Cardiometabolic Disease Risk Factors Research Articles

Associations of sedentary behavior and screen time with biomarkers of inflammation and insulin resistance.

Sedentary behavior (SB) has been linked to risk factors of cardiometabolic disease, with inconsistent findings reported in the literature. We aimed to assess the associations of SB with multiple biomarkers of inflammation and insulin resistance in adults. Domain-specific SB, sitting time and moderate-to-vigorous physical activity (MVPA) were measured in 78 adults (mean ± SD 52.0 ± 10.8 y). Body fat percentage (BF%) was assessed using multi-frequency bioelectrical impedance. A blood draw assessed glucose, insulin, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), leptin, and adiponectin. Adiponectin-leptin ratio (ALR), homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β) were calculated. Multivariable linear regression analyses, controlling for age, sex, MVPA, and BF%, were used to assess associations. After adjustment for age, sex and MVPA, total SB (7.5 ± 2.5h/day) was positively associated with leptin, insulin, HOMA-IR, HOMA-β (Standardized Beta (β) range 0.21-0.32) and negatively associated with ALR (β = -0.24, p < 0.05 for all). Similarly, total sitting time (7.2 ± 2.9h/day) was associated with TNF-α (β = 0.22) and ALR (β = -0.26). These associations were attenuated to non-significance after adjustment for BF%. Leisure screen time was detrimentally associated with IL-6 (β = 0.24), leptin (β = 0.21), insulin (β = 0.37), HOMA-IR (β = 0.37), and HOMA-β (β = 0.34), independent of age, sex and MVPA (p < 0.05 for all). Only the associations with insulin (β = 0.26), HOMA-IR (β = 0.26), and HOMA-β (β = 0.23) remained significant after further controlling BF% (p < 0.05). Self-reported SB is associated with biomarkers of inflammation and insulin resistance, independent of MVPA, and in some cases BF%.

Probiotics, prebiotics, synbiotics and other microbiome-based innovative therapeutics to mitigate obesity and enhance longevity via the gut-brain axis

The global prevalence of obesity currently exceeds 1 billion people and is accompanied by an increase in the aging population. Obesity and aging share many hallmarks and are leading risk factors for cardiometabolic disease and premature death. Current anti-obesity and pro-longevity pharmacotherapies are limited by side effects, warranting the development of novel therapies. The gut microbiota plays a major role in human health and disease, with a dysbiotic composition evident in obese and aged individuals. The bidirectional communication system between the gut and the central nervous system, known as the gut-brain axis, may link obesity to unhealthy aging. Modulating the gut with microbiome-targeted therapies, such as biotics, is a novel strategy to treat and/or manage obesity and promote longevity. Biotics represent material derived from living or once-living organisms, many of which have therapeutic effects. Pre-, pro-, syn- and post-biotics may beneficially modulate gut microbial composition and function to improve obesity and the aging process. However, the investigation of biotics as next-generation therapeutics has only just begun. Further research is needed to identify therapeutic biotics and understand their mechanisms of action. Investigating the function of the gut-brain axis in obesity and aging may lead to novel therapeutic strategies for obese, aged and comorbid (e.g., sarcopenic obese) patient populations. This review discusses the interrelationship between obesity and aging, with a particular emphasis on the gut microbiome, and presents biotics as novel therapeutic agents for obesity, aging and related disease states.

Systems genetics analysis of human body fat distribution genes identifies adipocyte processes.

Excess abdominal fat is a sexually dimorphic risk factor for cardio-metabolic disease and is approximated by the waist-to-hip ratio adjusted for body mass index (WHRadjBMI). Whereas this trait is highly heritable, few causal genes are known. We aimed to identify novel drivers of WHRadjBMI using systems genetics. We used two independent cohorts of adipose tissue gene expression and constructed sex- and depot-specific Bayesian networks to model gene-gene interactions from 8,492 genes. Using key driver analysis, we identified genes that, in silico and putatively in vitro, regulate many others. 51-119 key drivers in each network were replicated in both cohorts. In other cell types, 23 of these genes are found in crucial adipocyte pathways: Wnt signaling or mitochondrial function. We overexpressed or down-regulated seven key driver genes in human subcutaneous pre-adipocytes. Key driver genes ANAPC2 and RSPO1 inhibited adipogenesis, whereas PSME3 increased adipogenesis. RSPO1 increased Wnt signaling activity. In differentiated adipocytes, MIGA1 and UBR1 down-regulation led to mitochondrial dysfunction. These five genes regulate adipocyte function, and we hypothesize that they regulate fat distribution.

