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Abstract P3093: Impact of Health Technology on Cardiopulmonary Resuscitation Trainings, Globally: A Narrative Review
Introduction: Sudden cardiac death is a major global health concern, responsible for 15-20% of all deaths in developed countries. Timely cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use significantly improves survival rates. Advances in health technology have expanded CPR/AED training options to meet global demand, offering in-person, online, and hybrid formats. Methods: We conducted a global review of available CPR/AED training programs. Data were gathered from official health organizations, resuscitation councils, and nonprofits to map current training trends and regional adaptations, focusing on accessibility and scalability. Countries offering online training were analyzed for content, delivery methods, and skills assessments. Additionally, we identified collaborations with the American Heart Association (AHA) for standardized course delivery across different regions. Results: Our review identified 36 organizations offering CPR/AED training. The British Heart Foundation was the only one providing a standalone video-based skills assessment focused solely on recognizing CPR rates. AHA offered the most comprehensive online skills assessment, utilizing video conferencing, feedback devices, and a web application. The European Resuscitation Council introduced an innovative augmented reality game for CPR training. Five organizations provided only in-person skills training, supported by online knowledge assessments. Conclusion: Online and hybrid CPR/AED training modalities have increased accessibility, especially in developed countries. Expanding digital access to CPR/AED training and skills assessments globally could further enhance emergency response outcomes and improve survival rates worldwide.
Abstract MP74: Physical Activity Patterns and Cardiovascular-Kidney-Metabolic (CKM) Syndrome: An All of US Research Program Study
Background: Increased physical activity (PA) benefits cardiovascular, kidney, and metabolic health individually. However, its impact on cardiovascular-kidney-metabolic (CKM) syndrome, which integrates these interconnected disorders, is unknown. This study evaluated the association between PA and CKM syndrome among adults ≤70 years old from a population-based cohort. Methods: Using data from the National Institutes of Health All of Us Research Program, we defined the outcome, CKM syndrome stages, as follows: stage 0 (no risk factors), stage 1 (excess/dysfunctional adiposity or prediabetes), stages 2-3 (metabolic risk factors, moderated-to-high risk kidney disease, or subclinical cardiovascular disease [CVD]), and stage 4 (clinical CVD). PA was quantified using Fitbit data or self-reported surveys as sedentary mins/week, moderate-to-vigorous PA (MVPA) metabolic equivalent task (MET)-mins/week, and total PA MET-mins/week. Multinomial logistic regression models assessed the association between PA measures in quintiles and CKM syndrome stages, adjusting for demographics, socioeconomic status (individual and neighborhood levels), lifestyle factors and healthcare access. Results: Among 17,118 adults (mean age 50±13 years, 70% female, 81% White), 48% had CKM syndrome (24% stage 1, 20% stages 2 and 3, 3.9% stage 4). Mean (SD) sedentary mins/week, MVPA MET-mins/week, and total PA MET-mins/week were 4,046 (2,048), 1,670 (1,729), and 3,111 (1,965), respectively. Compared to the lowest quintile, adults in the highest quintile of sedentary time (>5729 vs ≤1704 mins/week) had a significantly higher odds of CKM syndrome across all stages ( Figure ), with the strongest association for stage 4 (OR 3.09, 95% CI 2.36-4.05). For MVPA, adults in the highest quintile (>2861 vs ≤480 MET-mins/week) had a significantly lower odds of CKM syndrome, most pronounced for stage 4 (OR 0.26, 95% CI 0.20-0.34). Similarly for total PA, the highest quintile (>4483 vs ≤1686 MET-mins/week) was associated with lower odds of CKM syndrome, particularly for stage 4 (OR 0.40, 95% CI 0.31-0.53). Dose-response relationships were observed across all measures and CKM stages. Conclusion: Exceeding the recommended 500-1000 MET-mins/week of MVPA is associated with a significant CKM Syndrome risk reduction across all stages.
