tbuckley/cabot-search huggingface dataset:
Abstract P142: Trends and Racial/Ethnic Differences in Age at Diagnosis of Type 1 and Type 2 Diabetes Among Adults in the United States, 2016-2022
Authors: Kexin Li, Victor W Zhong
Journal: Circulation (2024)

Introduction: Age at diagnosis of diabetes and diabetes type are associated with medical costs, lost productivity, vascular complications, and premature mortality that affect people disproportionately by race/ethnicity. However, age at diagnosis of diabetes by diabetes type and race/ethnicity along with their temporal trends are unclear. Hypothesis: We assessed the hypothesis that different trends and racial/ethnic differences in age at diagnosis of diabetes by diabetes type existed between 2016 and 2022. Methods: Adults aged 18 years or more were included from the National Health Interview Survey, 2016-2022. Type and age at diagnosis of diabetes were self-reported. Trends in age at diagnosis of type 1 diabetes (T1D) and type 2 diabetes (T2D) and in proportions of people with T1D or T2D diagnosed at different ages were assessed by linear and logistic regressions adjusted for sex and race/ethnicity, respectively. Racial/ethnic differences in age at diagnosis of T1D and T2D were estimated using Rao-Scott chi-square test. Results: Of 16,063 participants, 1,551 individuals had T1D with a mean [SE] age of 53.1 [0.6] years; 48.7% were women and 57.9% non-Hispanic White. T2D was found in 14,512 individuals with a mean [SE] age of 62.5 [0.2] years; 48.5% were women and 53.7% non-Hispanic White. The mean [SE] diagnosis age of T1D decreased from 37.5 [1.4] years in 2016 to 35.6 [1.4] years in 2022 ( P for trend = 0.03). During the same period for T2D, the mean [SE] diagnosis age increased from 48.7 [0.4] years to 49.2 [0.3] years ( P for trend &lt;0.001). From 2016 to 2022, the proportion of people with T1D and T2D diagnosed at &lt;45 years increased by 8% and decreased by 3% annually, respectively ( P for trend ≤0.01); the proportion of people with T1D and T2D diagnosed at ≥60 years decreased by 9% and increased by 3% annually, respectively ( P for trend ≤0.03). All results were adjusted for sex and race/ethnicity. Compared with non-Hispanic Whites, the mean diagnosis age of T1D was 7.8, 7.9, and 11.2 years higher whereas of T2D was 5.0, 6.4, and 2.5 years lower, respectively, in non-Hispanic Black, Hispanic, and non-Hispanic Asian people (all P for difference ≤0.002). Conclusions: In US adults, the mean age at diagnosis of T1D significantly decreased, whereas of T2D significantly increased from 2016 to 2022. Substantial differences in diagnosis age of T1D and T2D by race/ethnicity existed.
Abstract P327: Examination of Cardiometabolic Health Status, Obesity, and Brain Health in Community-Dwelling Older Adults
Authors: Kathryn H Alphin, Samuel N Lockhart, Cynthia Suerken, Sarah Gaussoin, Tina E Brinkley
Journal: Circulation (2024)

