1000-P: Plasma Water T2 Monitors Cardiometabolic Health and Improves with Lifestyle Modification

Abstract

Plasma water T2 is a screening tool for cardiometabolic health. It detects hidden insulin resistance, dyslipidemia and inflammation. To assess the response of T2 to lifestyle changes, we are conducting an ancillary study of PREMIER. The parent PREMIER trial evaluated the effect of lifestyle interventions on blood pressure. Many subjects had insulin resistance, prediabetes and/or metabolic syndrome. The interventions included physical activity, weight loss, ↓sodium and alcohol, and the DASH diet. Hypothesis: Plasma water T2 increases (improves) with PREMIER interventions. Methods: Subjects (n=810) were randomized into 3 arms: established, established+DASH and advice only. The subjects were 62% female, 34% black, age 50.0±8.9 years. Inclusion criteria were age ≥25, ↑BP and BMI 18.5-45.0 kg/m2. Exclusion criteria were diabetes, prior CV event, heart failure, cancer or psychiatric hospitalization within 2 yrs. In the ancillary study, mixed effects models were used to assess T2 values at 6- and 18-months post-intervention, after adjusting for baseline T2 and other co-variates. Multiple means comparisons used Dunnett’s test. Results: Model 1 adjusted for baseline T2, BMI, visit and treatment group as fixed effects, with nested subject ID-recruitment site as random effects. All three arms showed progressive increases in T2 at 6 and 18 mo, but were significant at 18 mo. Mean T2 at 18 mo for the established+DASH and advice-only arms were 792.8 ms (95% CI: 782.7, 802.8; p=0.0027) and 794.4 ms (95% CI: 784.5, 804.3; p=0.0006), respectively, compared with 767.5 ms (95% CI: 757.9, 777.0) for baseline controls. Similar results were seen in Model 2, which adjusted for fitness level measured by treadmill. Conclusion: Plasma water T2 values detected global improvement in cardiometabolic health after 18 months of PREMIER interventions, even after adjusting for BMI and fitness. Early T2 screening and monitoring, paired with a simple lifestyle change, is effective for improving cardiometabolic health. Disclosure D. P. Cistola: None. R. Patel: None. E. Campbell: None. V. Patel: None. A. K. Dwivedi: None. Funding National Heart, Lung, and Blood Institute (R21HL143030)