Abstract P1018: Incidence of Diagnosed Atrial Fibrillation in Community-Based Asian American, Native Hawaiian and other Pacific Islander Subpopulations: Findings from the PANACHE Study
Introduction: Atrial fibrillation (AF) is a potent risk factor for stroke, cardiovascular disease (CVD), and death. Data suggest variation in AF across racial and ethnic groups, but little is known among Asian American, Native Hawaiian, and other Pacific Islanders (AANHPI). We evaluated the incidence of AF in disaggregated AANHPI subgroups vs. non-Hispanic Whites (NHW) in California and Hawaii. Methods: We identified adults between 2012-2022 aged ≥30 years in Kaiser Permanente Northern California and Hawaii integrated healthcare delivery systems with no prior CVD. AANHPI subgroups included Filipino (N=193,327), Chinese (N=182,776), South Asian (N=92,738), Native Hawaiian/other Pacific Islander (NH/PI, N=64,488), Vietnamese (N=50,141), Japanese (N=45,502), other Southeast Asian (N=26,602), and Korean (N=21,989), with 1,975,444 NHW. Incident AF was defined as a hospitalization, emergency department visit, or ≥2 outpatient visits with a diagnosis code for AF through December 2023. We calculated age- and sex-adjusted rates of AF by race and ethnicity, and then used Cox regression to assess the association of AANHPI subgroup with incident AF after adjustment for age, sex, and clinical CVD risk factors. Results: Among 2,653,007 eligible adults, mean±SD age was 49±15 years and 53% were women. Age- and sex-adjusted incidence (per 1000 person-years) of AF was 6.64 in NHW, and significantly varied in AANHPI subgroups: NH/PI (8.13), Filipino (5.32), other Southeast Asian (4.40), South Asian (3.79), Japanese (3.70), Korean (3.54), Chinese (3.45), and Vietnamese (3.28). Compared to NHW, in the fully-adjusted model, the adjusted hazard ratio (aHR, 95%CI) for AF was modestly higher for NH/PI (aHR 1.07, 1.02-1.13) but variably lower for Filipino (aHR 0.71, 0.69-0.73), other Southeast Asian (aHR 0.64, 0.57-0.71), Vietnamese (aHR 0.54, 0.50-0.59), Korean (aHR 0.54, 0.49-0.60), Chinese (aHR 0.53, 0.52-0.55), South Asian (aHR 0.51, 0.48-0.55) and Japanese (aHR 0.50, 0.48-0.53) ( Figure ). Conclusions: Notable variation exists in incident AF across disaggregated AANHPI subgroups living in California and Hawaii, with a higher adjusted rate in NH/PI and variably lower rates for other subgroups compared with NHW that was not explained by demographic and clinical CVD risk factors. Differentiating potential pathophysiological mechanisms vs. variable ascertainment of AF across AANHPI subgroups will help improve personalized care strategies for prevention and treatment of AF.
Lung cancer associated autoantibody responses are detectable years before clinical presentation
The EarlyCDT-Lung® test detects elevated levels of tumour-associated autoantibodies generated in response to immune recognition of cancerous cells, and these autoantibodies have previously been shown to precede clinical presentation of lung cancer. Using a longitudinal cohort from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) study, we have established that elevated autoantibodies can be detected an average of four years in advance of clinical presentation, and in some cases up to 8 years prior to clinical presentation. This is the first study to establish pre-diagnostic elevation of autoantibodies using samples from a longitudinal prospective clinical trial using a clinically validated and commercially available biomarker panel.
Abstract P3099: Greater Adherence to the 2020-2025 Dietary Guidelines for Americans on Consumption of Dark Green Vegetables and Legumes is Associated with Lower Carotid Femoral Pulse Wave Velocity in a Cohort of Community-Dwelling Older Adults without Dementia
Introduction: Carotid-femoral pulse wave velocity (cfPWV) is the gold standard measure of arterial stiffness and is a well-established predictor of cardiovascular mortality and morbidity. Adherence to Dietary Guidelines for Americans, assessed by the Healthy Eating Index (HEI), has been associated with reduced cardiovascular mortality and morbidity and favorable blood pressure effects, potentially reducing arterial stiffness. Hypothesis: We hypothesize that greater adherence to the 2020-2025 Dietary Guidelines for Americans and its components is associated with lower cfPWV in a cohort of community-dwelling older adults aged 65-85 without dementia. Methods: We used the baseline data from the Arterial stiffness, Cognition, and Equol (ACE) trial, a multicenter RCT designed to test the effect of a 24-month intervention of equol supplementation on brain health among 400 self-reported White and Black/African Americans from Pittsburgh, PA, Winston-Salem, NC, and Atlanta, GA. Total cfPWV was measured supine after a 10-minute rest using the SphygmoCor XCEL system. Systolic blood pressure was assessed at the same visit without hypertension medication. Self-reported dietary intake from one weekday and one weekend interviewer-administered 24-hour dietary recalls was analyzed using the Nutrition Data System for Research software version 2022. The overall HEI-2020 and 13 component scores were determined. Multiple linear regression models were used to assess the associations of the HEI-2020 or individual components with cfPWV adjusting for demographic and cardiometabolic risk factors. Results: Our analytical cohort included 196 participants recruited at the Pittsburgh site. The cohort was 48.5% female and 8.7% Black/African American, with an average age of 71.9 years (SD: 4.6). Participants had a mean HEI-2020 score of 58.4 (SD: 13.8) and a mean cfPWV of 8.90 m/s (SD: 1.54). The participants were mostly in good health. Total HEI was not associated with cfPWV (p=0.78). On average, consuming adequate dark green vegetables and legumes (≥0.2 cup equiv. per 1,000 kcal) was associated with 0.6 m/s lower cfPWV than eating no dark green vegetables or legumes (p=0.03). Greater consumption of protein-dense food groups was positively associated with cfPWV (p=0.04); yet, total protein intake was not. Conclusion: Greater adherence to the 2020-2025 Dietary Guidelines for Americans on consumption of dark green vegetables and legumes is associated with lower cfPWV.
