for adherence to weekly PA goals was selected based on the best data fit:
low
adherence with a linear decline (n=80, 16.0%; b[intercept] ± SE: 73.18 ± 5.03, p<.0001; b[linear] ± SE: -6.37±.28, p<.0001);
low
initial adherence with nonlinear increase (n=194, 38.7%; b[intercept] ± SE: 93.48 ± 3.63, p<.0001; b[linear] ± SE: .49 ± .31, p=.108;b[quadratic] ± SE: -.03±.01, p<.0001);
moderate
initial adherence with linear decline (n=145, 28.8%, b[intercept] ± SE: 230.53 ±2.83, p<.0001; b[linear] ± SE: -.40±.09, p<.0001),
moderate
initial adherence with nonlinear decline (n=39, 7.8%, b[intercept] ± SE: 216.99 ± 18.72, p<.0001; b[linear] ± SE: 0.25 ± 7.46, p=.974; b[quadratic] ± SE: -1.57 ± .93, p=.090; b[cubic] ± SE: .12 ± .05, p=.010; b[quartic] ± SE: -.004 ± .001, p=.010; b[quantic] ± SE: .00003±.00001, p<.0001), and
high
initial adherence with nonlinear decline (n=44, 8.8%; b[intercept] ± SE: 379.46 ± 9.84, p<.0001; b[linear] ± SE: 2.37 ± 1.59, p=.138; b[quadratic] ± SE: .10 ± .07, p=.171; b[cubic] ± SE: -.003±.001, p=.003).

Conclusions:
We identified five distinct trajectories for long-term adherence to the PA goal over 52 weeks. More research is needed to determine additional means of supporting PA in individuals with low and declining adherence trajectories.
Abstract P070: Individual And Environmental Correlates Of Objectively Assessed Physical Activity Levels In Rural Residents
Authors: Serrano Natalicio , Brownson Ross , Beck Alan M
Published: April 2022

Introduction:
Rural communities in the US face disproportionately higher rates of physical inactivity as well as coronary heart disease mortality, when compared to their urban and suburban counterparts. As such, increasing physical activity (PA) and reducing barriers to PA is critical in improving population health. Neighborhood characteristics have been shown to influence PA, but are understudied in rural communities. The current analysis: (1) describes PA patterns in rural mid-western communities, and (2) examines the associations of and interactions between individual and environmental correlates of objectively assessed weekly moderate to vigorous physical activity (MVPA) minutes.

Hypotheses:
Overall, we expected low levels of weekly MVPA in rural residents; with lower levels anticipated in female, older, and low-income participants. We also expected positive associations of favorable perceptions of the neighborhood environment, trail use, and self-efficacy for PA with weekly MVPA. Finally, the test of interactions between intrapersonal and perceived environmental factors in relation to weekly MVPA is exploratory.

Methods:
Telephone surveys were conducted with 280 adults in 14 rural southeast Missouri communities, who were also asked to wear accelerometer devices for seven days. Participants were recruited via address-based sampling, and at local community events. Participants self-reported demographic information (age, sex, income), individual level behavioral factors (self-efficacy for PA, trail use) and neighborhood environment perceptions (indoor recreational access, safety from traffic, home neighborhood environment). Weekly MVPA minutes were assessed using the accelerometry data. Generalized linear mixed models using a negative binomial distribution were used examining associations of and interactions between individual characteristics and environmental correlates with weekly MVPA (Analyses were conducted using STATA V15).

Results:
Participants had a weekly average of 97 minutes MVPA, with 21% meeting PA guidelines. Increased age and being female were significantly associated with lower weekly MVPA. Additionally, increased self-efficacy and trail use were significantly associated with higher weekly MVPA. When exploring interaction effects, there was a significant interaction between gender and safety from traffic. For females, increased perceived safety from traffic was associated with lower MVPA.

Conclusions:
Rural residents have low levels of PA with less than a quarter meeting PA guidelines (75 minutes of vigorous and/or 150 minutes of moderate PA per week). Specifically, female residents face disproportionately lower levels of MVPA, with only 75 weekly minutes compared to 135 weekly minutes in males. Promoting trail use and targeting self efficacy for PA, may be effective strategies for increasing PA in rural residents.
Abstract P072: Elevated Coronary Artery Calcification In Highly Active Men: Role Of Exercise Intensity Versus Duration
Authors: Pavlovic Andjelka , Defina Laura F , Leonard David , Wright Beth B , Farrell Steve , Shuval Kerem , Levine Ben
Published: April 2022

Introduction:
While living a physically active lifestyle is associated with many health benefits, recent evidence suggests that high volume physical activity (PA) may contribute to coronary artery calcification (CAC). Whether exercise intensity or duration contributes more to CAC elevation is unknown.

Hypothesis:
Higher PA intensity, but not duration, predicts elevated CAC.

