bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P177: Effect of Coenzyme Q10 Supplementation on Statin-Related Myopathic Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Kelly Francinny A , Siebel Victoria M , Cavalcanti Souza Maria Eduarda E , Sudo Renan Y , Moraes Francisco Cezar A , Barros Maria Luisa S , Lima Pedro L , lopes Lucca M , Leite Marianna G , Lobo Artur D , LAURINAVICIUS Antonio , Sousa Marcio G , Souza Jonathan
Published: May 2024

Introduction:
Coenzyme Q10 (CoQ10) has shown promising results as an adjuvant therapy to statins. However, the efficacy of this agent is still unclear.

Hypothesis:
The use of CoQ10 mitigates statin-related myopathic pain.

Methods:
PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing CoQ10 supplementation with placebo in patients taking statins. A random-effects model was employed to compute the mean difference (MD) with 95% confidence interval (CI). Statistical analysis was performed using R software 4.3.1.

Results:
A total of 5 studies and 227 patients were included, of whom 48% were randomized to CoQ10 supplementation. Compared with placebo, CoQ10 had no effects on pain severity score (MD -0.94; 95% CI -3.80 to 1.91; p=0.5), and pain intensity score (MD -1.51; 95% CI -4.09 to 1.06; p = 0.2). Moreover, no association was found with low density lipoprotein cholesterol levels (MD -0.07; 95% CI -0.47 to 0.34; p = 0.7).

Conclusions:
In this meta-analysis of 5 RCTs, supplementation with CoQ10 did not yield statistically significant results. These findings suggest that CoQ10 has no impact on statin-related myopathic pain.
Abstract P201: Adherence to Time-Restricted Eating is Related to Long-Term Weight Changes Among Women
Authors: Heianza Yoriko , Cahill Leah E , DiMatteo Oona J , Drotz Emily M , Sun Qi , Manson JoAnn E , Qi Lu
Published: May 2024

Introduction:
Chronic disruption of circadian rhythms is linked to weight gain and metabolic dysregulation. Time-restricted eating (TRE), a form of intermittent fasting, has shown effectiveness in improving short-term weight loss and energy homeostasis. However, associations between habitual adherence to TRE and long-term weight change remain understudied.

Hypothesis:
We tested whether adherence to TRE assessed by the gold-standard seven-day dietary records (7DDRs) was related to 5-year change in body weight among women.

Methods:
The present analysis included 650 women (mean [SD]: age 63 [9] y; BMI 26.4 [5.3] kg/m
2
) without cardiovascular disease at baseline who completed 7DDRs in a sub-study of the Nurses’ Health Studies (NHS/NHSII), the Women’s Lifestyle Validation Study (WLVS) (2010-12). TRE was indicated by 4-12 hours of daily eating window (EW). The adherence to TRE was assessed by summing up the TRE days in a week. We also calculated 7-day averaged values of EW hours, last/first time of eating occasion (EO), and within-person variability of these variables. Weight change from baseline to a follow-up survey (NHS: 2016-18; NHSII: 2015-17) were analyzed. Total energy expenditure (TEE) and physical activity expenditure (PAEE) were measured at baseline using the doubly labeled water dilution method.

Results:
Longer averaged hours of EW were related to greater weight gain (β 0.7 [0.3] kg per 2 hours) after adjusting for covariates of demographic factors, total energy intake, physical activity, alcohol, within-person variation of EW, the averaged time of last EO, and the initial body weight (
p
=0.02). Consistently, adherence to TRE was associated with less weight gain (β -0.25 [SE 0.1] kg per day increment;
p
=0.03) in a model adjusting for these covariates. We found that lower adherence to TRE and longer hours of EW were associated with weight gain (
p
<0.05 for both) when the last eating time occurred at a later time in the day than at an earlier time. The baseline energy metabolism (TEE and PAEE) modified the associations between the hours of EW and weight changes (

P
interaction-EW-TEE

= 0.006;

P
interaction-EW-PAEE

=0.01), showing significant relationships particularly among women with higher levels of adiposity and greater energy expenditure at baseline.

Conclusions:
Adherence to TRE and fewer habitual hours of eating were related to long-term weight changes among middle-aged and elderly women. The last eating time and energy homeostasis may partly modify the associations.
Abstract P254: Association Between Protein Intake and Prevalence of Sarcopenia in Japanese Community-Dwelling Older Adults
Authors: Miyagawa Naoko , Harada Sei , Iida Miho , Shibuki Takuma , Matsumoto Minako , Hirata Aya , Kuwabara Kazuyo , Toki Ryota , Edagawa Shun , Okamura Tomonori , Takebayashi Toru
Published: May 2024

Background and Aim:
To determine the protein intake associated with the prevalence of sarcopenia, we conducted a cross-sectional study of 1251 community-dwelling older Japanese aged 60 years and older.

Methods:
The mean age of the participants was 68.8 years, and the percentage of women was 56.7%. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 by low muscle mass (skeletal muscle mass), muscle strength (grip strength), and physical performance (gait speed). Protein and energy intake were assessed using a food frequency questionnaire (FFQ). Logistic regression models were used to estimate the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (95%CIs) of the prevalence of sarcopenia according to gender-specific tertiles of protein intake as a percentage of total energy. Corresponding analyses were done also for protein intake per day and for protein intake per kg of body weight, separately, instead of protein intake as a percentage of total energy.

