bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P029: Sucralose Promotes Increase in Fat Accumulation in Human Mesenchymal Stem Cells
Authors: Sen Sabyasachi , Rouphael Carol , Houston Sara
Published: July 2021

Background:
Artificial sweeteners are extensively used nowadays as a non-caloric sugar alternative. They are sweeter than sugar, with a presumed high safety profile, hence commonly promoted in weight loss and weight maintenance programs as a sugar substitute. However, recent studies showed that saccharin and acesulfame potassium may actually increase adipogenesis. Here we choose to study the effect of Sucralose on Mesenchymal Stem Cells (MSCs), which was never been tested before. MSCs are multipotent cells which can differentiate to adipocytes, myoblasts, osteoblasts or chondroblasts. We were interested to note if presence of sucralose promotes adipocyte formation. Methods: We cultured MSCs in Normal Glucose DMEM media (5.5mM) or in Adipogenic Media (Lonza Inc., 5.5mM) with or without 0.00mM, 0.45mM or 4.5mM of Sucralose for a total of 6 days. At the end of day 6, cells were stained with Oil Red O stain (lipolysis). Cells were lysed post staining and absorbance of the assimilated dye was measured using a plate reader at 520 nm. Non-stained cells from each media and Sucralose concentration were also lysed as control and RNA was collected for RT-PCR to measure oxidation, inflammation and adipogenesis gene expression estimation. Results: Before lysing the cells for absorbance readings, cells were observed under the microscope for phase contrast image. As we increased the Sucralose concentration, (10-fold) a higher number of fat droplets was observed in MSCs cultured. Moreover, absorbance measurements showed that adipogenesis increased by 1.8 folds as we increased the Sucralose concentration from 0.00mM to 0.45mM. It was also increased by 2.85 folds as we increased the concentrations from 0.00mM to 4.5mM in cells cultured in both Normal Glucose and Adipogenic Media. RT-PCR results for oxidation genes ( Catalase, Superoxide dismutase 1, 2 and 3) , inflammation (TNF, IL-6) and adipogenesis( leptin, adiponectin, PPAR-g, FABP-4, c/EBP alpha and c/EBP beta) are pending. In summary, sucralose appears to promote fat accumulation by Oil Red O stain quantification. RT-PCR studies will confirm if adipogenic genes follow a similar pattern of up-regulation. Conclusion: Our studies indicate that sucralose may promote fat accumulation and warrants further cellular and animal model studies
Abstract P030: Traditional Cultural Beliefs and Length of Residence in the United States are Associated With Dietary Intakes Among South Asians
Authors: Talegawkar Sameera A , Kandula Namratha R , Gadgil Meghana D , Desai Dipika , Kanaya Alka M
Published: July 2021

Background:
Studies of immigrants in the United States (U.S.) have shown mixed consequences of acculturation on diet and health outcomes. Detailed investigations examining diets of South Asians in the U.S. are lacking.

Objective:
To examine whether nutrient and food intakes among South Asians differ by traditional cultural beliefs and length of residence in the U.S.

Methods:
Cross-sectional analyses of data collected from 890 South Asians [mean age (SD): 55(9) y; 47% women] who were part of the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. Dietary data were collected using an interviewer administered, validated, culturally appropriate food frequency questionnaire. Acculturation status was assessed by a South Asian traditional cultural beliefs scale which was categorized by tertiles as weak, moderate and strong beliefs, and by length of U.S. residence also categorized using tertiles. We computed daily adjusted mean intakes of selected nutrients across the traditional cultural beliefs and length of U.S. residence tertiles using ANCOVA. Final models were adjusted for age, sex, education, and daily energy intake. Differences in the consumption of foods and food groups (servings/week) between the groups were examined using the Kruskal-Wallis test.

Results:
Length of residence [mean 27 (10.8) y] in the U.S was directly associated with traditional cultural beliefs (P<0.001). Higher daily intakes of total fat, saturated fat, and dietary cholesterol were associated with weak traditional cultural beliefs and a longer length of residence in the U.S. Higher daily intakes of energy, carbohydrate, glycemic index and load, and protein were associated with strong traditional beliefs and a shorter length of residence in the U.S (P for trend <0.05). Weak traditional cultural beliefs and/or a longer length of residence in the U.S. were associated with higher weekly intakes of alcoholic beverages, meat, poultry, seafood and eggs, mixed dishes such as pizza and pasta, fats and oils, and lower intakes of beans and lentils, breads, grains and flour products, fried foods, milk and dairy products, nuts, rice and rice preparations and starchy vegetables (P for differences across groups <0.05).

Conclusions:
Cultural beliefs and length of residence in the U.S. both influence dietary intakes of South Asian immigrants. Unlike other immigrants, more acculturation in South Asians is associated with higher intakes of fat and animal protein and lower intakes of refined carbohydrates. These factors should therefore be considered when investigating and planning dietary interventions among South Indians to mitigate chronic disease risk.
Abstract P032: Wine Consumption and Cognitive Function
Authors: Kamson Chelsey , Bui Alexis K , Golomb Beatrice A
Published: July 2021

Background:
Regular modest wine consumption may be linked favorably or adversely to cognition.

Goal:
To assess the cross-sectional relation between wine consumption frequency (
WineF
) & cognitive indices.