Methods:
We studied 25,801 apparently healthy men who completed a self-report PA questionnaire and underwent EBT or MDCT scans as part of a preventive physical examination. Participants were categorized into two CAC groups (≥100 or <100 Agatston units (AU)) and three PA groups (≥3000, 1500 – 2999, and <1500 MET-minutes/week (MET-min/wk)). An exploratory classification tree model identified maximum intensity of activity as the second most important predictor of CAC≥100 AU after age. As such, maximal intensity of activity ≥8 METs was entered as a predictor in subsequent logistic regression models that were adjusted for age, current smoking status, body mass index, glucose, total cholesterol, and systolic blood pressure. We also included categories of PA duration ≥5 or <5 hours/week, the current PA Guidelines recommendation for increased performance.

Results:
The mean age was 52 years, and 6,075 men had CAC≥100 AU. Regardless of CAC category, the ≥3000 MET-min/wk group had more favorable glucose and lipid profiles compared to the <1500 group. The average PA volume reported in the most highly active group (≥3000 MET-min/wk) was 4626 MET-min/wk with all participants reporting ≥5 hours of PA/week. In the fully adjusted model, maximum exercise intensity ≥8 METs was associated with lower risk of CAC≥100 AU (Relative risk (RR): 0.93, 95% Confidence interval (CI): 0.88 – 0.98, p = 0.004), while total duration of ≥5 hours/week trended in the opposite direction yet without significance (RR: 1.07, CI 95%: 0.98 – 1.17, p = 0.14). Prevalence of CAC≥100 AU was highest among those engaging only in activities <8 METs and for a total duration ≥5 hours/week. Conversely, the lowest prevalence of CAC≥100 AU was found in the higher intensity, lower duration group (≥8 METs, <5 hours/week). Jointly, maximum intensity ≥8 METs was associated with a lower risk of CAC≥100 AU (RR: 0.92, CI 95%: 0.88 – 0.97, p =0.003) only among those with a total duration <5 hours/week.

Conclusions:
Exercise intensity ≥8 METs was associated with a lower likelihood of men patients presenting with clinically significant CAC while exercise duration of ≥5 hours/week trended in the opposite direction. These novel findings should be considered by clinicians when counseling highly active men with elevated CAC on their exercise prescriptions.
Abstract P076: Correlations In Hispanic/Latino Siblings’ Physical Activity And Sedentary Behavior: Results From The Hispanic Community Children’s Health Study/Study Of Latino Youth (SOL Youth)
Authors: LeCroy Madison N , Evenson Kelly R , Perreira Krista , Van Horn Linda , Xue Xiaonan , Gallo Linda , Daviglus Martha L , Isasi Carmen R
Published: April 2022

Background:
Hispanic/Latino youth in the United States are at an elevated risk for not meeting national guidelines for physical activity (PA). Siblings have the potential to influence each other’s PA and sedentary behavior (SB) through means such as role modeling and co-participation. However, to our knowledge, no study has examined correlations in Hispanic/Latino siblings’ PA and SB behavior using objective measures.

Objective:
To examine correlations in siblings’ total PA, moderate-to-vigorous physical activity (MVPA), and SB, and to explore whether social and environmental measures explain differences in siblings’ PA and SB.

Methods:
Hispanic/Latino 8-16-year-olds from the cross-sectional Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) with at least one sibling enrolled in the study were examined (
n
=537). Frequency, duration, and intensity of PA were assessed using the ActiCal
TM
accelerometer. PA-related social and environmental measures were assessed using validated, interviewer-administered questionnaires. Mixed effects linear regression models were used with total PA, MVPA, or SB as the outcome, individual and family-level socio-demographic variables as fixed effects, and family as a random effect. Correlations between siblings’ PA and SB were assessed with intraclass correlation coefficients (ICCs). All models were examined stratified by siblings’ sex concordance and age difference. PA-related social and environmental measures were subsequently added as fixed effects.

Results:
Mean total PA was 257.4 counts/minutes. On average, youth spent 35.9 minutes in MVPA and 599.4 minutes (10.0 hours) in SB per day. Overall correlations in siblings’ PA and SB were slight to fair, with ICCs of 0.28 (95% CI: 0.18, 0.38), 0.31 (95% CI: 0.22, 0.39), and 0.46 (95% CI: 0.38, 0.54) for total PA, MVPA, and SB, respectively. Siblings who were all brothers had the strongest correlations in total PA (0.61 [95% CI: 0.47, 0.74]) and MVPA (0.62 [95% CI: 0.48, 0.75]) compared to siblings who were all sisters (total PA only) or of differing sexes (total PA and MVPA). Correlations in SB did not differ according to siblings’ sex concordance. Correlations in PA and SB did not differ by siblings’ age difference. Friend support for PA, the after-school PA environment, and workout equipment use at home did not explain differences in siblings’ PA or SB.

