Browse Articles

Abstract P2042: Descriptive Analysis of Geographic and Sociodemographic Patterns in Poor Cardiovascular Health Across U.S. Census Tracts

Introduction: Examining geographic and sociodemographic differences in Poor Cardiovascular Health (PCVH) across U.S. neighborhoods can help identify where the most significant disparities in cardiovascular disease exist. We sought to map and examine the distribution of PCVH across U.S. census tracts by levels of social vulnerability and rurality from 2017 to 2021. Hypothesis: We hypothesize that PCVH will be more prevalent in regions with greater social vulnerability and in rural areas. Methods: We examined area-level PCVH score based on the Life’s Essential 8 (LE8) framework across 60,632 U.S. census tracts (~85% of Continental U.S. census tracts). Prevalence data for seven LE8 components (high blood pressure, poor sleep, physical inactivity, diabetes, smoking, obesity, and high cholesterol), as well as the Social Vulnerability Index (SVI) were from the Centers for Disease Control and Prevention. Rural-Urban Commuting Area (RUCA) codes and limited access to healthy food, used as a proxy for poor diet, were obtained from the U.S. Department of Agriculture. Percentile estimates from the eight components were averaged to generate a composite PCVH score for each tract (range 0-100), then classified as quartiles based on percentile ranking (Q4=poorest PCVH). We then mapped PCVH quartiles across census tracts (Figure 1). Differences in PCVH score were analyzed across SVI quartiles, urbanicity status (metro vs. rural), U.S. census regions, and racial/ethnic groups. Results: The median PCVH score was 62.5, with an interquartile range of 46.8 to 78.1. The mean PCVH score was higher in rural (61.2, SD = 16.6) compared to metropolitan (47.2, SD = 22.7) tracts. Tracts with the lowest SVI (less vulnerable) had a mean PCVH of 30.9 (SD = 15.2), while those in the highest quartile had 69.4 (SD = 17.4) (data not shown). Additionally, tracts in the South [60.7 (SD = 22.1)] and Midwest [52.9 (SD = 21.4)] states had a higher PCVH score compared to West and Northeast [35.3 (SD = 18.1] and 44.5 (SD = 19.5), respectively]. Tracts with larger Black or African American populations were overrepresented in the upper PCVH quartiles [30.1% (SD = 31.79) in PCVH Q4 vs 4.6% (SD = 7.1) in Q1]. Conclusion: These findings highlight geographic and sociodemographic disparities in PCVH across U.S. census tracts, with a higher burden found in the South and Midwest, as well as in rural and more socially vulnerable census tracts.

Abstract MP37: Proteomics Of Prediabetes Progression And Remission: The Atherosclerosis Risk In Communities (ARIC) Study

Introduction: Proteomics could improve our understanding of the mechanisms underlying short-term prediabetes progression and remission, i.e., reverting to normoglycemia. Objective: To identify proteomic predictors of 3-year progression from prediabetes to diabetes and remission. Method: We used data from the Atherosclerosis Risk in Communities (ARIC) Study visit 2 (1990-2) and visit 3 (1993-5). We examined associations of 4,955 plasma proteins (SOMAScan v4.0) in participants with baseline prediabetes (fasting glucose [FG] 100-125 mg/dL without diabetes). We used multivariable logistic regressions to examine protein associations with 3-year progression from prediabetes to diabetes (physician diagnosis, medication, or FG ≥126 mg/dL) or remission (FG <100 mg/dL). Analyses were adjusted for demographics, cardiometabolic risk factors, and baseline glucose. Statistical significance was based on p<10 -5 . We explored biologic pathways enriched among top proteins and calculated the delta-AUC for models with (and without) the associated proteins. Results: The 3,788 participants with prediabetes were mean aged 57 years (SD:6), 52% were women, 18% self-identified as Black. The 3-year cumulative incidence of diabetes was 6% and was 40% for prediabetes remission. We identified 6 proteins associated with 3-year progression to diabetes (e.g., lower adiponectin [ADIPOQ]) and 8 proteins (e.g., higher insulin growth factor binding protein 2 [IGFBP2], lower complement C3 [C3]) associated with prediabetes remission. Adipogenesis and Jak/STAT signaling were among the pathways enriched in diabetes-associated proteins. Regulation of IGF transport and uptake by IGFBPs and C3/C5 activation were pathways for remission-associated proteins. The 6 proteins collectively improved diabetes progression prediction (covariate only AUC=0.798; delta-AUC=0.03 p<0.001). The 8 proteins collectively improved remission prediction (covariate only AUC=0.722; delta-AUC=0.03 p<0.001). Conclusions: In persons with prediabetes, we identified known and novel proteins that were associated with 3-year progression to diabetes and remission. Proteins associated with remission relate to reduced inflammation and improved insulin sensitivity.

