Browse Articles

Abstract P3124: Risk Factors of Atrial Fibrillation, Heart Failure and Their Co-occurrence in Postmenopausal Women: A Womens’s Health Initiative Study

Introduction: Heart failure (HF) and atrial fibrillation/flutter (AF) often cooccur in older adults, the risk factors for which are understudied and was the objective herein. Method: This prospective cohort study included 31,171 post-menopausal women from the Women’s Health Initiative (WHI) with adjudicated HF merged with Medicare database for AF ascertainment during median follow-up of 17 years. Participants were categorized into 4 groups: no incident AF or HF (n=22,578), with incident AF (n=1,123), with incident HF (n=1,004), and with both incident AF-HF (n=6,466). Baseline exposures evaluated were age, race, obesity, alcohol consumption, smoking, education, income, companionship, physical activity, hypertension, hyperlipidemia, diabetes, and coronary artery disease (CAD). Exposures were compared using multinomial logistic regression model to assess odds ratios (OR) and 95% confidence intervals (CI) for each factor adjusting for the others. The jointly defined referent group was absence of the exposure and no HF or AF. Result: AF had an incidence proportion of 24.3%, HF 24%, and both AFHF was 20.7%, which is 3.55 times the expected co-incidence. Participants had a mean age of 63.2 (6.9) years at baseline. The odd of incident AF, incident HF and both incident AFHF was higher with older age [OR, 95% CI AF: 1.06 (1.06, 1.07); HF: 1.07 (1.07, 1.09); both AFHF: 1.12 (1.11, 1.13)], obesity [OR, 95% CI AF: 1.26 (1.18, 1.34); HF: 1.55 (1.34, 1.79); both AFHF: 1.72 (1.50, 1.97)], past/ current smoker [OR, 95% CI AF: 1.25 (1.12, 1.39); HF: 2.26 (1.81, 2.81); both AFHF: 1.77 (1.41, 2.24)], higher alcohol std drink/week [OR, 95% CI AF: 1.01 (1.01, 1.02); HF 1.01 (0.99, 1.02); both AFHF: 1.02 (1.01, 1.03)], CAD [OR, 95% CI AF: 1.23 (1.03, 1.47); HF: 2.25 (1.69, 2.99); both AFHF: 2.16 (1.63, 2.86)] and hypertension [OR, 95% CI AF: 1.19 (1.12, 1.27); HF: 1.44 (1.24, 1.67); both AFHF: 1.640 (1.42, 1.88)]. Diabetes was associated with incident HF [OR, 95% CI 2.53 (2.08, 3.08)] and both incident AF-HF [OR, 95% CI 2.03 (1.65, 2.50)] but not with AF alone. Conclusion: Incident AF, HF are common in older women with their co-incidence 3.55 times higher than expected suggesting a common underlying pathophysiology. Obesity, alcohol consumption, past/ current smoker, hypertension and CAD are major risk factors for AF, HF and their co-occurrence. These findings underscore the importance of targeted interventions to manage these modifiable risk factors to prevent both conditions.

Abstract P1170: Lifestyle interventions for prevention of cardiovascular disease among mothers of young children: a scoping review