Method:
Of 1018 adults age 20-85 without CVD or DM, 945 completed a food frequency questionnaire eliciting WineF.
Frequency
was of interest, since frequency of a food with antioxidant effects previously related favorably to cognitive indices in younger adults. Cognitive tests included grooved pegboard (time), Trails A & B (time), digit symbol, Elithorn mazes, Stroop color word. Memory and attention tests included digit span and recurrent words; and digit vigilance. (Table legend shows coding). Regression (robust standard errors) assessed how WineF predicted cognitive performance. Since two prior dietary predictors showed age-dependency in relation to cognition (selectively evident in younger adults), assessment included age-stratified analysis. Covariates adjusted were known cognitive predictors (per this sample and/or the literature): age, sex, education, exercise, diet variables linked to cognition in this sample, and metabolic variables (glucose, LDL, systolic blood pressure), recognizing that adjustment for the latter could attenuate associations if these variables are mediating.

Results:
More frequent WineF predicted significantly better performance, in younger adults and often in the full sample, for the tests shown in the Table (fully adjusted model). These tests involved timed performance and/or constructs such as executive function. WineF did
not
relate significantly to the tests above of memory or attention (data not shown).

Limitations:
Alcohol bears risks and findings are observational. Heavy drinkers were poorly represented and findings need not apply to them.

Conclusion:
More frequent WineF in a study sample (with few heavy wine drinkers) was favorably linked to performance on cognitive tests related to timed performance and executive function, particularly in younger adults.
Abstract P042: Association of Long-Term Coffee Consumption with Total and Cause-Specific Mortality
Authors: Ding Ming , Satija Ambika , Bhupathiraju Shilpa , Sun Qi , Han Jiali , Willett Walter , van Dam Rob , Hu Frank
Published: July 2021

BACKGROUND:
Coffee is one of the most popular beverages worldwide; however, the association between coffee consumption and risk of mortality remains inconclusive.

METHOD:
We examined the associations of consumption of total, caffeinated, and decaffeinated coffee with risk of subsequent total and cause-specific mortality among 121,704 women in the Nurses’ Health Study (1984 - 2013), 116,683 women in the Nurses’ Health Study 2 (1991 - 2013), and 51,530 men in the Health Professionals Follow-up Study (1986 - 2013). Participants with a history of cancer, heart disease, or stroke at baseline were excluded. Coffee consumption was assessed at baseline using a semi-quantitative food frequency questionnaire.

RESULTS:
During 5,048,976 person-years of follow-up, 20,025 women and 13,391 men died. Consumption of total, caffeinated, and decaffeinated coffee were non-linearly associated with total mortality (P for non-linear trend < 0.001). The pooled hazard ratios (HRs) for death among participants who drank coffee, as compared with those who did not, were 0.96 (95% CI: 0.92 - 1.00) for coffee consumption less than one cup/d, 0.89 (95% CI: 0.86 - 0.92) for coffee consumption one to three cups/d, 0.91 (95% CI: 0.87 - 0.95) for coffee consumption three to five cups/d, and 1.01 (95% CI: 0.96 - 1.06) for coffee consumption more than five cups/d (p for non-linearity < 0.001; p for non-linear trend < 0.001). When restricting to never smokers, compared to non-drinkers, the multivariate adjusted HRs of total mortality across categories of total coffee consumption were 0.93 (0.86-1.02) for 1 cup/d, 0.87 (0.82-0.96) for 1-3 cups/d, 0.85 (0.77-0.94) for 3-5 cups/d, and 0.83 (0.71-0.97) for >5 cups/d (p for non-linearity = 0.15; p for linear trend <0.001). A significant inverse association was observed for both caffeinated coffee (p for trend < 0.001) and decaffeinated coffee (p for trend = 0.03).

CONCLUSION:
These data indicate higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality.
Abstract P052: Coronary Heart Disease Mortality Declines in the United States From 1980 through 2011: Evidence for Stagnation in Young Adults, Especially Women
Authors: Wilmot Kobina A , O’Flaherty Martin , Capewell Simon , Ford Earl S , Vaccarino Viola
Published: July 2021

Background:
Cardiovascular mortality rates have fallen dramatically over the past four decades. However, recent unfavorable trends in coronary heart disease (CHD) risk factors among young adults (obesity, diabetes, and tobacco use) raise concerns about their subsequent impact on CHD mortality. Furthermore, recent data from the US and other countries suggest a worsening of CHD incidence and mortality among young women. We therefore examined recent trends in CHD mortality rates in the US according to age and sex.

Methods:
We used mortality data between 1980 and 2011 from US adults ≥ 25 years. We calculated age-specific CHD mortality rates and estimated annual percentage change (EAPC) for US adults, and compared three decades of data (1980-1989, 1990-1999, and 2000-2011). We also used Joinpoint regression modeling to assess changes in trends over time, based on inflection points of the mortality distribution.

Results:
Young men and women (aged<55 years) showed a robust decline in CHD mortality from 1980 until 1989 (EAPC -5.5% in men and -4.6% in women). However, the two subsequent decades saw stagnation with minimal improvement (Table). This was particularly true for young women who had no improvements between 1990 and 1999 (EAPC +0.1%), and only -1% EAPC since 2000. In contrast, older adults (65+years) showed steep annual declines since 2000, approximately doubled compared with the previous period (women, -5.0% and men, -4.4%). Jointpoint analyses provided consistent results.

