tbuckley/cabot-search huggingface dataset:
Abstract P283: Hispanic/Latino Ethnic Background and Genetic Ancestry in Relation to Atherosclerotic Cardiovascular Disease Risk Estimation: Insights From the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Bede N Nriagu, Karen F Rosario, Spencer Hansen, Priscilla Duran Luciano, Parag H Joshi, Anurag Mehta, Amit V Khera, Robert Kaplan, Tamar Sofer, Carmen A Peralta, Robyn McClelland, Carlos J Rodriguez
Journal: Circulation (2024)

Background: Hispanics are a highly admixed population. Pooled Cohort Equation (PCE) excluded them in its derivation. We analyzed Hispanic background and genetic ancestry in relation to atherosclerotic cardiovascular disease (ASCVD) risk. Methods: We included 966 Hispanics from Multi-Ethnic Study of Atherosclerosis (MESA), aged 44-75 years and free of diabetes/prior CVD. Statin users and those with LDL-C&gt;190 mg/dL were excluded. Continental genetic ancestry (West African [AA], European [EA]) was estimated by ADMIXTURE software. Predicted ASCVD events (myocardial infarction, stroke, coronary heart disease death) based on non-Hispanic White (NHW) and non-Hispanic Black (NHB) PCE versions, were compared with observed events based on 10-years Kaplan-Meier Estimates and presented as predicted-to-observed (P/O) ratios across Hispanic backgrounds and &gt;median genetic ancestry. Risk discrimination was assessed by Harrell’s C-statistic based on Cox models. Results: MESA Hispanics included 504 Mexicans [ME], 284 Caribbean [CA] and 178 Other Hispanics [OH]. At 10-years, there were 179 ASCVD events: 107 ME; 49 CA; 23 OH. PCE overestimates ASCVD risk (reflected by P/O ratio &gt;1.0). Using the NHW PCE, all Hispanics had a similar P/O ratio compared to NHW in the low-risk category, and lower P/O ratio compared to NHW in the high-risk category. The extent of overestimation varied across disaggregated Hispanic background (least in ME intermediate risk; most in CA high risk category). Higher P/O ratios were observed among Hispanics of &gt;median AA ancestry and lowest in Hispanics of &gt;median EA ancestry (Figure 1). Harrell’s C-statistic showed no statistically significant difference within groups. Conclusion: Disaggregating Hispanics by background and ancestry led to variability in PCE performance with greater overestimation of ASCVD risk for those of CA background or with &gt;median AA compared to those of ME background or &gt;median EA. The relationship between ethnicity, ancestry, and ASCVD risk in Hispanics should be further explored.
Abstract P147: Alcohol Consumption and Its Relation to Ectopic Adiposity in African Caribbean Men
Authors: Adrianna I Acevedo-Fontanez, Lily G Bessette, Ryan Cvejkus, John Jeffrey Carr, James G Terry, Sangeeta Nair, Allison L Kuipers, Victor Wheeler, Iva Miljkovic
Journal: Circulation (2024)

Introduction: Alcohol intake and ectopic fat are associated with cardiometabolic diseases. While previous studies primarily focused on visceral and/or liver fat, few studies to date have investigated the associations of alcohol intake with skeletal muscle fat infiltration, a fat depot which might contribute to the increased risk of diabetes and hypertension in African ancestry populations. Methods: Alcohol intake (drinks/day) was assessed using a 146-item semi-quantitative food frequency questionnaire in the Tobago Health Study (N=800). Ectopic fat was measured in the abdomen and thigh in a subset of this cohort (N=706, mean age=63.94 (8.66) years, mean BMI=27.72 (4.65) kg/m 2 ) using computed tomography. Men were divided into current drinkers/not current drinkers, and the current drinkers were further subdivided into types of alcohol consumed (wine, beer/stout, or liquor). Results: A majority of men (56.1%) were not current drinkers. Of drinking men, 76.1% were light drinkers (&lt;1 drink/day), 17.4% were moderate drinkers (1-3 drinks/day), and 6.5% were heavy drinkers (&gt;3 drinks/day). Men who did not drink were slightly older (65.1 vs 62.5, p&lt;0.001), with less visceral adiposity (91.4 vs. 101.9 cm 3 , p=0.002) and less psoas muscle fat (0.59 vs 0.64 cm 3 , p=0.017) than men who drank, independent of age. In fully adjusted models, drinking liquor was positively associated with BMI, waist circumference, visceral and subcutaneous adiposity, while drinking beer was positively associated with thigh muscle fat (Table). Conclusion: Alcohol intake was associated with greater ectopic fat accumulation in all studied compartments, except in the liver, in this cohort of African Caribbean men, who mostly had low alcohol consumption. We also report a novel finding that observed relationships differ by type of alcohol. † Adjusted for total energy intake, age, walking (hours/week), TV watching (≥14 hours/week), current smoking, diabetes, hypertension, and statin use status. * Additional adjustment for BMIHU = Houndsfield Units
Abstract P230: Association Between Gratitude and Lifestyle Related Diseases: The JAGES Cross-Sectional Study
Authors: Eri Eguchi, Kokoro Shirai, Fumikazu Hayazhi, Yuhi Hamaguchi, Katsunori Kondo, Tetsuya Ohira
Journal: Circulation (2024)