Background: The prevalence of cardiovascular disease (CVD) risk factors is high and rising among younger women. Mothers of young children often exhibit poorer diets and lower physical activity levels than mothers of older children and women without children. CVD risk remains elevated well past the 1-year postpartum period for those with adverse pregnancy outcomes. Yet, little is known about interventions for CVD prevention among this group. Objective: To review and synthesize the available literature on lifestyle interventions for CVD prevention among mothers of young children (≤5 years) and highlight gaps to inform future research. Methods: We searched PubMed, Scopus, Web of Science, CINAHL, and EMBASE for peer-reviewed English-language articles published 2009-2023 on lifestyle interventions for CVD prevention in mothers with children 1-5 years. The rationale for this age range was because the care needs for this age group are distinct from those of infants but require a higher degree of hands-on caregiving compared to older children. The review was conducted following PRISMA-ScR guidelines, with articles screened by two independent reviewers, with a third reviewer available to resolve conflicts. Results: Of 1,405 studies, none exclusively recruited mothers with children 1-5 years. Six studies were eligible because reported mean child age was ≤5 years (Figure 1). Total sample size across studies was 1,614. Five were randomized controlled trials testing in-person (n=3) or digital (n=2) lifestyle interventions. Interventions included workshops with physical activity sessions (n=1), in-person physical/mental health education (n=3), video-based physical/mental health education with peer support groups (n=1), and a smartphone app (n=1). No interventions focused on sleep or tobacco use (Life’s Essential 8 components), or addressed social determinants, which are major drivers of health. Study follow-up ranged from 6-18 months. Outcome measures included self-reported diet, physical activity, perceived stress, and quality of life, and objective assessments of blood pressure, glucose, lipid levels, and weight. Five of 6 studies reported positive results at their primary time points. Conclusions: Effective strategies to improve CVD risk in mothers of young children have the potential to prevent CV events in later life. Our results highlight a significant gap in the literature on such interventions, underscoring the need for targeted research for this population.

Enantioselective synthesis of chiroplasmonic helicoidal nanoparticles by nanoconfinement in chiral dielectric shells

Abstract MP36: Food and Nutrition Insecurity Impacts Cardiovascular Risk Factors Among Latina Women

Introduction: Nutrition security is an emerging concept that expands upon the definition of food security – consistent access to sufficient quantity and quality of food – to include prevention, management, and treatment of disease. There is limited evidence on how nutrition security is related to heart health, specifically in populations disproportionately impacted by cardiovascular disease risk, such as Latina women. Hypothesis: Latina women experiencing food and/or nutrition insecurity will have poorer indicators of Life’s Essential 8 compared to those with food and/or nutrition security. Methods: Vida Sana y Completa is randomized controlled trial of a multi-component Food is Medicine (FIM) intervention for Latina women with obesity (BMI>30kg/m 2 ). This analysis uses survey data from baseline assessment (n=165). Food security status was assessed using the USDA 6-item screener and nutrition security status was assessed using the 4-item Nutrition Security Scale. Outcomes included vegetable and fruit intake, BMI, blood pressure (BP), and mental health. Within group differences by food and nutrition security status were performed using ANOVA with Fischer’s least significant difference and independent two-sample t-tests. Results: The majority (82%) reported food insecurity and approximately half (47%) reported nutrition insecurity. Women with very low or low food security consumed fewer vegetables compared to those with food security (1.7 vs. 2.1 vs. 3.0, respectively; p=0.02). Women with nutrition insecurity also consumed fewer servings of vegetables compared to participants with nutrition security (1.7 vs. 2.5; p=0.01). Systolic BP was higher among women with low food security, compared to participants with very low food security or participants with food security (p=0.01). Diastolic BP was higher for participants with low and very low food security compared to participants with food security (p=0.03). There was no difference in BP by nutrition security status. Participants with food and nutrition insecurity had more symptoms of depression and anxiety compared to participants with food and nutrition security(p<0.05). There were no differences in daily servings of fruit or BMI by food and/or nutrition security status. Conclusion: Latina women with food and/or nutrition insecurity are at increased risk for cardiovascular disease. FIM interventions may effectively address food and/or nutrition insecurity, as well as Life’s Essential 8, to improve heart health.

Abstract P3143: The Association of Psychosocial Factors with Diet Quality in a Puerto Rican Adults

