bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract EP29: Sex Differences In Anxiety Associated With Left Ventricular Hypertrophy And Transmural Dispersion Of Repolarization In Hypertensive Patients
Authors: Zhu Ling , Cui Qianwei , Zhang Yong , Wang Juikui , Liu Fuqiang , Zhao Jingsha
Published: April 2022

Background:
Previous studies showed that hypertensive with anxiety have a higher mean left ventricular mass index (LVMI) and QTc dispersion. This study explores the associations between anxiety and left ventricular hypertrophy (LVH) as well as transmural dispersion of repolarization (TDR) (as detected by T peak-T end interval/QT interval, Tp-Te/QT ratio) in hypertensive patients.

Methods:
A total of 353 uncomplicated hypertensive patients were enrolled at Shaanxi Provincial People’s Hospital from 2017 to 2021. All enrolled subjects completed the Hamilton Anxiety Scale (HAMA). HAM-A score ≥14 was defined as the presence of anxiety. The association between HAM-A and hypertensive LVH was estimated with logistic regression models. The association between HAM-A score and Tp-Te/QT was estimated with linear regression model (adjusted for age, sex, body mass index, smoking, creatinine, uric acid, triglyceride, total cholesterol, low density lipoprotein cholesterol, and high-density lipoprotein cholesterol). This study was approved by the Ethics Committee of Shaanxi Provincial People’s Hospital and performed in keeping with the requirements of the Declaration of Helsinki.

Results:
Participants were divided into two groups according to anxiety or not. The LVMI was significantly higher in hypertensive patients with anxiety than hypertensive patients without anxiety (no anxiety: 84.36±23.82, anxiety: 105.75±25.45, g/m
2
,
P
<0.001). The HAM-A score was positive correlated with LVMI (r=0.578,
P
<0.001) and Tp-Te/QT (r=0.252,
P
<0.001). In logistic regression models, hypertensive patients with anxiety had a higher risk of hypertensive LVH than hypertensive patients without anxiety (unadjusted OR, 2.86, 95% CI, 1.65-4.93,
P
<0.001; adjusted OR, 2.62, 95% CI, 1.49-4.64,
P
<0.001). Linear regression analysis also showed that HAM-A score was associated with Tp-Te/QT ratio (unadjusted β, 0.002, 95% CI, 0.001-0.002,
P
<0.001; adjusted β, 0.002, 95% CI, 0.001-0.002,
P
<0.001). There was an interaction between sex and anxiety in regard to LVH risk (
P
for interaction = 0.035) and increased Tp-Te/QT (
P
for interaction = 0.014). After stratification by sex, the anxiety group had a higher risk of hypertensive LVH than no anxiety group in male (unadjusted OR, 5.73, 95% CI, 2.43-13.50,
P
<0.001; adjusted OR, 5.39, 95% CI, 2.13-13.66,
P
<0.001) but not in female (unadjusted OR, 1.70, 95% CI, 0.82-3.53,
P
=0.152; adjusted: OR, 1.62, 95% CI, 0.76-3.45,
P
=0.209) hypertensive patients. HAM-A score was also associated with Tp-Te/QT ratio in male (unadjusted β, 0.003, 95% CI, 0.002-0.004,
P
<0.001; adjusted β, 0.003, 95% CI, 0.001-0.004,
P
<0.001) but not in female (unadjusted β, 0.001, 95% CI, -0.0001-0.002,
P
=0.061; adjusted β, 0.001, 95% CI, -0.0001-0.002,
P
=0.086).

Conclusion:
Our data indicated that anxiety is associated with LVH and increased TDR in male but not female hypertensive patients.
Abstract EP39: Examining Capabilities, Opportunity, And Motivation For Healthy Eating Behaviors In Latin American Restaurants: A Quantitative Application Of The COM-B Model To Inform Future Interventions
Authors: Fuster Melissa , Santos Maria , Huang Terry T , Handley Margaret A
Published: April 2022

Introduction:
Latin American restaurants (LARs) are an increasingly important food source with the potential to positively influence diets to promote cardiovascular health. Yet, modifiable factors influencing food choices in LARs remain unclear. Determinants frameworks, such as the Capabilities, Opportunities, and Motivation for Behavior (COM-B Model) can help identify key drivers of dietary behaviors for informing intervention design.

Objectives:
(1) Apply the COM-B model to understand healthy eating behavior at LARs; (2) Examine differences in COM-B factors by ethnicity (Latin/Hispanic background), age, income, gender, and education.

Methods:
We developed a Likert scale to quantitatively assess the capabilities (physical and psychological), opportunities (social and physical), and motivation (reflective and automatic) factors associated with healthy eating in LARs. The scale was applied as part of an online survey with adults in the United States that reported eating food from LARs at least once a month (n=509). Bivariate analyses were used to examine the association between COM-B scores and demographic characteristics.

Results:
Within a possible range of 0-12, the mean COM-B total score was 7.35±1.97. Higher overall scores were significantly associated with being from a Latin background (p=0.04) and having a higher income (p=0.02). Within a possible range of 0-2 for COM-B area scores, the lowest score was found for Psychological Capability (0.95±0.97), where higher mean scores were found among men (p=0.03), older age (p=0.04), and those with higher education (p<0.001). The Social Opportunity score (1.04±0.48) was significantly associated with being younger (p=0.001) and of Latin background (p<0.001), while the Physical Opportunity score (1.27±0.55) was highest among those with lower education (p=0.04) and age (p=0.008). Reflective motivation presented the highest mean score (1.46±0.37) and was positively associated with high income (p=0.019) and education (p<0.001). No significant association with demographic characteristics was found for the Automatic Motivation and Physical Capability scores (1.21±0.53 and 1.43±0.73, respectively).