Purpose: Positive psychological factors have been reported to be effective in preventing lifestyle-related diseases. People with high frequency of gratitude are considered to have positive psychological factors and to be in a state of social participation. Serum levels of IL-6, an inflammatory marker, have also been reported to decrease in grateful individuals. However, the association between frequency of gratitude and lifestyle-related diseases has not been reported. Methods: Participants of the study was 25,036 (11,656 men and 13,346 women) who responded to the question about gratitude among those who answered the JAGES2019 questionnaire. To the question, "In your daily life, how often do you say "thank you" to those around you?", possible answers were "1. several times a day or more," "2. about once a day," "3. several times a week," "4. several times a month," or "5. almost never. Multivariate odds ratios and 95% confidence interval of hypertension, diabetes, hyperlipidemia, depression, stroke, heart disease, cancer, and dementia were calculated using logistic regression analysis for those who were less grateful compared to those who were grateful "several times a day or more" and the same analyses were conducted for men and women. Covariates were smoking habits, drinking habits, whether they lived alone, exercise time, and body mass index. Results: The prevalence of hypertension, diabetes, depression, and dementia was higher among those who were less frequently grateful compared to those who were more frequently grateful. Multivariate odds ratios (95% confidence interval) were 1.08 (1.00-1.16) for hypertension, 1.12 (1.02-1.24) for diabetes, 1.82 (1.25-2.64) for depression, and 1.81 (1.16-2.8) for dementia, respectively. In men, the association was more pronounced for dementia for 2.37 (1.16-4.87), and similar trends for hypertension, diabetes, and depression. For women, the association was more pronounced for depression for 1.86 (1.17-2.95) and similar trends for hypertension, diabetes, and depression. The prevalence of cancer was lower with lower frequency of gratitude. Discussion: The prevalence of hypertension, diabetes, depression, and dementia was higher among those who were less frequently grateful, and the associations were particularly pronounced for hypertension, diabetes, and depression, especially among women, and for dementia, especially among men. The frequency of gratitude was thought to be influenced by the frequency of social participation, and there is a possibility of a causal reversal in depression, dementia, and cancer. We will examine the association more in detail longitudinally.
Abstract P390: Cardiometabolic Disease Prevalence Are Inconsistent by Racial Group Across Three National United States Datasets From 2015 to 2021
Authors: Zeel Thakkar, Yan Wu, Mohammed A Khan, Xinran Qi, George Hung, Nicholas T Kikuta, Malathi Srinivasan, Robert J Huang, Armaan Jamal, Gloria Kim, Latha Palaniappan, Adrian Bacong
Journal: Circulation (2024)

