tbuckley/cabot-search huggingface dataset:
Abstract P183: Cholesterol Ester 18:2 is an Exercise Inducible Metabolite Associated With a Favorable Cardiometabolic Profile
Authors: Eric Leszczynski, Prasun K Dev, Jacob Barber, Prashant Rao, Michael Mi, Sujoy Ghosh, Clary Clish, Claude Bouchard, Jeremy Robbins, Robert E Gerszten, Mark A Sarzynski
Journal: Circulation (2024)

Background: Prospective cohort studies have shown plasma cholesterol ester (CE) 18:2 is inversely associated with all-cause and cardiovascular mortality. However, less is known about the association of CE18:2 with cardiometabolic risk factors and whether it is responsive to regular exercise. Methods: A total of 193 known plasma lipids, including 11 CEs, were measured using the C8-positive LC-MS method in 671 participants from the HERITAGE Family Study (56% Female, 35% Black, 35 yrs) before and after a 20-week exercise intervention. Linear mixed models were used to test the associations of all lipids with 6 cardiometabolic traits at baseline and post-training adjusting for age, sex, and race, with post-training models also adjusted for baseline lipid and trait values. Paired t-tests were used to test the difference in CE18:2 abundance before and after exercise training. Results: Out of the 193 lipids, CE18:2 was consistently among the top 2 associations with each cardiometabolic trait at baseline ( Table 1 ). Levels of CE18:2 were inversely associated with triglycerides, visceral fat, glycA, and small LDL, while positively associated with HDL-C and insulin sensitivity. Importantly, CE18:2 abundance was increased following the exercise intervention (p=0.0003). Exercise-induced change in CE18:2 was significantly (FDR&lt;0.05) associated with concomitant changes in all traits except visceral fat in the same directions as baseline, with CE18:2 among the top 3 associations with each training response trait ( Table 1 ). Conclusions: Plasma CE18:2 levels were associated with cardiometabolic traits in a favorable direction both before and after an exercise intervention. Thus, this plasma lipid may be an exercise inducible metabolite that is indicative of improvements in cardiometabolic health. However, additional studies are needed to confirm the observed findings and determine the mechanisms underlying these beneficial associations.
Abstract P269: Glycemic Dysregulation Detected by Continuous Glucose Monitoring in Children With Metabolic Dysfunction-Associated Steatotic Liver Disease
Authors: Helaina Huneault, Ana Ramirez Tovar, Cristian Sanchez-Torres, Claudia Yaranga, Karla DeSantos, Zhulin He, Liliana Aguayo, Jean A Welsh, Miriam B Vos
Journal: Circulation (2024)

MASLD, also known as NAFLD, is the leading cause of chronic liver disease in youth, especially among children who are obese and Hispanic/Latino. Insulin resistance and dysglycemia are strongly linked with MASLD. Current methods for evaluating dysglycemia, including fasting glucose, HbA1c, and oral glucose tolerance tests, have limitations. We utilized continuous glucose monitors (CGMs), wearable devices that detect 24 hour, real-time glucose alterations, to test our hypothesis that children with MASLD exhibit greater glycemic dysregulation compared to non-MASLD controls. This study included 19 Hispanic children (63% (12/19) male; mean age 7.8 years ± 0.9; mean BMI percentile 92% ± 17; 5% (10/19)) with MASLD who were otherwise healthy. Hepatic steatosis was measured by magnetic resonance spectroscopy (MRS). MASLD was defined as hepatic steatosis ≥5%, with at least one of five cardiometabolic risk factors. All participants underwent clinical evaluation and wore a blinded Dexcom G6 Pro CGM for 10 days or until the device became detached. Data was analyzed using RStudio v. 4.2.3. In children with MASLD, the mean time in range (TIR, 70-140 mg/dL) of 84% was lower than the mean TIR of 90% observed in non-MASLD controls ( p =0.02). The mean high TIR (140-250 mg/dL) of 16 % in MASLD subjects was significantly higher than the 9% observed in non-MASLD controls (p= 0.01). Mean average glucose and the coefficient of variation (CV) were also higher in children with MASLD, although differences were non-significant ( p &gt;0.05). Fasting insulin and ALT levels were significantly elevated in children with MASLD compared to controls (p&lt; 0.05).Findings demonstrate greater glycemic dysregulation in pre-pubertal children with MASLD compared to non-MASLD controls, as detected by CGM. Importantly, the 24 hour monitoring detected glycemic variability not apparent by fasting glucose or HbA1c. This study suggests early onset MASLD is associated with early glucose dysregulation, and treatments will need to address both conditions.
Abstract P268: Predictive Abilities of Anthropometric Indicators for Cardiometabolic Risk Factors and Diseases: The UK Whitehall II Study
Authors: Cunrong Huang, Peter Martin, Andre Lopes, Annie Britton
Journal: Circulation (2024)