Abstract P2070: Cardiovascular Health among Adults of African Heritage in the Groceries for Black Residents of Boston to Stop Hypertension (GoFresh) Program
Background: The American Heart Association’s Life’s Essential 8 (LE8) metrics offer a comprehensive assessment of cardiovascular well-being. However, it is unknown how these metrics differ among Black adults of African heritage recruited for a lifestyle intervention to improve cardiovascular health. Objective: To explore differences in LE8 metrics across different African heritage groups in the GoFresh Trial. Methods: We used screening data from the GoFresh Trial, two randomized controlled trials investigating the effects of the Dietary Approaches to Stop Hypertension (DASH) eating pattern on blood pressure after 12 weeks in adults living in Boston with and without treated hypertension. We examined cardiovascular health across African Heritage groups as assessed by the LE8 metrics. The LE8 metrics include the following components: diet quality, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure. The main predictor was African heritage group (African, Caribbean, and African American). We used linear regression to examine differences in cardiovascular health by African Heritage Group, adjusting for age, sex. Results: We examined data from 427 Black persons, 67% were female and the mean age (±SD) was 52 (±4) years. We observed variations in cardiovascular health metrics across African heritage groups. Persons identifying as African American generally showed lower scores for the LE8 metrics. Blood pressure and BMI scores were significantly lower for persons identifying as African American compared to those of African and Caribbean heritage. Caribbean participants exhibited the best sleep scores ( Table ). Conclusion: Significant differences in Life’s Essential 8 metrics were observed among Black adults of various African heritage backgrounds in the GoFresh Trial. The observed differences between the African heritage groups, underscore the importance of tailored interventions. These findings can guide the development of more effective, culturally sensitive strategies to improve cardiovascular health in these diverse populations, taking into account heritage.
Abstract P1038: Blood Metabolomic Signatures of Incident Coronary Heart Disease in Racially and Ethnically Diverse Populations
Background: Metabolic perturbation has been characterized in coronary heart disease (CHD), yet the comprehensive metabolic fingerprint of incident CHD and potential racial/ethnical differences remain unclear. Hypothesis: Circulating metabolite alterations are associated with CHD risk, but associations vary across race/ethnicity. Methods: We included 22,566 CHD-free individuals of multi-ethnic groups from 7 studies in the Trans-Omics for Precision Medicine Program ( Fig.a ). Associations between metabolites (1245 named metabolites) and incident CHD were assessed by study/race-specific Cox proportional hazards regression. Results were pooled via random-effect meta-analyses. Results: Over an average of 7.5~17.0 yrs of follow-up 1124 incident CHD cases were recorded. We found that 280 metabolites were associated with incident CHD after adjusting for sociodemographic, behavioral factors, medications use, physical activity, and diet (FDR < 0.05), with over 64% were independent of other major cardiometabolic traits ( Fig.b ). Over 90% of these metabolites showed positive associations, with strongest associations in metabolites of glycerolipids, phosphatidylethanolamine, fatty acids, lactoyl amino acid, histidine, aromatic amino acids, and branched amino acids ( Fig.b ). Race-specific analyses identified 70 metabolites presenting significant race/ethnicity differences (FDR<0.05) in associations with CHD, with 34 being race/ethnicity specific metabolites that were not found in all participants (16 in Blacks, 11 in Whites and 7 in Hispanics; Fig.c-e ). For example, guanidinosuccinate, a known uremic toxin, was associated with increased risk of CHD only in US Hispanics, reinforcing the chronic kidney disease (CKD)-cardiovascular diseases continuum, especially for populations at high risk of CKD. Conclusion: Our study characterized the most comprehensive metabolic signatures of incident CHD and revealed substantial racial differences, further emphasizing the need of multi-ethnic resources to uncover metabolic perturbation underlying CHD.
Intraindividual variability differentiated older adults with physical frailty and the role of education in the maintenance of cognitive intraindividual variability
Objectives Physical frailty is associated with increased risk of cognitive impairment. However, its impact on sustained cognitive processing as evaluated by intraindividual variability (IIV), and factors beneficial to IIV in physically frail older adults remain unexplored. This study aimed to quantify differences in IIV between older adults with and without physical frailty, and examine whether education facilitated maintenance of IIV. Methods This cross-sectional study included 121 community-dwelling older adults 65-90 years with/without physical frailty (PF and non-PF; n = 41 and n = 80 respectively). Physical frailty was determined via Short Physical Performance Battery. Dispersion across the seven components of the Montreal Cognitive Assessment (MoCA) was computed to ascertain IIV. Multivariate analysis of covariance was used to determine group differences in total score and IIV. Four moderation models were constructed to test the effects of education on age-total score and age-IIV relationships in PF and non-PF. Results Compared with non-PF, PF showed greater IIV ( p = .022; partial η² = 0.044). Among PF, education moderated age-total score (R-sq = 0.084, F = 5.840, p < 0.021) and age-IIV (R-sq = 0.101, F = 7.454, p = 0.010) relationships. IIV increased with age for those with five years (β = 0.313, p = 0.006) or no formal education (β = 0.610, p = 0.001). Greater than seven years of education (β = 0.217, p = 0.050) may be required to maintain IIV at older age. Conclusion IIV may be a sensitive method to differentiate physically frail older adults. Additionally, perceived cognitive benefits of education may be dependent on physical functioning.