Conclusions:
This work addresses a research gap to inform future interventions to improve community food environments through work with LARs. The application of the COM-B revealed areas for intervention, particularly the need to improve knowledge (Psychological Capability) and social opportunity, the areas with the lowest scores, to promote healthier eating behaviors at LARs. Future research can be used to promote innovative ways to change perceptions of Latin foods in LARs and awareness of existing healthy offerings, which at the same time may help motivate LARs owners in increasing healthy offerings.
Abstract EP42: Effects Of Bariatric Surgery On Acute Coronary Syndrome
Authors: Aung Pyi Phyo , Park Kyeeun , Wu Fangcheng , Konidala Navy , Nge Htoo Myat
Published: April 2022

Obesity is one of the most common and modifiable risk factors of cardiovascular diseases. Bariatric surgery (BS) is a fast-growing procedure being used to treat patients with morbid obesity, obesity with significant comorbidities or failed dietary and pharmacological therapy. We assessed the hypothesis that bariatric surgery has positive effects on acute coronary syndrome (ACS) in obese population.

We conducted a retrospective analysis of 3 years of the National Inpatient Sample (NIS) database, 2016 to 2018. Study populations were selected using ICD-10 diagnosis code. Discharge-level weight analysis was used to produce a national estimate. We conducted multivariate regression analysis to calculate odds ratio with STATA 17.

During the study period, 106,970,745 patients were discharged, and 2,996,629 patients experienced acute coronary artery syndrome during the hospitalization. Total 962,780 (0.90%) patients had history of bariatric surgery. Patients with BS tended to be female (77.84 % v 56.21 %), older (54.91± 0.30 v 49.43 ± 0.01), diabetic (28.47% v 22.50%) and hypertensive (42.60% v 29.23%) but prevalence of hyperlipidemia was similar in both groups (3.73% v 3.23%). The prevalence of ACS was significantly reduced with BS in patient with obesity (1.51% v 2.81%). After adjusting for age, sex, race and comorbid burden, obesity was associated with higher risk of ACS (OR 1.13, 1.13 - 1.15, p<0.0001), whereas patients with obesity who underwent BS was associated with lower risk for ACS (OR 0.61, 0.59 - 0.64, p< 0.0001). After adjusting for comorbidities, BS decreased the risk of in-hospital mortality (OR 0.67, 0.56-0.80, p< 0.0001) and major cardiovascular events (OR 0.59, 0.48-0.72, p< 0.0001).

In conclusion, bariatric surgery is associated with lower risk of acute coronary syndrome as well as better outcomes including lower in-hospital mortality and lower major cardiovascular events in obese population.
Abstract EP67: Early Menopause Is Linked To Increased Risk Of Presenile Dementia Before Age 65 Years
Authors: Hao Wenting , Fu Chunying , Zhu Dongshan
Published: April 2022

Introduction:
Evidence on the association between age at menopause and risk of dementia has been inconsistent. Some studies observed that later menopause was related to lower risk of dementia, while others reported no association, or even came to the opposite. Estradiol plays an important role in a wide range of neurological functions in brain, so the reduction of endogenous estrogen at menopause may aggravate brain changes related to neurodegenerative diseases, and accelerate the progression of dementia.

Hypothesis:
Based on the neuroprotective effects of estrogen, we hypothesized that earlier menopause might be related to higher risk of and earlier onset of dementia, compared with menopause at normal age or later.

Methods:
We used cohort data from UK Biobank and a total of 153 291 postmenopausal women were included. Age at menopause was categorized as <40 (premature), 40-44 (early), 45-49, 50-51 (reference), 52-55, and >55 years. The main outcome was all-cause dementia, a comprehensive outcome including Alzheimer's disease (AD), vascular dementia (VD) and dementia classified elsewhere. We used Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between menopausal age and all-cause dementia. We also stratified the age when dementia was diagnosed into ≤65 years and >65 years to explore the association between age at menopause and timing of experiencing dementia. All HRs were adjusted for age at last follow-up, race, education level, BMI, cigarette smoking, alcohol drinking, cardiovascular disease status, diabetes status, income, leisure activities and physical activities. We also used restricted cubic splines to analyze the dose-response relationship between menopausal age and dementia.

Results:
Among the 153 291 women, there were 1688 woman suffering from all-cause dementia. The average follow-up time was 11.7 years. Compared with menopausal age of 50-51 years, the HRs (95% CI) with dementia in women with menopausal age <40, 40-44, 45-49, 52-55 and >55 years were 1.53 (1.22-1.91), 1.07 (0.89-1.28), 1.08 (0.94-1.25), 0.81 (0.70-0.94), and 0.91 (0.78-1.06) respectively. Restricted cubic spline also showed an inverse dose-response relationship between them. In addition, compared to women with menopausal age of 50-51 years, women with early menopause (<45 years) had elevated risk of experiencing all-caused dementia before age 65 years (1.31, 1.07-1.72;
P
<0.001).

