tbuckley/cabot-search huggingface dataset:
Abstract P143: Lignan Intake and Mortality Among Adults With Incident Type 2 Diabetes
Authors: Binkai Liu, Yang Hu, Siyue Wang, Molin Wang, Eric B Rimm, Qi Sun
Journal: Circulation (2024)

Introduction: Lignans are polyphenolic compounds abundant in plant-based foods such as seeds, whole grains, and certain fruits and vegetables and may lead to better metabolic health. It remains elucidated regarding the role of lignan consumption in the etiology of premature deaths among diabetes patients. Hypothesis: We hypothesize that a higher intake of post-diagnosis lignans is associated with lower risk of mortality among individuals with incident type 2 diabetes (T2D). Design: Data from two prospective U.S. cohorts were analyzed, including the Nurses' Health Study (1984-2020) and Health Professionals Follow-up Study (1986-2022). Average daily consumption of total and individual lignans were calculated, and post-diagnosis lignan intakes were cumulatively averaged. Multivariable-adjusted Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between post-diagnosis lignan intake and mortality. Results: Among 8,691 incident T2D cases contributing 119,065 person-years of follow-up, 4,502 deaths were documented, among which 1,379 cases were attributed to cardiovascular disease (CVD) and 777 to cancer. The pooled multivariable-adjusted HRs (95% CIs) of all-cause mortality comparing extreme quintiles of post-diagnosis lignan intake were 0.83 (0.74, 0.94) for total lignans, 0.87 (0.78, 0.96) for matairesinol (MAT), 0.77 (0.69, 0.86) for secoisolariciresinol (SECO), 0.92 (0.82, 1.03) for pinoresinol (PINO), and 0.92 (0.82, 1.03) for lariciresinol (LARIC). Higher post-diagnosis intakes of SECO were also significantly associated with lower CVD and cancer mortality. The HRs (95% CIs) of total mortality comparing extreme quintiles of changes in lignan intake from pre- to post-diagnosis were 0.84 (0.75, 0.93) for total lignans, 0.85 (0.76, 0.94) for MAT, and 0.79 (0.71, 0.89) for SECO. No significant associations were observed for PINO and LARIC. Stratified analyses showed that the associations of lignans were significantly stronger among non-white individuals. Conclusions: In conclusion, among individuals diagnosed with T2D, a higher intake of lignans, particularly SECO, was significantly associated with reduced overall, cardiovascular, and cancer mortality. Minority groups may particularly benefit from lignan intake, although further studies are warranted to substantiate this observation.
Abstract MP34: Association of Biological Age Acceleration With Incident Type 2 Diabetes and Coronary Artery Disease
Authors: Guangrui Yang, Victor W Zhong
Journal: Circulation (2024)

Introduction: Biological age (BA), compared to chronological age, offers a more accurate reflection of aging status and prediction of cardiometabolic disease mortality. Genetics play an important role in the pathogenesis of type 2 diabetes (T2D) and coronary artery disease (CAD). However, the associations of BA acceleration with incident T2D and CAD as well as how the interactions between genetic risk and BA acceleration implicate in the development of these two diseases remain unclear. Hypothesis: We hypothesized that BA acceleration was significantly associated with incident T2D and CAD. We further hypothesized that there were significant interactions between BA acceleration and genetic risk in relation to risk of T2D and CAD. Methods: This prospective cohort study utilized data from the UK Biobank. BA was quantified by KDM-BA and PhenoAge, two composite measures derived from blood chemistry and physical examination data. T2D and CAD were diagnosed using self-reported medical history, medication, and hospital inpatient records. Multivariable Cox proportional hazard models were employed to estimate the associations of BA acceleration with incident T2D and CAD. A polygenic risk score (PRS) for T2D or CAD divided into tertiles was used to assess the interactions between BA acceleration (divided into quartiles) and genetic risk with regards to the development of T2D and CAD. Derived estimates were hazard ratios (HRs) and their 95% confidence intervals (CIs) per one standard deviation increment in each of the two BA measures. Results: This study analyzed 271,855 participants without T2D and 267,293 participants without CAD at baseline. Over a median follow-up time of 14.6 and 14.5 years, 9,562 incident T2D events and 18,509 incident CAD events occurred, respectively. Individuals with greater BA acceleration were at increased risk of T2D (HR for KDM-BA: 1.42, [95% CI: 1.39-1.46]; HR for PhenoAge: 1.23, [95% CI: 1.20-1.25]). Similarly, BA acceleration was significantly associated with a higher risk of CAD (HR for KDM-BA: 1.22, [95% CI: 1.20-1.25]; HR for PhenoAge: 1.12, [95% CI: 1.10-1.14]). People with greater genetic risk and BA acceleration had higher risks of T2D and CAD (P for interaction &lt; 0.002). Compared with participants with the lowest level of PRS and BA acceleration, those with the highest level of PRS and BA acceleration had a higher risk of developing T2D (HR for KDM-BA: 7.03, [95% CI: 6.16-8.02]; HR for PhenoAge: 6.39, [95% CI: 5.38-7.58]) and CAD (HR for KDM-BA: 2.83, [95% CI: 2.62-3.06]; HR for PhenoAge: 2.27, [95% CI: 2.09-2.46]). Conclusions: BA acceleration was significantly associated higher risks of T2D and CAD, especially among individuals with a high genetic predisposition to T2D and CAD.
Abstract MP72: For African-Born Blacks Living in the United States the Body Mass Index of Preference is in the Normal Weight Category
Authors: Jamaiica S Hurston, Charlita C Worthy, Eliza Huefner, Mariam Sayed, Christopher W DuBose, Lilian S Mabundo, Marshall K Tulloch-Reid, Margrethe Horlyck-Romanovsky, Novie Younger-Coleman, Anne E Sumner
Journal: Circulation (2024)

