tbuckley/cabot-search huggingface dataset:
Abstract P358: Association Between Psychological Distress and Cardiovascular Health Among Pregnant Individuals in the United States: Findings From Nationally Representative Data
Authors: Danish Iltaf Satti, Jeffrey S Chan, Reed Mszar, Yaa A Kwapong, Raymond Ngai Chiu Chan, Miriam E Katz, Faith Metlock, Yvonne Commodore-Mensah, Jared Spitz, Jason A Bonomo, Garima Sharma
Journal: Circulation (2024)

Background: Psychological health has an impact on pregnancy outcomes. The impact of psychological health during pregnancy on maternal cardiovascular health (CVH) is not well understood. Methods: Data from the US National Health Interview Survey (2013-2018) were used. All participants aged ≥18 years were included, excluding those with missing data for any of the exposure, outcome, or covariates. Psychological health was measured by the six-item Kessler scale (K6), and severe psychological distress (SPD) was defined as K6 ≥13. CVH was quantified based on the American Heart Association’s Life’s Essential 8 ; as detailed dietary data were unavailable, a seven-item CVH score was used (higher score indicated worse CVH). Multivariable Poisson regression was used to test associations between SPD and CVH, adjusting for the presence of any known cardiac condition, family income, education level, race, sex, sexual orientation, insurance coverage, and age. Results: Altogether, 1,111 participants were analyzed representing a weighted population of 1,576,091 persons. Worse psychological distress was independently associated with suboptimal cardiovascular health in pregnant individuals (adjusted risk ratio (aRR) 1.03 [95% confidence interval: 1.02, 1.04], p&lt;0.001), with similar findings for SPD (aRR 1.34 [1.14, 1.58], p=0.001). These associations remained consistent regardless of age and race. Conclusions: Although SPD was relatively uncommon among pregnant individuals, it was strongly associated with worse maternal CVH. This underscores the critical need for a multidisciplinary approach that incorporates thorough psychological assessments in the care of pregnant individuals.
Abstract P179: Association Between Serum Metabolites and Carotid Atherosclerosis Among Japanese Men
Authors: Gantsetseg Ganbaatar, Aya Kadota, Yukiko Okami, Luke Whiley, Queenie Chan, Emma Barinas-Mitchell, Sayuki Torii, Keiko Kondo, Katsutaro Morino, Takashi Hisamatsu, Akira Fujiyoshi, Akira M Sekikawa, Hirotsugu Ueshima, Katsuyuki Miura
Journal: Circulation (2024)

Background: Complex metabolic pathways may exist for atherosclerosis. We examined metabolomic signatures that reflect mechanistic pathways associated with carotid atherosclerosis in apparently healthy men. Methods: A cross-sectional study was conducted in 675 Japanese men (46-83 years) from the SESSA Study (2010-2014). A total of 468 serum metabolites were quantified by liquid chromatography mass spectrometry. The mean intima-media thickness (IMT) and total number of plaques from carotid arteries were measured using B-mode ultrasound. All metabolites were standardized prior to the analysis. We used partial least square regression and variable importance projection (VIP) method to extract the principal metabolites most associated with the mean IMT and total number of plaques. We used a multivariable linear model for the log-mean IMT and a multivariable Poisson model for the total number of plaques to assess the association between individual extracted serum metabolites and carotid measures. Each metabolite multivariable model adjusted for age, body mass index, smoking and drinking status, medications for hypertension, diabetes and dyslipidemia, and systolic blood pressure, high- and low-density lipoprotein cholesterols and hemoglobin A1c. We used false discovery rate adjusted p-values to control for multiple testing. Results: The average mean IMT and total number of plaques were 0.80 mm (SD: 0.16) and 2.06 (range: 0-14), respectively. There were 191 metabolites with a VIP value of one or higher for mean IMT. None of these metabolites was significantly associated with the log-mean IMT. On the other hand, there were 209 metabolites with a VIP value of one or higher for the total number of plaques. Among them, SulfoHexCer(d18:2/24:0(OH)) and SulfoHexCer(d18:2/16:0(OH)) had an inverse association with the total number of plaques (Figure 1). Conclusion: We identified distinct metabolites associated with the total number of plaques. The results suggest an important role of sphingolipids in carotid plaque formation.
Abstract P412: Exploration of Eating Disorder Behaviors in Adolescent Girls Engaged in a Cardiovascular Risk Assessment Study
Authors: Elizabeth H Zeichner, Andrew Jergel, Brianna Karim, Kourtney Peters, Holly C Gooding
Journal: Circulation (2024)