Abstract P2132: Impact of Midlife Physical Activity on Multimorbidity in a Rural Setting: Insights from the Bogalusa Heart Study

Introduction: The prevalence of multiple chronic conditions (CCs), especially cardiovascular-related, is increasing, leading to higher disability and mortality. Midlife is a critical period for the development of CCs, necessitating interventions to prevent progression to multimorbidity. Physical activity (PA) is a key intervention to reduce the risk of developing multimorbidity. However, the impact of midlife PA on CCs in rural communities remains under-explored. This study examined the relationship between PA and multimorbidity (defined as >2 CCs) in a rural middle-aged population. Hypothesis: Participants in midlife with higher levels of PA would be less likely to present multimorbidity compared to those with low PA. Methods. We examined 1,289 participants (mean age 48 ± 5.24 years; 34.6% Black, 65.4% White) from the Bogalusa Heart Study, a long-term longitudinal rural study. Logistic regression models assessed the association between PA scores low (minimal or no PA), moderate (>=600 MET-Minutes/week), and high (>=3,000 MET-Minutes/week) using the International Physical Activity Questionnaire (IPAQ) long form and multimorbidity defined as >2 CCs. Eight CCs (hypertension, dyslipidemia, diabetes, chronic kidney disease, cardiovascular disease, cancer, depression, and chronic obstructive pulmonary disease) were selected based on Centers for Medicare&Medicaid Services guidance using self-reported medical history. Models were adjusted for age, race, and sex. Results: Moderate PA was associated with lower odds of multimorbidity compared to low PA (Unadjusted OR=0.724, 95% CI=0.534–0.983, p =0.038), though this was not statistically significant after adjustment (OR=0.782, 95% CI= 0.57–1.06, p =0.114). Individuals with high PA scores also showed lower odds of multimorbidity in the unadjusted model (OR=0.88, 95% CI=0.62–1.24, p =0.482) but was not statistically significant after adjustment (OR=0.91, 95% CI=0.64-1.30, p =0.627). Conclusion: The data suggest a possible link between PA and multimorbidity, though no direct association was established. The reduced odds of multimorbidity with higher PA diminished after adjusting for sociodemographic factors, highlighting the need to consider these influences when evaluating PA's benefits in rural settings. Future studies should aim to better understand sociodemographic factors to develop effective and tailored PA interventions that can promote health and reduce CCs in rural populations.

Emergent quantum Majorana metal from a chiral spin liquid

Abstract P2120: Assessing the Accuracy of OpenStreetMap Sidewalk Data: A Comparative Study with Google Street View

Purpose: OpenStreetMap (OSM) serves as an open-and-crowd-sourced geospatial database widely utilized as a data-source in walkability studies, yet its sidewalk data accuracy remains unverified. Methods: An OSM base-map of Maryland was generated, excluding roads inaccessible to pedestrians, then clipped to 141 randomly selected census tracts (~10% of total census tracts), stratified by population density tertiles. Fifty points within each census tract were randomly distributed across qualifying roads. The OSM base-map and Google Street View (GSV) at each point were reviewed visually by trained researchers to determine sidewalk presence (one or both sides of the street) or absence. Points with unavailable GSV were excluded, and unclear points were re-reviewed for consensus. Percent agreement in sidewalk data between GSV and OSM was calculated for all tracts and for a subset excluding tracts with 0 sidewalks in GSV. ANOVA and post-hoc pairwise tests compared mean accuracy scores by population density tertiles. Results: Of the 7,050 points reviewed, across 141 census tracts, 6103 points were available in GSV, with 3674 points having sidewalks in GSV. When points without sidewalks were excluded from analysis, 11 census tracts were removed, showing that they had no points with sidewalks; all were from the low-density tertile. Agreement at all points and points with sidewalks in GSV are presented in Table 1. ANOVA analysis conducted at all points showed significant differences based on population density tertiles. Pairwise comparison found the low-density tertile had significantly (p>0.001) higher agreeance from mid and high-density tertiles. ANOVA and pairwise comparison for points with sidewalks in GSV showed no difference (p>0.05) between population density tertiles. Conclusions: OSM sidewalk data exhibits limited accuracy, with results showing underreporting of sidewalk presence in OSM. In 72% of points with sidewalks in GSV, OSM did not report sidewalks. The higher agreement at all points shows a lack of walkability, especially in lower density census tracts, combined with the default reporting setting of OSM, which is no sidewalks. These findings highlight the need to evaluate sidewalk presence when updating OSM content. Variations between census tracts may be caused by demographic factors, however, additional research is necessary. Potential limitations include availability and date of GSV images, and issues with generalizability outside study location.