Introduction: Obesity is an accepted risk factor for cardiometabolic diseases. Body mass index (BMI) is the most commonly-used anthropometric measurement for accessing healthy weight. However, some studies suggested that other adiposity indices may be better predictors of cardiometabolic risks and diseases. Our study aimed to compare the predictive abilities of 5 indices [BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-by-height0.5 (WHT.5R), and a body shape index (ABSI)]. Hypothesis: BMI is not good enough for accessing and predicting healthy condition. WHtR may be a more effective index for predicting cardiometabolic risk factors and diseases. Methods: Based on the UK Whitehall II study, we included participants with full records of weight, height, and waist circumference in Phase 3 (1991-1994). Our study indices, BMI, WC, WHtR, WHT.5R, and ABSI, were calculated from measured weight, height, or waist circumference. The outcomes were coronary heart disease (CHD), abnormal blood pressure (BP), insulin resistance (IR), hyperglycemia, and hyperlipidaemia. Receiver operator characteristic (ROC) curve analysis and logistic regression analysis were used to assess the predictive values of the study indices to the cardiometabolic risk factors and diseases. Results: A total of 7979 participants were included [mean age: 50.1 ± 6.0 years; 2468 (30.9%) females; 7188 (90.4%) whites]. Cross-sectionally, except for the association between ABSI and CHD, a significantly-positive association was observed between the all indices and all outcomes (all P&lt;0.001) in Phase 3. All 5 indicators showed the highest predictive ability when the outcome was IR [all the areas under the curve (AUC)&gt;0.714], and among them, WHT.5R had highest predictive value (AUC: 0.770, sensitivity: 76.5%, specificity: 65.1%). For other outcomes, WHtR showed the best prediction for hyperlipidaemia (AUC: 0.719, sensitivity: 54.7%, specificity: 79.6%) relative to the other 4 measurements, whereas WC had higher AUC for predicting abnormal BP (AUC: 0.704, sensitivity: 64.6%, specificity: 65.8%) than any other indices. However, among all of the study outcomes, these 5 indices had the relatively weak ability to predict CHD (all AUCs&lt;0.654). Conclusions: Some indices may provide a more accurate insight into cardiometabolic risk factors and diseases than BMI. WHT.5R appears to be an effective predictor of IR. WHtR has a better prediction for hyperlipidaemia. WC seems to be a good indicator for abnormal BP. We should pay more attention to waist circumference and its derived adiposity indices in the practice of preventing cardiometabolic diseases.
Abstract P161: Association Between Kidney Function and Pre-Heart Failure: Insights From the Echocardiographic Study of Latinos (Echo-SOL)
Authors: Cyrus Hadavi, Priscilla Duran Luciano, Ayana K April-Sanders, Yawen Yuan, Cristian Escalera, Un Jung Lee, Carmen A Peralta, Sylvia E Rosas, Daniela Sotres-Alvarez, Barry E Hurwitz, Gregory A Talavera, Mayank M Kansal, David B Hanna, Martha L Daviglus, James Lash, Jianwen Cai, Matthew Abramowitz, Carlos J Rodriguez
Journal: Circulation (2024)