Healthy dietary patterns are important for cardiometabolic health. Psychosocial factors are also associated with health outcomes, with studies suggesting that poor psychosocial health is associated with low diet quality. Few studies have examined these associations in adults living in Puerto Rico. This study examines the cross-sectional association of psychosocial factors (depression, loneliness, stress, and social support) with diet quality. This is a secondary analysis of a randomized pilot trial, the Puerto Rican Optimized Mediterranean-like Diet (PROMED), that examined the effect of a culturally appropriate Mediterranean-like diet on cardiometabolic health in a sample of adults with at least two cardiometabolic conditions living in Puerto Rico. Participants were randomized to an intervention or control group and completed 3 visits. Interviewer-administered questionnaires assessed perceived stress, depression, loneliness, and social support as well as a brief diet quality index. Responses were summarized into scores and examined as continuous variables. Diet quality score was log-transformed to aid interpretation of model coefficients. Mixed effects models were used to estimate the association of each psychosocial factor with diet quality. A backwards stepwise method was applied to assess the contribution of each psychosocial factor within a single model; likelihood ratio tests evaluated model fit. Multivariable models controlled for age, gender, education, marital status, and study group. Among 44 participants (94 observations, average 2 visits each), the mean age was 50.6 years (SD=9.5) and 80% were female (Table 1). Distribution of diet quality and psychosocial variables is shown in Figure 1. For every 1-unit increase in social support, diet quality increased by 0.35% (95% CI 0.02, 0.67), while every 1-unit increase in stress was associated with a 0.31% decrease in diet quality (95% CI -0.05, -0.56). Depression (-0.17%; 95% CI -0.35, 0.01) and loneliness (-1.34; 95% CI -2.78, 2.31) were also associated with decreases in diet quality, but these associations were not statistically significant (p>0.05). Backwards stepwise analysis identified stress as the main contributor to diet quality. Stress and social support are key factors affecting diet quality among adults living in Puerto Rico. Interventions aimed at improving diet and cardiometabolic health should consider how psychosocial factors impact dietary behaviors and overall health outcomes.

Abstract P1140: PREVENT 30-Year CVD Risk Associated With Greater Odds of Adverse Pregnancy Outcomes

Introduction: Poor pre-pregnancy cardiovascular health is associated with adverse pregnancy outcomes (APOs). We sought to investigate whether estimated 30-year CVD risk from the PREVENT equation similarly predicts APOs. Hypothesis: We hypothesized that higher 30-year CVD risk mid-pregnancy would be associated with greater risk of APOs, including preterm delivery and preeclampsia. Methods: Participants are from the Stress, Pregnancy, and Health (SPAH) study, conducted in Evanston, IL between 2018-2023. During the 2 nd trimester study visit, blood pressure was measured and participants provided a blood sample. Nuclear magnetic resonance was used to measure serum cholesterol and creatinine (used to estimate eGFR). Medication use, pre-gestational diabetes diagnosis, and APOs, including preterm delivery (<37 weeks gestation), early preterm delivery (<34 weeks) and preeclampsia, were abstracted from medical records. The PREVENT equation was used to estimate 30-year CVD risk based on 2 nd trimester measures. Logistic models were used to test associations between CVD risk in pregnancy and APOs, adjusted for race/ethnicity, as a marker of structural factors, socioeconomic position, based on household educational attainment and occupational prestige, and gestational age at the study visit. Results: SPAH included 605 participants, 524 of whom had complete data to estimate 30-year CVD risk from the 2 nd trimester study visit (mean gestational age at visit: 23.7 weeks, SD: 1.7). The mean age of participants was 33.3 years (SD: 5.5) and 18% identified as Black, 21% as Hispanic, 49% as White, and 12% as another group. The mean 30-year CVD risk during pregnancy was 7.6% (SD: 6.6), 11% delivered preterm, and 10% developed preeclampsia. In the adjusted model, a 1 SD increase in CVD risk was associated with 41% greater odds of preterm delivery (95% CI: 1.14, 1.74), 67% greater odds of early preterm delivery (95% CI: 1.27, 2.19), and 71% greater odds of developing preeclampsia (95% CI: 1.36, 2.14; Figure 1). Conclusions: Results suggest that a higher PREVENT 30-year estimated CVD risk in mid-pregnancy is associated with greater odds of delivering preterm and developing preeclampsia. These APOs are associated with long-term offspring CVD risk, also highlighting the intergenerational implications of PREVENT CVD risk estimates.