Results:
The prevalence of sarcopenia was 8.0% (100/1251). The median protein intake as a percentage of total energy, protein intake per day, and protein intake per body weight by gender were, in order, 11.8%E, 59.2 g/day, and 0.9 g/kg/day for males and 14.1%E, 54.7 g/day, and 1.0 g/kg/day for females. Since there was no gender interaction in the association between each protein intake and the prevalence of sarcopenia, we performed the analysis for males and females combined. The multivariable adjusted ORs (95%CI) of the prevalence of sarcopenia was lower in the high protein intake as a percentage of total energy (>12.6%E in males and >15.2%E in females, respectively) group (0.47 (0.27-0.83)) than in the low intake (<11.1%E in males and <13.4%E in females, respectively) group; the linear trend was significant (p =0.009). Similarly, we found a significantly inverse association for sarcopenia prevalence at protein intakes higher than 54.4 g/day for males and 50.6 g/day for females, compared to those with lower intakes. However, there was no association between protein intake per body weight and the prevalence of sarcopenia. We obtained similar results when the participants were restricted to those 65 years and older as a sensitivity analysis.

Conclusion:
Significant inverse associations were found between the prevalence of sarcopenia and protein intake in community-dwelling older Japanese. However, we should consider that protein intake assessed by the FFQ is often underestimated when discussing absolute protein intake for sarcopenia prevention.
Abstract P259: Favorable Ventricular-Arterial Mechanics Among Women is Associated With Better Mitochondrial Oxidation in the Left Ventricle
Authors: Wong Jie Jun , Zhang Hongzhou , Gao Fei , Leng Shuang , Tan Ru S , Zhong Liang , Kovalik Jean Paul , Koh Angela S
Published: May 2024

Background:
Traditional risk factors insufficiently characterize the biological phenomena underlying sex differences in ventriculoarterial coupling (VAC). We hypothesize that sex differences in VAC are due to differences in left ventricular global longitudinal strain (LVGLS), a fuel-dependent chamber closely linked to mitochondrial fuel oxidation pathways.

Methods:
Community older adults without cardiovascular disease were prospectively recruited for cardiac magnetic resonance imaging and concurrent serum metabolomics sampling. VAC was determined as aortic pulse wave velocity (PWV) divided by LVGLS. Multivariable models adjusted for clinical risk factors and metabolites.

Results:
Among 202 participants (46.0% female), fewer women were smokers compared to men (3.2% vs 25.7% p<0.001). Despite similarities in age, (women: 69.7 vs men: 70.7 p=0.432) women had better VAC (-0.39 vs -0.47 p = 0.003), LVGLS (-21.9 vs -20.1% p <0.001), and LV mass index (LVMI) (41.7 vs 49.5 g/m
2
p <0.001) compared to men. Both sexes had similar PWV (8.41 vs 9.13 m/s p = 0.087). LVGLS was inversely related to LVMI (β = -0.09 p <0.001). Among women, metabolomic determinants of better LVGLS, independent of LVMI, were lower levels of long chain acylcarnitines (LCACs) [C12:2-OH/C10:2-DC (OR 0.830 adj. p=0.020), C16:3-OH/C14:3-DC (OR 0.334 adj. p=0.048), C16-OH (OR 0.756 adj. p=0.029) and higher levels of C20:2 (OR 1.987 adj. p=0.033)] (Figure A). Among men, determinants of better LVGLS included lower levels of C12:2-OH/C10:2-DC (OR 0.864 adj. p=0.020), C12:1-OH (OR 0.969 adj. p=0.016), C16:1 (OR 0.923 adj. p=0.025), C16:3-OH/C14:3-DC (OR 0.566 adj. p=0.028)] and higher levels of C5:1 (OR 1.096 adj. p=0.026).

Conclusion:
Better LV longitudinal function contributed to better VAC among older women. Lower LCAC fatty acid metabolism intermediaries was linked to better LVGLS, implying improved mitochondrial β-oxidation. Circulating metabolites may represent novel precision medicine factors for sex-based stratification of vascular risks.
Abstract P276: De Novo Exposomic Geospatial Assembly of the Stroke Belt With Machine Learning and Network Analysis
Authors: Deonarine Andrew , Batwara Ayushi , Wada Roy , Nair Shoba , Sharma Puneet , Loscalzo Joseph , Ojikutu Bisola , Hall Kathryn
Published: May 2024

Introduction:
Geographical chronic disease patterns, such as the high stroke rates in the southeast United States that characterize the Stroke Belt, are known to vary with chronic disease rates and changes in the social determinants of health (SDOH). However, the role of regional variations in the exposome (quantified by pollution measures) is less clear.

Hypothesis:
We investigated the hypothesis that there is a geographical relationship between high-dimensional pollution indicators and stroke, and examined if this relationship could be identified using a novel machine-learning pipeline called aPEER (algorithm for Projection of Exposome and Epidemiological Relationships).

Methods:
aPEER assembles geographical regions from pollution and chronic disease data at the county and census-tract level using machine-learning, and validates findings with network analysis (Figure 1A). Multiple rounds of aPEER analyses were completed with different pollution datasets to iteratively identify the most important set of pollution measures that best predict the geographical distribution of the Stroke Belt and high stroke mortality regions (Figure 1B).

Results:
Using aPEER, the pollutants formaldehyde, methanol, acetaldehyde, benzene and carbon tetrachloride predicted high stroke mortality regions including the Stroke Belt with superior accuracy (area under the curve (AUC)=0.8417-0.9931) compared to SDOH (AUC=0.6853-0.8860) and chronic disease (AUC=0.8367-0.9731) indicators.