Background: Impaired kidney function is an independent risk factor for heart failure (HF), but its association with pre-HF is not as well studied. We assessed kidney function in relation to pre-HF in a diverse Hispanic/Latino population in the US. Methods: Echocardiographic data from visit (V) 1 and 2 of Echo-SOL were analyzed (unweighted n=1643). Prevalent pre-HF was defined as any abnormal echocardiographic parameter at V1: left ventricular (LV) systolic dysfunction (LVSD) [ejection fraction &lt;50%, global longitudinal strain &gt;15%]; LV diastolic dysfunction (LVDD) &gt;grade 1; and LV remodeling (LVR) [LV mass index &gt;115 g/m2 in men, &gt;95 g/m2 in women, relative wall thickness &gt;0.42]. Incident pre-HF was defined at V2 among those without pre-HF at V1 (unweighted n=588). Kidney function was assessed by cystatin C (per 10 mg/L), eGFR (MDRD-traditional and CKD-EPI, per 5 mL/min/1.73 m2), and urine albumin creatinine ratio (UACR, per 10 units). Survey logistic regression analyses were used to examine the association of kidney function measures with prevalent and incident pre-HF and its domains (LVSD, LVDD, LVR), unadjusted and adjusted for age and sex and accounting for the complex survey design. Results: At V1 (mean age 56 years, 55% female), 66.7% had prevalent pre-HF; at V2, 66.3% had incident pre-HF. UACR was significantly associated with prevalent pre-HF and LVR in all models (Table 1-2). Higher cystatin C was significantly associated with incident pre-HF, LVDD, and LVR in all models; whereas eGFR (CKD-EPI) showed a marginal inverse relation with prevalent and incident pre-HF, LVDD and LVR, but only remained associated with LVR in adjusted models (Table 1-2). Conclusion: Declining kidney function (higher UACR and cystatin C) is associated with prevalent and incident pre-HF, diastolic dysfunction, and cardiac remodeling. Lower eGFR is also associated with cardiac remodeling in this population. Screening for kidney function could help us identify pre-HF and start protective therapies earlier to most effectively prevent overt HF.
Abstract P470: The Virtual Home Clinic: Feasibility and Challenges for Longitudinal Cohorts
Authors: Elaine M Urbina, Marta Russell, Erin Cain, Camilo Fernandez, Lydia A Bazzano, Jessica G Woo
Journal: Circulation (2024)

Longitudinal studies provide rich sources of data to explore early risk factors for future CV diseases. However, cohort participants often move away from their initial recruitment site. Our study assesses feasibility of mailing of devices to the home for collection of biometric data and user acceptability of this approach. Participants (N=308) from the Bogalusa Heart Study, National Growth &amp; Health Study and the Princeton Lipid Research Study who were initially enrolled as children in the 1970s and 1980s were recruited to conduct on-line surveys. A subset (N=74) had biometric measurement devices sent to the home ( Table ) for anthropometrics, BP, HR, heart rhythm, resting metabolic rate, O 2 saturation, glucose, total cholesterol, physical activity, diet, sleep duration/quality, and arterial stiffness. Stool and saliva were also collected for microbiome, and DNA. Of the 74 agreeing to participate in the home study, 62 (84%) successfully completed at least some testing. Among those 62, 72% of participants on average (range: 23% for AimStrip total cholesterol to 97% for Oragene) completed all requested readings for a given device. The total cholesterol test had the highest proportion of missing requested readings (45%). Of the 46 of 62 (74%) participants who completed the user acceptability survey, 28% preferred an in-clinic visit, 46% preferred home, and 26% did not have a preference. More males (63% vs 42% females) preferred home assessment. There was little difference between Black and White participants. On a scale of 1 (hard to use, poor directions, took too long) to 5 (easy to use, easy to follow directions, took little time), most devices scored near 4.5. The cholesterol test elicited the most negative responses, and several devices scored lower on the impression of the time it took to complete the at-home test. This feasibility study demonstrates that home biometric assessment is feasible and acceptable as we continue to follow our participants who have provided invaluable contributions to science for the last 40 years.
Abstract P291: Understanding Participant Perspectives Towards the Formation of a National Participant Advisory Board Within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study: A Qualitative Study
Authors: Demetria M Hubbard, Marquita S Brooks, Suzanne E Judd, Monika M Safford, Emily B Levitan, Virginia J Howard, Elizabeth Baquero, Tomi Akinyemiju, Lonnie Hannon, Madeline R Sterling
Journal: Circulation (2024)