Introduction: Mid-life and late-life obesity have been associated with changes in brain structure and function, though the exact nature of this dynamic relationship is not well understood. Purpose: To determine whether associations between measures of obesity and neuroimaging biomarkers are independent of cardiometabolic health status in older adults. Methods: Adults 55 and older were recruited into the Clinical Core of the Wake Forest Alzheimer’s Disease Research Center (ADRC) between 2016 and 2023 and underwent standard evaluation in accordance with the National Alzheimer’s Coordinating Center protocols. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were measured to assess obesity. Cardiometabolic health was determined by the presence of impaired glucose tolerance (IGT) and hypertension (HTN). Brain MRI scans were conducted to assess cerebral blood flow (CBF) in white matter (WM) and gray matter (GM), WM microstructure using neurite orientation dispersion and density imaging (NODDI) of free water (FW), total brain volume (GM+WM), and temporal lobe cortical thickness. Linear regression was used to examine associations between anthropometric and neuroimaging measures, controlling for demographics (age, gender, race, education) in model 1 and demographics plus cardiometabolic health (HTN and IGT) in model 2. Results: A total of 647 Clinical Core participants with anthropometric, MRI, cardiometabolic, and demographic data available were analyzed. Mean age of participants was 70.1±8.2 years, 19% were African American, 48% had adjudicated cognitive impairment (35% mild cognitive impairment, 13% dementia), 76% had HTN, and 69% had IGT. BMI (p&lt;0.001), WC (p&lt;0.001), and WHR (p=0.006) were positively associated with WM CBF in models 1 and 2. BMI (p=0.039) was also positively associated with GM CBF in model 2. All three obesity measures were positively associated with NODDI FW in model 1: BMI (p=0.006), WC (p=0.007), and WHR (p=0.039), and WHR was negatively associated with total brain volume (p=0.043). However, these associations were attenuated after further adjustment. Cortical thickness was not significantly associated with obesity in any model. Conclusion: These results demonstrate that, among community-dwelling older adults, having higher BMI, WHR, and WC is associated with higher WM CBF even after adjusting for demographics, HTN and IGT, suggesting that obesity may be a risk factor for impaired brain perfusion in late life.
Abstract P138: Smoking Timing, Genetic Susceptibility, and Risk of Incident Type 2 Diabetes: A Cohort Study in UK Biobank
Authors: Ying Hu, Xiang Li, Xuan Wang, Hao Ma, Jian Zhou, Rui Tang, Minghao Kou, Yoriko Heianza, Zhaoxia Liang, Lu Qi
Journal: Circulation (2024)

Objective: Smoking is an establish risk factor for type 2 diabetes (T2D); however, little is known about how the timing patterns of smoking is related to T2D risk. We prospectively assessed the association of smoking timing with risk of T2D and examined whether smoking amount or genetic susceptibility might modify the relationship. Methods: This study analyzed 294815 participants from the UK Biobank who were free of diabetes at baseline and with complete data on the time from waking to the first cigarette. Cox proportional hazards models were used to evaluate the association between smoking timing and risk of incident T2D. Results: During a median follow-up time of 12 years, a total of 9937 incident cases of T2D were documented among the 294815 participants. Compared to non-smokers, shorter time from waking to the first cigarette was significantly associated with a higher risk of incident T2D ( P for trend &lt;0.0001). The adjusted hazard ratio (aHR) associated with smoking timing was 1.46 (95% confidence interval [CI] 1.17-1.81) for &gt;2 hours, 1.51 (1.21-1.87) for 1-2 hours, 1.58 (1.34-1.85) for 30-60 minutes, 1.86 (1.57-2.21) for 5-15 minutes, and 2.01 (1.60-2.54) for &lt;5 minutes, respectively. We found that even among light smokers, those with the shortest time from waking to the first cigarette had a 105% higher risk of T2D (HR 2.05, 95% CI 1.52-2.76), which was comparable to heavy smokers. The genetic risk score for T2D did not modify this association ( P -interaction =0.51). Conclusions: Our findings indicate that shorter time from waking to the first cigarette is significantly associated with a higher risk of incident T2D, independent of the amount of cigarettes smoked.
Abstract P512: Associations of Serum Insulin-Like Growth Factor (IGF)-1 Levels With Cognitive Function and Atherosclerosis in a Japanese General Population: The Tanushimaru Study
Authors: Yume Nohara-Shitama, Harumi Yoshimura, Morikawa Nagisa, Ako Fukami, Mika Enomoto, Hisashi Adachi, Yoshihiro Fukumoto
Journal: Circulation (2024)