Galvanic leaching recycling of spent lithium-ion batteries via low entropy-increasing strategy

Abstract P1032: De novo lipogenesis is related to multiple cardiometabolic diseases in post-myocardial infarction patients of the Alpha Omega Cohort

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 <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 <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 P3177: Longitudinal Recovery after Intracerebral Hemorrhage: Insights from BASIC Study

Background: Intracerebral hemorrhage (ICH) is a severe stroke type with high mortality, significantly affecting survivors' quality of life (QOL) through functional, cognitive, and psychosocial impairments. Objective: To investigate longitudinal trajectories of functional, neurological, cognitive, and QOL outcomes following ICH, utilizing data from the Brain Attack Surveillance in Corpus Christi (BASIC) project (2014-2019). Methods: Baseline demographic and clinical characteristics were collected. Neurological, functional, cognitive, and QOL outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living (ADL/IADL), Modified Mini-Mental State Exam (3-MSE), and Stroke-Specific QOL (SS-QOL) scale at 3-, 6-, and 12-months post-stroke. Linear regression models with generalized estimating equations assessed changes over time, adjusting for covariates including age, sex, race/ethnicity, education, pre-stroke status, and comorbidities. Inverse probability weighting and multiple imputation were applied. Results: Analysis included 328 first-ever ICH patients, with 117 completing at least one follow-up. Baseline demographics: 63.1% Mexican American, 55.5% male, mean age 68.9 years. One-year mortality was 43.3%. Among the 117, functional outcomes improved significantly: from 2.48 (SD=1.00) at 3 months to 2.14 (SD=0.93) at 12 months (adjusted difference: -0.33; 95% CI: -0.49 to -0.18; p<0.001). NIHSS scores reduced from 3.45 (SD=4.38) to 2.6 (SD=5.14) (adjusted change: -20%; 95% CI: -30% to -9%; p<0.001). Cognitive scores increased from 79.2 (SD=15.2) to 82.3 (SD=13.0) (adjusted difference: 5.13; 95% CI: 1.56 to 8.71; p=0.005). QOL improved from 3.16 (SD=1.09) to 3.45 (SD=1.01) (adjusted difference: 0.30; 95% CI: 0.16 to 0.44; p<0.001). Conclusion: Despite a high mortality rate of ICH, survivors demonstrated significant improvements in all outcomes over the first year. For most outcomes, the most notable gains occurred in the initial 3 to 6 months, though functional outcomes and quality of life showed continued improvement from 6 to 12 months. These findings emphasize the potential for recovery and the importance of early and intensive rehabilitation efforts to optimize long-term outcomes for ICH patients.

Abstract P3115: Summary Measure of Social Determinants of Health/Health Equity and Obesity among Mississippi Adults

Background: In 2022, about 752,180 Mississippi adults were classified as obese. Social determinants of health (SDOH) contribute to obesity and associated disparities. We examined the association between a summary measure of SDOH and obesity among Mississippi adults. Methods: Using the SDOH and Health Equity (SDOH/HE) Module data from 3,994 respondents in the 2022 Mississippi Behavioral Risk Factor Surveillance System survey, we conducted multivariable logistic regression models to examine the association between a SDOH/HE summary measure and obesity. Results: Mississippians experiencing two (AOR, 1.68, 95% CI 1.19-2.36) of SDOH/HE risk factors had higher odds of being obese compared to those experiencing no SDOH/HE risk factors. Conclusions: Mississippi adults with two SDOH/HE risk factors had significantly higher odds of obesity than those with no SDOH/HE risk factors. Findings highlight the importance of addressing multiple SDOH/HE factors in obesity prevalence among Mississippi adults experiencing two SDOH/HE risk factors.

Improved radicchio seedling growth under CsPbI3 perovskite rooftop in a laboratory-scale greenhouse for Agrivoltaics application

Abstract P2145: Low Physical Activity is Associated with Hypertensive Disorders of Pregnancy in Californian Women with Overweight or Obesity