Background: Both health and health behavior are highly influenced by cultural attitudes towards body size. However, the body size of preference and the degree to which body size dissatisfaction occurs in African-born Blacks living in the United States is unknown. Methods: To address this data gap, height and weight were measured, and BMI calculated in 412 African-born Blacks living in the Washington, DC area (female: 42% (174/412), age 39±11y (mean±SD), range 20-69y, range, BMI 27.9±4.6kg/m 2 , range 19.5-47.3kg/m 2 ). The Stunkard Figure Rating Scale was used to assess both body size preference and body size dissatisfaction. The Stunkard scale has 9 silhouettes which correspond to four BMI categories: Underweight: 1-2; Normal-Weight: 3-4; Overweight: 5-7; Obesity: 8-9. Participants chose the silhouettes which corresponded to their perceived BMI and to their ideal BMI. Body size dissatisfaction was calculated as the difference between perceived and ideal BMI. Results: Women had a higher BMI than men (29.1±5.0 vs. 27.0±4.2, P &lt;0.001). As their ideal body size, 75% (131/174) of women and 60% (143/238) of men chose the two silhouettes in the normal weight BMI category, specifically 3 or 4. However, silhouette 4 was chosen more often than silhouette 3 (61% vs. 39%, P &lt;0.001). In addition, and very importantly, as their body size of preference, no participant chose silhouettes in the obese BMI category. Overall, body size dissatisfaction occurred in 75% (309/412) of participants with women being more dissatisfied than men (84% (146/174) vs. 69% (164/238), P &lt;0.001). Dissatisfaction due to feeling too large occurred in 63% (260/412); whereas dissatisfaction due to feeling too small occurred in 12% (49/412). Mean BMI in participants who were dissatisfied because they were too large was: 29.8±4.3 kg/m 2 . Whereas mean BMI in participants who were dissatisfied because they felt too small was: 23.1±2.8 kg/m 2 . Silhouettes of preference in 74% (36/49) of the participants who thought they were too small were 4 and 5. Conclusion: Neither high nor low BMI categories were valued by the participants. Overall, the majority of African-born Blacks living in the United States preferred a body size in the normal-weight BMI range.
Abstract P387: Research Participation Rates and Characteristics in Underrepresented Groups in a West Virginia-Based Pregnancy Cohort Study
Authors: Katrina L Wilhite, Bethany Barone Gibbs, Kara M Whitaker, Carly Williamson, Elly Marshall, Lindsay Morris-Neuberger
Journal: Circulation (2024)