Background: Insulin-like growth factor (IGF)-1 is a peptide hormone implicated in insulin sensitivity and anti-inflammatory. However, there is limited exploration of the association of serum IGF-1 levels with cognitive function and atherosclerosis. This study aimed to investigate the association between serum IGF-1 levels and cognitive function, as well as carotid atherosclerosis in a general population. Methods: In 1,345 participants (544 men; mean age, 68.7 (11.3) years) recruited from the Tanushimaru cohort, we measured their serum IGF-1 levels and evaluated cognitive function using mini-mental state examination (MMSE) and atherosclerosis through carotid intima-media thickness (IMT). Linear regression models were utilized to analyze the association between quartiles of serum IGF-1 levels and MMSE scores, as well as IMT, continuous dependent variables. We also visualized the continuous associations using restricted cubic spline models. Two-sided statistical significance was defined as p &lt;0.05. All statistical analyses were performed using the SAS system (Release 9.4, SAS Institute, Cary, NC, USA). Results: The mean serum IGF-1 level was 96.6 (30.2) ng/ml. Multiple linear regression analysis revealed that the highest quartile of serum IGF-1 levels showed a statistically significant association with higher MMSE scores (p=0.0019), and the third quartile also reached statistical significance (p=0.0006) compared to the lowest. We observed a positive association between serum IGF-1 levels and MMSE scores, even when exploring the full spectrum of serum IGF-1 levels with their spline terms (Figure). In contrast, serum IGF-1 levels did not exhibit a significant association with IMT measurements. Conclusion: High serum IGF-1 levels were associated with higher cognitive function, while no significant association was observed with carotid atherosclerosis. Our findings suggest that IGF-1 levels may play a role in preserving cognitive function, potentially distinct from its role in atherosclerosis.
Abstract P260: Association of Hearing Impairment and Physical Functioning Among Chinese Adults Aged 60 Years or Older: Evidence From the China Health and Retirement Longitudinal Study (CHARLS)
Authors: Huiyuan Zhou, Zhengting He, Xiong Ding, Jie Hao, Xian Zhang, Lijing L Yan
Journal: Circulation (2024)

Introduction: Hearing impairment is a common treatable condition and a risk factor for various adverse health outcomes. Prior evidence associated hearing impairment with physical functioning declines in older adults of Western countries, but longitudinal evidence on such association is limited among Chinese older adults. Method: We pooled the first three waves of CHARLS (2011, 2013, and 2015) together as a longitudinal dataset with repeated measurements. For each participant, self-reported hearing status was collected at each wave and categorized as normal hearing or impaired hearing (reported fair or poor hearing). Physical functioning was assessed by Short Physical Performance Battery (SPPB), including gait speed, duration to complete five chair stands and balance test. Each SPPB component was assigned a score from 1 to 4 corresponding from the lowest to highest quartile. The SPPB score ranged from 1 to 12, with higher scores representing better physical functioning. We used a series of linear mixed-effects models with participant-level random intercepts and slopes to assess the association of hearing impairment with physical functioning, adjusting for demographics, socioeconomics, and comorbidities. Results: A total of 8,894 participants aged 60 or above at baseline were included, with a median age of 68 years. At baseline, the impaired hearing group were estimated to be 0.21 (0.11, 0.31) lower in average SPPB score, 0.02 (0.01, 0.03) lower in average gait speed, and 1.04 (1.02, 1.05) times longer in average duration to complete the chair stand test as compared to the normal hearing group ( Table ). Statistically significant differences in average rate of longitudinal changes were not observed for either outcome. Conclusion: Baseline hearing impairment was associated with poorer physical functioning among Chinese older adults, but no significant association with longitudinal changes was observed. This finding emphasizes the necessity of monitoring hearing status among the Chinese elderly population.
Abstract P316: Orthostatic Hypertension, Standing Hypertension, and Risk of Cardiovascular Disease
Authors: Sean W Dooley, Hannah Col, Ruth Turkson, Long H Ngo, Jennifer Cluett, Lewis Lipsitz, Natalie R Malek, Elizabeth Selvin, Joseph Coresh, Pamela L Lutsey, B Gwen Windham, Mingyu Zhang, Ken J Mukamal, Fredrick Larbi Kwapong, Stephen P Juraschek
Journal: Circulation (2024)