Abstract P2144: The Duration of Expectant Management During Hypertensive Disorders of Pregnancy and Blood Pressure 2-7 Years After Delivery

Expectant management of preterm pregnancies with hypertensive disorders (HDP), such as preeclampsia (PE), is standard practice for neonatal benefit, although the effects on the maternal cardiovascular (CV) system from longer exposure to endothelial inflammation is uncertain. Latency of expectant management is the time from HDP diagnosis to delivery. Studies from administrative databases suggest a higher rate of adverse CV outcomes several years post-pregnancy with latency >7 days. Using the nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Heart Health Study) cohort, we evaluated the relation between latency in nulliparas expectantly managed with HDP and mean systolic and diastolic blood pressure (BP) 2-7 years post-pregnancy. In the primary study (nuMoM2b), pregnancy diagnoses and outcomes were prospectively ascertained and biospecimens were obtained. We included those with HDP (PE with or without severe features, and gestational HTN) diagnosed <37 weeks. Latency was defined as short (2-7 days) or long (>7 days). We excluded those with chronic hypertension (HTN) or pregestational diabetes at index pregnancy, if exposure or outcome data were missing from the index pregnancy or HHS visit, or if latencies were implausible based on timing of diagnosis and delivery. We used linear regression models to examine the association between latency with BP and markers of CV risk (high-sensitivity CRP (hs-CRP), lipids, HgbA1C, NTproBNP, and ACC/AHA CV risk score) obtained 2-7 years post-pregnancy. We planned a sensitivity analysis of those with early-onset HDP (diagnosis <34 weeks). 150 participants, 32 with short and 118 with long latency, met inclusion criteria (Table 1). BP at HHS follow-up was not different by latency duration (Table 1, Fig 1). hs-CRP was significantly higher in those with long latency, including after adjustment for confounders (age, race, BMI, baseline CV markers, gestational diabetes, small for gestational age infant, and smoking [Fig 2]). The other markers of CV risk were not statistically different between groups [Table 1]. In sensitivity analysis, BP was not different between groups; however, hs-CRP was significantly higher in the longer latency group. In this cohort of prospectively adjudicated pregnancy outcomes, longer latency in those with expectantly managed preterm HDP was not associated with overall differences in CV risk, including BP 2-7 years after a first delivery. The finding of elevated hs-CRP warrants follow-up in a larger cohort.

Abstract P2146: Multiple Pathways of CD34 ⁺ Cell Differentiation during Embryogenesis

Introduction: CD34 + progenitor cells are widely used for stem cell therapy for cardiovascular diseases, but the effectiveness of the treatment is variable. To understand the fundamental mechanism of CD34 + cell development, we aimed to investigate cell fates of CD34 + progenitors during the embryogenesis of mice and humans. Methods: Human embryos from PCW 6 to 12 were obtained from patients who had undergone induced or spontaneous abortions and samples were subjected to mass spectrometry. For the animal model, embryos were obtained among C57BL/6J, Cd34 -DreER T2 ; IR, CD34 -CreER T2 ; R26-tdTomato, Cdh5 -dre; IR; Cd34 -creER, Cd34 -CreER T2 ; R26-tdTomato; Kdr flox , Cd34 -CreER T2 ; R26-tdTomato; Pdgfra flox mice. Single-cell RNA sequence (scRNA-seq) was performed using the databases generated from our group and publicly data from NCBI Gene Expression (GEO) Omnibus (E6.5 to E18.5 cells). Additionally, whole-mount staining and three-dimensional reconstruction were used to depict different types of CD34 + progenitor distribution within transparent embryos. Results: The proteomics unveiled an assumed intricate orchestration in developing human embryos from patients who experienced induced or spontaneous abortions. Our study demonstrated that the high level of CD34-expressing cells uncovered the potential naïve pluripotency to differentiate during embryonic development. Moreover, deletion of Kdr in CD34-derived cells resulted in stalled vessel development in stages spanning E6.5 to E8.5, which is crucial to endothelium development. Also, the activation of the cell cycle machinery was identified as a driver of endothelial-to-hematopoietic transition (EHT) in Cd34 + Runx1 + Cd44 + cells from E9.5 to E11.5. Until late embryogenesis, CD34 + progenitors gave rise to fibroblasts. Finally, CD34 + cells contribute to the quiescent stem cell pool in the adult stage and enter the cell cycle when the body suffers damage. Conclusions: Our results conducted a comprehensive study on the spatial and temporal induction of CD34 + cells and their intricate functions in embryonic development. These findings enlightened us on paving the way to innovatively tackle the complex hurdles present in stem cell and regenerative medicine, particularly in stem cell therapy.

