tbuckley/cabot-search huggingface dataset:
Abstract 035: Time-restricted eating for weight loss maintenance: a pilot feasibility and acceptability, randomized controlled trial.
Authors: Collin Popp, Blandine Laferrere, Nadia Islam, Holly Lofton, Jose Aleman, Emily Manoogian, Satchidananda Panda, Mary Sevick
Journal: Circulation (2025)

Background: Time-restricted eating (TRE) interventions demonstrate heterogeneity in the eating window duration. The purpose of this study was to examine the feasibility, acceptability, and adherence of two TRE strategies (10-hr vs 6-hr). Methods: Eligible participants had ≥5% non-surgical weight loss (self-reported) within the last 3 months and BMI: 20.5-45 kg/m 2 ; were 25-65 y; had an eating window &gt;12 h/day and completed a 4-week (wk) run-in to determine weight stability and eating window length. Participants were randomized to a self-selected 10 h (TRE10) or 6 h (TRE6) eating window for 12 weeks. Both arms received 8 educational and behavioral counseling sessions via videoconferencing (WebEx). Participants in both arms were asked to enter all eating occasions (foods and caloric beverages) into a smartphone application (MyCircadianClock) to assess eating window adherence. Feasibility and acceptability were determined based on retention and participant experience using an investigator-developed questionnaire (TRE Experience Questionnaire [TRE-EQ]). Mann-Whitney U test was used to compare data between the two arms. Baseline data are reported as means and standard deviations. Results: Participants were 46±10 y, 55% White, 36% African American, 27% Hispanic, and mostly female (73%) with a BMI of 30.1±6.2 kg/m 2 . The average self-reported weight loss before randomization was 9.2%±4.3%. A total of 29 participants were enrolled and 22 (n=11/arm) were randomized. Retention was 90%, with only two participants dropping out during the study, one from each arm. Additionally, TRE-EQ data indicates the participants in the TRE10 agreed to more statements around less hunger (p=0.09), their assigned program was easy to follow (p=0.02), their assigned program fits their daily routine (p=0.08) and they were adherent to their eating window (p=0.03) compared to participants in the TRE6 arm. Data from the mCC app suggests no difference between TRE10 and TRE6 regarding eating window adherence (p=0.41). There was a trend for the TRE10 arm to log fewer days with at least one eating occasion outside the designated eating window than the TRE6 arm (p=0.06). Conclusions: A 12-week 10-hr TRE intervention is more feasible and acceptable for adults with recent weight loss compared to a 6-hr TRE intervention.
Abstract P3029: Phenotypic and Genetic Correlations of Imaging Traits in the Abdomen-Heart-Brain Axis: Insights into Multimorbidity of Cardiometabolic Diseases and Depression
Authors: Jingxuan Wang, Guangrui Yang, Nannan FENG, Victor Zhong
Journal: Circulation (2025)

Objective: The development of multimorbidity of cardiometabolic diseases (CMDs) and depression likely involves pathophysiological processes across multiple organs. This study aimed to investigate imaging traits in the abdomen-heart-brain axis linked to the CMDs-depression multimorbidity and assess their phenotypic and genetic connections using magnetic resonance imaging (MRI) data. Methods: This study analyzed multi-organ MRI data including 7 abdominal, 82 cardiac, and 676 brain traits from 31,839 UK Biobank participants. CMDs included coronary artery disease, stroke, heart failure, type 2 diabetes, hypertension and hyperlipidemia. First, multivariable logistic regressions estimated associations of imaging traits with the CMDs-depression multimorbidity. Second, multivariable linear regressions quantified pairwise correlations among significant cross-organ traits. Third, transcriptome-wide association study (TWAS) identified shared genes of traits significantly correlated with each other across all 3 regions (i.e., triads). Fourth, LASSO regressions constructed genomics scores using single nucleotide polymorphisms from the shared genes. Fifth, the prediction performance of imaging traits and genomics scores for the CMDs-depression multimorbidity was evaluated by AUCs. FDR correction was used to adjust for multiple testing. Results: Seven abdominal, 27 cardiac, and 340 brain traits were significantly associated with the CMDs-depression multimorbidity. Among 11,749 pairs of significant cross-organ imaging traits, 6385 abdomen-heart-brain triads were identified, with liver volume as the most connected node. The directions of associations among imaging traits in these cross-organ triads aligned with directions of their biological functions, suggesting multiple organs acting as a coordinated system. TWAS revealed TNFSF12 from whole blood as the shared gene underlying the significant liver-heart-brain connection associated with the CMDs-depression multimorbidity. The integration of imaging traits with genomics score (AUC = 0.84) improved prediction performance for the CMDs-depression multimorbidity, outperforming demographic and lifestyle models (AUC = 0.78) (P = 0.014). Conclusions: This study identified highly correlated cross-organ imaging traits that were associated with the CMDs-depression multimorbidity. A shared gene was found for a liver-heart-brain triad. Imaging traits and genomic score significantly enhanced prediction performance on top of traditional factors.