Introduction: Hypertensive disorders of pregnancy (HDPs) are rising in the United States, leading to increased maternal mortality, future pregnancy complications, and cardiovascular disease (CVD) risk factors like hypertension and diabetes. Studies suggest that HDPs have different etiologies than non-pregnancy hypertensive disorders, and it is unclear whether behavioral and lifestyle risk factors for CVD in general are similar for HDPs. Hypothesis: We hypothesized that women with lower levels of physical activity early in pregnancy would have a higher risk for HDPs. Methods: We analyzed data from pregnant women in California with overweight or obesity enrolled in the Goals for Reaching Optimal Wellness (GROWell) trial. A logistic regression model was used to assess the association between physical activity in early pregnancy (10-16 weeks) and later HDPs (gestational or chronic hypertension, or preeclampsia) while controlling for diet, depression, anxiety, sleep, and factors such as age, parity, BMI, maternal education, and race. Physical activity was measured in metabolic equivalents using the pregnancy physical activity (PPAQ) survey. Results: Among 453 participants, 38 (~8.4%) experienced HDPs. Average age for participants was 33.6 ± 4.1 years, 59% identified as a member of a historically minoritized group. Lower physical activity levels were associated with an increased risk of developing HDPs later in pregnancy (OR = 0.98, p = 0.003), after controlling for diet quality, sleep, mood, and demographics. The association between lower PPAQ scores and HDPs was significant for light-intensity (OR = 0.98, p = 0.04), moderate-intensity (OR = 0.97, p = 0.008), and household/caregiving activities (OR = 0.98, p = 0.006). Conclusion: Low physical activity levels in early pregnancy may contribute to the risk of developing HDPs. Importantly, general activity and light to moderate intensity physical activity demonstrated benefit, suggesting that even small increases in activity may be protective. Future research with larger samples should explore the role of different kinds of activity in the prevention of HDPs, especially for women with overweight or obesity, where physical inactivity may compound the risk for adverse pregnancy outcomes.

Abstract P2059: Clinical Engagement Trajectories and Patient Factors Associated with Optimal Blood Pressure Management Patterns among Patients with Incident Diagnosis of Hypertension

Introduction: The established paradigm of “awareness (i.e. diagnosis), treatment and control” as a central strategy to achieve blood pressure control is well accepted as the optimal approach to hypertension (HTN) management, but few studies have explored real-world patterns of healthcare engagement, treatment and blood pressure control within the first two years of diagnosis of HTN, and how they may differ for different sociodemographic patient groups. Methods: We analyzed electronic health records from a large integrated healthcare system in Northern California to characterize trajectories of clinical engagement, blood pressure treatment and control after incident HTN diagnosis. The cohort included 40,469 primary care patients between 2012-2019, with incident HTN. Each month for 24 months after diagnosis, patients were assigned to one of 8 mutually exclusive states for HTN treatment with medications (Y/N), blood pressure control (Y/N), and visit status (up to date Y/N). We applied sequence and cluster analysis to identify common types of BP management trajectories. Using multinomial logistic regression, we estimated associations between patients’ race and ethnicity and these trajectories. We hypothesized that more optimal engagement trajectories are less common among non-Hispanic Black (NHB) individuals, given well documented disparities in BP control among this patient subgroup. Results: We observed 20,564 distinct care management trajectories among individuals that were classified into four clusters representing “Control without medications” (36.4%), “Control with medications” (16.7%), “Medications without control” (10.7%), and “Minimal engagement” (36.2%). The first two of these were classified as optimal care management (OCM), representing 52.6% of individuals. By 24 months only 50% of patients were up to date with their visits, and more than one-third of patients (36.2%) exhibited virtually no follow-up visit after the initial index visit. Comparing OCM with medication to the minimal engagement, those who self-identify as NHB had significantly lower odds (OR [95%CI] 0.75 [0.6, 0.9]) of belonging to the OCM cluster compared to non-Hispanic white (NHW) counterparts. Conclusion: Patients who self-identify as NHB experienced lower odds of OCM compared to NHW. Future studies are needed to identify predictors of clinical engagement trajectories resulting in lack of clinical engagement post-diagnosis, and interventions to encourage better engagement.