Conclusions:
Compared to women with menopausal age of 50-51 years, women with premature menopause (<40 years) had around 35% higher risk of having all-cause dementia, and women with early menopause (<45 years) were 1.3 times more likely to experience presenile dementia before age 65 years. Women with early menopause may need a close monitoring of their cognitive decline in clinical practice.
Abstract EP70: Adolescent Arterial Stiffness Precedes Elevated Resting Heart Rate In Young Adulthood: A 7-year Temporal Longitudinal Analysis Using Cross-lagged Structural Equation Model
Authors: Agbaje Andrew O , Barker Alan R , Tuomainen Tomi-Pekka
Published: April 2022

Introduction:
Elevated resting heart rate in adults is an established risk factor in the lifelong process of atherogenesis and its intermediate process such as arterial stiffness. Arterial stiffness is an independent predictor of cardiovascular events. However, it is unclear whether resting heart rate temporally and bi-directionally associates with arterial stiffness especially among healthy adolescents and young adults. Hence, plausible biologic pathways through which elevated resting heart rate associate with arterial stiffness in the young population remains unknown.

Hypothesis:
To examine the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, with resting heart rate among adolescents aged 17.7 years.

Methods:
We studied 3862 (55.5% female) British adolescents followed up for 7 years until 24.5 years of age, using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England, UK. At baseline and follow-up, fat mass and lean mass were measured by dual-energy Xray absorptiometry, systolic blood pressure and heart rate by Omron BP/pulse monitor, and cfPWV by Vicorder ultrasound scan. We conducted logistic regression and cross-lagged autoregressive structural equation model analyses and adjusted for age at baseline, sex, moderate to vigorous physical activity, smoking status, family history of cardiometabolic diseases, time in years between measurement at 17.7 and 24.5 years, systolic blood pressure, fat mass, lean mass, and fasting plasma samples viz. low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, high-sensitivity C-reactive protein, glucose, and insulin.

Results:
Participants' mean (SD) age in years was 17.72 (0.33) and 24.54 (0.73) at baseline and follow-up, respectively. Among 3862 adolescents, 10% were at moderate to high risk of elevated resting heart rate at 24.5 years. Higher cfPWV at 17.7 years was associated with the risk of elevated resting heart rate at follow-up [
Odds ratio
= 1.32 (95%
confidence interval
1.06 - 1.65); p=0.014]. In the cross-lagged temporal analysis, higher cfPWV at 17.7 years was associated with higher resting heart rate [
Standardized regression coefficient
(β) = 0.06
standard error
(SE) = 3.85, p<0.0001] at 24.5 years, however, higher resting heart rate at 17.7 years was not associated with cfPWV [β = -0.03, SE <0.0001, p=0.179] at 24.5 years.

Conclusion:
We observed, for the first time, in a large healthy cohort of adolescents that arterial stiffness temporally preceded elevated resting heart rate in young adulthood, after controlling for cardiometabolic and lifestyle factors. This evidence informs that public health and clinical effort may be targeted at early detection and prevention of arterial stiffness from adolescence.
Abstract MP10: Risk Factors For Diabetic Foot Infection: The Atherosclerosis Risk In Communities (ARIC) Study
Authors: Fang Michael , Hu Jiaqi , Matsushita Kuni , Selvin Elizabeth , Hicks Caitlin W
Published: April 2022

Introduction:
Foot infections occur frequently among people with diabetes and significantly elevate the risk of lower-extremity amputations. However, risk factors for the onset of diabetic foot infection (DFI) in the community remain poorly characterized.

Methods:
We conducted a prospective cohort analysis of incident DFI using data from the Atherosclerosis Risk in Communities (ARIC) Study. We used Cox regression models to evaluate associations of demographics, cardiometabolic measures, prevalent complications, diabetes duration, and glycemic control with DFI. Incident DFI was ascertained from ICD-9/10 codes from hospital records and Medicare claims, with follow-up to December 31, 2018.

Results:
We included 1,451 participants with diabetes (mean age, 63 years; 33% black; 47% female, median duration of diabetes 6.2 years). During a median follow-up of 14.4 years, there were 332 incident DFIs (16.8 per 1,000 person-years). Independent risk factors for DFI included older age at baseline (HR: 1.41 per 5 year, 95% CI: 1.11, 1.80), chronic kidney disease (HR: 1.39, 95% CI: 1.08, 1.78), glycemic control (poor vs good, HR: 1.66, 95% CI: 1.24, 2.21), long diabetes duration (
>
9 years vs <9 years, HR: 1.61, 95% CI: 1.28, 2.03), retinopathy (HR: 1.75, 95% CI: 1.33, 2.31), subclinical cardiovascular disease (vs no cardiovascular disease, HR: 1.95, 95% CI: 1.23, 3.08), and clinical cardiovascular disease (vs no cardiovascular disease, HR: 1.36, 95% CI: 1.06, 1.74)
(Figure)
.

Conclusion:
Our results suggest that older adults with poor glycemic control, long standing diabetes, and cardiovascular, renal, or retinal complications are at increased risk of developing DFIs. Individualized foot care education, frequent foot screenings, and access to specialized footwear are warranted to reduce foot-related complications for these high-risk populations.
Abstract MP11: Impact Of Severe Acute Respiratory Syndrome Coronavirus 2 (sars-cov-2) Pandemic On Diabetes Care Among A North Carolina Patient Population
Authors: Bancks Michael P , Lin Meng-Yun , Bertoni Alain G , Futrell Wendell , Liu Zhixiu , Ostasiewski Brian , Wells Brian J , Hanchate Amresh
Published: April 2022

Introduction:
We assessed whether the coronavirus disease 2019 (COVID-19) pandemic was associated with within-individual delays in diabetes care processes of glycated hemoglobin (HbA1c) testing, retinal exam, and nephropathy evaluation among patients receiving regular care with Wake Forest Baptist Health (WFBH), overall and stratified by clinical factors, race and ethnicity, and socioeconomic status.