Abstract P2020: Alcohol Use and Hypertension in the Eastern Caribbean
Authors: Katharine Fraser, Lisbette Acosta, Deron Galusha, Rohan Maharaj, Carol Oladele
Journal: Circulation (2025)

Introduction: Hypertension (HTN) and other non-communicable diseases are a leading cause of morbidity and mortality in the Caribbean. The region has high rates of alcohol use and binge drinking which has been associated with adverse health outcomes like HTN. This study aimed to fill evidence gaps on the relationship between binge drinking and HTN in the Eastern Caribbean. Hypothesis: Individuals with binge drinking behaviors have higher prevalence of HTN in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort. Methods: We conducted a cross-sectional analysis of data (2013-2018) from the ECHORN Study (n=2961), an ongoing longitudinal study of adults conducted across four island sites. Participants completed a self-reported health survey, underwent laboratory testing and a clinical examination. The main exposure was binge drinking, defined as more than 4 alcoholic beverages for women or 5 for men in a 24-hour period. Covariates included gender, participant age, smoking status, and BMI. The outcome, HTN, was defined using JNC-7 guidelines and operationalized as a binary variable (yes/no) for inclusion in analyses. Chi-Square tests and logistic regression were used for analyses. We examined associations overall and among those under 60 years of age. Results: Analysis included 1142 participants after accounting for skip patterns. Results showed 34 percent of participants reported binge drinking in the last 30 days and 42 percent had HTN. Forty five percent of those who binge drank had HTN compared to 40 percent among those who did not (p=.18). Among those under 60 years, there was a statistically significant difference in HTN prevalence between those who binge drank and those who did not (p=0.02). Aggregate results show that those who binge drank had 53 percent greater odds (CI=1.15-2.03) of HTN compared to those who did not binge drink. Results for participants under 60 showed 63 percent greater odds of HTN compared to those who did not binge drink (CI=1.15-2.31). Conclusion: Findings showed high prevalence of binge drinking in the Eastern Caribbean and that binge drinking is positively associated with higher prevalence of HTN. The stronger association found in younger individuals is consistent with other findings. Further research is warranted to understand factors that contribute to binge drinking in this population given implications for HTN.