Abstract P3164: Impact of Neighborhood Disadvantage on Neuroimaging and Plasma Biomarkers associated with Alzheimer’s Disease and Related Dementias
Introduction: Stark disparities exist in the prevalence of Alzheimer’s disease (AD) and related dementias (ADRD) by social determinants of health (SDoH). Limited research is available on associations of SDoH with AD/ADRD biomarkers. This study aims to assess the impact of SDoH measures on ADRD-associated neuroimaging and plasma biomarkers. Hypothesis: SDoH measures of area deprivation index (ADI), social vulnerability index (SVI), and environmental justice index (EJI) will be positively associated with poorer ADRD-associated neuroimaging and plasma biomarkers, and cardiometabolic health will partially account for this association. Methods: This study includes participant data from the Wake Forest Alzheimer’s Disease Research Center from baseline visits. Independent SDoH variables include ADI, SVI, and EJI. Dependent variables include cortical thickness and white matter hyperintensity (WMH) volume, adjusted for intracranial volume, from MRI, and plasma glial fibrillary acidic protein (GFAP) and pTau-181. We conducted bivariate and hierarchical multivariable linear regressions, with demographics (age, sex, education,&cognitive diagnosis) [Model 1], additional adjustment for cardiometabolic health with cardiometabolic index (CMI) [Model 2], and estimated glomerular filtration rate (eGFR) [Model 3; for plasma biomarkers] as covariates. Results: In bivariate analyses, a significant negative association was observed between ADI and cortical thickness (β=-0.08, p=0.047). No other significant associations were observed. In multivariable analyses (Table 1) , EJI was negatively associated with cortical thickness (β=-0.04, p=0.04), and both ADI and SVI were negatively associated with GFAP (β=-0.36, p<0.01&β=-0.52, p<0.01, respectively), in Model 1. Additionally adjusting for CMI in Model 2, the negative associations of ADI and SVI with GFAP were preserved (β=-0.33, p=0.02&β=-0.50, p<0.01, respectively). In Model 3, further adjusting for eGFR, ADI remained negatively associated with GFAP (β=-0.37, p=0.03). Conclusions: Place-based environmental injustice was associated with lower cortical thickness, while neighborhood disadvantage and social vulnerability were associated with higher GFAP levels in adjusted models, suggesting place-based SDoH may be associated with structural brain changes and neuroinflammation. The impact of place-based SDoH needs to be further studied in association with ADRD biomarkers to better understand how we may tackle SDoH among older adults.
Abstract P2133: Physical performance and coronary heart disease, cardiovascular disease and all-cause mortality: the REasons for Geographic And Racial Differences in Stroke prospective cohort study
Background: Poor physical performance, often measured by gait speed and chair stand tests, has been linked to mortality, but patterns may differ depending on prior history of cardiovascular disease (CVD). Objective: To examine associations between physical performance and death from coronary heart disease (CHD), CVD, and all-cause by history of CVD. Methods: Among 14,137 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants (2013-2016), participants were categorized by quartiles of gait speed and chair stand times or inability to complete the test. Deaths (CHD, CVD, and all-cause) were adjudicated through December 31, 2020. Stratified by history of CVD, we created survival curves and conducted Cox proportional hazards models adjusted for demographics, health behaviors, and medical history. Results: The average age of participants was 72.54±8.5, 56.1% were female, 63.3% were White, 36.7% were Black, and 42.9% had history of CVD; 2,749 participants died. Compared to the fastest quartile, participants with history of CVD and slowest gait speeds had adjusted hazards ratios (HRs) of 1.29 (95% CI: 0.75, 2.23) for CHD, 1.37 (0.92, 2.05) for CVD, and 1.81 (1.47, 2.23) for all-cause mortality; HR for those with incomplete gait speed tests were 1.66 (0.80, 3.44), 3.07 (1.94, 4.86), and 3.19 (2.48, 4.10), respectively. Participants with history of CVD and the slowest quartile of chair stand time had HRs of 1.05 (95% CI: 0.62, 1.78) for CHD, 1.49 (1.08, 2.04) for CVD, and 1.82 (1.48, 2.23) for all-cause mortality; those with incomplete chair stand tests had HR of 1.33 (0.76, 2.33), 2.30 (1.68, 3.16), and 3.18 (2.47, 4.09), respectively. A similar pattern was seen among those without history of CVD, but the magnitude of the associations was lower (p-interaction = 0.345, 0.028, and 0.026 for CHD, CVD, and all-cause mortality, respectively, for gait speed tests and p-interaction = 0.064, 0.084, and 0.034 for CHD, CVD, and all-cause mortality, respectively, for chair stand tests). Conclusions: While physical performance was associated with mortality among individuals with and without CVD, poor physical performance may be a stronger marker for risk of death among those with CVD.