Methods:
We used electronic health record data for 25,323 WFBH adult patients with diabetes (96% type 2; 53% women; mean age ± SD: 63±13 years). We used
Current Procedural Terminology
codes to identify each diabetes care process occurring between 3/1/2018 and 2/28/2021. Delayed care between serial assessments was defined as a duration of >6 months for HbA1c testing and >12 months for retinal exam and nephropathy evaluation. We used individual-level fixed effects regression to estimate within-person change in outcomes before and after the start of the COVID-19 pandemic (3/1/2020), overall and among subgroups.

Results:
During the pandemic, there was a 12.7 to 20.6 percentage point increase in the incidence of delayed diabetes care (
Table
). We did not observe clinically meaningful differences in delayed care for any of the diabetes care procedures during the pandemic across socio-demographic subgroups. However, individuals with the highest HbA1c and greatest burden of comorbidities, respectively, had the greatest increase in the incidence of a delayed HbA1c test during the pandemic.

Conclusions:
The COVID-19 pandemic was associated with an increase in within-individual delays in HbA1c testing, retinal exams, and nephropathy evaluations. Delays were greatest for individuals with the most severe disease and may portend an increase in diabetes complications.
Abstract MP13: Serum Metabolomic Signatures Of Plant-based Diets And Incident Chronic Kidney Disease
Authors: Kim Hyunju , Yu Bing , Li Xin , Wong Kari E , Boerwinkle Eric , Seidelmann Sara B , Levey Andrew S , Rhee Eugene P , Coresh Josef , Rebholz Casey M
Published: April 2022

Introduction:
Greater adherence to plant-based diets is associated with a lower risk of incident chronic kidney disease (CKD). Metabolomics can help identify blood biomarkers of plant-based diets and understand the underlying mechanisms.

Objectives:
Using untargeted metabolomics, we aimed to identify metabolites associated with 4 plant-based diet indices (PDI) [overall PDI, provegetarian, healthful PDI, and unhealthful PDI] and incident CKD in 2 subgroups within the Atherosclerosis Risk in Communities Study.

Methods:
Participants (n
1
=1,762; n
2
=2,152) reported usual dietary intake using a food frequency questionnaire. We used linear regression models to examine the association between 4 PDIs and 374 individual metabolites. We used Cox regression models to evaluate associations between PDI-related metabolites and incident CKD. Estimates were meta-analyzed across 2 subgroups. We calculated C-statistics to assess whether metabolites improved the prediction of those in the highest quintile vs. lower 4 quintiles of PDIs, and whether PDI-related metabolites predicted incident CKD.

Results:
We identified 82 significant PDI-metabolite associations (overall PDI=27; provegetarian=17; healthful PDI=20; unhealthful PDI=18); 11 metabolites overlapped across the overall PDI, provegetarian, and healthful PDI. The addition of metabolites improved prediction of those in the highest quintile vs. lower 4 quintiles of PDIs compared to participant characteristics alone (
P
-value ≤0.001 for all tests). Six PDI-related metabolites representing 2 pathways were significantly associated with incident CKD (
Table
) and improved prediction of incident CKD beyond traditional risk factors (difference in C-statistics for all 6 metabolites=0.005,
P
-value=0.006).

Conclusions:
In a community-based study of US adults, we identified metabolites that were related to plant-based diets that predicted incident CKD. These metabolites highlight pathways through which plant-based diets are associated with incident CKD.
Abstract MP14:
In Utero
Exposure To Metals And Trace Elements affects Cord Blood Metabolome Profile: Findings From An Urban Minority Birth Cohort In The United States
Authors: Zhang Mingyu , Buckley Jessie , Liang Liming , Hong Xiumei , Wang Guoying , Wang Mei-Cheng , Wills-Karp Marsha , Wang Xiaobin , Mueller Noel T
Published: April 2022

Background:
Exposure to metals lead (Pb), mercury (Hg), and cadmium (Cd) and trace elements selenium (Se) and manganese (Mn) has been linked to the developmental origins of cardiometabolic diseases, but the mechanisms are not well-understood.

Objective:
Conduct a metabolome-wide association study to understand how
in utero
exposure to Pb, Hg, Cd, Se, and Mn affects the metabolic programming of fetuses.

Methods:
We used data from mother-infant pairs in the Boston Birth Cohort. We measured metals and trace elements in maternal red blood cells (RBCs) collected 24-72 hours after delivery, and metabolites in cord blood collected at birth. We used multivariable linear regression to examine associations of metals and trace elements with metabolites and Bonferroni correction to account for multiple comparisons. We assessed non-linear associations of metals and trace elements with metabolites using restricted cubic spline plots.

Results:
This analysis included 690 mother-infant pairs (57% Black and 24% Hispanic). After Bonferroni correction, 25 cord metabolites were associated with at least one metal or trace element (Figure). Pb was negatively associated with the xenobiotic piperine, Cd was positively associated with xenobiotics cotinine and hydroxycotinine, and Hg was associated with 8 lipid metabolites (in both directions). Mn and Se shared associations with 6 metabolites (in both directions), which mostly included nucleotides and amino acids; Mn was additionally associated C36:4 hydroxy phosphatidylcholine and Se was additionally associated with 7 metabolites (mostly amino acids, nucleotides, and carnitines). Most associations were linear.