Abstract P1032: De novo lipogenesis is related to multiple cardiometabolic diseases in post-myocardial infarction patients of the Alpha Omega Cohort
Authors: Luc Heerkens, Kamalita Pertiwi, Franzel van Duijnhoven, Johanna Geleijnse
Journal: Circulation (2025)

Introduction: Hepatic de novo lipogenesis (DNL) is the biological process of fatty acids synthesis from non-lipid precursors of glycolysis. Elevated DNL has been implicated in metabolic dysregulation, potentially contributing to fatty liver disease (FLD), cardiovascular disease (CVD), and impaired kidney function. Little is known about DNL and cardiometabolic endpoints in patients with a history of a myocardial infarction (MI). Methods: We included 4305 patients from the Alpha Omega Cohort, aged 60-80 y, with an MI &lt;10 y prior to enrollment. DNL was assessed at baseline (2002-2006) using the lipogenic index, for which we calculated the ratio of palmitic acid (C16:0) and linoleic acid (C18:2n-6) in plasma cholesterol esters. Prevalent FLD was defined as the upper sex-specific tertile of the Fatty Liver Index (FLI), based on BMI, waist circumference, serum triglycerides and gamma-glutamyl transferase. The estimated glomerular filtration rate (eGFR; CKD-EPI equation) was monitored from baseline through 2009 (median follow-up: 3.4 y). CVD mortality risk was monitored through 2022 (median follow-up: 14.5 y). Prevalence ratios (PR) for FLD and hazard ratios (HR) with 95% confidence intervals (CI) for CVD mortality in quintiles of the lipogenic index (Q1, reference) were obtained from Cox models. Betas (95%CI) for annual eGFR change were obtained from linear regression models. Multivariable models included demographics, anthropometrics, lifestyle, and cardiovascular risk factors. Results: Patients (79% male) had a mean (SD) age of 69 (6) y and a BMI of 27.7 (3.8) kg/m 2 . Of the cohort, 24% were obese, 17% were smokers, and 86% were on lipid lowering medication. Baseline FLI was 65 (23) and eGFR was 81 (21) mL/min/1.73m 2 , with 15% having eGFR &lt;60. The annual eGFR change was -1.7 (3.8) during short-term follow-up. The number of deaths was 305 (138 from CVD) during short-term follow-up and 2827 (1096 from CVD) during long-term follow-up. The lipogenic index (Q5 vs Q1) was associated with a higher FLD prevalence (PR: 1.67; 95%CI: 1.40 to 2.00), more annual kidney function decline (beta: -0.76; -1.32 to -0.20), and an increased CVD mortality risk (short-term HR: 1.83; 1.06 to 3.15; long-term HR: 1.38; 1.14 to 1.68). Conclusion: Elevated DNL in post-MI patients is associated with FLD, kidney function decline, and CVD mortality risk. An abnormal hepatic fatty acid synthesis may represent a common pathophysiological pathway in cardiometabolic diseases.
Abstract P2006: Examining the Associations Between Resistance Exercise, Sleep, and Cardiometabolic Health in Young Black Women: Results from a 10-Week Randomized Controlled Trial
Authors: Chloe Jones, Meral Culver, Austin Robinson, Danielle Wadsworth
Journal: Circulation (2025)

Introduction: Insufficient sleep, including short duration, poor efficiency, and high variability (night-to-night variation in sleep), is associated with increased cardiometabolic disease risk. Black adults are more likely to exhibit poor sleep in comparison to White adults, and Black women in particular are at high risk for poor cardiometabolic health. Effective strategies to attenuate these disparities are not well studied. Therefore, this study aimed to assess the impact of resistance exercise (RE) on sleep and cardiometabolic health in young Black women. Methods: 30 young Black women [25±4 yrs; body mass index (BMI)]: 30.3±9.5kg/m 2 ) completed a 10-week, twice weekly, supervised RE intervention. During pre and post-intervention visits we measured BMI, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, triglycerides, and fasting blood glucose. We assessed objective sleep duration, efficiency, sleep timing standard deviation (SD), and midpoint using a Philips Actiwatch Spectrum PLUS watch. We measured self-reported sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We assessed pre to post RE changes in variables of interest via t-tests (PSQI) or Wilcoxon Signed Rank tests (sleep duration, efficiency, timing SD, midpoint), and Spearman’s Rank Correlations to assess associations between baseline sleep metrics and cardiometabolic factors with α set to ≤ 0.05. Results: There were no differences in objective sleep measures from pre to post RE. In contrast, self-reported sleep quality improved after RE (PSQI global scores- pre: 5.5±2.1 vs. post: 4.6±1.6, p = 0.020). Regarding sleep and cardiometabolic health, higher sleep efficiency was associated with a lower BMI (r= -0.458, p = 0.013), WC (r= -0.445, p = 0.015), DBP (r= -0.489, p = 0.007), and glucose concentration (r= -0.433, p = 0.019). Higher sleep timing SD (i.e., bedtime) was correlated with higher fasting glucose concentration (r= 0.521, p = 0.013). Unexpectedly, increased sleep midpoint was associated with lower SBP (r= -0.615, p = 0.002) and DBP (r= -0.613, p = 0.002). Conclusion: Our data indicate that 10 weeks of RE improved self-reported, but not objective, sleep quality in young Black women. Pre-intervention sleep efficiency and variability were associated with select measures of cardiometabolic health. Future studies should promote strategies to increase consistent sleep habits to reduce the risks for cardiometabolic disease in Black women.