Abstract P1043: Distinct Mortality Patterns in Cancer Patients with Heart Disease: Insights from SEER Database Analysis
Introduction: Heart disease and cancer are two of the leading causes of death worldwide. The interaction between cardiovascular health, cancer, and survival outcomes is a crucial area of investigation. Thus, understanding the treatment and survival outcomes in heart disease patients who develop cancer is vital. Hypothesis: We assessed the hypothesis that variables such as the primary site of cancer, chemotherapy received, median income, and ICD Code, for example, resulted in different treatment outcomes of heart disease patients in the SEER database. Methods: The SEER database, the largest publicly available cancer registry, was used to analyze demographic and clinical data from patients diagnosed with heart disease. Variables such as SDoH, cancer diagnosis and treatment, and survival outcomes were cross-examined. Statistical analyses included Cox proportional hazards models, Poisson regression, and chi-square tests. The sample size includes 783 patients. Results: Survival functions showed statistical differences with a p-value <.001 in 5-year or 10-year hazard experiences based on chemotherapy received, tumor size, RX-Surgery primary site, median income, cause of death (COD), metastasis of the bone, liver, and brain, and between ICD categories, highlighting distinct interactions of these variables with pathological cardiovascular states. The highest ICD-0-3 category was patients with hemangiosarcoma at 26% of the dataset population. Poisson regression showed it was statistically significant to have higher incident rates in patients with Hemangiosarcoma than Giant Cell Carcinoma. Chi-square tests for impact on COD showed it was statistically significant that each pairing of the primary site of cancer, chemotherapy received, median income, RX-Surgery primary site, metastasis of the bone, liver, and brain, and ICD Code combined with COD were different. With the observed frequencies different from expected with a p-value of <.001, this study prompts further investigation into the distinct mortality patterns that involve the interplay of cardiovascular complications and cancer progression. Conclusions: The results demonstrate tangible differences in mortality patterns of heart SEER patients based on many factors. Understanding these relationships is crucial to developing targeted clinical strategies and preventative measures. Future research should strive to foster a better understanding of pathologic cardiovascular conditions and how they interact with cancer states.
An optimized informer model design for electric vehicle SOC prediction
SOC prediction is of great value to electric vehicle status assessment. Informer model is better than other models in SOC prediction, but there is still a gap in practical application. Therefore, based on the health assessment algorithm, a new optimized Informer model is proposed to predict SOC. Firstly, the health assessment is carried out through the historical running data of the electric vehicle to obtain the health matrix. Then, the health matrix is used to improve Encoder and Decoder modules and improve the prediction accuracy and speed of Informer model. Subsequently, the health matrix is utilized to optimize the prediction logic, reduce the influence of truncation error, and further improve the SOC prediction accuracy. Finally, using the Informer model before and after optimization, SOC prediction is performed using four different datasets. The results indicate that after optimizing the En-De module of Informer, prediction accuracy improved by approximately 15%, with prediction speed increasing by about 100%. Furthermore, optimizing the prediction logic to reduce truncation error further enhanced Informer’s prediction accuracy by around 20%.
Abstract P1137: The associations between maternal cardiovascular health scores during pregnancy and growth status of 0-2 years old infants: A birth cohort study
Objective: Many maternal factors during pregnancy have been suggested to influence the physical development of offspring, while the overall effects haven’t been comprehensively evaluated. We aim to revise the Cardiovascular Health (CVH) metrics for pregnant women, a composite health indicator recommended and updated by the American Heart Association in 2022, and to explore its association with growth status within age 2 years based on a birth cohort. Methods: Pregnant women in 20-28 weeks of gestation were recruited in Guangzhou, China, from 2017 to 2018, and their offspring were followed up until 2 years old. Maternal behavioral factors were collected by standardized questionnaires, including diet, physical activity, nicotine exposure, and sleep. Maternal biochemical data were extracted from medical records, including weight, blood glucose, blood pressure, and blood lipid. Higher scores indicating better health (ranging from 0 to 100), three of the eight metrics were specifically adapted for pregnant women. Pre-pregnancy BMI and pregnancy weight gain were used to evaluate weight status. The Chinese Healthy Diet Index and the standard of the Chinese Guidelines for Gestational Diabetes Mellitus were applied to assess diet and blood glucose. Infants’ length and weight were repeatedly measured at 1, 3, 6, 8, 12, 18, and 24 months, and weight-for-length z-scores (WAZ), length-for-age z-scores (LAZ), body mass index z-scores (BAZ), and weight-for-age z-scores (WLZ) were calculated. The generalized estimating equation was conducted to explore the association between maternal CVH scores and infants’ growth status. Results: In 691 mother-child pairs, the average of CVH score was 67.02±9.52, with diet scoring the lowest (42.17±32.94). Approximately 3.47%, 85.82%, and 10.71% of mothers scored low (≤50), moderate (50-79), and high (≥80) in CVH levels, respectively. The CVH and health factor scores were positively correlated with family monthly income. Higher prenatal health behaviors and CVH scores were associated with increased LAZ, and health behavior, especially in sleep, was negatively associated with BAZ and WLZ of infants. Conclusion: This revised CVH score indicated a moderate overall health status for pregnant women, with dietary health warranting further improvement. Priority should be given to modifiable health behaviors during pregnancy, which showed a stronger and more stable association with the infant's physical growth.