Introduction: Cardiovascular disease risk factors and eating disorders are both common in young women. There is scant research regarding eating disorder behaviors within the context of cardiovascular health interventions focused on nutrition, physical activity, and weight reduction. This project explored eating disorder behaviors while developing a cardiovascular health promotion tool for young women. Methods: We used an exploratory sequential mixed-methods approach. We interviewed 10 young women about an existing adult cardiovascular risk assessment tool. Three independent coders analyzed the interview data for themes pertaining to weight, food, exercise, and eating disorder behaviors. We used this qualitative data to inform modifications to the adult tool and create the new tool, HerHeart, focusing on teen-friendly language that deprioritized feedback surrounding weight. We then recruited 60 young women ages 13-21 years to complete HerHeart during a clinical visit; 12 participants returned for a three-month follow-up visit. Participants completed the Eating Disorder Diagnostic Scale (EDDS; score ranges from 0-128) at the baseline and follow-up visits. Hypothesis: We hypothesized that there would be no deterioration in EDDS scores over the intervention phase of HerHeart. Results: We identified themes in interviews, such as the importance of word choice when discussing weight (“words can hurt […] especially if you're overweight”, "when you're telling somebody they [are] obese, I feel like [you] should word it differently”), influences on body image and dieting (“some people see people who are […] very fit and they're like, okay, I'm going to starve myself”), and emotional eating (“I shouldn’t be eating this much because I am emotional eater […] When I do get sad […] I mostly eat”). At baseline, one participant met criteria for binge eating disorder and one met criteria for night eating syndrome. At follow-up, a separate individual met criteria for night eating syndrome. The median EDDS composite score for these 12 participants changed from 19 (IQR 10.5, 24) to 21 (IQR 10.5, 26). Conclusion: In conclusion, there was no significant change in EDDS composite score for young adult participants in a cardiovascular health intervention; very few participants met criteria for eating disorders. This emphasizes the importance of thoughtful language surrounding weight, eating habits, and body image in interventions involving adolescents.
Abstract P401: Association of Healthy Lifestyle Score With Metabolic Syndrome in Hong Kong Chinese Women: An Age-Matched Nested Case-Control Study
Authors: Yao Jie Xie, Yunyang Deng, Qi Sun, Lin Yang, Chun Hao
Journal: Circulation (2024)

Introduction: Limited studies explored the combined effect of lifestyles on metabolic syndrome (MetS), especially in Hong Kong Chinese people. Hypothesis: We assessed the hypothesis that a combination of seven lifestyles, expressed as a healthy lifestyle score (HLS), was inversely associated with MetS. Methods: A nested case-control study was conducted in a cohort named Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women (MECH-HK). We recruited 4,221 women aged ≥30 years at baseline (2019-2021) and followed up with 3,435 subjects at the second-round survey until September 2023. The MetS was diagnosed based on the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) (2005 version). Women who developed MetS between baseline and second-round survey and had no hypertension, diabetes, hyperlipemia, myocardial infarction, stroke, or cancers at baseline were selected as cases. Age-matched controls were selected using a 1:1 ratio. Seven lifestyles were included in the HLS, each was assigned 0 or 1 point. The 1-point criteria were: smoking (never smoker), physical activity (vigorous physical activity ≥75 min/week), sleep (Pittsburgh Sleep Quality Index ≤5), stress (Perceived Stress Scale-10 ≤13), fatigue (≤ the median of a 10-point Likert scale), diet (≥ the median of a healthy diet score), and alcohol (&lt;20g/day). The overall score ranged from 0 to 7, where a higher score indicated better health. Leave-one-out test was performed by excluding the seven items from the HLS one at a time. A weighted HLS was generated based on the coefficient of each component in multivariable analysis. Results: A total of 123 MetS patients (aged 56.6±7.5 years) and 123 controls (aged 56.9±7.8 years) were included. The number of MetS cases and total subjects for the lowest (0-2 points), middle (3-4 points), and highest (5-7 points) HLS groups were 40/64 (62.5%), 51/107 (47.7%), and 32/75 (42.7%), respectively. Compared to the lowest HLS group, the ORs (95% CIs) for the highest HLS group in univariable and multivariable analysis were 0.45 (0.23, 0.88) (P=0.021) and 0.46 (0.23, 0.94) (P=0.032), respectively. Among the seven components, smoking was the strongest contributor, followed by physical activity and diet. The results were consistent in the leave-one-out test and weighted HLS. Conclusions: Higher HLS was associated with lower MetS risk in Hong Kong Chinese women. The combined healthy lifestyles could benefit the prevention of MetS.
Abstract P174: Food as Medicine: Evaluating the Effect of a Food Insecurity Intervention on Lipid-Lowering Prescription Medications
Authors: Aneeqa Abid, June Tester, Lisa Goldman Rosas, Lan Xiao
Journal: Circulation (2024)

