tbuckley/cabot-search huggingface dataset:
Abstract P213: Examining Sociodemographic Disparities in Physical Activity and Diabetes: Preliminary Findings From 2007-2020 National Health and Nutrition Examination Survey
Authors: Yangyang Deng, Mohammad Moniruzzaman, Breanna Rogers, Lu Hu, Ram Jagannathan, Kosuke Tamura
Journal: Circulation (2024)

Purpose: Physical activity (PA) plays a crucial role in preventing diabetes, but few studies have examined whether sociodemographic factors were associated to PA, and PA and sociodemographic factors were related to diabetes. We aimed to 1) examine associations between sociodemographic factors and PA, and 2) investigate whether PA and sociodemographic are related to the prevalence of diabetes. Methods: Data came from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), a series of cross-sectional cohort studies (total sample=30,788, Female: 49.1%, mean age =49.6). Two binary outcomes included: 1) Meeting PA guidelines (≥500 MET minutes/week) and 2) diabetes (yes/no). Sociodemographic variables included age group (20-44 [referent], 45-64, 65-79), sex, race/ethnicity (White [referent], Black, Hispanic, and other adults), and poverty income ratio (low, middle, high-income [referent]). PA guideline was also considered as exposure for diabetes analysis. By accounting for the complex survey design, two weighted generalized Poisson models were used to conduct the analyses, adjusting for covariates. Results: Model 1 showed that participants aged 45-64 and 65-79 had 14% and 16% lower likelihood of meeting PA guidelines than those aged 20-44. Females had an 18 % lower likelihood of meeting PA guidelines than males. Furthermore, Black, Hispanic, and other racial/ethnic adults were 7%, 8%, and 12% less likely to meet the PA guidelines than White adults. Adults with low- and middle-income had 13% and 8% lower likelihood of meeting PA guidelines than those with high income. Model 2 showed that participants from 2017-2020 were 22% more likely to have diabetes (AOR = 1.22) than those from 2007-2008. Adults aged 45-64 and 65-79 years had a 4.35- and 7.36-times higher likelihood of having diabetes than those aged 20-44. Females had a 25% lower likelihood of having diabetes than males. Black, Hispanic, and other groups were 49%, 35%, and 73% more likely to have diabetes than White adults, respectively. Adults with low- and middle-income had a 52% and 32% higher likelihood of having diabetes than those with high income. Adults meeting PA guidelines had a 28% lower likelihood of having diabetes than those not meeting the PA guidelines. Conclusion: The study highlights persistent disparities in PA levels and diabetes across different sociodemographic groups within the U.S. population. Future interventions targeting diabetes should prioritize addressing these disparities among vulnerable populations who do not meet PA guidelines. Emphasis should be placed on promoting PA as an integral component of diabetes prevention.
Abstract P489: Intake of Fiber-Rich Foods is Favorably Associated With Cardiac Structure and Function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: So-Yun Yi, Lyn M Steffen, Daniel Duprez, Weihua Guan, Kamakshi Lakshminarayan, David R Jacobs
Journal: Circulation (2024)

Background: Abnormal cardiac phenotypes, including left ventricular (LV) structure and function, are subclinical characteristics, detectable before experiencing heart failure (HF) symptoms. Identifying lifestyle risk factors of abnormal cardiac phenotypes can help to prevent or slow down the progression to HF and ultimately reduce the burden of the aging heart. Therefore, we aimed to identify the associations of carbohydrate (CHO) quality and fiber-rich foods with LV structure and function. Methods: We studied 3,171 Black and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary intake was assessed via Diet History and averaged across years 0 (1985-86), 7, and 20. CHO:fiber ratio was created to define CHO quality (greater CHO:fiber ratio representing lower CHO quality). The fiber-rich food score was created based on the servings of whole grains, fruits, vegetables, nuts, and legumes. LV structure and function measures were assessed via echocardiography at years 25 and 30 and were the dependent variables in linear repeated measures models, including random intercepts for individuals. CHO:fiber ratio was treated as a fixed effect. Results: Study participants were 25.1 (range: 18-30, SD: 3.61) years old on average at baseline, 57% (1,807 of 3,171) female, and 53% (1,678 of 3,171) White. Higher CHO quality ratio was favorably associated with global longitudinal strain (GLS); while the fiber-rich food score was favorably associated with LV mass index, GLS, and E/e’ ratio after adjusting for demographic and lifestyle characteristics (see table). Conclusions: Our study finding suggests that higher CHO quality is associated with better systolic function and greater intake of fiber-rich foods is associated with better LV structure and function, which support the Dietary Guidelines for Americans and the Dietary Guidance to Improve Cardiovascular Health by the AHA that recommend intakes of high-quality CHO foods such as whole grains, fruit, and vegetables.
Abstract MP78: A Comprehensive Investigation of the Effect of Dietary Intervention on Perfluorooctanoic Acid and Perfluorooctane Sulfonate
Authors: Ruiyuan Zhang, Yixi Sun, Ling Tian, Yang Pan, Xiao Sun, Zhijie Huang, Jia Fan, Kai Zhang, Shengxu Li, Lydia A Bazzano, Wei Chen, Jing Chen, Tanika N Kelly, Jiang He, Joshua D Bundy, Changwei Li
Journal: Circulation (2024)