Abstract P3041: Association of Urine Metabolites with All-Cause and Cause-Specific Mortality: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Circulating metabolites are associated with all-cause and cause-specific mortality. Cardiovascular disease (CVD) and cancer are two leading causes of mortality, providing complementary assessment of disease burden in addition to all-cause mortality. However, the role of urine markers in predicting the risk of mortality is understudied. Hypothesis: We hypothesize that urine metabolites are associated with all-cause, CVD, and cancer mortality. Methods: Using the Nightingale platform, urine metabolite profiling was performed at the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011-13). Urine metabolite levels were probability quotient normalized. We conducted Cox proportional models on 42 urine metabolites with all-cause, CVD, and cancer mortality, adjusting for traditional risk factors and kidney function. A metabolite risk score (MRS) was constructed using weights obtained from least absolute shrinkage and selection operator regression. Harrell’s C statistics was calculated to estimate the models’ predictive performance. Results: Over an average of 5 years of follow-up, 372, 113, and 85 all-cause, CVD, and cancer mortality cases were developed among 1,350 participants (mean age: 75 years, 74% women, 35% Blacks). Seven and one urine metabolites were associated with all-cause and CVD mortality (FDR<0.05, Figure.1). 4-deoxythreonate, a carboxylic acid found in foods, was associated with a decreased risk of all-cause (HR per SD: 0.77, 95% CI: 0.68-0.87) and CVD (HR per SD: 0.63, 95% CI: 0.50-0.80) mortality. The highest quartile of MRS, consisting of 13 and 5 selected urine metabolites, had about a three-fold and four-fold risk of all-cause and CVD mortality compared to the lowest quartile, respectively, and a graded effect across quartiles was observed (p for trend: p<0.001, Figure.2). Adding seven significant urine metabolites improved all-cause mortality prediction by 4% over a traditional risk model (p<0.05). Conclusions: We identified urine metabolites associated with all-cause and CVD mortality, suggesting the potential of considering urine markers in clinical practice and for at-risk population identification.
Abstract 066: Inclusion of Social Determinants of Health in Cardiovascular Disease Risk Prediction Models
Background: Social determinants of health (SDOH) impact CV health, but CVD risk prediction models either exclude SDOHs entirely or include a single factor. Here, we assess the incremental value of adding multiple individual- and neighborhood-level SDOHs to the 2013 Pooled Cohort Equations (PCE). Methods: We pooled data from 38,558 individuals in 6 longitudinal cohorts: Framingham Heart Study (Gen3 and Omni2 cohorts exam 1; 2002-2005), Jackson Heart Study (exam 1; 2000-2004), Coronary Artery Risk Development in Young Adults (year 20 exam; 2005-2006), Multi-Ethnic Study of Atherosclerosis (exam 5; 2010-2011), Reasons for Geographic and Racial Differences in Stroke (exam 1; 2003-2007), and Hispanic Community Health Study/Study of Latinos (exam 1; 2008-2011). Included participants were aged 40-79 with complete data on PCE predictors, were free of baseline atherosclerotic CVD (ASCVD), and were followed for 10 years for incident ASCVD (nonfatal MI, fatal CHD, fatal/nonfatal ischemic stroke). The PCEs were fit separately for each combination of sex and race/ethnicity (Black Women, Black Men, White or Hispanic/Latina Women, White or Hispanic/Latino Men) using Cox proportional hazards models with recalibrated beta coefficients for each CV risk factor (age, total and HDL cholesterol, treated/untreated SBP, current smoking, diabetes). Individual- and neighborhood-level SDOHs were added to the PCEs to assess the change in c-statistic, net reclassification improvement (NRI) and relative integrated discrimination improvement (rIDI). Results: During 340,267 person-years of follow-up, 1966 ASCVD events occurred. In both Black women and White or Hispanic/Latina women, jointly adding individual- and neighborhood-level SDOHs improved model performance the most (Black women Δc=0.034, NRI=0.105, rIDI=0.415; White or Hispanic/Latina women Δc=0.026, NRI=0.136, rIDI=0.329), whereas in White or Hispanic/Latino men, the subset of significant individual-level SDOHs most improved model performance (Δc=0.032, NRI=0.114, rIDI=0.163). Among Black men, no group of SDOHs was both significantly associated with incident ASCVD and improved model performance. Conclusion: Adding individual- and neighborhood-level SDOHs to the PCEs modestly improved model performance and the effect of these groups of SDOHs varied by gender and race. Future studies should examine the impact of inclusion of these and additional individual- and neighborhood-level SDOHs in the PREVENT and other risk prediction models.