Introduction: Food insecurity and chronic diseases are interrelated challenges, as access to healthful food can hinder effective prevention and management of chronic diseases such as hyperlipidemia. ‘Food as Medicine’ programs that integrate food deliveries and behavioral interventions into healthcare have been recommended for addressing this challenge. While there is some evidence to support the benefits of these initiatives, there has been limited research to evaluate their effectiveness, especially on outcomes related to hyperlipidemia or lipid medication utilization. Methods: This study utilized a quasi-experimental design, using propensity-score matching to compare participants enrolled in the Recipe4Health intervention (R4H) to a control group of participants in clinics where this intervention was not implemented. R4H included 12 weekly deliveries of produce, with or without group medical visits (GMV) with 12 weekly sessions. We examined whether R4H was associated with a change in the intensity of participants’ prescribed regimens. Patient prescriptions for statins as well as any other prescription medications and relevant supplements were assessed. Regimens were standardized to assess whether if a patient’s daily prescribed regimen intensified (e.g. increased dose or added medications), de-intensified (e.g. decreased dose and/or removed medications), or demonstrated no change. Two outcome measures were defined, Overall Regimen Change and Statin-specific Change. Adult participants were included, excluding pregnant women. Generalized linear mixed models were used assuming a multinomial distribution for the outcomes separately for the categories. Results: Patients who took part in the R4H with GMV were more likely to have a medication regimen intensification compared to controls (28.2% vs. 21%, p=0.05). Although not significant, there was a trend of greater reduction in overall medication regimen among patients who participated in R4H with GMV compared to controls ( 6.1/5.2% vs. 1.4%). There was a non-significant trend of reduction in medication among patients in Food Farmacy with GMV/without GMV alone compared to controls for the statin potency change outcome (1.2/3.2% vs 0%), whereas the trend of medication intensification was comparable for all three groups. Conclusion: These results indicate that the group medical visit component of the R4H intervention may have increased patient engagement with medical services, thus resulting intensified medication regimen.
Abstract P296: The Association Between Maternal Occupation and Adverse Birth Outcomes Among Infants With Congenital Heart Defects
Authors: Jenil Patel, Omobola Oluwafemi, A J Agopian, Renata Benjamin, Charles Shumate, David Gimeno
Journal: Circulation (2024)