Introduction: The US Environment Protection Agency has proposed National Primary Drinking Water Regulation for six per- and polyfluoroalkyl substances including perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). The health effects of the two chemicals need to be thoroughly evaluated. In addition, few studies have investigated interventions that can help clear the two chemicals from the human body. Hypothesis: We hypothesize that the plasma metabolome reflects reactions of the human body to PFOA/PFOS exposures and dietary supplements can reduce PFOA/PFOS. Methods: In the Protein and Blood Pressure (ProBP) trial, 80 participants were randomly assigned to take 40 grams/day of soy protein, milk protein, or carbohydrate supplementation each for 8 weeks in a cross-over design. Plasma PFOA and PFOS levels were tracked from baseline to each of the three intervention phases. We analyzed the associations of serum PFOS and PFOA with a total of 964 known metabolites at baseline and each dietary intervention, respectively. Age, sex, and race were adjusted in all analyses. ProBP findings were evaluated for replication among 1261 participants of the Bogalusa Heart Study (BHS). Results: PFOA and PFOS were significantly reduced after phase I and were decreased further with intervention phases. Soy protein showed the strongest reduction on both PFOA (net change: -0.13, p=1.13х10 -5 ) and PFOS (net change: -0.18, p=4.32х10 -5 ) compared with carbohydrate and milk protein. After Bonferroni correction for 77 independent metabolite clusters (p&lt;6.49х10 -4 ), PFOS was positively associated with 54 metabolites (47 at baseline, 9 at soy protein, 8 at milk protein, and 6 at carbohydrate, respectively). Of which, 20 associations were replicated in BHS ( Table ). PFOA was positively associated with 3-methyladipate at soy protein and bilirubin (E,E) at milk protein. Conclusions: Dietary intervention reduced serum PFOA and PFOS. Several metabolites may play important roles in PFOA/PFOS related health effects.
Abstract P334: The Impact of Cardiovascular Risk Factors on Cognition in Adults With Down Syndrome
Authors: Lauren Ptomey, Brian Helsel, Amy Bodde, Jessica Danon, Joseph Sherman, Daniel E Forsha, Joseph Donnelly
Journal: Circulation (2024)