Introduction: While participant advisory boards (PABs) are common among public health initiatives and clinical trials, they are less common among national, epidemiologic cohort studies. PABs could add value to researchers and participants alike, but their formation and functioning in this context is less understood. We aimed to elicit the perspectives of participants from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) Study towards the formation of a PAB, which can inform future efforts to form one for this cohort study and others like it. Methods: REGARDS is a national prospective cohort study that enrolled &gt;30,000 Black and White community-dwelling adults aged ≥45 years from 48 states 2003-2007. Enrollment and follow-up is ongoing and done through mail and telephone. We used a convenience sampling approach to recruit from a subset of participants who responded to a newsletter about joining a PAB. Participants completed a one-on-one telephone or Zoom-based interview with study staff following a semi-structured interview guide. Interviews were recorded and professionally transcribed. Data were organized with NVivo software. Informed by the Cargo and Mercer’s Health Equity Research Practice Framework for Academic-Community Partnerships, we conducted a thematic analysis. Each transcript was independently coded by two team members, then reconciled by a third. Major themes and subthemes were identified. Results: The 18 participants had a median age of 69 years, 67% were women, 39% were Black, and 78% had a college degree or higher. Overall, participants were enthusiastic about the PAB and were inclined to meet as a group regularly via Zoom or telephone. Four key themes emerged: (1) The PAB should form and function with a core set of principles, including: trust, diversity, mutual respect, and accountability; of these, diversity was most important; (2) The PAB should not only inform studies (i.e. research questions, methodology), but also assist with the dissemination of science to diverse networks; (3) A formal process is required to form and maintain the PAB, as well as keeping members engaged; (4) Core values influenced participants’ willingness to serve on the PAB; they included internal motivation, the desire to translate knowledge into action, and social and environmental justice. Conclusion: This study highlights a willingness of participants in large epidemiologic cohort to participate in a PAB. Our results can inform the formation of a PAB in the REGARDS Study, and may be important for other observational cohorts interested in including participants in an advisory capacity.
Abstract P475: Adherence to the EAT-Lancet Planetary Health Diet and Cardiometabolic Risk Markers in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study
Authors: Nilendra K Nair, Linh P Bui, Caleigh M Sawicki, Namratha Kandula, Alka M Kanaya, Kyu Ha Lee, Meir J Stampfer, Walter C Willett, Shilpa N Bhupathiraju
Journal: Circulation (2024)

Introduction: Poor diet is among the top risk factors for cardiometabolic disease, which disproportionately burdens South Asians. In 2019, the EAT-Lancet Commission proposed a Planetary Health Diet (PHD) designed to optimize human and global environmental health. Objective: We examined associations between a novel Planetary Health Diet Index (PHDI), that reflects adherence to the EAT-Lancet recommendations, and cardiometabolic risk in a prospective cohort of South Asians in the US. Methods: We included participants from the MASALA study with complete baseline (n=891) and 5-year follow-up (n=735) examinations. The PHDI was comprised of 15 food components with scoring based on the ranges prescribed by the EAT-Lancet commission for a total score range of 0–140. Higher scores indicate greater adherence to the PHDI. We used multivariable linear and logistic regression models to examine cross-sectional and prospective (5-years) associations between baseline PHDI and measures of glycemia, blood lipids, inflammation, and adiposity, adjusting for demographic, health, lifestyle, and baseline value of biomarker (for prospective models). Logistic regression was used to examine association between baseline PHDI and incident type 2 diabetes (among n=661 participants free from diabetes at baseline) Results: Among MASALA study participants (49% female, mean age 57 y), the mean PHDI score was 88.8 (SD 9.47). At baseline, each 10 unit increase in PHDI scores were associated with (β ± SE) lower fasting glucose (-0.5±0.24 mmol/L), HbA1c (-0.49±0.22%), LDL cholesterol (-0.015±0.007 mmol/L), CRP (-5.87±2.35 mg/L), higher adiponectin (4.71 ±2.01 mg/dL), lower body weight (-0.59 ±0.26 kg), BMI (-0.27±0.11 kg/m 2 ), waist circumference (-0.82±0.29 cm), visceral fat (-3.22±1.32 cm 2 ), and pericardial fat (-0.92±0.43 cm 3 ) ( p &lt;0.05 for all). Higher PHDI scores were associated lower odds of obesity [OR (95% CI): 0.80 (0.71-0.92] and overweight [0.77 (0.74-0.85)]. Prospectively, higher PHDI scores were associated with lower fasting glucose (-0.28 ± 0.14 mmol/L), lower HbA1c (-0.08±0.03%), higher HDL (0.38±0.17 mmol/L), lower body weight (-0.37±0.12 kg), BMI (-0.08±0.03 kg/m 2 ), waist circumference (-0.49±0.17 cm), and systolic blood pressure (-0.65 ± 0.30 mmHg) ( p &lt;0.05 for all). Each 10-unit higher PHDI was associated with a 20% lower risk of incident diabetes [OR (95%CI): 0.80 (0.54-0.86)]. Conclusions: In the MASALA study, we found that greater adherence to the PHDI was associated with better cardiometabolic risk factors and lower risk of incident type 2 diabetes. These observations support the planetary health diet as a feasible strategy to address planetary health while optimizing human health outcomes.
Abstract P171: Patient and Interdisciplinary HIV Care Experts Illness Representations on HIV Comorbidities and Usability of a Virtual Environment as Heart Disease Prevention Education in Ethnic and Racial Sexual Minority Men With HIV
Authors: S. Raquel Ramos, Allison Vorderstrasse, Constance Johnson, Gail Melkus, Trace Kershaw, Harmony Reynolds
Journal: Circulation (2024)