Background: Neonates with critical congenital heart defects (cCHDs) face increased risks of neonatal complications, including low birth weight (LBW) and preterm birth (PTB). Maternal occupation has known associations with adverse birth outcomes in the general population. We aimed to assess the link between maternal occupation and adverse birth outcomes in neonates with cCHDs. Methods: We examined Texas Birth Defects Registry (TBDR) data from 1999-2014, focusing on employed mothers of non-syndromic live born singletons with cCHD. Using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS) and manual coding, we categorized maternal occupation into 23 major groups. Neonates with cCHDs and adverse birth outcomes were compared to neonates with cCHDs without adverse outcomes. Logistic regression models assessed the association between maternal occupation and PTB and LBW, with the reference group being all other occupations. Results: There were 712 mothers with preterm neonates with cCHDs and 3,076 mothers with full-term neonates with cCHDs. Additionally, 776 mothers delivered LBW neonates, while 3,012 had normal birthweight neonates. Maternal occupations in computer/math science were negatively linked to PTB (OR: 0.29; 95% CI: 0.10-0.79) and LBW (OR: 0.26; 95% CI: 0.09-0.70). Food preparation occupations were positively associated with PTB (OR: 1.67; 95% CI: 1.17-2.38), while arts/entertainment occupations were negatively associated with LBW (OR: 0.30; 95% CI: 0.11-0.84). Conclusion: These findings align with previous reports, suggesting that mothers in certain occupations may engage in behaviors linked to adverse pregnancy outcomes in the general population, such as insufficient folic acid supplementation, delayed prenatal care, smoking, and drinking. Understanding these associations can inform targeted workplace interventions, particularly for pregnancies involving birth defects.
Abstract MP47: Fetal Life Exposure to GDM and Postnatal Breastfeeding and Beverage Intake in the First Year Are Associated With Severe Child Obesity at 6 to 11 Years: The SWIFT Study in Youth
Authors: Baiyang Sun, Alexis S King, Joan C Lo, Louise C Greenspan, Patricia Wakimoto, Stacey Alexeeff, Erica P Gunderson
Journal: Circulation (2024)

Objective: To evaluate associations between fetal exposure to GDM and postnatal breastfeeding (BF) and sugary beverages in the first year with risk of child overweight and obesity severity at 6-11 y. Methods: The sample included 850 children exposed to maternal GDM with BF and infant diet assessed by monthly surveys from birth to 1 y and weight and length/height measurements up to ages 6-11 y from electronic health records. Maternal GDM severity was classified by diagnosis time (Early &lt;24 wks or Standard ≥24 wks) and treatment type (Diet or Medication). Child BMI percentiles at 6-11 y were categorized as normal &lt;85 th (referent), overweight 85 th to &lt;95 th , moderate obesity 100 to &lt;120% of 95 th and severe obesity ≥120% of 95 th . Multinomial logistic regression estimated adjusted odds ratios (aOR) and 95%CI of child BMI categories associated with fetal GDM exposure (diagnosis time &amp; treatment) and postnatal diet; BF inadequate &lt;6 months or adequate &gt;6 months and sugary beverages (fruit juice or sugar added) adjusted for race/ethnicity, WIC recipient, pre-pregnancy BMI and gestational weight gain. Results: There were 480 (56.5%) children with normal weight, 150 (17.6%) with overweight, 155 (18.2%) with moderate obesity and 65 (7.6%) with severe obesity. Child average age (SD) at follow-up was 9.6 (1.4) y. Early GDM diagnosis was associated with aORs [95%CI] of severe obesity = 3.06 (1.33-7.04) with medication, and 2.61 (1.08-6.35) with diet and of moderate obesity = 1.93 (1.05-3.55) with diet vs. Standard diagnosis with diet. Inadequate BF with sugary beverage or fruit juice was associated with aOR [95%CI] of severe obesity = 3.06 (1.07-8.72) vs. adequate BF and no beverage. Conclusions: Earlier fetal exposure to maternal GDM and shorter BF combined with sugary beverages in the first postnatal year shows persistent higher risk of severe child obesity about 10 y later. These findings highlight pre-pregnancy screening to avert GDM and the importance of adequate BF and avoidance of sugary beverages and fruit juice among offspring exposed to GDM.
Abstract P417: A Cumulative Score Approach to Evaluating the Impact of Five Modifiable Lifestyle Factors on Kidney Function
Authors: Martino W Laurenzi, Massimo Cirillo, Oscar Terradura Vagnarelli
Journal: Circulation (2024)