Introduction: Most adults with Down Syndrome (DS) will develop Alzheimer's disease. Evidence in the general population suggests that factors associated with cardiovascular health including, moderate to vigorous physical activity (MVPA), cardiorespiratory fitness, and systolic blood pressure, are associated with better cognitive outcomes and decreased risk of Alzheimer's disease. Studies supporting these associations in adults with DS are limited. The purpose of this study was to examine the associations between systolic blood pressure, cardiorespiratory fitness, and MVPA on cognition in adults with DS. Methods: This is a cross-sectional analysis using baseline data from a trial in adults with DS. Participants attended a laboratory visit where resting blood pressure, cardiorespiratory fitness (VO 2 Peak ) and cognitive function (CANTAB ® DS Battery) were obtained. The cognitive battery included tests measuring multitasking, episodic memory, and reaction time. Physical activity (accelerometer) was collected over the week following the laboratory visit. Pearson correlations and linear regressions were used to measure the impact of systolic blood pressure, cardiorespiratory fitness, and MVPA on cognitive outcomes. Results: Complete data was available for 72 adults with DS (26.8 ± 9.3 years of age, 57% female). At baseline, VO 2 Peak (21.1 ± 4.2 ml/kg/min) and MVPA were low (14.4 ±14.4 min/day), and systolic blood pressure was 118.3 ± 13.3 mmHg. VO 2 Peak was correlated with simple movement time (rho = -0.28, p=0.03) but was not significant using a linear regression controlling for age and sex. Systolic blood pressure was significantly associated with episodic memory (first attempt memory score: β = -0.11, p=0.002; total errors: β = 0.58, p = 0.001) and reaction time (five-choice movement time: β = 4.11, p = 0.03; simple movement time: β = 6.14, p = 0.005) using age-and sex-adjusted linear regressions. No associations were observed between MVPA and multitasking, episodic memory, or reaction time. Conclusion: Cardiovascular risk factors, including cardiorespiratory fitness and systolic blood pressure, were associated with cognition in adults with DS. Given the high prevalence of Alzheimer's disease in adults with DS, future research examining cardiovascular health and Alzheimer's disease risk is warranted.
Abstract P117: Trial Recruitment Advertisement Modalities and Demographics of Participants: Implications for Equitable Representation in Clinical Trials
Authors: Jaeyoon Cha, Jingyi Cao, Hannah Col, Yuanyuan Feng, Nikhilsai Choppa, Tamunotonye Harry, Timothy Plante, Manuel Hermosilla, Marwa Elborki, Emily Aidoo, Ruth-Alma N Turkson-Ocran, Stephen P Juraschek
Journal: Circulation (2024)

Background: Convenience and cost are major determinants of which strategies are used to recruit clinical trial participants. However, little is known about the impacts of recruitment strategy on representation of people from diverse backgrounds. Objective: Using the high-throughput recruitment drives of two trials, we assessed whether referral source was associated with demographic and social characteristics of people who inquired about the trials or participated in screening. Methods: The GoFresh studies (NCT05121337 &amp; NCT05393232) are two randomized trials testing the impact of a home-delivered DASH-patterned grocery intervention on blood pressures of Black adults residing in urban food deserts, with or without treated hypertension (HTN). Both share a common recruitment drive, incentive plan, and study design. Principal recruitment strategies were: mailed brochure to patients, advertising on public transit (bus or subway), or word-of-mouth referral. In prescreening, participants provide their age, HTN treatment status, and how they heard about the trial. Those eligible proceed to in-person screening, where they are asked about biologic sex, ethnicity, birthplace, car ownership, insurance status, education, employment, marital status, home ownership, income, and number of dependents. Results: Of 1,601 people who submitted a prescreening inquiry, 602 (38%) completed screening. At prescreening, people responding via public transit were younger (mean [SD] 36 [13]; overall 46 [16]) and fewer had treated HTN (18%; overall 35%). At screening, there were significant differences by referral source in sex, car ownership, employment, marital status, and home ownership ( Table ). Other factors did not differ (ethnicity, birthplace, insurance status, education, income, and dependents). Conclusion: Demographics and social characteristics of clinical trial participants differed by advertising modality. Trials intending to recruit diverse populations would benefit from multimodal forms of outreach.
Abstract P338: Abdominal Myosteatosis and Cognitive Function: Insights From CARDIA Study
Authors: Adrianna I Acevedo-Fontanez, Caterina Rosano, Kristine Yaffe, J Jeffrey Carr, James G Terry, Sangeeta Nair, Ryan Cvejkus, Iva Miljkovic
Journal: Circulation (2024)