Abstract P3113: Impact of MRI Body Fat Imaging Report on Obesity-Related Cardiometabolic Risk: Findings From The BODY-REAL Study

Introduction: Excess visceral adipose tissue (VAT) is more discriminatory of obesity-related cardiometabolic risk than body mass index (BMI) but is not routinely assessed by clinicians. It is not known whether providing patients with direct visualization of VAT could improve cardiometabolic health. Hypothesis: We tested dual hypotheses that presenting patients with body fat imaging results will be superior to BMI alone, and that giving reports directly to patients will be superior to giving reports to their providers when comparing changes in risk perception, lifestyle and cardiometabolic outcomes. Methods: The BODY-REAL study is a single-site, 2x2 factorial design pilot trial, randomizing adults with BMI≥25, A1C≥5.7% and additional cardiovascular risk factors to 1) receive a visual report of body fat distribution based on MRI analysis or BMI alone and 2) have the report received by the patient or their provider. At 2 weeks, 3 months and 6 months from baseline, we used validated survey instruments to assess physical activity, medication adherence, risk perception of diabetes and heart disease, and measured changes in BMI, blood pressure, lipid profile, A1C and fasting glucose. We created analysis of covariance models and linear models with both fixed and random (time-updated) effects. Results: 29 patients (31% female) were assigned to 4 study arms, with average baseline BMI of 33.6 kg/m 2 . Changes in HDL and preventive behaviors varied by report recipient, and lifestyle changes by report type. Among patient-received reports, those with MRI data (vs BMI data) showed a mild but significant increase in HDL over time (p=0.047). Preventive behavior scores increased over time among those with provider-received reports (p=0.009), regardless of report type. Lifestyle scores decreased among those with BMI data vs MRI data (p=0.004), regardless of report recipient. There were no significant changes over time in BMI, blood pressure, LDL, total cholesterol, A1C or risk perception associated with body fat imaging vs BMI data, or with patient- vs provider-received reports. Conclusions: This pilot study demonstrated potential for direct-to-patient visualization of VAT to improve HDL and preventive behaviors, however was likely underpowered to detect significant change in cardiometabolic risk indicators, thus warranting further investigation.

Cross-cultural validation of acculturation measures: Expanding the East Asian acculturation framework for global applicability

In a globalised world, understanding acculturation, the process by which individuals adapt to new cultural environments, is crucial, especially in multicultural societies experiencing increased migration. The East Asian Acculturation Measure (EAAM), based on Berry’s acculturation model, has been a cornerstone for assessing acculturation strategies among East Asian populations in the United States; however, its cultural specificity limits utility in broader contexts. This study addresses this gap by adapting and validating the EAAM for diverse populations, producing the Shortened Adapted Acculturation Scale (SAAS). Across two phases involving 490 university students from 87 nationalities in Germany and 329 university students from 25 nationalities in South Africa, both Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) identified a five-factor structure: Social Disconnection, cultural adaptation, Social Perception, Interpersonal Comfort, and Language Integration. The SAAS showed high internal consistency and measurement invariance across genders. These results highlight the importance of culturally adapting psychological measures to ensure their relevance and reliability in global contexts. The SAAS offers practical benefits for clinicians, educators, and policymakers who serve multicultural populations. By illuminating specific dimensions of acculturation, the scale can help identify areas where targeted interventions such as mental health counselling, cultural orientation programs, or inclusive campus policies may foster better social integration and well-being. Although the present study focused on structural validity, future research should examine the SAAS’s predictive utility for mental health and social integration outcomes. These findings contribute to cross-cultural psychology and underline the need to refine and validate tools for assessing acculturation in an increasingly interconnected world.

The structural basis for the human procollagen lysine hydroxylation and dual-glycosylation

Abstract P3052: Ttitle: Multi-Omic Responses to Low-Calorie Diet Intervention for Remission of Type 2 Diabetes and Individual Variability Short title: Multi-Omics, Low-Calorie Diet, and Diabetes Remission