Background: Data from the Gubbio population study were used to investigate the impact of a cumulative score combining physical activity, intake of alcohol, sodium, potassium and protein on the decline of kidney function. Methods: The Gubbio Study is a longitudinal study on the population of Gubbio, a town in central Italy; it started in the year 1983, and addressed the resident population aged 5 +. Three exams were performed: Exam 1 (baseline) Exam 2 (6-year follow-up) and Exam 3 (20-year follow-up); this analysis is on the 3,039 adult individuals (Age 18+ at baseline) who participated in Exam 2 (1989-92) and Exam 3 (2001-07). Kidney function was estimated as glomerular filtration rate (eGFR) with the CKD-Epi equation (mL/min x 1.73 m 2 ). Habitual physical activity and alcohol intake were assessed by standard questionnaires. Dietary intake of protein, sodium and potassium were measured by urinary markers. Each factor received score 0 for the tertile associated with greater eGFR decline, score 1 for the tertile associated with intermediate decline and score 2 for the tertile associated with greater decline. A cumulative score (CS) was then calculated for each individual and used as main independent variable. Results: After correction to avoid low-n bias, the CS ranged from 1 (low risk for all factors) to 9 (high risk for all factors). The mean was 5+/-2, with skewness = 0.016. Multiple linear regression showed a relation with the annualized decline in eGFR (slope = - 0,027, 95% CI = - 0.039/ - 0.014, p &lt; 0.001). Incidence of low eGFR was higher in the groups with higher CS, ranging from 2% in the group with CS = 1 to 12.9% in the group with CS = 9. Multivariate logistic regression analysis confirmed the correlation (p &lt; 0.001). Conclusion: These data indicate a significant independent association between a score comprising five modifiable lifestyle factors and the long-term decline of kidney function, providing a tool for the quantification of its impact on the long-term incidence of low eGFR.
Abstract P526: Association of Hemoglobin A1c With Sleep Duration in Non-Diabetic Population
Authors: Ekamol Tantisattamo, Wanprapit Noree, Voramol Rochanaroon, Urairat Chuenchaem, Nisha Wanichwecharungruang, Narathorn Kulthamrongsri, Narisara Tribuddharat, Thitiphan Srikulmontri, Thanathip Suenghataiphorn, Chanokporn Puchongmart, Ben Thiravetyan, Piengpitch Naunsilp, Possawat Vutthikraivit, Jiayuan Wang, Alan Bao, Bahaar Ghaffarian, Young Ha, Andrea Yanez, Michael Au, Manasawee Tanariyakul, Phuuwadith Wattanachayakul, Kamonluk Rodsom, Irin Jariyayothin
Journal: Circulation (2024)

Background: Shorter sleep duration is associated with higher hemoglobin A1c (HbA1c) in patients with type 2 diabetes. We aim to examine the association between HbA1c level and sleep duration in non-diabetic population. Methods: A cross-sectional study using 2017-2020 NHANES included self-questionnaires of the presence or absence of diabetes and sleep duration on weekdays and weekends. The association between the quartile (Q) of HbA1c and sleep duration in non-diabetic patients was examined by multiple linear regression. Results: Of 7,998 non-diabetic participants ≥18 years old, mean±SD age was 47±19 and 52% were female. Mean HbA1c levels from Q1 to Q4 were 5.0±0.2, 5.4±0.1, 5.7±0.1, and 6.5±0.9%, respectively (Figure 1). Mean sleep durations on the weekdays and weekends were 7.6±1.7 and 8.3±1.8 hours, respectively. Compared to participants with HbA1c in Q1, sleep durations in both weekdays and weekends were lower in Q2 to 4 with the lowest sleep duration in Q3 (β weekdays_Q3 -0.32; 95%CI -0.43, -0.21; P &lt;0.001 and β weekends_Q3 -0.43; 95%CI -0.54, -0.31; P &lt;0.001). After adjusting for age, gender, race, SBP, DBP, BMI, serum creatinine, urinary albumin:creatinine ratio, hemoglobin, ferritin and interaction term between HbA1c quartile and race (white vs. non-white), the direction of HbA1c - weekday sleep duration association remains with the lowest sleep duration in Q3 (β weekdays_Q3 -0.34; 95%CI -0.48, -0.19; P &lt;0.001). Furthermore, race was identified as an effect modifier with an increased weekday sleep duration observed in White with HbA1c in Q3 (β weekdays_Q3 0.26; 95%CI 0.04, 0.49; P interaction 0.022). Only HbA1c Q3 was significantly associated with weekend sleep duration (β weekends_Q3 -0.18; 95%CI -0.34, -0.03; P 0.022). Conclusions: In non-diabetic population, HbA1c was inversely associated with sleep duration on both weekdays and weekends and in a U-shaped relationship except for White whose HbA1c was positively related to sleep duration on the weekdays. Glycemic status may be involved in sleep duration or quality.