Introduction: The United States uses the National Health Interview Survey (NHIS), Behavioral Risk Factor Surveillance System (BRFSS), and National Health and Nutrition Examination Survey (NHANES) to inform disease trends and preventative research. However, the consistency in prevalence of cardiometabolic disorders in these datasets by race is understudied. We examined differences in the crude and age/sex adjusted prevalence of self-reported doctor diagnosis of myocardial infarction (MI), stroke (CVA), coronary heart disease (CHD), any cardiovascular disease (CVD), and diabetes (DM) by racial group across the datasets. Methods: We harmonized available NHIS (N = 179,593), BRFSS (N = 2,592,050), and NHANES (N = 12,506) datasets of adults aged ≥ 30 from 2015-2021. We first calculated crude prevalence by race and survey. We then used multivariable logistic regression to calculate age and sex adjusted prevalence by race and survey, accounting for survey weights. Results: The majority of participants were female (52.3%) and 53.6 years old (SD=14.4). Crude prevalence was most similar within a given race group for CVA (Table). Prevalence across surveys varied up to 4.6% by race and was most variable on average for DM. For each race group, prevalence estimates were generally higher in BRFSS than NHIS. Prevalence estimates varied most in people of Other/Multiple race. Racial differences in DM were significant in all datasets (p&lt;0.001). Results were similar after adjustment for age and sex. Conclusion: While prevalence estimates for our national datasets are consistent for the NH-White population, estimates are less consistent for other racial groups. Additional work is needed to ensure consistency of cardiometabolic surveillance both nationally and among minoritized groups.
Abstract P180: Navigating Lipid Discrepancies: Implications for Cardiovascular Risk With LDL, Non-HDL, LDL-P, and ApoB
Authors: Sharjeel Hassan, Douglas W Triffon
Journal: Circulation (2024)

Background: Lipid discordance, characterized by conflicting results among various lipid measures used in cardiovascular risk assessment, has been a subject of interest and concern. Previous comparisons of LDL-C and non-HDL-C with ApoB and LDL particle numbers as cardiovascular risk predictors have shown conflicting results, partly because they were treated as independent variables. This study aimed to examine the extent of lipid discordance and its implications for risk assessment. Methods: A cross-sectional study involving 106 individuals with lipid panels was conducted, and LDL cholesterol (LDL-C), non-HDL cholesterol (non-HDL-C), LDL particle number (LDL-P), and Apolipoprotein B (ApoB) were measured using standardized methods. Lipid discordance was defined as disagreement in risk categorization between different measures based on established cut-off values. Prior studies have described three different approaches to identify discordance such as quintiles, percentiles or the median, and all have demonstrated similar clinical results. Our analysis utilized the percentile method. Results: The results revealed a substantial level of lipid discordance, with 91.5% of individuals having at least one discordance among the four lipid measures. Most prevalent was the discordance between LDL-C and LDL-P, observed in 70.75% of individuals, with an average discordance of approximately 45.03% for LDL-P. Additionally, 20.75% of individuals displayed discordance between LDL-C and ApoB, averaging about 17.07%. The remaining 8.49% showed relative concordance. Conclusion: Our study highlights significant lipid discordance among various measures, impacting cardiovascular risk assessment. Increased ApoB or LDL particle numbers elevate risk, even with stable LDL-C and non-HDL-C. Conversely, low ApoB or LDL particles and elevated LDL-C or non-HDL-C indicate lower risk. We stress the limitations of population-based lipid management and advocate personalized strategies based on the most discordant lipid measure, improving accuracy and outcomes. Individualized risk assessment and tailored interventions are crucial.
Abstract P347: Variability in Predictive Error of Waist Circumference Models: A Stratified Analysis Based on Body Mass Index, Waist Circumference, and Their Ratio
Authors: Tomas Karpati, Tsafnat Test, Orna Reges
Journal: Circulation (2024)