Reflecting on Dunbar’s numbers: Individual differences in energy allocation to personal relationships
Past studies have investigated the variability in how people engage with their personal networks, yet less is known about how people perceive their energy allocation to different ties. Drawing on an online survey sample (N = 906), we tested whether subjective perceptions of energy allocation conform to so-called Dunbar’s Number(s). In addition, we evaluated the predictive roles of Big Five personality traits and self-esteem while controlling for differences in network structure. Results revealed significant heterogeneity in perceived energy allocation to different layers of personal networks (i.e., inner 5 vs. middle 15 vs. outer 150 relationships). In contrast to expectations, extraversion was not associated with perceived energy allocation, whereas self-esteem was associated with greater energy allocation to the middle (vs. inner) network layer. Our findings add to our knowledge of how people perceive relationship maintenance across their personal networks, along with the links to key psychological traits. More broadly, the findings suggest that more attention should be paid to psychological implications of the middle layer of personal networks. To conclude, we discuss the importance of studying individual differences in how people prioritize – and reflect on – different relationships in their networks.
Abstract P1144: Changes in Dietary Intake, Physical Activity and Cardiometabolic Risk Factors in University Students
It is well recognized that lifestyle habits are more critical during certain stages of life. For young adults, the transition to university appears to be one of these periods. Beginning university involves many changes for young adults. Several studies have described unhealthy student lifestyles with decreased physical activity and deterioration of eating habits. This lifestyle deterioration at the beginning of university has also been associated with weight gain which may impact cardiometabolic health. The purpose of the present study was to examine changes in physical activity, dietary intake and cardiometabolic risk factors in Canadian university students over the course of one academic year. Fifty university students (17 men and 33 women) from 18 to 27 years of age (21.0 ± 1.7 years for men and 20.2 ± 1.3 years for women) were selected to participate in this study. All measurements were performed at baseline and at the end of the academic year. Anthropometric parameters and metabolic risk variables were measured according to standardized procedures. Food intakes were assessed using a web-based food frequency questionnaire. Cardiorespiratory fitness capacity was estimated using the 20m shuttle run test. Over the university year, waist circumference significantly increased in both men (76.1 to 79.1 cm, p=0.0015) and women (69.6 to 71.8 cm, p=0.003) while body mass index was significantly increased only in men (22.5 to 23.1 kg/m 2 , p=0.0024). Total cholesterol, LDL cholesterol and apolipoprotein (apo) B levels significantly increased in men over the study period (p < 0.0175). In women, apo B levels increased significantly, while total cholesterol/HDL cholesterol ratio decreased (p < 0.027). There were small but statistically insignificant changes in total caloric intake during the study. However, daily servings of fruits and vegetables significantly decreased over the study in both men (11.1 to 7.64 servings per day, p=0.0085) and women (8.31 to 5.71, p=0.0202). These decreases seem to be mainly attributable to reduced vegetable consumption (p < 0.04). Lastly, we found that cardiorespiratory fitness did not change significantly over the study period. In conclusion, our results demonstrated deterioration in some cardiometabolic risk factors as well as in some eating habits during the academic year. Targeted interventions should be developed to help university students achieve or maintain a healthy lifestyle during this period.