Abstract P1110: Pecan Intake Improves Lipoprotein Particle Concentrations Compared to Usual Intake in Adults at Increased Risk for Cardiometabolic Diseases: a 12-Week Randomized Controlled Trial
Authors: Tricia Hart, Penny Kris-Etherton, Kristina Petersen
Journal: Circulation (2025)

Background: Pecan consumption consistently improves lipids and lipoproteins, but less research has investigated the effect of pecan consumption on lipoprotein subfractions. Objectives: The aim was to investigate how substitution of usual snack foods with 57 g/day of pecans affects the concentration of lipoprotein particle subfractions, lipoprotein particle size and apolipoproteins compared to continuing usual intake after 12 weeks in adults at risk for cardiometabolic diseases. Exploratory analyses were done to evaluate early markers of insulin resistance including the Lipoprotein Insulin Resistance score (LPIR), Diabetes Risk Index (DRI), and GlycA. Methods: This is a secondary analysis of data from a 12-week randomized controlled trial including adults at risk for cardiometabolic disease. Participants were randomized to either consume 57 g/day of pecans in place of usual snacks or to continue their usual intake. EDTA plasma samples collected at baseline and after the 12 week-intervention period were used for analysis. Samples were analyzed via proton nuclear magnetic resonance spectroscopy for lipoprotein subfractions, apolipoproteins, GlycA, and branched chain amino acids. Lipoprotein subfractions and branched chain amino acids were used to calculate the LPIR and DRI. Results: The pecan group had a greater reduction from baseline in the concentrations of apolipoprotein B (apoB) (-4.38 mg/dL; 95% CI -8.02, -0.73), total LDL (-75.3 nmol/L; 95% CI -144, -6.93), total triglyceride rich lipoproteins (TRLP) (-20.4 nmol/L; 95% CI -33.8, -7.03), large TRLP (-1.47 nmol/L; 95% CI -2.69, -0.26), small TRLP (-11.3 nmol/L; 95% CI -22.4, -0.27), and the LPIR (-4.42 points; 95% CI -8.14, -0.69) and greater increases from baseline in the concentration of large high density lipoproteins (HDL) (0.35 μmol/L; 95% CI 0.07, 0.63) and HDL subspecies, H5 (0.40 μmol/L; 95% CI 0.10, 0.62) compared to the usual diet group. There were no between-group differences in branched chain amino acids or the DRI. Conclusions: Incorporating 57 g/day of pecans into the diet in place of usual snacks for 12 weeks reduced apoB, atherogenic lipoprotein subfractions, and an early marker of insulin resistance compared to usual intake.