Conclusions:
The dramatic declines in cardiovascular mortality since 1980 conceals major heterogeneities. CHD death rates in older groups are now falling steeply. However, young men and women have enjoyed small decreases in CHD mortality rates since 1990. The drivers of these major differences in CHD mortality trends by age and sex needs urgent study.
Abstract P112: Changes in Lifestyle Behavior to Reduce Uncontrolled Blood Pressure in the Faith Trial
Authors: Lancaster Kristie J , Schoenthaler Antoinette M , Chaplin William , Ogedegbe Gbenga
Published: July 2021

Introduction:
Modifying lifestyle behaviors is a key method for controlling hypertension. This strategy is extremely important for hypertensive Black Americans, as they are more likely to have uncontrolled blood pressure (BP), have a higher risk of complications, and poorer outcomes. To address this need, we conducted a cluster-randomized controlled trial to reduce BP through lifestyle modification that was delivered by lay health advisors in Black churches. The Faith-based Approaches in the Treatment of Hypertension (FAITH) trial was designed to evaluate the effectiveness of a 12-week faith-based lifestyle intervention and subsequent 3-month motivational interviewing vs. health education control on BP reduction among hypertensive Black adults. This study examines the change in lifestyle behaviors during the trial from baseline to 6 months.

Methods:
We recruited 373 Black Americans with uncontrolled hypertension from 32 urban churches. BP was considered to be uncontrolled if systolic BP (SBP)≥140 mmHg or diastolic BP (DBP)≥90 mmHg, or DBP≥130 mmHg or DBP≥80 mmHg for participants with self-reported diabetes or kidney disease The primary outcome was within-participant change in BP from baseline to 6 months. Lifestyle data collected included the NCI fruit/vegetable intake screener and % calories from fat screener, the International Physical Activity Questionnaire (IPAQ), medication adherence, and measured height and weight.

Results:
Participants’ mean age was 63.4 y, 76.4% were female, and 96.1% reported being of African descent. The mean BMI was 32.1 kg/m2. At 6 months, the intervention was associated with significant reduction in SBP but not DBP compared with the control group (-16.0 mmHg vs -10.3 mmHg, p=0.017). There was no significant change in number of servings of fruits and vegetables consumed, minutes walked per day, or weight for either group. However, the intervention group had a slight but significantly greater decrease of 1.08 % calories from fat over time compared with the control (p=0.018), but that change was not related to change in SBP. Most notably, there was a significant months x treatment interaction on medication adherence the intervention group had a greater decrease in non-adherence score than the control (-0.84 vs -0.30, p=0.28). This improvement in adherence was related to decrease in SBP (p=0.019).

Conclusion:
Community-based lifestyle modification program led to significantly reduced systolic BP; and this intervention effect was mediated by improved medication adherence. However, the 12-week intervention resulted in little change in key diet and physical activity behaviors found in other trials to positively affect BP.
Abstract P150: Weight-Loss Diets and 2-Year Change of Circulating Amino Acids in Two Randomized Intervention Trials
Authors: Zheng Yan , Ceglarek Uta , Huang Tao , Li Lerong , Rood Jennifer , Ryan Donna H , Bray George A , Sacks Frank M , Schwarzfuchs Dan , Thiery Joachim , Shai Iris , Qi Lu
Published: July 2021

Background:
Emerging evidence has related circulating amino acids to diabetes and cardiovascular risk. Little is known about how diet modifications affect circulating amino acids. The present study aimed to examine the effects of weight-loss diets on long-term changes in plasma amino acids, and their relations with weight loss and metabolic outcomes.

Methods and Results:
We repeatedly measured plasma amino acid profiles over 2 years among overweight or obese participants from two randomized dietary interventional weight-loss trials: 774 from the Preventing Overweight Using Novel Dietary Strategies trial (POUNDS LOST) and 318 from Dietary Intervention Randomized Controlled Trial (DIRECT). The plasma levels of most amino acids decreased from baseline during follow-up in both trials. In the POUNDS LOST trial, compared to the high-protein diets, the average-protein weight-loss diets showed a greater effect on decreasing plasma levels of a diabetes-associated branched-chain amino acid (BCAA) valine and another amino acid methyl-histidine at 6 months, independent of weight change (p<0.002). Furthermore, the changes of plasma BCAA leucine/isoleucine, aromatic amino acid tyrosine and phenylalanine, and four other amino acids (alanine, sarcosine, hydroxyproline, and methionine) were positively related to concurrent weight loss, consistently in both trials (5-13g weight loss per 1 unit decease in log[amino acid in μmol/L], p<0.002). Moreover, the changes in tyrosine and alanine were positively related to changes in insulin resistance, independent of weight change, in both trials (p<0.05).

Conclusion:
Our findings underscore the potential importance of weight-loss dietary interventions in improvement of amino acid profiles and related cardiometabolic risk.
Abstract P168: The Relationship of Urinary Sodium and Potassium Excretion with Left Ventricular Structure and Function in Patients with Chronic Kidney Disease: Prospective Analyses from the Chronic Renal Insufficiency Cohort Study
Authors: Mills Katherine T , Chen Jing , Yang Wei , Appel Lawrence J , Kusek John , Alper Arnold B , Delafontaine Patrice , Keane Martin G , Mohler Emile R , Ojo Akinlolu O , Rahman Mahboob , Ricardo Ana C , Soliman Elsayed Z , Steigerwalt Susan P , Townsend Raymond R , He Jiang
Published: July 2021

Introduction:
Patients with chronic kidney disease (CKD) are at an increased risk of CVD compared to the general population. Left ventricular hypertrophy (LVH) is an independent risk factor for CVD in the general population and in CKD patients. In the general population, sodium (Na) excretion is directly associated with LVH. However, this association has not been examined in patients with CKD.

Hypothesis:
We hypothesized that in CKD patients, urinary Na excretion would be directly and urinary potassium (K) would be indirectly associated with development of ejection fraction (EF) < 50% and LVH and longitudinal changes in EF and left ventricular mass index (LVMI).