Introduction: Remission of type 2 diabetes (T2D) can be achieved by a low-calorie diet (LCD) intervention, but molecular mechanisms remain poorly understood. Furthermore, whether responders for T2D remission and non-responders to an LCD intervention have distinct molecular responses and genetic determinants is yet clear. Methods: A 6-month LCD intervention (815-835 kcal/d) was conducted among Chinese patients with T2D who had BMI of 24-45 kg/m 2 and HbA1c level of 6.5-12.0%. Clinical biomarkers, genome, serum proteome, metabolome (serum and feces), and gut microbiome were measured at baseline and weeks 1, 12, and 24. Linear mixed models were used to identify significant changes in multi-omic markers during the 24-week intervention. A noise-augmented von Mises-Fisher mixture model was used to cluster the trajectories of significant omic markers. Different multi-omic responses between responders for T2D remission and non-responders were identified using linear mixed models, adjusting for age, sex, T2D duration, visit time, and baseline BMI as fixed effects and participant ID as random effect. Genome-wide association analysis (GWAS) was used to find single nucleotide polymorphisms (SNPs) associated with T2D remission. We used the Benjamini-Hochberg procedure to control the false discovery rate < 5% for all analyses. Results: Thirty-two participants were analyzed (mean age: 39.8 years, BMI: 29.8 kg/m 2 , HbA1c: 8.0%; 34% women). Significant changes in omic markers post intervention were observed in 46 proteins, 106 serum metabolites, 222 fecal metabolites, and 153 gut bacteria, clustering into 6-8 distinct trajectories per omics. Pathway enrichment analysis mapped these signatures to cholesterol metabolism, glycolysis, and TCA cycle pathways. Between responders and non-responders, 261 proteins, 197 serum metabolites, 212 fecal metabolites, and 171 gut bacteria differed; among these markers, 11 proteins, 27 serum metabolites, 37 fecal metabolites, and 23 gut bacteria also changed significantly post the LCD intervention. However, no SNP was associated with T2D remission. Significant associations of multi-omic markers with muscle mass, liver fat, glycemic control, insulin resistance, and insulin secretion were found. Conclusions: Dramatical changes in multi-omic markers, enriched in glucose, lipid, and energy metabolism pathways, were observed following an LCD intervention. Multi-omic differences between responders and non-responders for T2D remission were delineated.

Abstract MP08: The Association of Urinary Sodium with Incident Apparent Treatment Resistant Hypertension among African Americans: Findings from The Jackson Heart Study

Background: Hypertension is a leading cause of cardiovascular disease and disproportionately affects African American (AA) adults, contributing significantly to morbidity and mortality in this population. Apparent Treatment Resistant hypertension (aTRH), where blood pressure (BP) remains uncontrolled despite the use of multiple antihypertensive medications, is particularly prevalent among AA adults. Sodium intake is associated with BP levels, yet the relationship between urinary sodium (a measure of dietary sodium intake) and aTRH in AA adults remains unclear. This study examined the association between 24-hour urinary sodium excretion and incident aTRH among AA adults with hypertension, using data from the Jackson Heart Study (JHS). Methods: The JHS included 5,306 self-identified AA adults from Jackson, Mississippi, with data collected at three visits (2000-2013). For this analysis, we focused on 452 participants with hypertension at baseline with non-missing urinary excretion and medication data. Urinary sodium excretion was categorized into quartiles, and aTRH was defined as uncontrolled BP while taking ≥3 classes of antihypertensive medication. We used a semi-parametric proportional hazards regression model to determine the association between 24-hour urinary sodium excretion and incident aTRH, adjusting for potential confounders. RESULTs: Participants were 63 years old on average and 27.7% men. Higher sodium excretion was associated with younger age, higher income, alcohol consumption, and greater antihypertensive medication use, whereas those with history of stroke or chronic kidney disease had lower sodium excretion. Over a median follow-up of 7.5 years, 123 participants (27.2%) developed aTRH. Participants in quartiles 3 and 4 of urinary sodium excretion showed higher incidence rates of aTRH, though fully adjusted hazard ratios were not statistically significant [HRs (95% confidence intervals [CIs]): [Q2=0.71 (0.34, 1.46), Q3=1.02 (0.50, 2.06), Q4=0.95 (0.46, 2.00); P=0.166). Conclusions: There was no statistically significant association between urinary sodium and incident aTRH among AA adults with hypertension. However, the findings highlight the need for targeted public health interventions to reduce sodium consumption in this population. Larger, longitudinal studies are needed to confirm these findings and explore the complex associations between sodium intake and hypertension management.