Full-color tuning in multi-layer core-shell nanoparticles from single-wavelength excitation

Abstract P2126: Physical Activity, Inflammation, and Cardiometabolic Risk in Diabetic Kidney Disease: A Population-Based Study

Introduction: Diabetic kidney disease (DKD) increases morbidity and mortality in individuals with diabetes. This study aimed to examine the relationships between cardiometabolic factors, high-sensitivity C-reactive protein (hs-CRP), physical activity (PA) measured as total METs, and the risk of DKD in adults. Additionally, it explored moderators of the association between total PA METs-DKD. Hypothesis: We hypothesized that lower levels of cardiometabolic factors and hs-CRP, along with higher levels of total PA METs are associated with reduced DKD risk in adults. We also posited that age and race/ethnicity moderate the relationship between total PA METs and DKD. Methods: The study analyzed 5,856 adults aged ≥18 years (mean age = 49.89) from the 2017-2018 National Health and Nutrition Examination Survey. DKD was defined by diabetes with an estimated glomerular filtration rate of <60 mL/min/1.73m2 or an albumin to creatinine ratio was ≥30 mg/g. The International Physical Activity Questionnaire was used to subjectively measure PA in the survey. Multiple imputations were conducted to address the missing data. Hierarchical logistic regression was used to assess the odds of DKD and identify moderators. Results: DKD was present in 13.32% of participants. Age strongly predicted DKD, with those aged 70-80 having an 18.13 times higher risk than those aged 20-29. Non-Hispanic Black participants had 1.51 times higher DKD risk than non-Hispanic Whites. Among metabolic and inflammatory markers, high systolic blood pressure, elevated fasting glucose level, and hs-CRP were associated with increased odds of DKD. Conversely, total cholesterol levels of 5.2-6.2 mmol/L and total PA METs ≥1,110 METs-minutes/week were linked to a 24% and 25% reduction in DKD odds, respectively. Age and race/ethnicity did not moderate the relationship between total PA METs and DKD. Conclusions: Most cardiometabolic markers and hs-CRP were associated with increased DKD risk, while total cholesterol and total PA METs were associated with reduced DKD risk. Contrary to our hypothesis, age and race/ethnicity did not moderate the relationship between total PA METs and DKD risk.

Abstract P2143: Adverse Pregnancy Outcomes – Planning for Fourth Trimester Interventions to Promote Equitable Long-Term Cardiovascular Health

Introduction: Adverse pregnancy outcomes (APOs) are significantly associated with future cardiovascular disease and cardiovascular mortality and disproportionately affect women from minority racial and ethnic groups. Maternal and perinatal morbidity in the Southeast US is among the highest in the country, and cardiovascular disease (CVD) is the #1 cause of death in pregnant and nonpregnant patients. Therefore, we sought to define the contemporary epidemiology of APOs among pregnant and postpartum individuals at a major tertiary center in the Southeast US to plan a fourth-trimester cardiovascular disease intervention. We assessed the hypothesis that there is racial and ethnic variation in the epidemiology of APOs. Methods: We performed a retrospective study including pregnant/postpartum patients from a tertiary center between 2013 and 2018. The primary outcome was APO prevalence, defined as ≥1 of the following diagnoses during pregnancy or <6 weeks postpartum: hypertensive disorders of pregnancy (HDP), preterm birth (PTB), diabetes, placental abruption, intrauterine fetal demise (IUFD), and small for gestational age (SGA) neonate. Secondary outcomes included trends in APO prevalence, and prevalence of and adjusted relative risks (aRR) of APOs by self-reported race/ethnicity. Results: Of 24,637 patients included in this study, all baseline characteristics significantly differed between groups. APOs occurred in 11,507 (47%) of pregnancies. Overall trends of HDP increased dramatically across the study period from 17% to 22% (p<0.001). APO prevalence in Non-Hispanic Black, Non-Hispanic White, and Hispanic individuals were significantly different at 53%, 32%, and 12% (p<0.001) (Figure). In adjusted analysis with Non-Hispanic White as a reference, Non-Hispanic Black individuals had an increased risk of APO aRR 1.03 (95% confidence interval (CI) 1.01-1.04), while Hispanic individuals had a reduced risk of APOs aRR 0.91 (95% CI 0.88-0.94). Hispanic individuals had an increased risk of diabetes aRR 1.73 (95% CI 1.51-1.94) while Non-Hispanic Black patients had an increased risk for IUFD aRR 1.33 (95% CI 1.05-1.60) and SGA aRR 1.32 (1.25-1.39). Conclusion: Nearly half of the patients in the study period experienced an APO with marked racial/ethnic disparities. As APOs are associated with future CVD - the #1 cause of death - these findings underscore an urgent need for timely fourth-trimester interventions to promote equitable cardiovascular health.