Methods:
The Chronic Renal Insufficiency Cohort Study (CRIC) is a prospective cohort study of 3,939 participants with CKD. Dietary Na and K excretion were assessed by averaging three 24-hour urinary measures (over 2 years) and calibrated to sex-specific mean 24-hour urinary creatinine excretion. Echocardiograms (ECHO) were conducted at follow-up years 1, 4, and 7 and centrally analyzed to quantify EF and LVMI. LVH is defined as LVMI ≥ 47 g/m
2.7
in women and LVMI ≥ 50 g/m
2.7
in men. Log-linear binomial and linear mixed effects models were used.

Results:
During follow-up, 676 participants developed EF <50% and 238 developed LVH among those with EF ≥ 50% or free of LVH at the first ECHO, respectively. After multivariate adjustment, participants in the highest quartile of adjusted sodium excretion (>196.2 mmol/24 hours) had a relative risk of 1.31 (95% CI 1.08, 1.59) of developing an EF < 50% during follow-up compared to those in the lowest quartile (<127.8 mmol/24 hours). Furthermore, participants in the highest quartile of adjusted urinary sodium excretion had a greater annual decrease in ejection fraction (-1.36%, 95 CI: -1.53, -1.19%) compared to those in the lowest quartile (-0.95%, 95% CI: -1.11, -0.79%; p for trend across quartiles 0.0003). No significant association was observed between K excretion and development of EF < 50% or change in EF. In addition, no association was observed between adjusted Na or K excretion and development of LVH or change in LVMI during follow-up.

Conclusions:
Higher Na excretion is associated with a greater likelihood of developing an EF <50% and a greater annual decrease in EF. Further studies are needed to determine if interventions to reduce high dietary sodium could slow the decline in left ventricular structure and function in patients with CKD.
Abstract P177: Associations Between Complement Proteins and Arterial Calcification in Midlife Women: Role of Cardiovascular Fat, The Study of Women’s Health Across the Nation (SWAN)
Authors: Nagaraj Nayana , Matthews Karen A , Shields Kelly J , Barinas-Mitchel Emma , Budoff Matthew , El Khoudary Samar R
Published: July 2021

Background:
Risk of cardiovascular disease(CVD) in women increases after the fifth decade of life. We have previously shown that compared to premenopausal women, postmenopausal women have significantly higher levels of complement protein C3 and cardiovascular fat. We hypothesize that complement protein levels in women transitioning through menopause are positively associated with early markers of vascular disease, arterial calcification, and that this association will be explained by the higher volumes of cardiovascular fat in women at midlife.

Methods:
Pilot data from the Study of Women’s Health Across the Nation(SWAN) were used. Complement proteins C3 and C4 were measured using frozen serum specimens by immunoturbidimetric assay. Extent of Aortic(AC) and coronary calcification(CAC) were identified using EBCT scans and Agatston scoring method, and were used as continuous variables. Same CT scans were used to quantify volumes of cardiovascular fat around the heart (total heart adipose tissue: TAT) and the descending aorta(peri-vascular adipose tissue: PVAT). Tobit regression was used for statistical analyses.

Results:
A total of 100 women (50% late peri/postmenopausal; 73% Caucasian), mean age 50.48±2.63 were included. In univariate analyses, higher levels of C3 were significantly associated with greater CAC [β(SE)=0.87(0.23), P=0.0001] and AC [β(SE)=3.49(1.45), P=0.02], while higher levels of C4 were significantly associated with greater CAC only. Similar results were seen after adjusting for age, race and menopausal status. For CAC models, controlling for TAT did not change the significant associations with both C3 (P=0.008) and C4 (P=0.03). On the other hand, adjusting for PVAT partially explained the association between C3 and CAC (P=0.02), while the association between C4 and CAC disappeared (p=0.09). For AC models, associations of C3 and C4 with AC were more pronounced at greater volumes of TAT (Interactions p<0.001) but not of PVAT. Adjusting for PVAT eliminated the association between AC and C3 (p=0.2)

Conclusion:
Higher levels of complement proteins were significantly associated with greater CAC and AC in women at midlife. The associations with CAC were independent of TAT but not of PVAT, while the associations with AC largely explained by PVAT and modified by TAT. Our findings extend support for the potential inflammatory influence of small visceral adipose depots in the development of arterial calcification and possibly suggest PVAT as a local source for the complement proteins. Early recognition of the high complement protein levels and volumes of cardiovascular fat in women at midlife could be used in early diagnosis of subclinical CVD. These findings need to be replicated in larger samples.
Abstract P190: The Associations of Brachial Artery Shear Rate and Endothelial Dysfunction with Age Related Carotid Distensibility
Authors: Vaidya Dhananjay , Zhang Yan , Kral Brian G , Yanek Lisa R , Becker Lewis C , Becker Diane M
Published: July 2021

Loss of carotid artery distensibility (CD) with age portends of clinical cerebrovascular disease. Endothelial dysfunction mediated by impaired nitric oxide vascular dilatation precedes vascular remodeling and age-related stiffening of arteries. However, it is unknown whether endothelial dysfunction contributes to loss of vascular distensibility with age.

Methods:
We examined 828 asymptomatic healthy subjects in the GeneSTAR family cohort, identified from index cases with early-onset coronary artery disease. We determined mean CD of both common carotid arteries using ultrasound; CD was quantified as the pulsatile change in lumen diameter/diastolic lumen diameter/brachial pulse pressure. Vascular shear rate (SR) was determined in the brachial artery as 4 х maximum blood flow velocity/maximum lumen diameter, and brachial flow mediated dilatation (FMD), a measure of endothelial dysfunction, as % change in diastolic diameter during reactive hyperemia. We tabulated both rest and hyperemic responses by age, sex and race-indexed tertiles of CD generated by quantile regression. Generalized estimating equations (GEE) were used to estimate the family correlation corrected associations of CD with FMD and SR.