Conclusion:
In conclusion, we identified five pollutants associated with stroke geography using a combination of machine-learning methods comprising the aPEER pipeline. These pollutants showed superior predictive power compared to conventional SDOH and chronic disease risk factors, highlighting the potential role of the exposome in stroke pathogenesis.
Abstract P279: Proteomic Profiling Identifies Mortality-Associated Markers in Coronary Artery Disease
Authors: Liu Chang , Hui Qin , Quyyumi Arshed A , Vaccarino Viola , Sun Yan
Published: May 2024

Background:
Coronary artery disease (CAD) is a leading global cause of mortality. Proteomics has emerged as a promising tool for understanding CAD prognosis. We explored proteomic profiles in CAD patients to identify protein markers which predict mortality.

Methods:
The discovery cohort included 2,072 participants from the UK Biobank (UKB) with proteomics data and prevalent CAD at enrollment, defined by the ICD-10 and OPCS-4 codes from the in-patient Hospital Episode Statistics data. All-cause mortality was ascertained based on the Death Register records. Plasma proteomic profiling of 1,463 unique proteins at enrollment was conducted using the Olink platform. The validation cohort included 91 participants from the Mental Stress Ischemia Prognosis Study (MIPS), a prospective study of CAD patients enrolled from Emory University hospitals in whom plasma proteomic profiling of 6,159 proteins was measured by the SomaScan Assay. We analyzed 1,203 common proteins in both cohorts with missing rate < 20%. In the UKB, we examined the proteome-wide associations between the rank-based inverse normal transformed protein levels and mortality, using Cox proportional hazards models adjusting for race, sex, age, body mass index, diabetes, hypertension, heart attack history, frequent drinking (≥ 3 times /week), smoking history, high- and low-density lipoprotein, triglycerides, C-reactive protein and estimated glomerular filtration rate. Mortality-associated proteins at Bonferroni corrected p < 0.05 were analyzed for pathway enrichment. LASSO regression was used to further select the best performing proteins in predicting mortality. Prediction performance of the proteins was evaluated using the C statistic. The mortality-associated proteins were validated in MIPS, using Cox models adjusting for race, sex, and age.

Results:
The UKB cohort was 69% male, 96% White, with mean age of 62 years, and there were 646 (31%) deaths during median follow-up of 13.3 years. The MIPS cohort was 79% male, 24% Black, with mean age of 64 years, and 11 (12%) died during median follow-up of 6.3 years. A total of 274 proteins were significantly associated with mortality in the UKB, representing enriched pathways such as inflammatory response. Seven proteins, including
GDF15
,
TNFRSF10B
,
PLAUR
,
SPON1
,
CXCL17
,
ANGPT2
, and
ICAM5
were identified by LASSO model as key predictors. Adding these proteins to the model with traditional risk factors improved the prediction of mortality by 5.3% (75.8% vs 70.5%, 95% CI 3.7% - 6.9%). All associations except for
CXCL17
were validated in the MIPS.

Conclusion:
The findings suggest the potential added value of plasma proteins for predicting mortality in CAD patients beyond traditional factors. The functions of mortality-associated proteins indicate underlying biological mechanisms, such as inflammation and cell growth regulation, linked to CAD progression.
Abstract P283: Hispanic/Latino Ethnic Background and Genetic Ancestry in Relation to Atherosclerotic Cardiovascular Disease Risk Estimation: Insights From the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Nriagu Bede N , Rosario Karen F , Hansen Spencer , Duran Luciano Priscilla , Joshi Parag H , Mehta Anurag , Khera Amit V , Kaplan Robert , Sofer Tamar , Peralta Carmen A , McClelland Robyn , Rodriguez Carlos J
Published: May 2024

Background:
Hispanics are a highly admixed population. Pooled Cohort Equation (PCE) excluded them in its derivation. We analyzed Hispanic background and genetic ancestry in relation to atherosclerotic cardiovascular disease (ASCVD) risk.

Methods:
We included 966 Hispanics from Multi-Ethnic Study of Atherosclerosis (MESA), aged 44-75 years and free of diabetes/prior CVD. Statin users and those with LDL-C>190 mg/dL were excluded. Continental genetic ancestry (West African [AA], European [EA]) was estimated by ADMIXTURE software. Predicted ASCVD events (myocardial infarction, stroke, coronary heart disease death) based on non-Hispanic White (NHW) and non-Hispanic Black (NHB) PCE versions, were compared with observed events based on 10-years Kaplan-Meier Estimates and presented as predicted-to-observed (P/O) ratios across Hispanic backgrounds and >median genetic ancestry. Risk discrimination was assessed by Harrell’s C-statistic based on Cox models.

Results:
MESA Hispanics included 504 Mexicans [ME], 284 Caribbean [CA] and 178 Other Hispanics [OH]. At 10-years, there were 179 ASCVD events: 107 ME; 49 CA; 23 OH. PCE overestimates ASCVD risk (reflected by P/O ratio >1.0). Using the NHW PCE, all Hispanics had a similar P/O ratio compared to NHW in the low-risk category, and lower P/O ratio compared to NHW in the high-risk category. The extent of overestimation varied across disaggregated Hispanic background (least in ME intermediate risk; most in CA high risk category). Higher P/O ratios were observed among Hispanics of >median AA ancestry and lowest in Hispanics of >median EA ancestry (Figure 1). Harrell’s C-statistic showed no statistically significant difference within groups.