Abstract P2166: Neighborhood-level socioeconomic deprivation associates with monocyte phenotypes involved in atherogenesis: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)

Introduction: Chronic neighborhood stressors contribute to disparate CVD outcomes, with neighborhood socioeconomic deprivation (NSD) linked to inflammation. Separately, relationships have been seen with CVD and specific monocyte phenotypes. However, the connection between neighborhood exposures and monocyte subsets is less clear. Thus, we examined NSD with monocyte phenotypes, hypothesizing that chronic NSD cross-sectionally associates with monocyte subsets. Methods: This study utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based prospective cohort of adults aged 45-84 years (N=6814). NSD was scored from principal factor analyses using U.S. Census data (2000), with higher values indicating higher deprivation. Monocyte phenotypes were measured from cryopreserved peripheral blood mononuclear cells by flow cytometry at MESA Exam 1 (2000-02). Subsets were characterized as classical monocytes (CMs, CD14++CD16-), intermediate monocytes (IMs, CD14+CD16+), and non-classical monocytes (NCMs, CD14+CD16++). Linear regression models were used to examine associations between NSD and monocyte phenotypes, adjusting for individual-level covariates. Results: Of the MESA cohort, participants with monocyte phenotypes (n=1527) were included in analyses (age 62.9±10.5 years, 50.5% male, 37.4% White, 28.6% Black, 20.6% Hispanic). Higher NSD was associated with lower CMs but higher IMs and NCMs (Table). When gender-stratified, relationships remained significant for CMs but not for IMs. In men, higher NSD was associated with higher NCMs but not when adjusted for covariates. Conclusion: Neighborhood deprivation as a marker of chronic stress was associated with shifts in monocyte subsets in a partially sex-dependent manner, with differential relationships with CMs, IMs, and NCMs. With IMs and NCMs associated with accelerated CVD, these findings may help illuminate the role of monocytes in how neighborhood exposures lead to CVD. Future analyses will examine interactions with race/ethnicity and inflammatory biomarkers.

Binary peptide coacervates as an active model for biomolecular condensates

Abstract Biomolecular condensates formed by proteins and nucleic acids are critical for cellular processes. Macromolecule-based coacervate droplets formed by liquid-liquid phase separation serve as synthetic analogues, but are limited by complex compositions and high molecular weights. Recently, short peptides have emerged as an alternative component of coacervates, but tend to form metastable microdroplets that evolve into rigid nanostructures. Here we present programmable coacervates using binary mixtures of diphenylalanine-based short peptides. We show that the presence of different short peptides stabilizes the coacervate phase and prevents the formation of rigid structures, allowing peptide coacervates to be used as stable adaptive compartments. This approach allows fine control of droplet formation and dynamic morphological changes in response to physiological triggers. As compartments, short peptide coacervates sequester hydrophobic molecules and enhance bio-orthogonal catalysis. In addition, the incorporation of coacervates into model synthetic cells enables the design of Boolean logic gates. Our findings highlight the potential of short peptide coacervates for creating adaptive biomimetic systems and provide insight into the principles of phase separation in biomolecular condensates.

Abstract P2142: Hypertensive disorders of pregnancy (HDP) and cardiovascular disease (CVD) in American Indians: The Strong Heart Family Study (SHFS)