Conclusions:
Correlations in Hispanic/Latino siblings’ PA and SB were slight to fair, with siblings who were all brothers having the strongest correlations in PA. Future research should examine how role-modeling, caregiving responsibilities, and sibling-specific familial support contribute to similarities in siblings’ PA and SB and sex-specific differences in PA correlations.
Abstract P078: Determinants Of Functionality In An Elderly Population With Hip Osteoarthritis
Authors: Baena Cristina P , Baena Cristina P , DE MELLO GRAZIELLA MARTINS DE , Souza Dyego Leandro Bezerra de , Roig Javier , Barreto Haagsma Ariele , Olandoski Marcia
Published: April 2022

Background:
Osteoarthritis (OA) is the major cause of pain and disability in the elderly. Current treatments include rest, which could potentially harness the global health of these individuals.

Aim:
To test age, sex, number of comorbidities and levels of physical activity (PA) as determinants of functionality in a well stablished elderly population with hip OA.

Methods:
We analyzed 548 men and 1540 women with self-reported OA and hip pain over 60 years from SHARE. Sex and age groups were created 428 men 60-79 years old (20.5%) ; 1128 women 60-79 years old ( 54%); 120 men 80-100 ( 5.7%) years and 412 women 80-100 years ( 19.7%). PA was measured as moderate and vigorous (reference)or physically inactive . Five or more comorbidities were compared to one (reference) . Functionality measurement were handgrip strength (cutoffs were <27kg for men and <16kg for women); single chair five times ( limited when arms were used or across their chest) to stand up from a sitting position ; daily living activities (ADL) (dressing, including shoes and socks) and number of limitations on ADL. We built logistic regression models having functional measures as dependent variables and gender/age, number of comorbidities and levels of PA as response variables. In order to explore the determinants of the association we used stepwise analysis, including all significant variables in the univariate analysis.

Results:
Limited handgrip was associated with age in women 80-100 compared to women 60-79 OR (95%) 2.40 (1.74-3.32); to five or more comorbidities OR (95% CI) 3.08 ( 1.70-5.60) and to physical inactivity OR (95% CI) 2.08 (1 .53-2.82). Limited single chair was associated with age , women 80-100 OR (95% CI) 2.01 ( 1.55-2.61) compared to women 60-79; five or more comorbidities OR (95% CI) 2.52 ( 2.49-4.81); physical inactivity OR (95% CI) 5.93 ( 6.26-9.91). ADL limitation was associated with age in women 80-100y compared to women 60-79y OR (95% CI) 1.79 (1.38-2.32); five or more comorbidities OR (95% CI) 2.80 ( 1.91-4.09); and physical inactivity OR (95% CI) 4.69 ( 3.74-5.88). Limitations in dressing shoes or socks were associated with five or more comorbidities OR(95%) 2.49 (1.63-3.80); physical inactivity OR(95%) 4.22 (95% CI 3.34-5.32) . Limitation to get up from the chair was associated with five or more comorbidities OR(95%) 2.84 (2.06-3.92) and physical inactivity OR (95% CI) 2.49 1.95-3.16). All associations were independent from smoke, alcohol consumption BMI and previous illnesses.

Conclusion:
Functionality decreased significantly across age with a steep decline over 79 y for men and women with OA. The association with the number of comorbidities and levels of physical activity point to timely interventions aiming at global health in this population.
Abstract P079: Comparing General Versus Disease-specific Patient-reported Outcomes Instruments Among Patients With Peripheral Artery Disease
Authors: Powell Chloe , Kim Gloria , Byrnes Mary , Gallagher Katherine , Corriere Matthew A
Published: April 2022

Objectives:
Patient-reported outcomes (PRO) are championed for assessment of peripheral artery disease (PAD) outcomes. Both general and PAD-specific instruments are available, but associations with clinical and demographic variables are unknown. We initiated a cohort study of PRO among patients with PAD and evaluated baseline correlations between PRO, clinical, and demographic variables.

Methods:
Patients were recruited from a diagnostic unit based on ankle brachial index (ABI). QOL was assessed using one PAD-specific (VascuQol6) and two general instruments (PROMIS Physical Function Short Form 6b & PROMIS Pain Interference Short Form 6a). Associations between PRO were evaluated with correlation coefficients. Associations with clinical and demographic variables were evaluated with simple and multivariable models.

Results:
93 patients participated. All PRO were significantly correlated; greatest correlation was between VascuQol6 and PROMIS Pain Interference (-0.84; P<0.001). Lowest correlation was between PROMIS Physical Function and VascuQol6 (-0.611; P<0.001) (Figure). VascuQol-6 was associated with age (P=0.002), ABI (P=0,002), and symptom level (P=0.001). Physical Function scores were associated with smoking (P=0.058), neuropathy (P=0.003), symptom category (P=0.078), and symptom level (P=0.043). Pain Interference scores were associated with age (P=0.007), symptom category (P=0.010), and symptom level (P=0.01).

Conclusions:
QOL scores correlate with factors related and unrelated to PAD. Different measures may be helpful for capturing specific QOL domains and clinical factors.

*Normalized T-scores