Introduction: Waist circumference (WC) independently predicts cardiovascular risks, yet clinical measurements are sporadic. Some models have been developed for WC prediction, with body mass index (BMI) as a key predictor. While these models are generally efficient, variability in error across distinct subpopulations is possible. This study aimed to assess the prediction error (PE) variability of WC models across different strata of BMI, WC, and their ratio, and to evaluate the role of BMI for WC prediction. Hypothesis: 1) PE varies across BMI, WC, and their interrelated strata. 2) BMI is a key feature for WC prediction. Methods: Data from 30,298 individuals from the National Health and Nutrition Examination Survey (2007-2018) were analyzed. After outlier removal and kNN-imputation for missing values, machine learning predictive models for WC were developed. The base model included age, gender, ethnicity, height, weight, and BMI. A non-BMI model was also formulated, incorporating demographics and clinical variables selected via a feature-selection process. Root Mean Square Error (RMSE) across BMI, WC, and ratio of BMI-decile to WC-decile categories were assessed. Results: The base model's RMSE for the entire cohort was 5.70. Stratification by BMI revealed higher error rates for obesity classes II (5.88) and III (12.28), contrasting with lower RMSEs in participants with normal BMI (3.95), overweight (4.63), and obesity class I (5.41). Individuals with high WC had an increased RMSE (6.28) compared to those with low WC (5.04). Those with a BMI-decile/WC-decile below one had elevated error (6.98) compared to those with ratios equal to (4.60) or above one (5.52). Across all categories, the base model outperformed the non-BMI model (Figure 1). Conclusion: WC model PE demonstrated variability across BMI, WC, and their respective ratios, underscoring the predictive significance of BMI for WC. Considering population-specific variations in predictive WC modeling is important within clinical and research sets.
Abstract P398: Family History of Cardiovascular Disease and Hypertension Are Associated With Prevalent Disease in US Americans of South Asian Origin
Authors: Eshaan Vasudev, Krish Vasudev, Lisa R Yanek, Dhananjay Vaidya
Journal: Circulation (2024)

Introduction: Cardiovascular disease (coronary artery disease and stroke, CVD) is a major health risk among the South Asian diaspora in the US. Factors like genetics and acculturation can influence the onset and progression of these diseases. Our study investigated the associations of acculturation and family history with CVD and a major CVD risk factor of hypertension (HTN) in US South Asians. Methods: We surveyed 105 US South Asian adult participants recruited at a community event. Respondents provided information on acculturation (measured by the adoption of English spoken at home), and family history of CVD and HTN in parents and siblings. Prevalence of CVD and HTN were compared between those with or without factors of interest. Multivariate logistic regression models were run for family history variables of interest, adjusted for age, gender, and English speaking at home. Results: Participants had median age 54 (range 20-75) years, and 69.2% were male. The Table shows the association of parental and sibling history of CVD and hypertension with having CVD or HTN personally, and the association of home language with these conditions. Multivariate adjusted logistic regression analysis found little attenuation, in that , sibling history of CVD remained significantly associated with personal CVD (p = 0.026), parental history of HTN remained significantly associated with personal HTN (p=0.004) and sibling history of HTN remained significantly associated with personal HTN (p=0.014). Conclusion: Among South Asians in the US, family history in 1st degree relatives, rather than language acculturation, is associated with personal CVD and HTN, suggesting a genetic burden. The stronger association of sibling history rather than parental history of CVD suggests a possible role of environmental or secular factors that siblings may share more than parents and offspring. In this population at high risk of CVD, careful recording of family history may help early prevention strategies.
Abstract P151: Increased Gain of Skeletal Muscle Adiposity in Middle-Aged African Caribbean Men With Type 2 Diabetes
Authors: Ryan Cvejkus, Joseph Zmuda, Adam Santanasto, Victor Wheeler, Iva Miljkovic
Journal: Circulation (2024)

While type 2 diabetes (T2D) is a known risk factor for the acceleration of muscle loss with aging, less is known about the impact of T2D on skeletal muscle fat infiltration (i.e., myosteatosis) and overall adiposity. Myosteatosis increases with aging, is greater in African as compared to European ancestry individuals, and plays an important role in the development of T2D. Thus, we investigated the association of T2D with changes in body adiposity distribution, with a particular interest in myosteatosis. T2D was identified by self-report, use of hypoglycemic agents, or fasting glucose levels of ≥ 126 mg/dL. Longitudinal changes in computed tomography-measured calf skeletal muscle density [as an inverse surrogate measure of intramuscular adiposity (mg/cm 3 )] and dual-energy X-ray absorptiometry-measured regional and whole body fat were examined by T2D status over an average of 6 years in 724 African-Caribbean men aged 40-54 years from the Tobago Health Study. Total body, arm, leg, and trunk adiposity increased to a significantly greater extent among men without compared to with T2D. In contrast, men with T2D had a 1.6 times greater decrease in calf skeletal muscle density compared with their non-diabetic counterparts (p=0.03). T2D is associated with lower gains in general adiposity, but an increased gain in skeletal muscle adiposity among middle aged African Caribbean men. Our novel findings suggest that middle-aged African Caribbean men with T2D might be at especially high risk for increased gain of myosteatosis. Interventions targeted for men in this age group could focus on controlling diabetes, slowing myosteatosis, and promoting healthy aging.
Abstract P472: Dietary Consumption of Potatoes and Incidence of Cardiovascular Disease
Authors: Hasan M Mahbub, JoAnn E Manson, Julie E Buring, Eunjung Kim, I-min M Lee, Howard D Sesso, Michael Gaziano, Luc Djousse
Journal: Circulation (2024)