Results:
The sample was 60% female, 40% African American, with mean age 52 (SD 12) years. While SR was significantly associated with higher tertiles of CD, FMD was not (Table). Adjusted for age, sex and race, every 540/s (1 SD) higher of shear rate was significantly associated with a 6.2% higher CD (p = 0.019) but FMD was not associated at all (p = 0.54). This pattern remained after adjustment for LDL and HDL- cholesterol, hypertension, diabetes and smoking (p = 0.03 and 0.95, respectively).

Conclusion:
Higher vascular shear rate is associated with preserved arterial distensibility indexed for age. FMD is not related to CD. The pathophysiological interpretations of this finding need further study before either CD or vascular shear rate can be used for assessing stoke risk in a population at increased risk for vascular disease.
Abstract P216: The Association Between Reduction in Inflammation and Changes in Lipoprotein Levels and HDL Cholesterol Efflux Capacity in Rheumatoid Arthritis
Authors: Liao Katherine , Playford Martin , Frits Michelle , Coblyn Jonathan , Iannaccone Christine , Weinblatt Michael , Shadick Nancy , Mehta Nehal
Published: July 2021

Background:
Potent anti-inflammatory RA treatments are associated with reduced cardiovascular (CV) risk as well as increases in low density lipoprotein (LDL). This apparent paradox may be explained by favorable changes in other lipid measurements. The objective of this study was to determine the longitudinal association between changes in inflammation with advanced lipoprotein measurements and HDL cholesterol efflux capacity.

Methods and Results:
We conducted this study in a longitudinal RA cohort from a large academic center. We included subjects with hsCRP reduction ≥10mg/L at two time points one year apart. Subjects on statins during the study period or 6 months prior were excluded. We measured total cholesterol (TC), LDL, high density lipoprotein (HDL), apolipoprotein B (apoB), apoA1, and HDL cholesterol efflux capacity at baseline and one year follow-up. We determined the correlations between reduction in hsCRP and change in lipid parameters using the Pearson test.

We studied 90 RA subjects, mean age 57 years, 89% female, all subjects were on disease modifying anti-rheumatic drugs; median baseline hsCRP was 28.6mg/L and follow-up 4.3 mg/L (reduction of 85%, p<0.0001). We observed significant correlations between a reduction in hsCRP with increases in LDL (r=0.25,p=0.02, Figure 1a), HDL (r=0.23, p=0.03), apoA1 (r=0.27, p=0.01 and HDL cholesterol efflux capacity (r=0.24, p=0.02), an overall improvement of efflux capacity of 5.7% (p=5x10
-4
, Figure 1b).

Conclusion:
Reduction in inflammation was associated increased LDL levels, and concomitant increases in HDL, ApoA1, and improvements in HDL cholesterol efflux capacity. These findings provide further insight into lipid modulation and the beneficial effect of reduction in inflammation on lipids in vivo.
Abstract P220: Sustained Disparity in Ever Having Received a Serum Cholesterol Measurement by Educational Level among US Adults, 1999-2012
Authors: Kinoshita Otome , Sugiyama Takehiro , Tsujimoto Tetsuro , Shapiro Martin F , Kobayashi Yasuki
Published: July 2021

Background:
A previous study showed that lower educational level was significantly associated with less likelihood of ever having received a serum cholesterol test among US adults during 1999-2002. No study, however, has examined the time trends after 2002.

Objectives:
To examine whether disparity by educational level in lifetime receipt of a serum cholesterol test persisted in the US from 1999 through 2012.

Methods:
A serial cross-sectional study in a nationally representative sample of 29,662 US adults from the National Health and Nutrition Examination Survey, 1999-2012. We excluded those had coronary heart disease and/or diabetes. The lifetime history of having had a serum test for cholesterol and educational level were asked in the interview. Educational level was grouped as greater than high school (HS), HS, or less than HS. We investigated time trends of lifetime cholesterol measurement by educational level, using a logistic regression model that included interaction terms between survey period and educational level, adjusted for covariates.

Results:
In 1999-2000, the proportion of ever having had a serum cholesterol test was significantly lower for participants with less education (greater than HS: 76.2%, HS: 62.0%, less than HS: 51.4%). In 2011-2012, the pattern of lifetime testing by educational level was similar to the initial period (greater than HS: 77.5%, HS: 67.5%, less than HS: 55.4%). Although the uptake of cholesterol testing significantly increased over the survey period among the less-than-HS group, the difference in trends across the three groups was not significant.

Conclusions:
The difference by educational level in lifetime serum cholesterol measurement observed in 1999-2002 persisted through 2011-2012. Public health policy should focus on increasing the uptake of serum cholesterol test and early detection of hypercholesterolemia, particularly among people with lower educational level.

Figure. Trends of lifetime serum cholesterol measurement by educational level among US adults, 1999-2012
Abstract P237: Measuring Cognition in the Atherosclerosis Risk in Communities (ARIC) Study Cohort: An approach to Account for Informative Attrition
Authors: Wruck Lisa M , Alonso Alvaro , Albert Marilyn , Coresh Josef , Couper David , Gottesman Rebecca , Knopman David S , Rosamond Wayne , Sharrett A. R , Mosley Thomas H
Published: July 2021

Introduction:
Understanding the role of risk factors associated with accelerated cognitive decline has important public health relevance for the aging US population. To test hypotheses that mid-life cardiovascular (CV) risk factors increase risk of dementia in old age, the Atherosclerosis Risk in Communities (ARIC) cohort was evaluated for dementia in 2011-2013. Anticipating challenges of complete dementia ascertainment in an elderly population, supplementary data sources were collected to aid analysis accounting for potentially informative attrition.