Conclusion:
Disaggregating Hispanics by background and ancestry led to variability in PCE performance with greater overestimation of ASCVD risk for those of CA background or with >median AA compared to those of ME background or >median EA. The relationship between ethnicity, ancestry, and ASCVD risk in Hispanics should be further explored.
Abstract P285: Relationship Between Body Mass Index, Waist Measurement, Six-Minute Walk Performance and Whole-Body Strength in Adults With Cardiovascular Disease: Findings From the Lifestyle Heart Health Study
Authors: Parmenter Belinda J , McLeod Kelly , Feng Xiaoqi
Published: May 2024

Introduction:
Cardiovascular disease (CVD) is the leading cause of death, killing 17.9 million people annually worldwide. Key risk factors include physical inactivity, overweight/obesity, high blood pressure, high cholesterol which worsen with age, and smoking and excessive alcohol intake. Six-minute walk (6MW) performance and whole-body muscle strength are both related to cardiovascular mortality and also worsen with age, particularly in the absence of physical activity. The aims of this study were to understand levels of cardiovascular risk and compliance to usual medical treatment (medication, lifestyle modifications) in a high socioeconomic Australian population, and to identify relationships between key risk factors, 6MW and muscle strength. A secondary aim was to help inform development of the Lifestyle Heart Health Education Program.

Methods:
This was a cross-sectional study of 473 people with CVD in Sydney. Class was classified based on the Australian socioeconomic index for areas. Conditions were defined according to Australian national guidelines. Medical history, body mass index (BMI), waist measurement, whole-body muscle strength and 6MW measurements were assessed. Simple linear and stepwise regressions were used to assess potential relationships.

Results:
Mean age of the cohort was 66.8±11.6; range 21-94 yrs; 68.5% female; socioeconomic index was deemed high. All participants had CVD, of which 25% were on aspirin. Hypertension was prevalent in 65% (38% on anti-hypertensives); 65% had dyslipidaemia (40% on a statin); 91% had a BMI over 26.0; and 85% of males and 80% of females had a waist measurement over gender-specific heart health recommendations. Less than 3% of the cohort smoked, and less than 10% consumed alcohol at a level deemed high-risk. Almost 20% of the cohort were at risk of CV mortality according to 6MW performance with scores less than 350 metres. Waist measurement, BMI, and blood pressure were the greatest risk factors across the cohort. Muscle strength (r=-0.34; r
2
=0.17; p<0.001) and 6MW performance (r=-0.37; r
2
=0.17; p<0.001) both decreased with age. BMI and age were the most significant predictors of 6MW (r=-0.45; r
2
=0.20; p=0.004) and whole-body strength (r=0.49; r
2
=0.24; p<0.001) in females; waist and age were the most significant predictors of 6MW (r=-0.38; r
2
=0.14; p=0.11) and whole-body strength (r=0.41; r
2
=0.17; p=0.04) in males.

Conclusion:
Whilst alcohol and smoking campaigns are working to reduce consumption of these harmful substances, low cardiorespiratory and muscular fitness and overweight/obesity remain highly prevalent. Population-level interventions such as the Lifestyle Heart Health Program that aim to reduce weight and waist and improve physical activity, walking ability and muscle strength are urgently needed to reduce cardiovascular risk and mortality.
Abstract P315: Consumption of Potatoes and Risk of Hypertension: A Pooled Analysis of US Cohorts
Authors: Djousse Luc , Sesso Howard D , Zhou Xia , Kim Eunjung , Lee I-min M , Steffen Lyn , Buring Julie , Manson JoAnn E , Gaziano John M
Published: May 2024

Background:
Limited and inconsistent observational data are available on the association of potato consumption with risk of hypertension.

Objective:
To test the hypothesis that consumption of total; combined baked, boiled, and mashed; and fried potatoes is associated with incidence of hypertension and that dietary pattern (assessed using the plant-based diet index [PDI]) modifies such association.

Methods:
We pooled and analyzed harmonized, individual-level data from 5 US cohorts (n=67,146). Frequency of baked, boiled, mashed, and fried potato consumption during the previous year was ascertained using a food frequency questionnaire. We used Cox regression to estimate hazard ratios separately in each cohort adjusting for age, sex, race/ethnicity, education, body mass index, energy intake, physical activity, smoking, alcohol intake, trans fats, and PDI score. We then pooled cohort-specific results using an inverse-variance weighted method to estimate summary relative risks.

Results:
Mean age ranged from 25 to 72 years and median total potato consumption ranged from 1.2 to 3.2 times per week across the cohorts. During the follow up, 31,546 new cases of hypertension occurred. Total potato consumption was not associated with the risk of hypertension: adjusted HR (95% CI): 1.00 (ref), 1.01(0.96-1.05), 1.01(0.96-1.05), 1.04(1.00-1.08), and 1.04(0.99-1.08) for total potato intake of 0; 1-2; >2 to <3; 3-<5; and 5+ times per week, respectively. HR (95% CI) for combined baked, boiled, and mashed potato consumption were 1.0 (ref), 1.00 (0.97-1.04), 1.02 (0.98-1.05), and 1.02(0.98-1.07) for intake of 0, 1-2; >2 to <3; and 3+ times/week, respectively. In contrast, intake of fried potatoes was positively associated with hypertension risk (figure). There was no significant interaction between PDI score and potato consumption on HTN risk.

Conclusions:
Our pooled analysis showed a positive association between fried, but not combined baked, boiled, and mashed, potatoes and incidence of hypertension.
Abstract P323: Awareness of Recent Blood Pressure Levels and Blood Pressure Goals Among US Adults With Diabetes - National Health and Nutrition Examination Survey 2013-2020
Authors: Poudel Bharat , Chen Ligong , Dubal Medha , Christenson Ashley , Foti Kathryn
Published: May 2024

Background:
Reducing blood pressure (BP) is important for decreasing cardiovascular disease risk among adults with diabetes. Individuals with diabetes are recommended to know their BP level and BP goal.