Introduction: Skeletal muscle adipose tissue infiltration (i.e. myosteatosis) increases with age and is considered a significant risk factor for cardio-metabolic diseases. Emerging data hint at its role in cognitive decline, but largely from cross-sectional studies in White populations. Longitudinal studies including Black populations, who have a higher risk of both myosteatosis and Alzheimer’s Disease and related dementias than Whites, are warranted. Aim: Determine the association between abdominal myosteatosis with cognitive function in a cohort of White and Black American men (n=1,095; 42.1% Black) and women (n=1,450; 49.1% Black) from the Coronary Artery Risk Development in Young Adults (CARDIA), and whether associations vary by race and sex. We included those with baseline (Year 25, 2010-11) and 5-year follow-up (Year 30, 2015-16) cognitive assessment. Methods: Computed Tomography measured abdominal intermuscular adipose tissue (IMAT) volume. Cognition assessed by the Digit Symbol Substitution Test (DSST). Linear regression used to assess the cross-sectional and longitudinal (Year 30-Year 25 DSST score) associations of IMAT with cognitive function after adjusting for age, sex, race, center, education, height, follow-up-time, and baseline DSST score (longitudinal models). IMAT was log-transformed, and results were standardized with effects shown per standard deviation (SD). Sex and race interactions with IMAT were statistically significant. Results: Overall, participants were 50.2 (3.6) years old, with a BMI of 30.2 (7.1) kg/m 2 , IMAT of 4.9 (0.6) cm 3 , DSST score of 70.6 (15.8) and 5-year change in DSST score of -2.5 (9.3). Compared to men, women had higher BMI, lower IMAT, and higher baseline DSST scores (p-values&lt;0.001), yet a 5-year change in DSST score between sexes was not significantly different (both &amp;#946;=-2.5, p-value=0.94). By race, Blacks had higher BMI, lower IMAT, lower DSST score, and greater DSST score decline than Whites (-3.0 (9.3) and -2.1 (9.3), respectively) (p-values&lt;0.05). Longitudinally, higher IMAT predicted significant DSST decline in women (5-year decrease in DSST score &amp;#946;=-0.68 points for 1 SD of log IMAT, p-value&lt;0.05) but not in men (&amp;#946;=-0.24, p-value=0.345). By race, higher IMAT was associated with significant decline in DSST score in Whites (5-year decrease in DSST: &amp;#946;=-0.79 points for 1 SD of log IMAT, p-value=&lt;0.01) but not in Blacks (&amp;#946;=-0.18, p-value=0.497). Conclusions: Abdominal myosteatosis may be a novel risk factor for cognitive decline, especially in women and Whites. Future studies using an expanded battery of cognitive tests and longer follow-ups are warranted to further advance our understanding of the novel role of myosteatosis in dementia risk.
Abstract P257: Olfactory Impairment and Frailty in Older Adults the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Hannah Pleasants, Anna Kucharska-Newton, Honglei Chen, Yaqun Yuan, Keran Chamberlin, David Couper, Srishti Shrestha, Vidya Kamath, Jennifer A Deal, Priya Palta, Jay Pinto
Journal: Circulation (2024)

Introduction: Olfactory impairment, which has been associated with poor physical and cognitive performance has been understudied as a potential marker of frailty among older adults. Hypothesis: Poor compared to good olfaction is associated with the risk of frailty cross-sectionally and in longitudinal assessments. Methods: Olfactory function was evaluated among participants of ARIC Study Visit 5 (2011-2013) using a 12-item Sniffin’ Sticks test. The continuous olfaction score (range 0-12) was categorized as poor (0-8), moderate (9-10), or good (11-12). Frailty was based on the Fried frailty phenotype, encompassing the following criteria: unintentional weight loss, weakness, exhaustion, slowness, and low physical activity. Logistic regression models were used to examine the association of olfaction with frailty at Visit 5 and at Visit 6 (2016-2017), for participants robust at baseline. All models were adjusted for age, sex, race, field center, and cardiovascular risk factors. Interaction by median age, sex, and race was examined. Sensitivity analyses used inverse probability of attrition weighting. Results: Among 5094 study participants (mean age 75.3 (SD 5.0) years, 58% female, 21% Black), 32.5% had poor olfaction at Visit 5. A gradient in the association of olfaction categories with frailty status was observed in both the cross-sectional and longitudinal analyses. The adjusted odds ratio for the cross-sectional association of poor vs. good olfaction with frailty was 2.08 (95% CI 1.51, 2.86) and it was 1.82 (95% CI 0.86, 3.87) in longitudinal analysis (median follow-up time: 4 years). The findings remained consistent when adjusting for cardiovascular health and attrition. No observed associations differed by race or sex. Conclusion: Poor olfaction is associated with prevalent and incident frailty. These findings suggest olfaction as a marker of frailty in older adults.
Abstract P118: Scheduling Recruitment Calls Based on Participant’s Preference Increases Screening Success Among Black Adults
Authors: Oluwagbemisola Ibikunle, Ruth-Alma N Turkson-Ocran, Stephanie L Fitzpatrick, Jingyi Cao, Hannah Col, Tamunotonye Harry, Yuanyuan Feng, Nikhilsai R Choppa, Timothy B Plante, Manuel Hermosilla, Marwa Elborki, Emily Aidoo, Stephen P Juraschek
Journal: Circulation (2024)