Methods:
ARIC enrolled 15,792 participants 45-64 years old at baseline (1987-1989) from four US communities and collected baseline CV exposure data. A complete neurocognitive battery including informant interview was completed 2011-2013, yielding an algorithmic diagnosis of dementia, mild cognitive impairment (MCI) or normal cognition. Cognitively impaired and a random sample of cognitively normal were selected for further clinical evaluation. Syndromic diagnoses (dementia/MCI/normal) and etiologic diagnoses were made by a panel of experts using standardized criteria. Standardized protocols, timely reports of reviewer reliability, ongoing training of reviewers and a web-based data management system were developed to ensure reliability, consistency and efficiency of data collection and review.

Living participants not attending the visit were asked to complete the Telephone Interview for Cognitive Status (TICS). Based on dementia discharge codes and death codes identified during cohort surveillance, interviewer impression of hearing loss or cognitive impairment or need for a proxy during semi-annual calls, or random sampling, participants refusing the TICS are eligible for proxy dementia interview. Medicare claims are being examined to identify missed dementia discharge codes.

Results:
Of 11,017 participants alive as of 2011, 6495 (59%) completed the neurocognitive battery; 2937 of these (45%) were selected for, and completed, additional clinical assessments and classification by committee (algorithmic or reviewer diagnosis: dementia 5%, MCI 21%). Of the 4522 participants who did not undergo the neurocognitive battery, 1463 (32%) completed the TICS (dementia 7%), while 1627 of the remaining participants were eligible for proxy calls (903 completed to date, dementia 58%).

Conclusions:
Participants who were not examined were more likely to be cognitively impaired, highlighting the importance of collecting supplementary data to support analyses of midlife CV risk factors accounting for informative attrition. Collection of exam data in an elderly cohort is difficult and requires a multi-pronged approach, especially for an outcome highly correlated with attrition. The strategy described here could be applied in other settings.
Abstract P259: Overweight People Increased in the Evacuation Zone of Fukushima Prefecture After the Great East Japan Earthquake: The Fukushima Health Management Survey
Authors: Ohira Tetsuya , Hosoya Mitsuaki , Yasumura Seiji , Satoh Hiroaki , Suzuki Hitoshi , Sakai Akira , Ohtsuru Akira , Takahashi Atsushi , Nagai Masato , Zhang Wen , Nakano Hironori , Otani Koji , Hayashi Masayuki , Hashimoto Shigeatsu , Abe Masafumi
Published: July 2021

Introduction:
The Great East Japan Earthquake occurred in Japan on March 11, 2011, with a nuclear accident subsequently occurring at the Fukushima Daiichi Nuclear Power Plant. The disaster forced many evacuees to change particular aspects of their lifestyles, such as their diet, physical exercise, and other personal habits.
Hypothesis:
We assessed the hypothesis that mean body weight and the proportion of people being of overweight/obese would increase among residents in the evacuation zone after the disaster compared with before the disaster.
Methods:
This longitudinal study examined Japanese subjects aged 40-90 years using data collected from 53,925 participants (23,936 men and 29,989 women) sourced from general health checkups conducted in 16 communities, including the evacuation zone specified by the government, between 2008 and 2010. The participants were divided into 3 groups; evacuees and non-evacuees living in communities near the Fukushima Daiichi Nuclear Power Plant and non-evacuees living in communities 75 miles far from the plant. Height in stocking feet and weight in light clothing were measured, with the body mass index calculated as the weight (kg)/height (m)
2
. Follow-up examinations were conducted from June 2011 to the end of March 2013.
Results:
A total of 35,532 participants (15,799 men and 19.733 women, follow-up proportion: 66%) received follow-up examinations after the disaster, with an average follow-up of 1.5 years. Mean body weight significantly increased in both evacuees (n=9,671) and non-evacuees (n=17,815) living in communities near the plant after the disaster, but not non-evacuees living in communities far from the plant (n=8.046); changes in body weight were +1.2kg , +0.3kg, and -0.3kg, respectively (p for difference <0.001). The proportion of overweight/obese people also increased among residents living in communities near the plant after the disaster. The proportions of overweight people before and after the disaster were 31.8% and 39.4% for evacuees and 28.3% and 30.3% for non-evacuees living in communities near the plant, respectively, while proportions among non-evacuees living in communities far from the plant were 30.6% and 30.5%, respectively.
Conclusions:
Body weight and the proportion of people being overweight/obese increased among residents, especially evacuees, in the evacuation zone of Fukushima prefecture after the Great East Japan Earthquake.
Abstract P306: Increase of the Inflammatory Burden at a Young Age in Patients with Coronary Artery Disease
Authors: Byambaa Enkhmaa , Erdembileg Anuurad , Zhang Wei , Kim Kyoungmi , Berglund Lars
Published: July 2021

Introduction:
Age and inflammation both are considered risk factors for coronary artery disease (CAD) and the levels of inflammatory markers increase with aging. However, the role of age-induced inflammatory burden in CAD development is not fully understood. We investigated the trajectories of inflammatory markers with increasing age in subjects with or without CAD.

Hypothesis:
We hypothesized that the rate of increase in inflammatory markers as a function of age would depend on the presence of CAD and differ between subjects with and without CAD.