Abstract P1114: Correlations Between VeggieMeter and Self-reported Carotenoid, Fruit and Vegetable Intake Among Older Adults: Results from Bringing the Diabetes Prevention Program to Geriatric Populations
Background: Fruit and vegetable intake (FVI) among older adults remains below recommended levels for disease prevention. Subjective dietary assessment can be burdensome and costly. Reflection spectroscopy (RS) can be used to non-invasively assess skin carotenoids as a biomarker of fruit and vegetable intake but is an underexplored research area for older adult communities. Objective: To test the hypothesis that VM scores will be positively correlated with self-reported vegetable and carotenoid intake among older adults. Design: This is a secondary analysis of data from an ongoing NIH-funded randomized, controlled trial where participants were counseled to make healthy changes including increased FVI. Participants were n=79 older adults (age ≥ 65 years) with prediabetes and had their skin carotenoids levels (scored 0-800) measured by VeggieMeter® - a portable device that uses RS technology. We performed univariate descriptive analyses of population characteristics, Spearman correlations, and linear regression models to examine the association between VM scores and self-reported FVI and carotenoid intake measured by food records (mean days=5.5 (sd=1.0)), adjusted for participant characteristics, using Python. Results: Participants were 73.0 (sd=5.4) years old, 65.8% were female, 68.4% White, 13.9% Hispanic/Latinx, with an average BMI of 32.4 (sd=4.2) kg/m 2 and 68.4% reported use of dietary supplements. The average FVI was 3.7 (sd=2.0) servings per day, reported carotenoid intake was 10,202 (sd=7,755) mcg, and mean VM score was 294.2 (sd=121.1). VM score was not correlated with self-reported FVI, vegetable intake alone, or fruit intake alone (all p>0.05). VM scores were correlated with carotenoid intake (R=0.25, p<0.05), but this correlation was no longer significant after adjustment for age, sex, race, ethnicity, BMI, smoking status, and reported supplement use. Conclusions: This study supports the hypothesis that VM score is correlated with self-reported carotenoid intake reported on food records, suggesting potential utility of VM in assessing carotenoid status among older adults with prediabetes. Future work will examine sensitivity to change after participation in a Diabetes Prevention Program adapted for older adults.
Abstract P1068: Comparative Analysis of Children’s Persistence in a Lifestyle Modification Program and Body Mass Index Z-Score Changes According to the Access to a Family Grant Program at a Pediatric Obesity Management Clinic
Introduction: Improving access to healthcare for childhood obesity is crucial, especially in contexts where social vulnerability is a significant risk factor for developing obesity in childhood. Little is known about whether family grant programs (FGP) help remove systemic and institutional barriers to lifestyle therapies for children with obesity. Hypothesis: We tested the hypothesis that access to a FGP favors engagement in a lifestyle modification program and body mass index z-score (BMIz) reduction of children with overweight or obesity at a pediatric obesity management clinic, the Maison de santé prévention – Approche 180, in Montreal (QC, Canada). Methods: This study is designed as a retrospective, longitudinal, comparative analysis of medical records of children (2 to 17 years) with overweight or obesity. Data were collected between April 8, 2021 (FGP implementation) and March 31, 2023. Children in youth centers, foster families, with refugee status or whose parents had a low-income per Canada’s Revenue Agency were eligible for the FGP, which fully covered the costs of multiprofessional services at the clinic. Persistence in the lifestyle program, measured by the number of appointments and follow-up duration, and changes in BMIz over the study period were compared between children based on access to the FGP. Results: Among the 198 included children (100 girls, 98 boys; mean age=11.1 years ± standard deviation (SD)=3.0; mean BMIz=3.30 ± SD=1.05), 62 benefited from the FGP and 136 were not eligible to it. Children from non-two-parent families were 2.46 times more likely to receive the grant compared to those from two-parent families (95% confidence interval (CI): 1.46, 4.13; P=0.0007). Children with the grant had longer follow-up duration [10.29 (95%CI: 8.59, 11.99) vs 6.71 (95%CI: 5.48, 7.93) months; P=0.0007] and similar number of appointments per month [0.81 (95%CI: 0.66, 0.95) vs 0.92 (95%CI: 0.81, 1.02); P=0.42] compared to those without it. Children with the grant achieved similar BMIz changes compared to those without it [-0.31 (95%CI: -0.61, -0.01) vs -0.32 (95%CI: -0.57, -0.06); P=0.92]. Conclusions: FGP was associated with persistence in a lifestyle program that surpassed that of those who were not eligible to it. It enabled children with social vulnerabilities to achieve BMIz reductions comparable to those of children without such vulnerabilities. Free care could help address systemic and institutional barriers to childhood obesity management.
Passenger and freight travel patterns: A cluster analysis based on urban networks
While research on population travel patterns and urban networks has been active, it has primarily focused on passenger travel, leaving freight travel relatively underexplored. This study addresses this gap by analyzing both passenger and freight travel patterns, network structures, and central areas. It uses origin-destination (OD) data, considering total travel volume by purpose and mode. The study applies regular equivalence and power centrality to examine differences in human and logistics flows across South Korea from an urban network theory perspective. The key findings are as follows. First, passenger travel, predominantly short-distance, exhibits lower density and intensity than freight travel. Freight travel, on the other hand, demonstrates strong density across short, medium, and long distances, with more travel routes concentrated around nodal regions. Second, passenger travel forms several polynucleated clusters, including short-distance movements. Conversely, freight travel forms a few extensive clusters that encompass medium and long-distance movements. Third, the spatial interaction of passenger travel is influenced by the OD distance, unlike freight travel. Interestingly, the distance between central areas of freight travel can be longer than that of passenger travel. This may stem from the strategic positioning of certain suburban areas as central areas to optimize logistics efficiency. This study emphasizes the importance of morphological and functional linkages between cities by identifying inter-regional differences in passenger and freight flows. It also proposes spatial planning strategies based on urban hierarchy.