Hemoglobin levels are associated with retinal vascular caliber in a middle-aged birth cohort

Vascular and neural structures of the retina can be visualized non-invasively and used to predict ocular and systemic pathologies. We set out to evaluate the association of hemoglobin (Hb) levels within the national reference interval with retinal vascular caliber, optical coherence tomography (OCT) and visual field (VF) parameters in the Northern Finland 1966 Birth Cohort (n = 2319, 42.1% male, average age 47 years). The studied parameters were evaluated in Hb quintiles and multivariable linear regression models. The lowest Hb quintile of both sexes presented the narrowest central retinal vein equivalent (CRVE) and the healthiest cardiometabolic profile compared to the other Hb quintiles. In the regression models, CRVE associated positively with Hb levels in both sexes, (Bmales = 0.068 [0.001; 0.135], Bfemales = 0.087 [0.033; 0.140]), after being adjusted for key cardiometabolic and inflammatory parameters, smoking status, and fellow vessel caliber. No statistically significant associations of Hb levels with central retinal artery equivalent, OCT or VF parameters were detected. In conclusion, Hb levels were positively and specifically associated with CRVE, indicating that Hb levels are an independent factor affecting CRVE and the effect is in parallel with established risk factors for cardiometabolic diseases.

Diets high in subsidized foods and chronic kidney disease in Hispanic communities in the United States: the Hispanic Community Health Study/Study of Latinos.

Prior research shows that diets high in government subsidized foods may be associated with cardiometabolic disease risk factors. Our aim was to evaluate the relationship between diets high in subsidized foods and the development of chronic kidney disease (CKD) and other cardiometabolic risk factors in United States (US) Hispanics/Latinos. Using data from 16,172 Hispanics/Latino's living in the United States, we used the Cochran-Armitage test to assess the relationship between subsidized foods in the diets of participants and baseline characteristics. We used survey-weighted Poisson regression models to examine whether intake of subsidized foods was associated with incident CKD or cardiometabolic risk factors. Several baseline characteristics were associated with higher subsidized food scores. Higher subsidized food scores were not associated with incident CKD or cardiometabolic risk factors. These findings may be useful for future researchers, clinicians, and nutritional policy advocates who are interested in the way Hispanic and Latinos consume foods subsidized by the US government and the structural factors that may shape observed dietary and disease patterns.

Inflammatory Bowel Disease exercise and diet (IBDeat) habits study: exploring lifestyle habits and cardiometabolic disease risk factors

Patients with inflammatory bowel disease (IBD) have higher risk of developing cardiometabolic diseases due to chronic gut and systemic inflammation which promotes atherogenesis. Adopting healthy lifestyle habits can prevent development of cardiometabolic diseases, but can be challenging for people with IBD. The IBD exercise and diet (IBDeat) habits study describes the lifestyle habits and cardiometabolic disease risk factors of adults with IBD in Aotearoa, New Zealand (NZ).This is a cross-sectional study including adult NZ IBD patients recruited online via Crohn’s and Colitis NZ and Dunedin hospital from 2021 to 2022. An online questionnaire collected demographics, smoking status, comorbidities, medications, disease severity scores, quality of life, physical activity, and dietary intake. The Dunedin cohort had physical measurements taken including anthropometrics, handgrip strength, blood pressure, body composition (bioelectrical impedance), blood nutritional markers, and faecal calprotectin. Data were compared to established reference values and linear regression analysis investigated associations between lifestyle habits and cardiometabolic risk factors. The study received University of Otago ethical approval (reference: H21/135). A total of 213 adults with IBD (54% Crohn’s disease; 46% ulcerative colitis) completed the online questionnaire and a subset of 102 from Dunedin provided physical measurements. Participants characteristics were: median age 37 (IQR 25, 51) years, 71% female, 82% NZ European, 4% smokers, and 1.4% had active IBD. Thirty-five percent of participants had at least one comorbidity and 34% of participants had poor quality of life. Known dietary risk factors associated with cardiometabolic diseases were common: low intakes of vegetables (77%), fruit (51%), fibre (35%) and high intakes of total fat (84%) and saturated fat (98%). Physical activity recommendations were met by 61% of participants and 63% reported barriers to being more active from fatigue (63%) and joint pain (54%). Other cardiometabolic risk factors were common in the Dunedin cohort: high LDL (79%) and total cholesterol (76%), central adiposity (64%), high body fat percentage (44%), high blood pressure (26%), and low handgrip strength (25%). Regression analysis showed that vegetable (per serve) and carbohydrate (per 5% of total daily energy intake (TE)) were associated with 0.22 mmol/L (95%CI 0.43, 0.013) and 0.20 mmol/L (95%CI 0.34, 0.057) lower LDL cholesterol. Discretionary food items were associated with higher LDL cholesterol, 0.11 mmol/L per daily serve (95%CI 0.028, 0.19). A 5% difference in TE intake from carbohydrate was associated with 1.11% (95%CI 2.22%, 0.0038%) lower body fat percentage while protein was associated with 3.1% (95%CI 0.81%, 5.39%) higher body fat percentage. Physical activity had weak associations with cardiometabolic disease risk factors. Adults with IBD have multiple modifiable risk factors for cardiometabolic diseases. Vegetable and carbohydrate intake were associated with lower LDL cholesterol concentration while discretionary food items showed otherwise. Protein intake was associated with higher body fat percentage.