Discussion:
Maternal RBC metal and trace element concentrations were associated in a dose-dependent fashion with cord blood metabolites. What remains to be determined is whether these metals- and trace elements-associated changes in cord metabolites can influence a child’s future risk of cardiometabolic diseases.
Abstract MP24: Neighborhood Cohesion And Violence In Port-au-Prince, Haiti, And Their Relationship To Cardiovascular Risk Factors Of Stress, Depression, And Blood Pressure
Authors: Rouzier Vanessa , Yan Lily D , Lookens Pierre Jean , Devieux Jessy G , GERBER Linda M , Apollon Alexandra , St-Preux Stephano , Metz Miranda , Deschamps Marie , Pape Jean William , Mcnairy Margaret
Published: April 2022

Introduction:
Neighborhood social context including violence and cohesion may impact cardiovascular disease risk factors in countries like Haiti with high civil unrest. We describe these factors using validated instruments (Neighborhood Collective Efficacy, City Stress Inventory), and hypothesized higher cohesion and lower violence were associated with lower stress, depression, blood pressure (BP), and hypertension.

Methods:
We collected data from a population-representative cohort of adults in Port-au-Prince, Haiti between March 2019 to April 2021, including stress (Perceived Stress Scale), depression (PHQ-9), blood pressure, and hypertension (SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or on medications). Adjusting for age and sex, multivariable linear and Poisson regressions assessed the relationship between exposures (neighborhood violence, neighborhood cohesion) and outcomes (stress, depression, BP, hypertension).

Results:
Among 2,799 adults, 59.7% were female and median age was 41 years (IQR:28-55). Participants reported high cohesion (median 15/25, IQR:14-17) and moderate violence (9/20, IQR:7-11). Stress was moderate (8/16), 12.8% had at least moderate depression, and 30.4% had hypertension. In regressions, higher violence at all levels was associated with higher depressive symptoms (Q4 vs Q1: +2.94 score, 95%CI 2.51, 3.38). Violence was also weakly associated with slightly higher stress (Q4 vs Q1: +0.32 score, 95%CI 0.04, 0.59), and lower hypertension prevalence (Q2 vs Q1: PR 0.86, 95%CI 0.75, 0.99). Cohesion was weakly associated with lower stress (T3 vs T1: -0.43 score, 95%CI -0.71, -0.16), depression (T2 vs T1: -0.63 score, 95%CI -1.02, -0.24), and higher DBP (T2 vs T1: 1.23 mmHg, 95%CI 0.065, 2.39).

Conclusions:
In conclusion, we found high perceived cohesion and moderate violence. The strongest association was between higher violence and higher depression. Paradoxically, higher violence and lower cohesion were associated with lower hypertension and DBP, possibly due to unmeasured confounding.
Abstract MP30: Circulating MicroRNA-128-1 And Changes In Energy Metabolism And Insulin Sensitivity In Response To Weight Loss Diet Interventions: The Pounds Lost Trial
Authors: Heianza Yoriko , Xue Qiaochu , Rood Jennifer , Bray George , Sacks Frank , Qi Lu
Published: April 2022

Background:
MicroRNA (miRNAs) are short non-coding RNAs that play important roles in regulating gene expression. Recently, miR-128-1 was identified as a potential thrifty miRNA that controls energy expenditure, contributing to obesity and metabolic diseases. miR-128-1 is located at the locus harboring the lactase (
LCT
) gene, a hallmark gene of the positive selection and evolutionary adaptation to famine by promoting energy storage.

Hypothesis:
We investigated whether circulating thrifty miR-128-1 was associated with insulin resistance, adiposity, and energy expenditure among adults with overweight and obesity and tested whether miR-128-1 was associated with changes in these metabolic conditions after low-calorie weight-loss diet interventions.

Methods:
We included 495 participants from the POUNDS Lost trial with available data on circulating miR-128-1-5p measured at baseline and 6 months after the intervention. The
LCT
genotype rs4988235, which is responsible for lactase persistence in Europeans, was assessed to analyze the relationship between miR-128-1 and the positive selection at this locus. Outcome measurements included adiposity (weight, waist circumference [WC], and body composition), insulin resistance (HOMA-IR), and energy metabolism. Habitual physical activity was assessed by the Baecke questionnaires; total, leisure time, sport, work index were calculated.

Results:
The
LCT
rs4988235 (A) allele was associated with higher levels of miR-128-1 (
p
=0.04). Pre-intervention miR-128-1 was significantly and positively associated with HOMA-IR (
p
=0.009), insulin (
p
=0.008), BMI (
p
=0.0002), WC (
p
=0.036), and whole-body total % fat mass (
p
=0.013), and energy metabolism (resting energy expenditure, oxygen consumption, and carbon dioxide production;
p
<0.05 for all). Also, we found that higher miR-128-1 was related to lower total physical activity index (
p
=0.001) and subscales (leisure index (
p
=0.007) and sport index (
p
=0.02)). We found significant interactions between miR-128-1 and physical activity on changes in adiposity and insulin resistance at 6 months after the interventions (

P
interaction

=0.03 for weight;

P
interaction

=0.004 for WC; and

P
interaction

=0.01 for HOMA-IR). Participants with lower levels of physical activity and higher miR-128-1 at baseline responded better to the intervention to improve HOMA-IR at 6 months. There were also significant interactions between changes in miR-128-1 and changes in physical activity on changes in HOMA-IR and energy expenditure.

Conclusions:
Elevated levels of circulating miR-128-1 were associated with greater adiposity and insulin resistance in adults with overweight and obesity. The thrifty miR-128-1 interacted with physical activity on changes in energy metabolism and insulin sensitivity in response to weight-loss diet interventions.
Abstract MP36: Association Between The Quality Of Plant-based Diets And Risk Of Frailty
Authors: Sotos-Prieto Mercedes , Struijk Ellen A , Fung Teresa T , Rodriguez-Artalejo Fernando , Willett Walter , Hu Frank B , Lopez-Garcia Esther
Published: April 2022

Importance:
The Mediterranean diet, and other dietary patterns rich in fruits and vegetables, have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk.