Methods:
Systemic inflammatory burden was assessed by levels of C-reactive protein (CRP), serum amyloid A (SAA) and fibrinogen in Caucasians (n=184) and African-Americans (n=154) (age range: 20-60 years). The presence of CAD was defined as the presence of ≥50% stenosis in any one of 15 coronary artery segments.

Results:
The prevalence of CAD was 46% (85 of 184) and 38% (58 of 154) in Caucasians and African-Americans, respectively. In both ethnic groups, subjects with CAD were older and had an atherogenic lipid profile compared to subjects without CAD. For both subjects with and without CAD, HDL cholesterol level was significantly higher and triglyceride level was significantly lower in African-Americans compared to Caucasians. The pattern of inflammatory burden over age differed across CAD status and ethnicity. Among Caucasians, the trend patterns of CRP (p<0.05), SAA (p<0.01) and fibrinogen (p<0.001) over age differed significantly between subjects with and without CAD. Levels of all three markers were elevated already at young ages and remained relatively constant over age in Caucasians with CAD. In contrast, in Caucasians without CAD, the levels of these markers were lower at young ages with a gradual increase over age. The findings for African-Americans differed from that of Caucasians. The levels of inflammatory markers increased with age with no significant differences in trends between subjects with and without CAD. In multivariate analyses adjusting for covariates, the trend pattern of fibrinogen over age differed significantly between Caucasians with and without CAD.

Conclusions:
There was a diverging pattern in age-induced inflammatory burden associated with CAD, with an early start and faster rate of increase in Caucasian patients with CAD. The findings suggest an accelerated inflammation over age in individuals with CAD with a possible modulatory role of ethnicity/race.
Abstract P371: Prevalence of Cardiometabolically Healthy and Cardiometabolically Unhealthy Peruvians by Body Mass Index Categories: The CRONICAS Cohort Study
Authors: Benziger Catherine P , Bernabe-Ortiz Antonio ` , Gilman Robert H , Checkley William , Smeeth Liam , Malaga German , Miranda J. Jaime ,   CRONICAS Cohort Study Group
Published: July 2021

Background:
Obesity is associated with a number of cardiometabolic risk factors. However, despite increased adiposity, some obese individuals display normal metabolic features. Conversely, individuals with normal weight can display metabolically unhealthy features. These profiles have not been researched in Latin American populations. We aimed to characterize cardiometabolic status by body mass index (BMI) status with emphasis on unhealthy cardiometabolic profile among normal weight individuals, and healthy cardiometabolic profile among overweight and obese.

Methods:
The CRONICAS Cohort is a an age- and sex-matched population-based study across four different geographical settings: Lima (Peru’s capital, urban), Tumbes (lowland, semirural), Puno rural and Puno urban (both high altitude). Individuals were classified into two groups: cardiometabolically healthy with (0-1 abnormality) or cardiometabolically unhealthy (≥2 abnormalities). The conditions for cardiometabolic assessment included components of the metabolic syndrome, high-sensitivity C-reactive protein, and insulin resistance.

Results:
A total of 3088 individuals, mean age 55.6 (SD±12.6) years, 51.3% females, had all measurements for this analysis. Of these, 889 subjects (28.8%), 1359 (44.1%) and 838 (27.1%) had normal weight, overweight and obese, respectively. Among normal weight individuals, 43.1% were cardiometabolically unhealthy (figure), and age ≥65 years, female, and highest wealth index groups were more likely to have this pattern. In contrast, only 16.0% of overweight and 3.6% of obese individuals were cardiometabolically healthy. In the combined overweight/obese group, compared to Lima, rural and urban sites in Puno were more likely of having the cardiometabolically healthier profile.

Conclusions:
Our results indicate a high prevalence of cardiometabolic abnormalities in Peru, specifically among normal weight individuals. Prevention programs to address cardiovascular risk need to include people of normal weight.
Abstract P388: Novel Metabolic Markers for the Risk of Carotid Plaque Progression in American Indians
Authors: Zhu Yun , Qiang An , Best Lyle G , Lee Elisa T , Howard Barbara V , Devereux Richard B , Roman Mary J , Zhao Jinying
Published: July 2021

Background:
Carotid atherosclerotic plaque and its progression significantly predict cardiovascular events. Traditional clinical factors have limited value in early risk prediction. Metabolomics is an emerging technology that can accurately quantify hundreds to thousands of small metabolites in biofluids, thus providing a powerful tool for early biomarker discovery. Previous studies were largely cross-sectional with a focus on the European population, results of which may not be generalized to other ethnic groups. In addition, causality cannot be resolved in cross-sectional analysis.

Objective:
To prospectively identify novel metabolic markers predictive of carotid plaque onset and progression in American Indians in the Strong Heart Study (SHS).

Methods:
This study includes 396 apparently healthy American Indians attending both clinical exams in 2001-2003 and 2006-2009 (average 5.5 years of follow-up). All participants had normal fasting glucose and were free of overt CVD at baseline. Plaque progression was defined as having a higher plaque score at the end of follow-up compared to baseline. Fasting plasma metabolites were detected using untargeted LC-MS. A total of 1,364 matching metabolites that passed stringent QC were included in the current analysis. The prospective association of plaque progression with each metabolite was examined using Cox proportional hazards model, adjusting for sex, site, age, BMI, eGFR, lipids, blood pressure, smoking and alcohol drinking at baseline. The combined metabolic effect was examined using a weighted multi-marker metabolites score comprising of all significant metabolites. Incremental value of novel metabolites over traditional risk factors for risk prediction was tested using the net reclassification improvement index (NRI). Multiple testing was corrected using the q-value method (q< 0.05 was considered statistical significance).