Methods:
We used data from the 2013-2020 National Health and Nutrition Examination Surveys (NHANES) for US adults with diabetes (N=2,344). Diabetes was defined as having a prior diagnosis with use of insulin or glucose-lowering medication. Participants with diabetes were asked their most recent BP and their goal BP according to their doctor. Hypertension was defined as systolic/diastolic BP ≥140/90 mm Hg or self-reported antihypertensive medication use. Poisson regression with robust variance estimation was used to estimate associations of participant characteristics with knowing their recent BP level and BP goal for those without hypertension and with hypertension, separately. All analyses accounted for the NHANES complex survey design and were weighted to represent US adults with diabetes.

Results:
Among US adults with diabetes, 69.8% reported that they knew their recent BP level and 41.5% reported they knew their BP goal. Among those without hypertension and with hypertension, 58.7% and 75.5% reported knowing their recent BP level and 27.5% and 48.5%, respectively, reported knowing their BP goal, respectively. Among adults without hypertension and those with hypertension, non-Hispanic Black or Hispanic versus non-Hispanic White adults, with less than high school education, and without insurance were less likely to know their recent BP (
Table
). Hispanic versus non-Hispanic White adults without hypertension and adults with less than a high school education with hypertension were less likely to know their BP goal.

Conclusion:
Low percentages of US adults with diabetes knew their BP level and knew their BP goal.
Abstract P342: Gut Microbiota and Microbial Metabolites Are Associated With DXA Measured Overall Fat and Trunk Fat in 5-year-old Children
Authors: Chen Yingan , Mueller Noel T , Tilves Curtis , Doyon Myriam , Bouchard Luigi , Perron Patrice , Guerin Renee , Masse Eric , Hivert Marie-France
Published: May 2024

Introduction:
Gut microbiota (GMB) has been associated with obesity in children, but no studies have examined GMB with direct measures of fat mass and trunk fat in children. In our study we examine GMB and GMB metabolites with overall body fat and trunk fat mass (TFM) measured by dual x-ray absorptiometry (DXA) in 5-year-old children.

Hypothesis:
GMB composition and GMB metabolites are associated with DXA-measured overall fat and TFM.

Methods:
We conducted our study in children from the Gen3G cohort, a community-based cohort enrolled prenatally in 2010-2013 in Quebec, Canada. A total of 153 children had data on GMB and 140 had data on plasma metabolites in addition to DXA scan at 5-6.5 years of age. We assessed GMB by 16s rRNA sequencing of stool samples, and measured plasma metabolites using the untargeted approach by Metabolon. We used multivariable-adjusted (see figure for covariates) linear regression to examine associations of DXA measured fat with 67 pre-defined GMB-derived metabolites from the Metabolon database. We used ANCOM-BC to examine 542 GMB amplicon sequence variants (ASVs) with body composition measurements. We used a false discovery rate (FDR) correction for multiple testing and considered an FDR value of < 0.2 as significant.

Results:
Of the 153 children, 43.1% female, 96.1% self-identified as white. Average BMI z-score was 0.18 ± 0.90, with average TFM 2125 ± 637 g. A total of 7 ASVs were associated with total body fat, 3 ASVs with TFM, and 1 ASV with BMI (
Fig. panel A
). Of 67 metabolites tested, 1 was associated with total body fat, 2 with TFM, and 3 with BMI. The two metabolites associated with TFM in a linear fashion (
Fig. panel B
) were deoxycholic acid and glycoursodeoxycholate, which are know to be involved in secondary bile acid metabolism and the etiology of diabetes.

Conclusion:
In children, associations of GMB composition and metabolites with DXA-measured overall fat mass, TFM, and BMI were in a similar direction. In particular, GMB metabolites related to bile acid metabolism were related to adipose tissue accumulation.
Abstract P366: Targeted Facebook Ads Increased Engagement Among Rural Communities During Pre-Recruitment Phases of the Mississippi Core of the Risk Underlying Rural Areas Longitudinal Study
Authors: Harris Kisa K , Grant Abril , Caples Felicia V , Ferrell Christina D , Smith Dantwan S , Lucas Eric D , Poe Kenyatta A , Vasan Ramachandran S , Henderson Frances C , Fox Ervin R
Published: May 2024

Background:
Data is sparse regarding the utility of social media in engaging southern, rural communities to participate in health research. Community Advisory Board (CAB) members of the Mississippi (MS) Core of the Risk Underlying Rural Areas Longitudinal (RURAL) Study suggested the use of the Facebook social media platform to promote the RURAL Study. During the pre-recruitment phase of engagement (6 months prior to initiation of examinations and 3 months prior to official recruitment), RURAL investigators used Facebook posts to help increase awareness of and interest in the RURAL Study.

Objective:
To use Facebook metrics to identify the types of posts that garnered the most engagement.

Methods:
The Principal Investigator of the RURAL Study’s MS Core collaborated with the University of MS Medical Center Social Media Coordinator to implement a Facebook page for the Study. The MS team implemented social media posts to promote the RURAL Study. Data on the number of post reactions, comments, and shares, as well as the reach of organic and paid ads, were collected to identify posts with highest engagement.

Findings:
In Oktibbeha County, the greatest number of Facebook profile visits occurred October 15-November 7, 2022. Facebook posts had the greatest reach between June 24-27 and September 19-30, 2022. Paid ads (boosted posts) produced greater reach than organic ads. In addition, post reactions positively correlated with the number of people reached. Posts with the greatest number of reactions were related to RURAL-sponsored events (e.g., the County Health Fair and the RURAL Open House event). There was significant Facebook activity around popular community events during which the RURAL Study was promoted (e.g., Fannie Lou Hamer event, the Open House event, and the Black Jack Morning Church Service). Although MS Core of RURAL investigators participated in interviews on local TV media prior to recruitment, organic Facebook ads that included links to videos of these interviews did not receive many reactions on the MS Core of the RURAL Study’s Facebook page.