Introduction: American Indian populations have high risks of both hypertensive disorders of pregnancy (HDP) and cardiovascular disease (CVD) yet few studies have evaluated associations of HDP and CVD in these populations. Aim: To determine if the odds of hypertension outside of pregnancy (HTN), carotid artery plaque, left ventricular mass indexed to body surface area (LVM/BSA), ejection fraction (EF), or clinical CVD events are higher in HDP cases compared to controls from the SHFS. Methods: We included 66 cases of HDP (preeclampsia and gestational hypertension) confirmed by medical records and/or birth certificates, matched on date of delivery (±3 years) to 185 controls. We defined HTN as systolic blood pressure (BP) ≥140 mm HG, diastolic BP ≥ 90 mmHg, or taking HTN medication. We used ultrasounds to measure carotid artery plaque, echocardiograms to measure LVM/BSA and EF, and physician adjudication to determine CVD events. We used conditional logistic regression to determine if the odds of HTN, plaque, LVM/BSA, EF, or CVD were different in HDP cases compared to controls while controlling for maternal age, center (Arizona, Oklahoma, or Dakotas), body mass index, smoking, and diabetes. Results: Of the total sample (n=251), 44 had HTN outside of pregnancy (23 were HDP cases), 29 had plaque (9 were HDP cases), and 12 had CVD (4 were HDP cases). Mean LVM/BSA was 70.4 (std=12.8) and mean EF was 59.7% (std=4.3%). The odds of HTN and CVD were higher in HDP cases compared to controls, while controlling for covariates (HTN OR= 7.53, 95% CI=2.22-25.67; CVD OR=6.04, 95% CI=1.05-34.91, Table 1). The univariate odds of LVM/BSA were higher in HDP cases compared to controls (OR=1.024, 95% CI=1.001-1.048), but the association attenuated when controlling for covariates. Conclusions: These data suggest that HDP is associated with HTN outside of pregnancy and CVD events in American Indian populations, which has never been demonstrated. Thus, these analyses may provide a critical step toward reducing HTN or CVD in American Indians diagnosed with HDP.

Abstract P3024: Phenotypic vs. Genetic Mismatch of Body Mass Index and Its Risk Factors: Evidence from the China Kadoorie Biobank and the UK Biobank

Background: The mismatch between phenotypic and genotypic BMI (BMI-PGM) contributes to the sky-rocketing obesity prevalence in both developed and developing countries. However, little is known about BMI-PGM and its risk factors. Methods: We included 86,205 participants who were genotyped and with valid BMI measurements from the China Kadoorie Biobank (CKB). BMI-PGM was calculated for each participant as the difference between the percentile for his/her adjusted BMI and the percentile for his/her adjusted polygenetic risk score of BMI (BMI-PRS), ranging from -100 to 100. A higher BMI-PGM means one’s measured BMI was much greater than his/her genetically-determined BMI. We then categorized participants into three groups according to BMI-PGM quartiles: discordantly low (bottom quartile), concordant (2nd and 3rd quartiles), and discordantly high (top quartile). Potential risk factors of BMI-PGM, including socio-demographic characteristics and lifestyle factors, were tested by multivariate linear regression. External replication analyses were performed among 102,514 UK Biobank (UKB) participants. Results: In both CKB and UKB, BMI-PGM exhibited a symmetric and normal distribution. Across all four BMI categories (underweight, normal weight, overweight, and obese), the concordant BMI-PGM group accounted for approximately 50% of participants. Of interest, over 50% of obese and underweight adults were categorized into the discordantly high BMI-PGM group and the discordantly low BMI-PGM group, respectively. In both cohorts, participants with higher BMI-PGM were more likely to be younger, current smokers, physically inactive, and meat lovers. However, the associations of BMI-PGM with sex, urban-rural status, education level, household income, alcohol consumption, fruit intake, and sleep duration varied between the two cohorts. Conclusions: A new metric was developed to quantify the mismatch between phenotypic and genetic BMI in both East Asian and European adults. The obesogenic environment affects obesity in different populations with both commonalities and distinct differences.

Abstract MP29: Cardiovascular Health Effects of a Free-Sugar-Restricted Diet vs. a Usual Diet: A Randomized Clinical Trial in Adolescent Boys with MASLD