Introduction: Individuals living in rural areas, identifying as underrepresented racial minorities, and with low socioeconomic status tend to be poorly represented in research. Each underrepresented group experiences unique barriers that may prevent them from participating in research. Objectives and Hypothesis: This study aimed to test the hypotheses that 1) in a West Virginia-based pregnancy cohort study, individuals identifying as rural, an underrepresented racial minority, or receiving Medicaid/Medicare (as a surrogate for socioeconomic status) would have lower participation rates than typically better represented populations; and 2) that people from each underrepresented group would have different characteristics associated with screening for and consenting to participate in the pregnancy cohort study. Methods: Potentially eligible participants were sent recruitment messages via MyChart, a patient facing app linked to their electronic medical record. Upon receiving the message, participants could express their interest to participate in the study by filling out an eligibility screening form and, eventually, consent to participate at a study visit. Screening and consenting rates were calculated, stratified by rurality (i.e., urban, micropolitan rural, small town rural), race (i.e., white, underrepresented racial minority), and insurance status (i.e., Medicaid/Medicare, private). Logistic regression was used to test which characteristics were associated with screening for and participating in the study in each group. Results: Between October 2022 - April 2023, 1024 potential participants were sent recruitment messages. Screening rates (7.3% urban, 7.6% micropolitan rural, 8.8% small town rural; 7.3% White, 10.1% underrepresented racial minorities; 7.9% private insurance, 7.1% Medicaid/Medicare) and consenting rates (2.5% urban, 2.1% micropolitan rural, 4.6% small town rural; 2.8% White, 1.4% underrepresented racial minorities; 3.6% private insurance, 1.9% Medicaid/Medicare) were similar between different underrepresented groups and their better represented counterparts. For small town rural participants, preterm births (OR 6.85 [2.04 - 33.7]) and number of children (OR .24 [.05 - .71]) were associated with participating in the study. Those who identified as an underrepresented racial minority were more likely to screen for the study if they had private health insurance (OR 16.81 [1.53 - 500]). People with Medicaid/Medicare were more likely to participate in the study if they lived in a small town rural area (OR 7.71 [1.57 - 58.97]). Conclusion: Differences in characteristics associated with research participation suggest that researchers may need to tailor recruitment strategies to better consider characteristics of different underserved groups.
Abstract P346: Effect of Low-Fat versus Low-Carbohydrate Diet on Visceral Fat
Authors: Shawna Follis, Kristen Cunanan, Matthew J Landry, Catherine Ward, Marcia L Stefanick, Christopher D Gardner
Journal: Circulation (2024)

Introduction: A healthy low fat (HLF) and healthy low carbohydrate (HLC) diet are common strategies for weight loss that vary in their effects on adiposity and metabolism. Visceral adipose tissue (VAT) is the major contributor to metabolism deregulation, beyond subcutaneous adipose tissue (SAT). Despite strong biological evidence that a HLC diet preferentially decreases VAT relative to SAT, the difficulty in measuring adipose sub-types has impeded its use in diet trials. To address this research gap, we measured VAT and SAT in a secondary analysis of the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) weight loss trial to compare the effects of HLF and HLC diets and potential effect modification by sex and insulin resistance status. Hypothesis: We hypothesized that a HLC diet is associated with greater VAT loss compared with a HLF diet. Secondly, we hypothesized that men and those with greater baseline insulin secretion assigned to HLC diet would experience greater VAT loss. Methods: DIETFITS was a single-site, parallel-group, weight loss diet trial, randomizing 609 adults with overweight and obesity to a HLC or HLF diet for 12 months. Data collection occurred at baseline, 6 months, and 12 months. Insulin resistance status was proxy measured using insulin concentration 30 minutes after a glucose challenge (INS 30). In this secondary analysis, we measured VAT and SAT in the abdominal region by reanalyzing the dual-energy x-ray absorptiometry (DXA) scans. We fit a linear mixed model to evaluate the change in VAT after 6 and 12 months on HLF and HLC, with fixed effects: time, diet, and their interaction; and a random effect for repeated observations. We built separate models for each of the secondary hypotheses, with additional fixed effects INS 30 and sex, respectively. Results: We included 449 participants with baseline DXA (60% women; mean age 40 years). From baseline to 6-months, participants assigned to a HLC diet experienced a significant 10.6 cm 2 (95% CI: 5.1, 16.1) greater decrease in mean VAT compared to those assigned to a HLF diet. The 12-month difference in diets attenuated to 5.5 cm 2 (95% CI: -0.1, 11.1). Contrary to our hypothesis, INS 30 did not modify the diet-related changes in VAT. Among men, both diets resulted in a 12-month decrease in VAT. The HLC diet was associated with a 12.1 cm 2 (95% CI: 1.6, 22.7) greater loss of VAT compared to HLF. Among women, HLF but not HLC was associated with decreased VAT, and there was no difference in VAT loss between diets 1.8 cm 2 (95% CI: -4.1, 7.6). Models controlling for SAT indicated that VAT decreased independently of SAT. Conclusion: These findings contribute to the understanding of the nuanced impacts of HLF and HLC diets on adipose sub-types and underscore the relevance of considering sex in designing effective dietary interventions targeting VAT reduction and metabolic health.
Abstract MP40: Associations Between Meal Timing and Sleep in Older Adults
Authors: Niket Gupta, Katharine Harrington, Sindhu Chiluka, Velarie Ansu Baidoo, Shaina J Alexandria, Kristen Knutson, Mercedes R Carnethon
Journal: Circulation (2024)