Conclusion:
Using social media may be an effective tool for reaching communities during the pre-recruitment phase of engagement. Our findings support that paid ads that targeted specific audiences were more effective than organic ads. Facebook posts that documented RURAL’s participation and engagement in community events were more effective than posts about RURAL’s promotion in broadcast media.
Abstract P370: Prevalence of the AHA Life's Essential 8 in Midlife Women and Its Prospective Associations With Total Mortality and Cardiovascular Diseases Events: The Study of Women’s Health Across the Nation (SWAN)
Authors: Wang Ziyuan , Barinas-Mitchell Emma , Brooks Maria M , Derby Carol A , Magnani Jared W , Thurston Rebecca C , El Khoudary Samar R
Published: May 2024

Objective:
Midlife women face significant acceleration in CVD risk during the menopause transition. We aim to determine the cardiovascular health (CVH) as measured by Life's Essential 8 (LE8) in midlife women and to test the associations of midlife LE8 with future CVD events/total mortality.

Methods:
Participants were from the SWAN study, a multi-ethnic study of the menopause transition. LE8 includes diet, physical activity (PA), nicotine exposure, sleep, BMI, and blood lipids/glucose/pressure. The total and each LE8 scores (0 [lowest] - 100 [highest]) were calculated using AHA definitions. Scores were grouped into low (0-49), intermediate (50-74) and high (75-100) to characterize women. CVD events were self-reported between visits 1-16 and included: myocardial infarction, stroke, heart failure and revascularization. A subset of the events was adjudicated via medical record. Death certificates were obtained. Cox proportional hazards model was used to test the association between continuous LE8 metrics and CVD events/total mortality.

Results:
A total of 3302 women (mean age 46±3 years, 54% premenopausal) free of CVD at baseline were included. Among them, 28% achieved high total LE8 scores (mean 83±6) and many women had low scores on sleep, PA and diet (
Figure
). During a median (IQR) follow-up of 19 (7) years, 156 deaths and 202 CVD events were recorded. Higher midlife LE8 scores were associated with significantly lower risk of total mortality and CVD events adjusting for demographic and health factors (
Figure
). For individual components, BMI, blood lipids/glucose/pressure, nicotine exposure and sleep were associated with CVD events; BMI, blood glucose/pressure, nicotine exposure and PA were associated with total mortality (
Figure
).

Conclusions:
The prevalence of healthy diet, physical activity and healthy sleep is low in midlife women. Lower CVH is an independent risk factor of subsequent risk of CVD events/total mortality in midlife women. The findings highlight the need to promote healthy behaviors in midlife women.
Abstract P374: Understanding the Mediating Role of Allostatic Load on the Relationship Between Long-Term Financial Strain and Subclinical CVD Among Black Women: The Study of Women's Health Across the Nation (SWAN)
Authors: Brown-Podgorski Brittany , Barinas-Mitchell Emma , Magnani Jared W , Brooks Maria M , Thurston Rebecca C , Janssen Imke , Burnett-Bowie Sherri-Ann M , Karvonen-Gutierrez Carrie , Jarlenski Marian
Published: May 2024

Introduction:
Black adults are disproportionately burdened by poor cardiovascular health, and Black women bear the brunt of this disparity. Cardiovascular disease (CVD) disparities among Black women have been attributed to chronic exposure to psychosocial stressors and the cumulative “wear and tear” of these stressors on the body (i.e., allostatic load). Financial strain has been linked to both higher allostatic load and CVD risk. We aimed to determine whether allostatic load (AL) mediates the relationship between financial strain and cumulative CVD risk among Black women.

Methods:
This study utilized longitudinal data from the Black participants in the Study of Women's Health Across the Nation (SWAN). We conducted a causal mediation analysis with fourfold decomposition to determine if the relationship between long-term financial strain and subclinical CVD was mediated by AL. The study outcome was defined as the presence of any indicator of subclinical CVD from carotid ultrasounds conducted in visit 12/13: carotid artery intima-media thickness (cIMT) ≥ 75
th
percentile of the study sample, carotid adventitial diameter (cAD) ≥ 75
th
percentile of the study sample, or plaque index (a measure of number and size of plaques) >2. Long-term financial strain was defined as reporting “money problems” or “difficulty paying for basics” at >50% of the 6 most recent visits prior to the carotid ultrasound. AL was calculated using a validated summary score method based on 10 component measures from visit 12: systolic and diastolic blood pressure, serum glucose, BMI, triglycerides, C-reactive protein, HDL-C, total cholesterol, waist-to-hip ratio, and dehydroepiandrosterone sulfate. AL was considered “high” if the score was ≥75
th
percentile of the study sample.

Results:
Of the 390 Black women in our sample [Mean (SD) age at subclinical CVD visit = 60.0 (2.7)], 42.3% had subclinical CVD (24.9% with cIMT or cAD, 9.7% with plaque), 56.9% reported long-term financial strain, and 38.0% had high AL. Both long-term financial strain (β=0.132,
p
<0.01) and high AL (β=0.134,
p
<0.01) were associated with a significantly higher likelihood of subclinical CVD. However, causal mediation analysis indicated that the effect of long-term financial strain on subclinical CVD was not mediated by AL (β=0.004,
p
=0.66).