Objective:
To assess the association between plant-based diet quality and risk of frailty.

Design, setting, and participants:
Prospective cohort with 82,234 women aged ≥60y from the Nurses’ Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to -June 23, 2021.

Exposures:
Dietary data were collected every 4-y using a validated semi-quantitative food frequency questionnaire. The plant-based diet quality was assessed with 2 indices (range 18 - 90 points).: a) Healthful Plant-Based Diet Index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, sweets/desserts) and animal foods received reverse scores; and b) Unhealthful Plant-Based Diet Index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods.

Main outcomes:
Frailty incidence was assessed every 4 years, being defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss ≥5%.

Methods:
Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs), and their 95% confidence interval (CI).

Results:
We identified 12,910 incident cases of frailty over 1,176,401 person-year follow-up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (HR for the highest vs. lowest quintile: 0.69, 95% CI: 0.65-0.73; p-trend<0.001). In addition, a 10-unit increment in the hPDI was associated with a relative 20% lower risk of frailty. Conversely, a direct association was found between the uPDI and risk of frailty (HR highest vs. lowest quintile: 1.41, 95% CI: 1.32-1.49]; p-trend<0.001). These associations were consistent for each frailty criterion, among participants with no frailty criteria at baseline, after excluding participants with diabetes, cancer, and CVD at baseline, for alternative versions of the PDIs, in subgroup analysis by categories of potential confounders, and in latency analysis.

Conclusions and relevance:
A healthful plant-based diet was associated with lower risk of frailty whereas an unhealthful plant-based diet was associated with higher risk.
Abstract MP42: Physical Activity And Clinical Outcomes Among Older Adults With Atrial Fibrillation
Authors: Mehawej Jordy , Dai Qiying , Saczynski Jane , Tran Khanh-van T , Hariri Essa , Abu Hawa O , Paul Tenes , Filippaios Andreas , Kiefe Catarina I , Tisminetzky Mayra , Wang Weijia , Soni Apurv , Goldberg Robert , McManus David D
Published: April 2022

Background:
Current guidelines encourage adults with atrial fibrillation (AF) to engage in regular physical activity. However, little is known about the association between meeting the recommended level of regular physical activity and clinical outcomes among older adults with AF.

Objective:
To examine the association between meeting the recommended level of physical activity and clinical outcomes including mortality, stroke, and major bleeding.

Methods:
We used data collected from the Systemic Assessment of Geriatrics Elements (SAGE)-AF study which include patients with AF (≥65 years) and a CHA
2
DS
2
-VASc score ≥2. Participants were recruited from several clinics in Massachusetts and Georgia. We used the Minnesota Leisure Time Physical Activity questionnaire to examine if participants met the recommended level of physical activity (i.e. at least 500 metabolic equivalent task (MET)-minutes per week). A multivariable cox regression model was used to examine the association between meeting the recommended level of physical activity and our clinical outcomes while controlling for several potentially confounding variables.

Results:
A total of 1,244 participants (average age 75 years; 49% male; 85 % non-Hispanic White) were included in this study. Nearly one-half of participants engaged in regular physical activity. Meeting the recommended level of physical activity was associated with improved survival
(adjusted HR (aHR) = 0.60, 95% CI = 0.38-0.96).
However, engaging in regular physical activity was not significantly associated with reduced risk of stroke or major bleeding (
aHR = 1.37, 95% CI = 0.51-3.69; aHR = 0.86, 95% CI = 0.56-1.33, respectively
), although we may have lacked power for these associations, therefore, these results should be interpreted with caution.

Conclusions:
Meeting the recommended level of physical activity among older adults with AF significantly reduces the risk of mortality. Clinicians and health care providers should promote and encourage engagement in physical activity and tailor interventions to address barriers of engagement to improve patient survival.
Abstract MP55: Declining Annual Trends In Us Daily Sleep Duration Are Greater Among Racial/ethnic Minorities: Implications For Cardiometabolic Disease Disparities
Authors: Grandner Michael A , Tubbs Andrew , Ghani Sadia , Jean-Louis Girardin , Killgore William , Fernandez Fabian-Xose
Published: April 2022

Introduction:
Habitual insufficient sleep may contribute to cardiometabolic disease in the United States, particularly among racial and ethnic minorities. However, there is mixed evidence on secular trends in U.S. sleep duration. Therefore, this study investigated annual changes in sleep duration, including variations across demographics and how sleep duration was associated with prevalent cardiometabolic disease.

Methods:
Data on 413,417 individuals were acquired from the National Health Interview Survey from 2005-2018. Variables included self-reported sleep duration, lifetime diagnosis of hypertension, coronary heart disease, diabetes, and pre-diabetes, and obesity. Population-weighted linear models estimated annual trends in sleep duration, while population-weighted quasi-Poisson models estimated the prevalence risk of cardiometabolic disease as a function of sleep duration.

Results:
Average daily sleep duration decreased -0.62 minutes annually from 2005-2018. A significant race/ethnicity interaction was found. Compared to Non-Hispanic Whites, the rate of decline was 119% greater among Blacks/African-Americans, 206% greater among Mexican-Americans, 4% greater in other Hispanics/Latinos, and 43% greater in Asians. A 1-hour loss in daily sleep duration was linked to 4% greater prevalence of hypertension, 3% greater prevalence of diabetes, and 8% greater prevalence of obesity after adjusting for age, sex, employment, marital status, and survey year. A significant race/ethnicity interaction was observed, with differential elevated risk of cardiometabolic risk factor prevalence associated with declining sleep (see table).