Background: Black and Latinx sexual minority men with HIV are at increased risk of CVD and have been underrepresented in clinical trials. The American Heart Association has called for an increase in interventions that focus on enhancing cardiovascular health in underserved communities by addressing social determinants and modifiable risk factors of CVD. Objective: To explore patient and HIV care experts’ perceptions about HIV comorbidities and assess usability of a virtual environment as CVD prevention education in Black and Latinx sexual minority men with HIV. Methods: This two-phase study is part of a pilot behavioral clinical trial informed by the American Heart Association’s metrics for cardiovascular health. Qualitative Phase 1 data were collected June 2021 to May 2022. Phase 2 data were collected August 2022 to October 2022. Using convenience sampling, we recruited a) Black and Latinx sexual minority men with HIV, and b) interdisciplinary HIV care experts. Eligibility criteria for non-HIV care experts were: 1) self-identify as gay or bisexual; 2) HIV serostatus positive; 3) ages 30 to 65; 4) access to a laptop or desktop. We explored HIV comorbidities of concern and conducted usability testing of the virtual environment. Eighty-four pages of interview data were analyzed using NVivo 12. Results: Phase 1 themes included: Mixed Perceptions about Health, High Risk for Comorbidities, and Virtual Environment Features. CVD risk factors were consistently expressed in relation to HIV, including hypertension, heart attack, stroke, and diabetes. Additionally, kidney, and liver disease were identified as important. Cancer was a common concern and so were the development of mental health conditions. All participants in Phase 2 completed the usability checklist with favorable feedback. Conclusions: We identified hypertension, diabetes, asthma, and cancer were comorbidities of concern. These findings carry significant implications for mitigating barriers to preventative health screenings in Black and Latinx sexual minority men with HIV, given shared risk factors between HIV, CVD, and cancer. We also found that usability of a virtual environment as CVD prevention education was promising as it offered anonymity and access to reliable health information that traverses geography. A virtual environment may serve as a novel modality for extending the reach of prevention education and clinical trials into the hands of ethnic and racial, sexual minoritized individuals that have been underrepresented in advancements in health equity.
Abstract P399: Cardiovascular Risk Factors and Measures of Early Atherosclerosis in Children With Down Syndrome
Authors: Adam Ware, Sarah D De Ferranti, Heather Keenan, Linda M Lambert, Zhining Ou, Elaine M Urbina, Richard V Williams, Brian W McCrindle
Journal: Circulation (2024)

Background: Children with Down syndrome (DS) have unique cardiovascular (CV) risk profiles compared to the general population. Early markers of atherosclerosis can be measured and are associated with CV risk factors, although limited data are available for children with DS. Methods: A multicenter, cross-sectional study of children with DS between 8-18 years. CV risks assessed: BMI, blood pressure, diet, activity, smoke exposure, congenital heart disease, hypothyroid, cancer, apnea, family history of early coronary disease, lipids, lipoprotein subfractions, glucose, insulin, and HS-CRP. Vascular testing included pulse wave velocity (PWV) and carotid intimal medial thickness (CIMT). Prevalence of categorical CV risks were compared to population prevalence from NHANES data using Fisher’s exact or chi squared. Vascular measures were converted to Z scores using height and compared to population means with single sample t test, and linear regression evaluating associations between CV risks and vascular measures. Results: A total of 55 children with DS participated, 28 (51%) female, mean age 14.3 years (range 8.1-18.9). Compared to NHANES, DS children were more likely to have triglycerides &gt;90 mg/dL (63% DS vs. 10% NHANES, p=&lt;0.001) and non-HDL-cholesterol &gt;120 mg/dL (54% DS vs. 22% NHANES, p = &lt;0.001). PWV and CIMT Z scores were not significantly different from general population with mean (SD) of -0.1 (1.0) and 0.27 (1.5), respectively. Univariable analysis for PWV showed significant associations with systolic blood pressure [coefficient (95% CI): 0.04 (0.02, 0.06)] and smoke exposure [1.70 (0.35, 3.05)]. No associations were found for CIMT. Multivariable models are shown in Table 1. PWV was associated with BMI percentile and smoke exposure. No associations were found for CIMT. Conclusion: Children with DS had higher rates of lipid abnormalities compared to the general population. Lipid abnormalities were not associated with CIMT or PWV, and vascular measures adjusted for height were similar to children without DS.