Conclusions:
Though higher AL is associated with higher CVD risk among Black women, it did not mediate the causal relationship between long-term financial strain and CVD risk in these midlife women. Future research should examine the pathways by which financial strain and AL influence premature cardiovascular weathering among midlife Black women and explore potential large-scale interventions.
Abstract P384: Longitudinal Associations of Deprived Neighborhoods With Incident Cardiovascular Disease and Cardiovascular Mortality Among UK Biobank Participants
Authors: Tamura Kosuke , Deng Yangyang , Mohammad Moniruzzaman , Rogers Breanna , Jagannathan Ram , Hu Lu , Roger Veronique L , Marino-Ramirez Leonardo
Published: May 2024

Introduction:
In 2019, the global prevalence of cardiovascular disease (CVD) reached 523 million, and CVD resulted in 18.6 million deaths. Despite well-documented associations between social determinants of health and CVD, sparse data exist on the associations between living in deprived neighborhoods and incident CVD and mortality.

Hypothesis:
Living in deprived neighborhoods increases the risk of CVD incidence and mortality.

Methods:
We analyzed the UK Biobank prospective cohort, excluding prevalent CVD cases at baseline (n=297,950, mean age=55.5 years, female=53.2%). The primary exposure was the neighborhood deprivation index (NDI), defined as an area-level proximity measure of neighborhood socioeconomic status. A higher score indicates more deprived neighborhoods (expressed in quartiles). The primary outcomes were incident CVD and CVD-related mortality, including 1) overall CVD, 2) ischemic heart disease (IHD), and 3) cerebrovascular disease (CeVD). Cox proportional-hazard regression models were used to examine associations between NDI and CVD outcomes, adjusting for covariates and reported hazard ratios (HRs) with 95% confidence intervals (CIs).

Results:
During a median follow-up of 14.3 years (4,261,877 person-years), 20,113 incidents and 12,619 deaths were included in the analysis. In comparison to those living in the lowest NDI quartile (least deprived), those in the highest NDI quartile (most deprived) had a 20%, 15%, and 34% greater risk of developing overall CVD, IHD, and CeVD incidence, respectively (
Table
). Moreover, they exhibited a 33%, 34%, and 35% greater risk of mortality for overall CVD, IHD, and CeVD, respectively.

Conclusions:
Our study demonstrates that living in highly deprived neighborhoods increased the risk for CVD, IHD, and CeVD incidence and mortality in the UK Biobank cohort. Future research should consider analyzing such linkages by sex and race and reducing CVD risk via local efforts to invest in deprived neighborhoods to alleviate the burden of CVD.
Abstract P391: Case Review of Congenital Ectopic Coronary Artery Disease
Authors: Ogundipe Ayomide , Adjei Abdul-Nasser
Published: May 2024

Coronary artery anomalies (CAAs), rare congenital conditions affecting approximately 1% of adults, are associated with adverse cardiac events, including sudden cardiac death. This article reviews three recent clinical cases involving CAAs, delving into their origins, clinical presentations, diagnostics, treatments, and outcomes. CAAs involve irregularities in coronary artery origin, distribution, and termination. Notably, the left coronary artery arising from the right sinus (0.15%) and the right coronary artery from the left sinus (0.92%) are common variations. Other anomalies include the left circumflex artery (LCX) originating from the right coronary sinus and the left main coronary artery or Left anterior descending artery (LAD) emerging from opposite sinuses, leading to diverse clinical presentations.

Case 1 features a 70-year-old female with hypertension presenting with exertional angina. Surgical revascularization was performed after coronary angiography revealed an ectopic LAD. In Case 2, a 72-year-old male with hypertension presented with chest pain and NSTEMI. Coronary angiography showed an ectopic LCX and significant stenosis in LAD and RCA, treated with PCI. Case 3, involving a 49-year-old female with hypertension and syncope, was managed medically as angiography revealed an anomalous RCA origin without significant obstructive disease.

Treatment approaches for CAAs are patient-specific due to limited guidelines. Case 1 underwent coronary artery bypass surgery, Case 2 received PCI, and Case 3 was treated medically. Diagnostic methods encompass stress testing, coronary angiography, and coronary CT angiography (CCTA). CCTA is particularly valuable for distinguishing benign and clinically significant ectopic origins. For intramural courses, coronary unroofing is the preferred surgical technique, while absent intramural courses may require coronary translocation or reimplantation.Percutaneous coronary intervention (PCI) primarily addresses downstream atherosclerotic lesions without directly addressing the CAA. Treatment choice depends on patient-specific risk factors and pathology.

In summary, CAAs pose challenges in interventional cardiology, warranting early and accurate diagnosis to prevent adverse events. A personalized approach, considering patient characteristics, is crucial due to the lack of robust guidelines. Advanced imaging technologies like CCTA and MRA aid in assessing CAAs' clinical significance and guiding treatment decisions. Further research is required to establish optimal treatment strategies, including investigating CAAs' prevalence in specific regions such as Arkansas.Top of Form Bottom of Form
Abstract P398: Family History of Cardiovascular Disease and Hypertension Are Associated With Prevalent Disease in US Americans of South Asian Origin
Authors: Vasudev Eshaan , Vasudev Krish , Yanek Lisa R , Vaidya Dhananjay
Published: May 2024

Introduction:
Cardiovascular disease (coronary artery disease and stroke, CVD) is a major health risk among the South Asian diaspora in the US. Factors like genetics and acculturation can influence the onset and progression of these diseases. Our study investigated the associations of acculturation and family history with CVD and a major CVD risk factor of hypertension (HTN) in US South Asians.

Methods:
We surveyed 105 US South Asian adult participants recruited at a community event. Respondents provided information on acculturation (measured by the adoption of English spoken at home), and family history of CVD and HTN in parents and siblings. Prevalence of CVD and HTN were compared between those with or without factors of interest. Multivariate logistic regression models were run for family history variables of interest, adjusted for age, gender, and English speaking at home.