Background: Black adults are underrepresented in cardiovascular trials. Competing priorities may limit when they are available to complete trial prescreening requirements. Examining the impact of calling potential participants during their stated preferred time of day could inform strategies to improve recruitment of Black adults in clinical research. Objective: To characterize when Black adults in the Boston area prefer to be called regarding enrollment in two ongoing trials and the association with the number of times a participant was called and/or completion of a phone-based prescreening visit (PSV). Methods: The GoFresh trials are two single-masked, parallel-arm, randomized trials, testing a home-delivered, DASH-patterned grocery intervention on BP among Black adults with and without treated hypertension, residing in Boston-area food deserts. Both trials are identical in recruitment drive, design, assessments, and incentives. Participants’ preferred call time was self-reported via a web-based Qualtrics survey. We logged each time staff called participants, whether they were successfully reached, and if a PSV was completed. Results: Of 2,861 inquiries, 30.1% did not specify a preferred time, 5.8% preferred a call before 9 am, 11.8% preferred a call between 12-1 pm, and 16.3% preferred a call after 4 pm; the remaining 36% fell within working hours. Of the 2,516 attempted calls between August 2022 - July 2023; 1,883 (74.8%) were reached by phone and of those, 1,467 (77.9%) completed a PSV. There was a positive association between preferred call time category and completion of a PSV ( P &lt; 0.0001). There was also a positive association between calling a participant at least once during their preferred call time and reaching that participant ( P = 0.0005). Conclusion: Contacting participants during their preferred call time was associated with completion of a PSV. These data highlight the importance of study teams’ flexibility in outreach time to enhance recruitment of Black adults into cardiovascular clinical trials.
Abstract MP56: Screening for Familial Hypercholesterolemia: School Based Programs May Be Best Alternative
Authors: Gary J Luckasen, NaNet Jenkins, Austin Pollack, Landon D Hamilton, Meghan Willis, Paige Lueders
Journal: Circulation (2024)

Introduction: Familial Hypercholesterolemia (FH) is an autosomal dominant condition characterized by elevated cholesterol and premature development of cardiovascular (CV) disease affecting 1/200 - 1/500 individuals. Only 10% of the affected population in the United States have been identified and treated compared to 50-70% in Scandinavian countries identified through school-based or universal screening programs. Hypothesis Statement: School based programs are the best mechanism for FH screening. Methods: The Healthy Hearts and Minds Program (HHM) through UCHealth performs biometric screenings on 5th, 7th, and 10th grade students in Northern Colorado. HHM tested 10,991 5th grade students (9/2017 - 5/2022) and identified 424 students with total cholesterol levels ≥200 mg/dL (range 200-302). A buccal smear test (APOB, LDLR, PCSK9) was performed on 99 individuals with the highest total cholesterol levels to identify genetic status. A binomial logistic regression model was used for analysis. Results: Of the 99 students, six tested positive (50% male, 10.3 years, 22.8 BMI) for FH with five (40% male, 11.3 years, 17.3 BMI.) reporting a variant of indeterminate significance. A sigmoidal association between total cholesterol and predicted chance of FH was identified with the inflection point at ~270 mg/dL. Conclusions: Comprehensive school based programs are the most effective and equitable means of identifying this genetic based disease and should be supported in a collaborative manner with health care systems, industry and the community. With availability to all students, diversity, equity, and inclusion concerns are addressed and provide at risk populations with personalized health information. The results from this study suggest a school-based screening program can be effective at identifying students most at risk for FH. These results further define the relation between total cholesterol and predicted chance of FH for a school-aged population where 245 mg/dL indicates a 10.3% of testing positive for FH whereas 275 mg/dL has a 54.8% chance. Additionally, the multiplier effect documented through cascade FH testing enhances the benefit of the information to other family members, as the autosomal dominant pattern insures that 50% of members will be at risk. The individual benefit of identifying FH early is the treatability of this condition. Early use of lipid lowering agents can make the CV disease risk equal to the general population. If left untreated, CV disease occurs approximately 10 years earlier which results in increased mortality and disability, along with increased health care costs. Therefore, if elevated cholesterol is present in school children, genetic testing is warranted and treatment considered by age 8-10 years, especially if signs of abnormal vascular plaquing is identified.