Abstract P2090: Comparison of Medicare Claims Recorded and Surveillance Identified Myocardial Infarction in the Strong Heart Study

Introduction: The Strong Heart Study (SHS) is a cohort study of cardiovascular disease (CVD) in American Indians. Center for Medicare and Medicaid Service (CMS) data may improve CVD outcome capture. Hypothesis: Participants with myocardial infarction (MI) events captured in CMS will align with those identified in SHS morbidity and mortality (M&M) surveillance. Methods: CMS data were available from 2010-2021 for 2,144 SHS participants. A CMS-identified MI event was defined as meeting the Chronic Conditions Data Warehouse (CCW) claims criteria (at least one inpatient claim with an MI ICD-9 or ICD-10 diagnosis code in first or second position) during this timeframe. SHS MI and coronary heart disease (CHD) events were identified by medical chart review, adjudicated by physicians, and classified as definite, possible, or probable (MI only). We defined SHS-identified MI as having a fatal or non-fatal definite MI event during 2010-2021. A summary table compared participants with SHS-identified and CMS-identified MI. Cohen’s kappa coefficient, sensitivity, specificity, and positive predictive value (calculated using SHS as the gold standard) assessed diagnosis agreement. Results: We identified 206 participants with SHS-identified MI and 198 participants with CMS-identified MI. There was moderate agreement between SHS-identified and CMS-identified MI (kappa=0.601, 95% CI: 0.542, 0.660). About 63% of those with SHS-identified MI had a CMS-identified MI and 65% of those with CMS-identified MI had an SHS-identified MI. Among the 69 participants with only an SHS-identified MI, 40.3% had an outpatient MI code or an inpatient MI code in the third position or lower in CMS data. SHS M&M detected possible MI, probable MI, or any type of CHD event, excluding definite MI, in 39.1% of the 77 participants with only a CMS-identified MI. Conclusions: Moderate agreement was observed between SHS definite MI and CMS MI events. CMS data may complement the identification of MI events in M&M surveillance of prospective cohort studies such as the SHS.

Development of new bilingual oral health behavior social support (OHBSS) scales in English and Spanish

This paper describes the simultaneous co-development of Oral Health Behavior Social Support (OHBSS) scales in English and Spanish. OHBSS scales assess social support for toothbrushing, flossing, and dental care utilization, which are targets for interpersonal-level interventions to promote oral health among Hispanic/Latino adults. The focus was on Mexican-origin adults, who comprise the largest United States Hispanic/Latino subgroup and experience a high oral disease burden. All participants self-identified as Mexican-origin adults (ages 21–40 years old), living along the California-Arizona-Mexico border. Independent samples were recruited for each study partnering with Federally Qualified Health Centers. First, we conducted semi-structured interviews about social support for oral health behaviors in August to November 2018 (Study 1, N = 72). Interviews were audio recorded, transcribed (in original language, Spanish or English), and qualitative data were coded and analyzed in Dedoose following three topical codebooks; excerpts were used to co-create the large bilingual item data bank (OHBSSv1). The item bank was pre-tested via 39 cognitive interviews between December 2019 to March 2020, reviewed by an expert panel with several bilingual members, reduced to 107 Spanish/109 English items (OHBSSv2), then pilot tested in January to December 2021 (Study 2, N = 309). Pilot survey data were analyzed through Exploratory Factor Analysis and Horn’s parallel analysis, overall and by language, to examine response patterns and inform item selection (OHBSSv3). The scales queried social support for toothbrushing, flossing, and dental care utilization across 39 items from three sources (family, health providers, others/friends), plus up to nine optional dental care-related items (Study 3, conducted April 2022 to February 2023, N = 502). Confirmatory Factor Analysis (CFA) assessed model fit, overall and by language (multiple group CFA). Final OHBSS scales include 37 items, plus seven optional items. Acceptable model fit for three-factor structures for each oral health behavior was found, providing evidence of the scales’ construct validity. Cronbach’s alphas and McDonald’s omegas were tabulated; all were above 0.95, overall and by language, supporting scales’ internal consistency.