Introduction: Poor sleep health has been associated with increased risk and worse outcomes for a number of diseases such as cognitive dysfunction, dementia and Alzheimer’s disease. An emerging area of research has highlighted the association between dietary factors and sleep. Meal timing is one aspect of diet that has unclear effects on sleep. Few studies have examined this relationship in older adults, an important distinction because sleep architecture and dietary habits change significantly across the lifespan. By identifying the involvement of meal timing in sleep health, specific behavioral interventions can be developed for older adults with sleep-related morbidity. Hypotheses: We tested the hypothesis that a longer time duration between the last meal of the day and bedtime is associated with positive changes in sleep quality Methods: Forty-six healthy older adults (72% (33 of 46) female, 13% (6 of 46) Black, mean age=70.1 years) recruited from the community in Chicago were included in the analysis. Participants underwent sleep assessment with 7 days of sleep actigraphy, one night of sleep profiler, and sleep questionnaires. Two 24-hour diet recalls within 1 week were administered with the ASA24 tool to evaluate meal timing. The data was analyzed with linear regression models adjusting for age, sex, educational attainment, and BMI. Results: For every 1-hour increase in time from last meal to bedtime, sleep onset latency (SOL) increased by 7.4 minutes (SE=3.0, p=0.019), total sleep time (measured from actigraphy) decreased by 10.6 minutes (SE=4.4, p=0.022), and sleep midpoint was delayed by 17.5 minutes (SE=0.09, p=0.002). Other sleep measures showed no significant associations with time from last meal to bedtime. Conclusions: Meals consumed closer to bedtime were associated with shorter SOL, longer total sleep time, and delayed sleep midpoint in older adults. These findings suggest that meal timing may correlate with sleep, however further investigation with larger sample sizes should be done to clarify this link.
Abstract P323: Awareness of Recent Blood Pressure Levels and Blood Pressure Goals Among US Adults With Diabetes - National Health and Nutrition Examination Survey 2013-2020
Authors: Bharat Poudel, Ligong Chen, Medha Dubal, Ashley Christenson, Kathryn Foti
Journal: Circulation (2024)

Background: Reducing blood pressure (BP) is important for decreasing cardiovascular disease risk among adults with diabetes. Individuals with diabetes are recommended to know their BP level and BP goal. Methods: We used data from the 2013-2020 National Health and Nutrition Examination Surveys (NHANES) for US adults with diabetes (N=2,344). Diabetes was defined as having a prior diagnosis with use of insulin or glucose-lowering medication. Participants with diabetes were asked their most recent BP and their goal BP according to their doctor. Hypertension was defined as systolic/diastolic BP ≥140/90 mm Hg or self-reported antihypertensive medication use. Poisson regression with robust variance estimation was used to estimate associations of participant characteristics with knowing their recent BP level and BP goal for those without hypertension and with hypertension, separately. All analyses accounted for the NHANES complex survey design and were weighted to represent US adults with diabetes. Results: Among US adults with diabetes, 69.8% reported that they knew their recent BP level and 41.5% reported they knew their BP goal. Among those without hypertension and with hypertension, 58.7% and 75.5% reported knowing their recent BP level and 27.5% and 48.5%, respectively, reported knowing their BP goal, respectively. Among adults without hypertension and those with hypertension, non-Hispanic Black or Hispanic versus non-Hispanic White adults, with less than high school education, and without insurance were less likely to know their recent BP ( Table ). Hispanic versus non-Hispanic White adults without hypertension and adults with less than a high school education with hypertension were less likely to know their BP goal. Conclusion: Low percentages of US adults with diabetes knew their BP level and knew their BP goal.
Abstract P431: Heparin-Warfarin Administered for Pulmonary Vein Thrombi Partially Dissolves Thrombi and Ameliorates Mild to Moderate Type 2 Diabetes Mellitus
Authors: Hidekazu Takeuchi
Journal: Circulation (2024)