Results:
Of all 396 participants, 100 developed new plaque or progressed to a high order of atherosclerosis during follow-up. Five metabolites including PC (6:2/14:2) (HR 1.56[1.23-1.96]), proscillaridin A (HR 1.68 [1.27-2.21]), 8e-heptadecenedioic acid (HR 1.56 [1.22-1.98]), flavone (HR 1.69 [1.27-2.26]), and n-palmitoyl methionine (HR 1.72 [1.28-2.32]), significantly increase, whereas one metabolite, PC (18:0/18:1) (HR 0.62 [0.52-0.73]), significantly decreases the risk of plaque progression. A multi-marker score comprising of all six metabolites significantly improves risk prediction beyond traditional risk factors (NRI=0.22, P=1.23x10-5).

Conclusions:
Altered levels of fasting plasma metabolites significantly predict the risk of plaque onset and progression over and above conventional risk factors. The newly detected metabolites may unravel novel metabolic pathways underlying CVD pathogenesis and could be used as new markers for risk prediction and stratification.
Abstract P390: Insulin Resistance Determines Severity of Vascular Inflammation by 18-Fluorodeoxy Glucose PET-CT in Psoriasis
Authors: Natarajan Balaji , Salahuddin Taufiq , Dave Jenny , Playford Martin , Doveikis Julia , Herscovitch Peter , Mehta Nehal
Published: July 2021

Introduction:
Psoriasis (PSO), an inflammatory skin disease is associated with increased cardiovascular disease (CVD) risk. We have previously shown the presence of insulin resistance (IR) in psoriasis, however how this relates to subclinical vascular disease is unknown. Here, our aim was to determine whether IR relates to vascular inflammation (VI) measured by
18
FDG PET-CT in a well-phenotyped psoriasis cohort (NCT 01778569).

Hypothesis:
We assessed the hypothesis that an increase in IR is associated with greater VI.

Methods:
We performed
18
FDG PET-CT scans on 86 consecutive patients with psoriasis (Siemens Biograph). Target-to-background ratio (TBR) was used as the VI measure. Fasting plasma samples were collected and homeostatic model assessment of IR (HOMA-IR) was used to stratify the study group into normal (n=41) vs high (n=45) HOMA-IR groups using an accepted cut-off value (3.0). Lipid profile and lipoprotein characteristics were also obtained using NMR spectroscopy (Liposcience, USA).

Results:
Our study cohort was middle aged with mild to moderate PSO (Table 1). There was increased VI by TBR in this sample (mean 1.8±0.3) as compared to published values for CAD (mean 1.6±0.3). The high HOMA-IR group had greater skin involvement by psoriasis, an increased incidence of CVD risk factors and an atherogenic lipid profile on NMR spectroscopy when compared to the normal HOMA-IR group. There was greater VI in the high HOMA-IR group (Mean±SD: 1.91±0.3 vs 1.69±0.2, p<0.001) which was robust to multivariate adjustment for age, gender, CVD risk factors and BMI (beta 0.38, p <0.01). Finally, on likelihood ratio testing, we observed an incremental effect when HOMA-IR was added to a fully adjusted model with BMI as a covariate (chi
2
5.65, p = 0.02).

Conclusion:
Psoriasis increases VI by
18
FDG PET-CT, which is strongly related to the presence of IR beyond traditional CVD risk factors and BMI. This suggests that inflammatory IR may have direct impact on the development of vascular inflammation.
Abstract P394: Opioid Use and Atrial Fibrillation: The Reasons for Geographic and Racial Differences in Stroke (regards) Study
Authors: Qureshi Waqas , O'neal Wesley , Safford Monika , Munter Paul , Khednova Yulia , Judd Suzanne , Howard Virginia , Howard George , Soliman Elsayed
Published: July 2021

Background:
The use of opioids has been linked to adverse cardiovascular outcomes, suggesting a potential for an association with atrial fibrillation (AF). Conversely, opioid agonists have shown to reduce AF development in animals. It is unknown whether the use of opioids is associated with AF.

Objective:
The aim of this study was to examine the baseline association between prescription opioid use and AF in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study.

Methods:
A total of 24,632 participants (mean age: 65 ± 9.4 years; 54% women; 40% blacks) were included in this analysis. Prescription use of opioids was ascertained by pill bottle review during the in-home study visit. AF was identified at baseline by the study electrocardiogram or self-reported history of a previous physician diagnosis. Logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI) for the cross-sectional association between opioid use and AF.

Results:
A total of 1,887 (7.6%) participants reported opioid use and 2,086 (8.5%) had evidence of AF at baseline. A total of 235 (12.5%) opioid users and 1,851 (8.1%) non-opioid users had AF (p<0.001). In a model adjusted for age, sex, race, region of residence, income, and education, systolic blood pressure, high density lipoprotein cholesterol, total cholesterol, body mass index, smoking, diabetes, antihypertensive and lipid-lowering medications, aspirin, coronary heart disease, stroke, C-reactive protein, serum creatinine, albumin-to-creatinine ratio, peripheral arterial disease, and electrocardiographic left ventricular hypertrophy, opioid use was associated a higher prevalence of AF (OR=1.35, 95% CI=1.16, 1.57). The results were consistent across subgroups of stratified by age, sex, race, coronary heart disease, hypertension, and diabetes.

Conclusions:
In REGARDS, AF was more common among opioid users. Further research is needed to confirm our findings and to explore the underlying mechanisms of this association.