Introduction: High intake of added sugars (>10% total energy) is associated with major cardiovascular risk factors and cardiovascular disease (CVD). Less is known about the effects on cardiovascular health (CVH) that could result from free-sugar restriction, particularly in adolescence, a critical period of CVH loss. Hypothesis: An 8-week low free-sugar diet will improve CVH more than a usual diet in adolescent boys with metabolic dysfunction-associated steatotic liver disease MASLD (formerly NAFLD). Methods: This is a secondary analysis of data from a randomized controlled open-label trial designed to test the effects of a diet that restricted free-sugar intake on hepatic steatosis (NCT02513121). Boys aged 11–16 years old with a diagnosis of MASLD (n=40) were randomized to an 8-week, study-provided low free-sugar diet (<3% of daily calories from sugar) or their usual diet in a 1:1 ratio. CVH was measured using the AHA Life’s Essential 8 (LE8) criteria to estimate a continuous score (range: 0-100) and a categorical variable (high: 80-100, moderate: 50-79, low: 0-49) by averaging the scores from 4 CVH metrics (blood pressure, BMI, non-HDL cholesterol, and glucose). Intention-to-treat mixed model analyses were employed, adjusting for age, study site (Emory or UCSD) and total energy intake. Analyses were performed in SAS (v.9.4) with significance evaluated two-sided at 0.05. Results: All 40 randomized participants (mean (SD) age 13.0 (±1.8) years; 95% Latinx) completed the study. At baseline, the mean LE8 scores were 63.0 ±14.6, and 10% of boys had high, 75% moderate, and 15% low CVH. From baseline to 8-weeks, the mean CVH scores of boys in the low free-sugar diet (n=20) significantly improved by 8 points (mean difference (MD) 8.27; 95% Confidence Interval (CI), 2.9, 13.7; P=0.003) from 62.7 ±13.5 to 67.7 ±11.7. Among boys in the usual diet (n=20), the mean CVH scores had a non-significant decrease of MD=1.15 points (95% CI, -6.6, 4.3) from 63.4 ±15.8 to 62.2 ±13.6 (P=0.68). After 8 weeks, the mean changes in CVH scores for the free-sugar diet were not significantly different from those of the usual diet (MD=4.98, 95% CI, 0.6, 10.6; P=0.08). Conclusion: In this small sample of adolescents, a low free-sugar diet was associated with improvements in CVH after only 8-weeks, but outcomes were not statistically different from the usual diet. Further research is needed to determine if a free-sugar diet can support the maintenance of CVH in youth with and without MASLD.

Improving the fast-charging capability of NbWO-based Li-ion batteries

Abstract The discovery of Nb-W-O materials years ago marks the milestone of charging a lithium-ion battery in minutes. Nevertheless, for many applications, charging lithium-ion battery within one minute is urgently demanded, the bottleneck of which largely lies in the lack of fundamental understanding of Li+ storage mechanisms in these materials. Herein, by visualizing Li+ intercalated into representative Nb16W5O55, we find that the fast-charging nature of such material originates from an interesting rate-dependent lattice relaxation process associated with the Jahn-Teller effect. Furthermore, in situ electron microscopy further reveals a directional, [010]-preferred Li+ transport mechanism in Nb16W5O55 crystals being the “bottleneck” toward fast charging that deprives the entry of any desolvated Li+ through the prevailing non-(010) surfaces. Hence, we propose a machine learning-assisted interface engineering strategy to swiftly collect desolvated Li+ and relocate them to (010) surfaces for their fast intercalation. As a result, a capacity of ≈ 116 mAh g−1 (68.5% of the theoretical capacity) at 80 C (45 s) is achieved when coupled with a Li negative electrode.

Abstract P2130: Identifying Predictors of Achieving 150 Minutes of Weekly Walking in Aging Latinx Adults Enrolled in a 12-month Physical Activity RCT: Insights from Signal Detection Analysis

Physical activity, a key component of Life’s Essential 8, is critical for cardiovascular health, especially among older Latinx adults—a demographic with a high prevalence of at least one cardiovascular disease (CVD) risk factor. Despite previous interventions aimed at helping older adults meet age-specific physical activity (PA) guidelines, achieving this objective continues to be a challenge. This study utilized signal detection analysis (SDA) to identify combinations of baseline demographic, clinical, behavioral, and psychosocial factors, alongside intervention type, that predicted meeting the ≥ 150 minutes per week walking goal at the 12-month study endpoint among insufficiently active older Latinx adults enrolled in COMPASS (Computerized Physical Activity Support for Seniors) – a cluster-randomized physical activity (PA) effectiveness trial. From July 2014 to July 2016, a total of 245 participants aged 50 and older from the San Francisco Bay Area were randomly assigned to either a human peer advisor or a virtual advisor intervention arm. The PA goal was assessed using the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. SDA, a recursive partitioning exploratory method, was used to explore subgroups of participants most and least likely to achieve the goal of ≥150 minutes of walking per week, based on the intervention arm and other predictors. Overall, 49.8% of participants met the walking goal. Among those living in smaller households (<3 people), higher acculturation to US media (score of 5) and lower resting systolic blood pressure (<117 mmHg) were the strongest predictors of success. For participants in larger households (≥3 people), fewer hours of sedentary behavior (<33.8 hr/week) and lower resting heart rate (<64 bpm) were key predictors of success. Notably, the intervention arm was not a significant factor in achieving the PA goal. Study findings underscore the need to focus on specific subgroups to optimize PA interventions. Combinations of factors such as acculturation, cardiovascular health markers, and sedentary behavior may play a critical role in achieving PA outcomes among older Latinx adults. These findings support a precision exercise approach to PA interventions that target the unique needs of aging, underactive minority populations.