Results:
Participants had median age 54 (range 20-75) years, and 69.2% were male. The Table shows the association of parental and sibling history of CVD and hypertension with having CVD or HTN personally, and the association of home language with these conditions. Multivariate adjusted logistic regression analysis found little attenuation, in that , sibling history of CVD remained significantly associated with personal CVD (p = 0.026), parental history of HTN remained significantly associated with personal HTN (p=0.004) and sibling history of HTN remained significantly associated with personal HTN (p=0.014).

Conclusion:
Among South Asians in the US, family history in 1st degree relatives, rather than language acculturation, is associated with personal CVD and HTN, suggesting a genetic burden. The stronger association of sibling history rather than parental history of CVD suggests a possible role of environmental or secular factors that siblings may share more than parents and offspring. In this population at high risk of CVD, careful recording of family history may help early prevention strategies.
Abstract P429: Coffee Intake is Associated With Enhanced Insulin Sensitivity, Lower Post-Load Glucose Responses, and Lower Truncal Adiposity
Authors: Sevilla-Gonzalez Magdalena , Tobias Deirdre K , LeBoff Meryl , Demler Olga , Pradhan Aruna D , Mora Samia , Lee I-Min , Buring Julie , Manson JoAnn , Li Jun
Published: May 2024

Higher coffee consumption has been associated with lower type 2 diabetes (T2D) risk, but the underlying mechanisms remain unclear.

We tested the hypothesis that coffee intake is associated with improved glycemia insulin sensitivity, and reduced adiposity.

We leveraged data in the VITamin D and OmegA-3 Trial (VITAL), a completed placebo-controlled 5-year trial including 25871 participants. Coffee intake was assessed by a diet questionnaire at baseline and year 2. In the VITAL clinical subcohort (n= 1054), glucose metabolism and insulin resistance were assessed by a 2-hr oral glucose tolerance test, body composition was measured by the dual X-ray absorptiometry, at baseline and year 2. We analyzed the association of coffee intake with glycemic traits and body composition, leveraging repeated assessments using multivariable-adjusted linear mixed models. Secondarily, we tested associations between coffee intake and T2D risk, in 22327 initially T2D-free individuals (482 cases in 5 years of follow-up) using multivariable-adjusted Cox regression.

While coffee intake was not associated with fasting glucose or insulin levels, it was significantly associated with lower levels of 2-hr post-load glucose (SD difference per cup increment β = -0.062,
P
= 0.04) and insulin (β = -0.064,
P
= 0.02), and a higher metabolic clearance rate of glucose (β= 0.057,
P
= 0.007) and insulin sensitivity index (β= 0.059,
P
= 0.02). The associations were consistent for caffeinated and decaffeinated coffee. Further, caffeinated coffee intake was associated with higher body weight (β= 0.018,
P
= 0.02), but total coffee intake was associated with a lower truncal to limb fat ratio before and after adjusting for BMI (β= -0.057,
P
= 0.03). We did not observe evidence of association with incident T2D (HR =0.63; 95% CI 0.15-2.50).

Higher coffee intake was associated with improved post-load glucose metabolism and insulin sensitivity, and lower truncal adiposity.

The figure displays result estimates of linear mixed models. Asterisks represent associations
P
< 0.05.
Abstract P461: Concordance of Hypoglycemia Symptoms Reported in Real-Time via Smartphone and Hypoglycemia Detected Using Continuous Glucose Monitoring (CGM) in Adults With Type 2 Diabetes
Authors: Sartini Joseph , Fang Michael , Mu Scott , Wang Dan , Rebholz Casey M , Mitchell Christine M , Appel Lawrence J , Zeger Scott , Pilla Scott , Selvin Elizabeth
Published: May 2024

Introduction:
Understanding the association between low glucose readings (hypoglycemia) detected by CGM and hypoglycemic symptoms experienced by people with diabetes is critically important for diabetes management. However, tools that capture hypoglycemic symptoms in real-time are lacking.

Objective:
Implement a real-time hypoglycemia symptom reporting tool and examine agreement between self-reported hypoglycemia symptoms and CGM-detected hypoglycemia.

Methods:
We developed a survey tool for real-time reporting of symptoms via smartphone (
Fig. 1A
) using REDCap, and implemented this tool in an ongoing, randomized clinical trial of adults with type 2 diabetes, the Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) trial. DASH4D participants wore a CGM sensor (Abbott Libre Pro) for up to 5 periods (max 2-weeks per period), and we offered the option to report symptoms using the real-time survey tool during each CGM wear. We examined the concordance of real-time reported symptoms and CGM-detected hypoglycemia (glucose <70 mg/dL for > 15 minutes) (
Fig. 1B
). Concordance was defined as CGM-detected hypoglycemia occurring within 30 minutes before or after a reported symptom.

Results:
Of 159 participants who wore a CGM, 114 (72%; mean age 64 years; 86% Black; 64% female) used the real-time symptom reporting tool (the remainder used a paper-based booklet). Across all CGM wear-periods (N=280), participants reported a mean 1.94 symptoms per period. Fatigue was the most common (37 occurrences); unsteadiness and passing out were not reported (
Fig. 1C
). The overall concordance between self-reported symptoms and CGM-detected hypoglycemia was 3% (
Fig. 1D
).

Conclusion:
We developed a simple and secure smartphone-based tool allowing patients with diabetes to report hypoglycemic symptoms in real-time. Concordance of CGM-detected hypoglycemia with symptoms was low, indicating substantial disconnect between perceived symptoms and CGM-detected hypoglycemic events among adults with type 2 diabetes. [NCT04286555]