Abstract 054: Prospective associations of pregnancy heavy metals and essential elements with women’s mid-life obesity risk: implications of folate supplementation as a possible intervention strategy to mitigate metal-related health effects
Authors: Mingyu Zhang, Izzuddin Aris, Andres Cardenas, Sheryl Rifas-Shiman, Pi-i Lin, Long Ngo, Emily Oken, Stephen Juraschek, Marie-France Hivert
Journal: Circulation (2025)

Background: Pregnancy is a critical period for women’s long-term cardiometabolic health, with women being particularly sensitive to environmental exposures. The effects of heavy metals and essential elements during pregnancy on long-term obesity risk are understudied. Cohort studies and trials suggest that folate may mitigate metal toxicity—a recent AHA Scientific Statement on metals identified this area of research as a critical gap and priority. Objective: 1) To investigate the associations of pregnancy levels of metals and elements with women’s mid-life obesity risk; and 2) to explore whether adequate pregnancy folate mitigates the obesogenic effects of metals. Methods: Project Viva is a pregnancy cohort enrolled in Eastern MA between 1999-2002 (median age: 32.9y). We measured (As, Ba, Cd, Cs, Hg, Pb) and elements (Cu, Mg, Mn, Se, Zn) in red blood cells and folate in plasma collected during the first trimester. At the Mid-Life visit (2017-2021; median age: 51.2y), we measured weight and height and defined obesity as BMI &gt;30 kg/m 2 (reference: ≤30 kg/m 2 ). We examined associations of metals and elements with obesity using modified Poisson regression, adjusting for confounders ( Figure 1 footnote ). We used Bayesian kernel machine regression (BKMR) to assess the mixture effects of all metals, elements, and folate. Results: We followed 500 women (72% White, 11% Black) for a median of 18.1y (range: 17.5-20.8y). Cs and Cu were associated with a lower risk of obesity: per doubling, Cs and Cu were associated with 0.78 (95% CI: 0.63-0.97) and 0.71 (95% CI: 0.50-0.99) times the obesity risk, respectively. Mg, Se, and Zn were also associated with &gt;10% lower obesity risk, though the 95% CIs crossed the null ( Figure 1 ). BKMR results confirmed consistent dose-response associations ( Figure 2 ). Although neither As nor folate was individually associated with obesity, they showed an interaction in association with obesity ( Figure 3 ): at lower folate levels, As was associated with a higher obesity risk, but as folate levels increased, the As-obesity association was attenuated and eventually became inverse. Conclusion: Optimal pregnancy levels of essential elements (e.g., Cu, Se, Mg, Zn) were associated with a lower risk of mid-life obesity, while adequate folate levels may counteract the obesogenic effects of As. Our study advances a research priority in the AHA Scientific Statement, suggesting folate as a potential intervention strategy to mitigate metal-related health effects.
Abstract P1164: Sex Differences in Cardiovascular Risk Factors among Cardiac Rehabilitation Participants
Authors: Montika Bush, Elizabeth Thomas, Laurie Tester, Adam Moskowitz
Journal: Circulation (2025)

Introduction: Cardiac rehabilitation (CR) programs collect cardiovascular health measures related to AHA core component recommendations for patient care and American Association of Cardiovascular and Pulmonary Rehabilitation certification. In secondary data analysis, we investigated sex differences in cardiovascular risk factors. Hypothesis: Cardiovascular risk factors will be different by sex. Methods: We obtained certification data [BMI, smoking status (Never, Former, Current), and Patient Health Questionnaire (PHQ9) score] as well as Generalized Anxiety Disorder (GAD7) score and diet (Picture Your Plate) score for CR participants in 2023 from our hospital associated outpatient CR program. Since data did not have a normal or log-normal distribution, categorical analyses were completed. BMI (kg/m 2 ) was categorized into Ideal (&lt;25), Intermediate (25 to &lt;30), Poor (≥30). PHQ9 and GAD7 were categorized as No, Minimal, or &gt;Minimal Symptoms. Diet score categories were based upon published thresholds: Ideal (&gt;60), Intermediate (51-60), Poor (&lt;51). Descriptive statistics and standardized differences were computed. Results: Of the 202 CR participants, 29% were female, 31% were &lt;65 years old, 86% were White, and 25% had a qualifying event of NSTEMI. Heart failure was higher in females (17%) than males (10%). On average, participants completed 31(SD:5.5) sessions. The majority (60% to 99%) of participants with data at program entry and exit did not switch categories regardless of measurement. There were similar proportions of males and females with stable ideal (25% vs 21%) or intermediate (37% vs 36%) BMI; however, a higher proportion of females (36%) had stable poor BMI than males (27%) (Table 1). Higher proportions of males had no symptoms (PHQ9: 22%, GAD7: 48%) than females (9%, 28%) pre-CR (Table 2). Among those with pre-/post-CR PHQ9 (25% missing), we observed improvement in a higher proportion of females (38%) than males (30%). Although 13% of pre-CR diet scores were missing, we observed higher proportions of females with ideal and intermediate (64%, 30%) diet scores than males (58%, 25%) (Table 3). One participant quit smoking post-CR. Except BMI and smoking, missing data was a limitation of post-CR analyses. Conclusions: Females gained greater mental health benefit from CR participation than males. Although exercise prescriptions are personalized, investigating the effect of sex-specific educational content is warranted given the differences we observed.
Abstract MP33: Inflammatory proteomic signatures of metabolically unhealthy obesity
Authors: Cong Wang, Azam Yazdani, Olga Demler, Edward Giovannucci, Xuehong Zhang, Aditi Hazra, Meryl LeBoff, Howard Sesso, JoAnn Manson, Deirdre Tobias
Journal: Circulation (2025)

Background: Obesity is a risk factor for CVD incidence and mortality. Accumulating evidence implicates viscerally located adiposity may be particularly relevant for the progression of cardiovascular risk factors, with chronic inflammation as a plausible causal pathway. However, prior research has lacked precise phenotyping to characterize the relationship between visceral fat and inflammatory markers. Objective: Leveraging DXA body composition imaging and plasma proteomics measured by the Olink 384 inflammation panel, we aimed to (i) characterize phenotypes of metabolically glycemic unhealthy obesity and (ii) develop related novel inflammatory proteomic signatures ( i.e . “inflammotypes”). Methods: We analyzed 639 participants (mean age 63.7) from the VITamin D and OmegA-3 TriaL (VITAL) with DXA and proteomics at baseline. We defined four metabolic obesity phenotypes for each participant, as the sum of standardized values of visceral adipose tissue (VAT) mass and one of four glycemic metabolic traits, including fasting glucose, HbA1c, HOMA-IR, and LPIR (a lipid-based score predictive of incident diabetes). We also derived categorical phenotypes by cross-classifying VAT (high/low) with each glycemic trait (unhealthy/healthy), using cut-points that yielded the highest AUC. We then used elastic net regression models to identify the inflammotypes related to each of the four metabolic obesity phenotypes. Finally, we performed an external validation in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS; N=371, mean age 69.0). Results: The continuous metabolic obesity measures were related to unique inflammotypes consisting of 86 to 102 proteins, with 21 proteins (including HGF, IL1RN, ISM1, PON3, and HSD11B1) shared across all phenotypes. For the categorical phenotypes, we identified 19, 22, and 3 proteins differentially expressed among metabolically unhealthy obesity subgroups, as defined for HbA1c, HOMA-IR, and LPIR metabolically unhealthy, respectively, but none were specific to fasting glucose. The inflammotypes were highly correlated with the corresponding phenotypes in COSMOS (Pearson correlation coefficients ranged from 0.63 to 0.82). Conclusion: We derived and externally validated novel proteomic inflammotypes of metabolically unhealthy obesity. These inflammotypes will be evaluated for the associations with subsequent risk of cardiometabolic outcomes in prospective longitudinal cohorts, to elucidate visceral adiposity-related pathways of CVD risk.