Conclusion:
There is a secular decline in U.S. daily sleep duration that is disproportionately impacting Black/African-American and Mexican individuals. Moreover, reduced sleep duration is associated with more prevalent cardiometabolic disease and these relationships are disproportionately impacting racial/ethnic minority groups.
Abstract MP56: Sleep Regularity Modifies The Association Of Visceral Adiposity With Elevated Blood Pressure In Adolescents
Authors: Morales-Ghinaglia Natasha , Calhoun Susan L , He Fan , Liao Jason , Vgontzas Alexandros N , Bixler Edward O , Liao Duanping , Fernandez-Mendoza Julio
Published: April 2022

Introduction:
Although obesity, insufficient sleep and sleep apnea are known risk factors for elevated blood pressure, the circadian timing of sleep is also involved in metabolic and blood pressure regulation. As a result, sleep irregularity, which is highly prevalent in adolescents, may be a potential risk factor for obesity-related adverse cardiovascular outcomes.

Hypothesis:
We hypothesize that greater sleep irregularity increases the impact of visceral adiposity on elevated blood pressure in adolescents.

Methods:
We analyzed cross-sectional data from the Penn State Child Cohort follow-up study, a random population-based sample of 303 adolescents (16.2 ± 2.2 year old; 47.5% female; 21.5% racial/ethnic minority) who had complete at-home 7-night (at least 5) actigraphy (ACT) data and in-lab dual-energy X-ray absorptiometry (DEXA) scan and polysomnography (PSG) data. ACT-measured sleep duration and sleep midpoint were calculated as the intra-individual mean of the 7-night total sleep time and the midpoint (zeroed to midnight) of the sleep period, respectively. ACT-measured sleep regularity was calculated as the intra-individual standard deviation of the 7-night sleep midpoint. DEXA-measured visceral adipose tissue (VAT) was the primary predictor. Systolic (SBP) and diastolic (DBP) blood pressure, measured three times in the seated position, were the primary outcomes. Multivariable linear regression models tested sleep midpoint and sleep regularity as effect modifiers of VAT on SBP/DBP levels, while simultaneously adjusting for sex, race/ethnicity, age, ACT-measured sleep duration and PSG-measured apnea/hypopnea index.

Results:
Significant interactions were found between sleep regularity and VAT on SBP (p-interaction=0.009) and DBP (p-interaction=0.039), while not between mean sleep midpoint and VAT (p-interactions=0.210 and 0.883). These findings remained valid even after further adjusting for body mass index percentile (p-interactions=0.006 and 0.034). Among adolescents with high sleep irregularity (≥ 45 minutes; n=124), each standard deviation increase in VAT was associated with a 5.55 (0.91) and 3.07 (0.70) mmHg increase in SBP and DBP, respectively (both p<0.001). Among those with low sleep irregularity (< 45 minutes; n=179) VAT was not significantly associated with SBP [0.69 (0.99), p=0.488] or DBP [0.04 (0.77), p=0.956].

Conclusions:
An irregular circadian timing of sleep may increase the impact of visceral adiposity on elevated blood pressure in adolescents. These data support that sleep irregularity, independent of sleep apnea and insufficient sleep, may contribute to the development of cardiovascular sequelae associated with central obesity.
Abstract MP61: 1-year Prognosis By Coronary Artery And Extra-coronary Calcification In The 75-and-older Population
Authors: Mok Yejin , Honda Yasuyuki , Wang Frances , Howard Candace , Folsom Aaron R , Coresh Josef , Budoff Matthew , Blaha Michael J , Matsushita Kuni
Published: April 2022

Background:
Coronary artery calcium (CAC) is one of the most potent predictors of cardiovascular disease (CVD). Also, thoracic extra-coronary calcification (ECC) (e.g., aortic valve calcification) has provided additional prognostic information beyond CAC. However, data on CAC and ECC as predictors of CVD outcomes are limited in individuals aged ≥75 years and rarely report near-term prognosis despite its importance in the 75-and-older population given life expectancy.

Methods:
In 1,672 ARIC participants (age 75-94 years) without history of clinical coronary heart disease (CHD) at visit 7 (2018-2019), we assessed the associations of CAC and ECC with CVD (including CHD, stroke, and heart failure) over a median follow-up of 1.1 (IQI 0.7-1.5) years (46 CVD total cases), using adjusted Cox models. CAC and ECC were modeled categorically (Agatston scores 0-99 [reference], 100-299, and 300+) and continuously (log[Agatston score+1]).

Results:
Higher scores of CAC and calcium in the aortic valve (only when modeled continuously) and ascending aorta were significantly associated with elevated risk of CVD (e.g., adjusted hazard ratio [HR]: 2.79 [95% CI 1.21, 6.44] for CAC 300+ and 5.90 [2.42, 14.39] for ascending aorta calcium 300+ vs. 0-99.) (
Table
). We confirmed consistent results after excluding participants with prevalent stroke, and the association of aortic valve calcium 300+ with CVD became statistically significant (HR 2.31 [95% CI 1.02, 5.24]. When each CVD outcome was analyzed separately, significant associations with CHD and heart failure were shown in CAC (only when modeled continuously) and ascending aorta calcium (e.g., 4.98 [95% CI 1.10, 22.58] for CHD and 6.88 [2.14, 22.04] in ascending aorta calcium 300+).