Background: Pulmonary infection generates arterial thrombi, an important component of which are neutrophil extracellular traps, to defend the host. Pulmonary vein thrombi (PVTs) are underrated compared to arterial thrombi. In 2014, we reported that at least 61% (35 of 57) of elderly patients with chest pain had PVTs, as estimated using cardiac computed tomography (CT), and in 2022, we reported that 98.6% (215 of 218) of senior patients with age-related diseases such as hypertension, dyslipidemia, and type 2 diabetes mellitus (T2DM) had PVTs, as evaluated using cardiac CT and transesophageal echocardiography. T2DM is a common disease that can cause atherosclerosis, leading to ischemic stroke and acute myocardial infarction. It is important to better understand the mechanisms of T2DM and how to treat T2DM patients. The relationships between PVTs and T2DM are still unclear. Additionally, the relationships between heparin-warfarin therapy and T2DM are unknown. Methods: We identified PVTs in 15 T2DM patients (73.5 ± 9.9 y.o., range 50 y.o. to 88 y.o.; 10 males and 5 females) using both cardiac CT and transesophageal echocardiography. Among the 15 patients, two did not take DM medications; one took one DM medication; one took two DM medications; five took three DM medications; four took 4 DM medications; one took 5 DM medications; and one was treated with insulin. Results: The PVTs were partially dissolved by standard doses of heparin and warfarin given at the same time for one month. During the treatment, blood glucose levels were examined 30 minutes before breakfast, lunch, dinner and sleep. Between one and two weeks, the blood glucose levels of 10 patients decreased, especially before lunch, and some patients showed symptoms of hypoglycemia; therefore, the number of administered DM medications was decreased to zero for 6 patients and to one for 4 patients. After one month, the patients’ HbA1c levels had decreased slightly. We treated 10 patients with warfarin for the next several months, none of whom needed to resume DM medications, although their blood glucose tended to increase slightly. Three patients with comparatively severe T2DM showed no change in blood glucose following therapy. Conclusions: Heparin-warfarin therapy partially dissolved PVTs and decreased DM medications in patients with mild to moderate T2DM.
Abstract MP73: The Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Irene Martinez-Morata, Kathrin Schilling, Ronald Glabonjat, Katlyn McGraw, Tiffany Sanchez, Joel D Kaufman, Dhananjay Vaidya, Wendy S Post, Miranda R Jones, Michael Bancks, Daichi Shimbo, R. Graham Barr, Steven Shea, Ana Navas-Acien
Journal: Circulation (2024)

Background: Environmental exposure to metals is widespread yet preventable and has been associated with cardiovascular disease (CVD) endpoints, although evidence from prospective studies with racial and ethnic diversity is limited. Objective: We assessed the prospective association of urinary metals with incident coronary heart disease (CHD) and CVD and all-cause mortality in a diverse population of adults from the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We included 6,638 MESA participants (mean (SD) age 62.1(10.2) years, 53% female, 39% non-Hispanic white, 27% non-Hispanic Black, 22% Hispanic/Latino, 12% Chinese). Urinary non-essential metals (cadmium, tungsten, and uranium), and essential metals (cobalt, copper, and zinc) were assessed at baseline (2000-2001). We used Cox proportional hazards regression to estimate adjusted (table footnote) hazard ratios (HR) for the association between urine metals with incident CHD, CVD, and all-cause mortality through 2019. Results: Over 17.7 years median follow up (IQR: 12.4, 18.5), 749 (11%) participants developed CHD, 1,162 (17%) developed CVD, and 1,844 (28%) died. In the models adjusted by sociodemographic and behavioral factors (Table 1, [Model 1]), one IQR increase in urinary cadmium, tungsten, cobalt, copper, and zinc at baseline was significantly associated with higher risk of incident CHD, incident CVD and all-cause mortality. Uranium levels were significantly associated with all-cause mortality and incident CVD, but not CHD. The magnitude of the association was attenuated when adjusting the models for clinical risk factors (Table 1, [Model 2]). A linear trend was identified for cadmium and copper and all endpoints. Conclusion: Our findings among a large and ethnically diverse US population support that metal exposure is associated with incident CVD and premature mortality. These findings can inform the development of novel preventive strategies to improve cardiovascular health.