Background: Previous studies have reported conflicting results of the relationship between types of potato consumption (baked and boiled potatoes and French fries) and cardiometabolic outcomes. We examined associations of potato consumption with incidence of CVD from 4 large cohorts. Methods: We meta-analyzed data from 4 large studies (COSMOS, PHS, WACS, and WHS). Consumption of baked, boiled, and mashed potatoes and French Fries was assessed using a food frequency questionnaire. The primary outcome was 3-point MACE (myocardial infarction, stroke, and cardiovascular death). Within each cohort, Cox regression model was used to compute hazard ratios (95% CI) adjusting for age, sex, race, caloric intake, smoking status, alcohol use, education level, exercise level, body mass index, and dietary factors (e. g., Fruits and vegetables, red/processed meat, beverages, trans fats, etc.), and prevalent diabetes and hypertension. Cohort-specific effect sizes were pooled using an inverse-variance weighted method. Results: Among 84,700 subjects, mean age ranged from 54 (WHS) to 72 (COSMOS) years, 68% were women, and 5231 CVD events occurred during follow-up. Consumption of combined baked, boiled, and mashed potatoes was not associated with the incidence of CVD: Pooled HR (95% CI): 1.00 (ref), 0.96 (0.89-1.04), 0.94 (0.86-1.02), and 0.97 (0.87-1.08) for consumption of 0, 0.5-1, &gt;1 to &lt;3, and ≥3 servings per week, respectively, p for linear trend 0.47. Furthermore, Consumption of French fries was not associated with CVD risk with pooled HR (95% CI) of 1.00 (ref), 0.99 (0.92-1.05) and 1.02 (0.88-1.18) for intake of 0, &lt;1, and ≥1 servings/week. The p for linear trend 0.55. Conclusion: Our data do not support an association of baked, boiled, and mashed potatoes, or French fries with incidence of CVD.
Abstract P348: Weight Loss of Machine Learning Identified Metabolic Subtypes in Response to Dietary Interventions
Authors: Xiang Li, Han Feng, Qian Qian, George Bray, Frank M Sacks, Lu Qi
Journal: Circulation (2024)

Introduction: Metabolic syndrome is a constellation of metabolic risk factors. However, various combinations of metabolic disorders may exhibit distinct responses to weight loss interventions. Objective: To identify metabolic subtypes using the machine learning method and assess their associations with weight loss response to dietary interventions. Methods: The study includes 645 participants from the POUNDS Lost trial. Five criteria for metabolic syndrome were used as the grouping factors. Hierarchical clustering was performed with an 8:2 train/test ratio. Results: Three metabolic subtypes were identified and validated among the POUNDS Lost participants. Cluster 1 was characterized by high proportions of central obesity and high blood pressure but low triglycerides; Cluster 2 showed central obesity with relatively low blood pressure; Cluster 3 had the lowest level of central obesity and blood pressure but the highest triglycerides level. Changes in body weight varied significantly across clusters (p=0.003 at 6 months and p&amp;lt; 0.001 at 2 years). At 6 months, adjusted least-square mean (SE) weights were: -6.5 (0.8) kg in cluster 1, -5.4 (0.6) kg in cluster 2, and -4.2 (0.7) kg in cluster 3. Participants regained weight after 6 months, but the difference across the clusters persisted: -5.5 (1.0) kg in Cluster 1, -3.1 (0.8) kg in Cluster 2, and -1.7 (0.8) kg in Cluster 3. Conclusion: We identified 3 metabolic subtypes that predict different responses to dietary weight loss interventions, which may contribute to subtype-specific precision medicine for obesity prevention and management.