Conclusions:
Coronary artery, ascending aorta, and aortic valve calcifications were positively associated with 1-year risk of CVD in 75+ year old. Our results support the prognostic value of CAC and ECC even in very old adults and suggest distinct prognostic implications of different vascular beds.
Abstract MP62: Sex-specific Associations Of Vascular Risk Factors And Brain Mri Measures In The Framingham Offspring
Authors: Petrea Rodica E , Kojis Daniel , Scott Matthew R , Beiser Alexa S , Romero Jose R , De Carli Charles , Seshadri Sudha
Published: April 2022

Aim:
To examine if the associations between vascular risk factors (VRF) and brain MRI measures of brain aging and cerebral small vessel disease are different in men and women.

Background:
Men and women differ in their propensity to develop stroke and this is reflected in sex-specific versions of the widely used Framingham Stroke Risk Prediction (FSRP) index, that provides an estimate of 10-year risk of incident clinical stroke. However, sex-specific associations between the individual risk factor components of FSRP and subclinical vascular brain injury have not been previously explored in our data.

Methods/Design:
We related levels of blood pressure, diabetes, current smoking and prevalent non-stroke cardiovascular disease (CVD) to brain MRI measures of total cerebral brain, hippocampal and white matter hyperintensity volumes (TCBV, HPV, WMHV) and covert brain infarcts (CBI) in 1,579 stroke- and dementia-free Framingham Offspring who attended their 8th quadrennial examination (53% F; age 66±9 years). We examined age-adjusted, sex-stratified linear or logistic regression analyses for all VRF that suggested a sex-interaction at a p<0.1.

Results:
Higher blood pressure (assessed as systolic blood pressure (SBP) or as JNC7 defined Stage 1 HTN (≥140/90 mm Hg or use of antihypertensive medication), had a greater adverse impact on WMHV in women compared to men (SBP: β±SE: 0.009±0.002, p<0.001 versus 0.004±0.002, p<0.031; HTN: β 0.176±0.066, p=0.008 versus non-significant association, in women and men respectively), although prevalent CVD, reflecting lifetime vascular risk factor exposure and injury, had a larger adverse effect on WMHV in men (β -0.221±0.087, p=0.012, versus a non-significant association in women). In addition, both Stage 1 HTN and diabetes had larger adverse effects on TCBV in men (β -0.309±0.141, p<0.029 and -0.853±0.177, p<0.001 respectively, versus non-significant associations in women).

Conclusions:
In our cohort of young-old participants, wherein most women were post-menopausal, current levels of VRF at the time of examination, were associated with a greater burden of vascular brain injury in women than in men of the same age, whereas current VRF levels appeared to have a greater global impact on brain volumes in men. Our data suggest that the greater risk of dementia noted in older women compared to men may be substantially attributable to modifiable vascular risk factors; more aggressively controlling these in women may reduce sex disparities.
Abstract MP63: Longitudinal Analysis Of Handgrip Strength And Cognitive Function During Aging- Share
Authors: Baena Cristina P , Barreto Haagsma Ariele , Souza Dyego , DE MELLO GRAZIELLA MARTINS DE , Olandoski Marcia , Roig Javier J
Published: April 2022

Background:
Aging is associated with various chronic conditions, such as cognitive and muscle strength decline. Previous studies have analysed the association between physical factors and cognitive decline however, the magnitude and the direction of the association between handgrip strength (HGS) and cognitive decline are not fully understood.

Objectives:
To analyse the association between HGS and cognitive decline in numeracy, recall and verbal fluency according to sex in a large multicentric population.

Methods:
A longitudinal study including people aged 50 and over from the Survey of Health, Aging and Retirement in Europe (SHARE) was conducted, involving participants from 28 European countries. Repeated HGS measures from a dynamometer and cognitive scores in numeracy, recall, and verbal fluency were biannually analysed for 4 years. Individuals with Parkinson along the study or dementia diagnosis at baseline were excluded. For the analysis of HGS as a predictor of future cognitive decline, HGS was categorized in quintiles by sex. In men HGS quintiles were Q1 (8-35kg), Q2 (36-41kg), Q3 (42-45kg), Q4 (46-50kg) and Q5 (51-80kg). In women HGS quintiles were Q1 (4-21kg), Q2 (22-25 kg), Q3 (26-28 kg), Q4 (29-32 kg) and Q5 (33-55 kg). First quintile in each sex was used as reference. In the analysis of cognitive performance as a predictor of HGS decline, different cognitive scores were treated in their logarithmical form as a function of HGS continuously. Possible confounding factors were controlled through general estimated equations and adjusted for baseline handgrip strength quintile and time-varying covariates as age, time, education, smoking status, alcohol consumption, physical activity, BMI index, chronical illnesses, Alzheimer disease, depression, functionality scores, and sarcopenia.

Results:
A total of 8,236 individuals were included, 55.73% were females with a mean age of 67.55 (± 8.4) years, while in males it was of 68.42 (±7.7) years. A significant longitudinal association between HGS and cognitive function in all three domains was found in both sexes, except numeracy in males. The fully adjusted β coefficients CI (95%) for the fifth HGS quintile in numeracy, verbal fluency and recall were 0.041 (0.004-0.082), 0.078 (0.038-0.117) and 0.095 (0.039-0.151) respectively for men and 0.076 (0.039-0.113), 0.094 (0.060-0.0128) and 0.092 (0.047-0.137) respectively for women. On the other hand the greatest cognitive predictor of HGS was verbal fluency in both sexes, β(95%), 0.796 (0.464 to 1.128)kg in men and 0.801 (0.567 to 1.109)kg in women.

Conclusion:
There is a significant and bidirectional association between HGS and the cognitive performance in men and women over 50 years studied in SHARE.