Background: There is substantial controversy over how to define orthostatic hypertension (OHTN), an increase in blood pressure (BP) after standing. Recent consensus statements combine both orthostatic and standing hypertension. This could be problematic if their individual associations with cardiovascular disease (CVD) differed as one phenotype would subsume the risk attributes of the other. Objectives: To compare the association between OHTN or standing HTN with CVD. Methods: The Atherosclerosis Risk in Communities Study measured supine and standing BP during visit 1 (1987-1989). OHTN was defined as a rise in SBP ≥20 mm Hg or DBP ≥10 mm Hg (standing minus supine BP). We also examined a new consensus statement definition of a rise of ≥20 mm Hg in SBP (systolic OHTN) and standing SBP of ≥140 mm Hg. We excluded participants with a history of CVD. We determined risk associations with incident CHD, heart failure, stroke, fatal CHD, and all-cause mortality using Cox models adjusted for CVD risk factors (see Table footnote). Results: Of 11,369 participants (56% female, 25% Black adults, mean age 54 years), 10% had OHTN, 20% had standing systolic HTN, and 1% had systolic OHTN with standing SBP ≥140 mm Hg. Over a range of 25-28 years of follow-up, OHTN was not significantly associated with any of the outcomes, while standing systolic HTN was significantly associated with all outcomes. In joint models comparing systolic OHTN and standing HTN, standing HTN was significantly associated with CVD and associations differed significantly from systolic OHTN (Table). Conclusions: Unlike OHTN, standing HTN was strongly associated with CVD and death. These differences in CVD risk raise important concerns about combining OHTN and standing HTN in a consensus definition.
Abstract P105: Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Multi-Racial Populations
Authors: Kui Deng, Xiong-Fei Pan, Markus W Voehler, Hui Cai, Qiuyin Cai, Xiao-Ou Shu, Deepak K Gupta, Loren Lipworth, Wei Zheng, Danxia Yu
Journal: Circulation (2024)

Background: Blood lipids, such as total cholesterol (TC), LDL-cholesterol (LDL-C), and triglycerides (TG), are well-known risk factors for coronary heart disease (CHD). However, studies that examined the associations of circulating lipids and apolipoproteins carried by different lipoproteins with incident CHD remain limited, particularly among racially diverse populations. Hypothesis: Potential novel lipoprotein biomarkers, other than TC, TG, LDL-C, and HDL-C, are associated with incident CHD in diverse populations. Methods: We conducted nested case-control studies of CHD among White Americans (542 pairs; n =1084), Black Americans (622 pairs; n =1244), and Chinese adults (557 pairs; n =1114) drawn from the Southern Community Cohort Study and Shanghai Women’s and Men’s Health Studies. We examined the associations of 36 plasma lipids, lipoproteins, and apolipoproteins (measured by Bruker IVDr NMR platform) with incident CHD using conditional logistic regression, adjusted for sociodemographics, lifestyle, family history of CHD, and menopausal status (women only). Race-specific odds ratios (ORs) were pooled using fixed-effect meta-analysis. Results: TC, TG, LDL-C, and HDL-C were associated with incident CHD, with pooled ORs being 1.35, 1.31, 1.26, and 0.79 per 1-SD increase. Sixteen lipoprotein biomarkers showed larger effect sizes than those conventional lipids, with pooled ORs per 1-SD ranged from 1.37 to 1.59 and a negative OR of 0.77 ( Figure 1 ); all associations were significant within each race. Significant associations were observed across subpopulations defined by sociodemographics, lifestyle, and status of obesity, diabetes, hypertension, and dyslipidemia, including among individuals with normal levels of TC, TG, LDL-C, and HDL-C. Conclusion: Our study identified several lipoprotein biomarkers (e.g., ApoB/ApoA1 ratio and LDL-TG) associated with incident CHD among multi-racial populations, suggesting potential clinical utility complementing the current lipid panel.
Abstract P227: Association Between Depressive Symptoms and Insulin Resistance in Midlife Women: The Study of Women’s Health Across the Nation (SWAN)
Authors: Yuqing Chen, Alicia B Colvin, Maria M Brooks, Samar R El Khoudary, Rebecca C Thurston
Journal: Circulation (2024)