Abstract P3076: Incident hypertension by biomarker patterns: REasons for Geographic and Racial Differences in Stroke (REGARDS) stud

Background: We recently empirically identified 3 novel patterns of cardiovascular risk factor biomarkers with factor analysis: Renal-inflammatory, thrombo-inflammatory, and dyslipidemic-inflammatory. Hypertension is a major cardiovascular disease risk factor. Whether these patterns are associated with incident hypertension are unknown. Objectives: To determine the association between novel risk patterns and incident hypertension. Methods: REGARDS recruited 30,239 Black and White adults from the 48 contiguous US states in 2003-2007 with a second visit in 2013-2016. Baseline fasting lipids, C-reactive protein (CRP), cystatin C, urine albumin/creatinine ratio, blood urea nitrogen (BUN), complete blood count, and serum albumin were measured in all or most participants. A robust set of other baseline biomarkers was measured in a sex-race stratified sample of 4,400 participants who attended both visits. Factor scores for each pattern were developed and applied to each of the 2,723 participants with all available baseline biomarkers. Hypertension was defined as baseline blood pressure (BP) ≥140/90 mm Hg or self-reported use of antihypertensive medications. We excluded participants with prevalent hypertension. Tertiles of each factor score were computed in the analytical population. Modified Poisson regression estimated the adjusted relative risk (RR) of incident hypertension by factor pattern tertile, testing for pairwise interactions between each factor. Because of a significant thrombo-inflammatory*dyslipidemic-inflammatory interaction on hypertension (P=0.06; interaction significance threshold <0.10), these groups were stratified across each other’s tertiles. Results: Among the 1,223 included (mean [SD] age 61 [8] years, 25% Black race, 64% women), 34% developed incident hypertension. There was no difference in age, sex, race, or baseline systolic BP-adjusted RR of hypertension by tertile of the renal-inflammatory pattern ( Figure ). Relative to the lowest tertile combination, there was a higher RR of incident hypertension across higher dyslipidemic- and thrombo-inflammatory pattern tertiles (3 rd tertile of each: RR 1.67; 1.10 to 2.52). Discussion: Among Black and White adults, thrombo-inflammatory and dyslipidemic-inflammatory biomarker patterns were strongly associated with incident hypertension. Behavioral or medical therapies targeting specific biological pathways represented by these patterns may provide targets to prevent hypertension and its sequelae.

Abstract P2017: Baseline Androgenic State Modifies the Effect of Intensive Lifestyle Intervention on Triglyceride Levels in Males with Diabetes: The Look AHEAD Trial Sex Hormone Study

Background: In people with type 2 diabetes (T2D), weight loss due to an intensive lifestyle intervention (ILI) reduces triglyceride (TG) levels, a risk factor for cardiovascular disease. However, efficacy of treatment varies between people. Both testosterone and estradiol are associated with TG level. We examined whether baseline androgenic state, i.e., the ratio of testosterone to estradiol (T/E), modifies the treatment effect and partially explains the TG variability. Methods: The Look AHEAD Study was a randomized control trial of 5145 individuals with T2D and overweight/obesity to evaluate the effect of ILI compared to the control group on cardiovascular outcomes. We selected a random sample of 1166 postmenopausal females and 1166 males (mean age 60 years [SD 6.2]) to examine heterogeneity of treatment effect by baseline T/E ratio on changes in TG at years 1 (weight loss nadir) and 4. We created longitudinal mixed models stratified by sex, and modeled the interaction between log-transformed baseline T/E ratio, ILI (vs control), and year, with log-transformed TG as the outcome. We plotted the estimated treatment effects over time for 25 th and 75 th percentile of baseline T/E ratio. Results: Figure, panel A, shows that males with T/E ratio at the 75 th percentile (vs 25 th percentile) had a larger reduction in TG due to ILI (vs control) at year 1 (p = 0.002), which is no longer statistically significant at year 4 (p = 0.14, overall heterogeneity for both years, p = 0.009). We did not detect any statistically significant heterogeneity in TG levels by T/E ratio for females (panel B, p = 0.87). Conclusion: Greater baseline androgenic state (T/E ratio) in males, but not females, was associated with a larger reduction in TG due to ILI, compared to the control at year 1 but not year 4. Males with lower T/E ratio might need more aggressive lipid treatment to achieve TG-reducing benefits of ILI.

Correction for Ganley et al., Iron limitation triggers roseoceramide biosynthesis and membrane remodeling in marine roseobacter