Introduction: Recent meta-analyses and cross-sectional studies propose that insulin resistance (IR) is a transient and not a lasting feature of depression. However, longitudinal evidence is lacking, particularly in midlife women across the menopause and ethnically diverse cohorts. The goals of this study were to 1) assess the longitudinal association between IR and concurrent and prior depressive symptoms among midlife women and 2) determine if these associations vary by menopausal status and ethnicity. Methods: We included 2694 women (48.4% White, 27.3% Black, 6.5% Hispanic, 8.1% Chinese, and 9.7% Japanese) from The Study of Women’s Health Across the Nation (SWAN) followed for approximately 20 years. The Center for Epidemiologic Studies Depression Scale (CES-D) score was used to assess depressive symptoms (CES-D ≥16 indicating high depressive symptoms) and IR was obtained from the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and log-transformed for analysis. Multivariable linear mixed regression was used to estimate IR as a function of concurrent and prior depressive symptoms adjusting for baseline and time-varying covariates. We tested interactions between depressive symptoms and 1) time-varying menopausal status and 2) race/ethnicity in relation to IR. Results: At baseline women (mean age 45.86 ± 2.70 years, 48.4% white) were premenopausal (54.7%) or early perimenopausal (45.3%). In separate adjusted models, neither concurrent high depressive symptoms nor high depressive symptoms from the prior visit were statistically associated with log-HOMA-IR. When both concurrent and prior visit depressive symptoms were included in the model, the estimated effect of concurrent high depressive symptoms was comparable and statistically significant. High depressive symptoms were associated with a 0.03 increase in log-HOMA-IR (95% CI: 0.01, 0.06), equivalent to a 3% change in HOMA-IR compared to women with low depressive symptoms. Interaction effects were detected between high depressive symptoms and race/ethnicity (P=0.005) but not with menopausal status in relation to HOMA. The relationship between concurrent high depressive symptoms and IR was driven by the association observed among Hispanic women [β=0.18, 95% CI: 0.18 (0.08, 0.27), a 20% change in HOMA-IR]. Conclusion: Current reporting of high depressive symptoms, but not prior reporting, was associated with elevated future IR over time among midlife women. This study provides longitudinal evidence in support of IR as a transient and not a lasting feature of depression. Moreover, the results suggest that Hispanic women with high depressive symptoms may be particularly susceptible to IR. Supported by NIH/DHHS {Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, and U19AG063720}
Abstract P385: Comparison of Food Insecurity Classifications and Associations With Premature Cardiovascular Disease Mortality Among US Adults
Authors: Ling Tian, Byron C Jaeger, Kirsten Dorans, Jing Chen, Jiang He, Joshua D Bundy
Journal: Circulation (2024)

Background: Food security is usually measured with the 10-item US Adult Food Security Survey Module (FSSM). Shorter 6- or 2-item tools may capture similar information, but this has not been validated with hard endpoints. Hypothesis: We hypothesize a 2-item food security instrument reflects the same premature mortality risk as 10- and 6-item instruments. Methods: We included 37,027 participants aged 20-74 years from the National Health and Nutrition Examination Survey (NHANES) 2004-2018, linked to the National Death Index with follow-up through 2019. Cardiovascular disease (CVD) mortality was ascertained by ICD-10 codes for heart disease or stroke. Food security was assessed by the 10-item FSSM, which can derive 6- and 2-item instruments. Multivariable Cox regression was used to assess the associations of food insecurity classifications with risks of premature all-cause and CVD mortality. We calculated C-statistics to estimate model discrimination. We repeated the analyses among 218,136 participants from the National Health Interview Survey (NHIS) 2011-2018. Results: During a mean 7.8-year follow-up, 2025 premature deaths (512 from CVD) were recorded in NHANES. In age-sex-race/ethnicity-adjusted models (Model 1), food insecurity with any classification was strongly associated with premature all-cause and CVD mortality (Table). After adjusting for confounders (Model 2), associations were attenuated but remained statistically significant. After further including potential mediators (Model 3), associations diminished, suggesting pathways by which food insecurity is associated with mortality. Hazard ratios and C-statistics were nearly identical comparing 10-, 6-, and 2-item instruments. Results were equivalent among NHIS participants during a mean 5.0-year follow-up including 7025 premature deaths (1711 from CVD). Conclusions: Among two independent samples of US adults, a 2-item food security instrument is equivalently associated with premature mortality compared with 10- and 6-item instruments.