57 Utilizing a Digital Phenotype for Metabolic Syndrome to Elucidate Risk Profiles for Neurocognitive Disease: An Electronic Medical Record Study

OBJECTIVES/GOALS: Metabolic syndrome (MetS), defined as a cluster of cardiometabolic disease risk factors, is seldom coded using the ICD-10 system in electronic medical records (EMR). The goal of this study was to use EMR to construct MetS with a digital phenotype to amplify the pool of patients available to assess risk for neurocognitive disease in this population. METHODS/STUDY POPULATION: A digital phenotype using the EMR platform TriNetX (n=38 million patients between age 50 and 80) was created by clustering codes for the individual components of MetS (insulin resistance, hypertension, dyslipidemia, and central adiposity). The research network database on TriNetX was utilized to elucidate risk ratios for neurocognitive decline, Alzheimer’s disease and related dementias (ADRDs), and cerebrovascular disease between a preclinical sample of older adults with and without MetS. Propensity score matching was used to match cohorts on demographic variables, medication use, and relevant comorbidities. Risk ratios (RR) and confidence intervals (95% CI) were presented for all outcomes. RESULTS/ANTICIPATED RESULTS: The digital phenotype for MetS expanded the sample from 29,830 to 274,703, a 10-fold increase. Sensitivity to the standard MetS ICD-10 code was 95.1%, showing strong agreement between coding schema. Older adults with MetS had higher risk of cognitive decline (RR: 1.30, 95% CI: 1.15–1.48, p &lt;0.001), ADRDs (RR: 1.48, 95% CI: 1.25–1.75, p &lt;0.001), and cerebrovascular issues (RR: 1.62, 95% CI: 1.55–1.70, p &lt;0.001) when controlling for demographics, medication, and comorbidities. MetS individuals with cerebrovascular dysfunction had even greater risks for neurocognitive decline (RR: 1.70, 95% CI: 1.38–2.08, p &lt; 0.001) and ADRDs (RR: 2.09, 95% CI: 1.56–2.80, p &lt; 0.001) than those with only MetS. DISCUSSION/SIGNIFICANCE: Implementing a digital MetS phenotype in EMR effectively increased sample size and power for analyses. Older adults with MetS have higher risk for neurocognitive decline, especially among those with cerebrovascular dysfunction, highlighting a critical intervention window prior to overt cardiometabolic disease.

Influence of visceral manipulation on hormonal profile in women with polycystic ovarian syndrome: A randomized trial

Background. Polycystic ovary syndrome (PCOS) is the most common endocrine condition in women of reproductive age and has been suggested as a risk factor for cardiometabolic disease. Depending on which diagnostic criteria are applied, approximately 10–15% of the women of reproductive age are affected by PCOS.Objective. To examine how viscera manipulation Influences hormonal profile in women with PCO. Design. A prospective randomized single-blind controlled trial. Setting. Outpatient clinics of Sadat General Hospital. Methods. Thirty patients of PCO females were recruited and randomized into two equal groups: the control group received a diet guidelines therapy in the form of the hypocaloric Mediterranean diet for 12 weeks, and the study group received the same control group interventions in addition to visceral manipulation (VM). biochemical analysis (FSH &amp; LH) and BMI was the primary outcome. All variables were measured at the baseline and after 12 weeks of the intervention. Results. Statistical analysis was done by using paired’ test which showed significant improvement in both groups. Therefore, using mixed design MANOVA and multiple pairwise comparison tests (Post hoc tests) for the BMI and LH/FSH ratio post-treatment revealed that there were significant decreases in LH/FSH ratio (p =0.007) in favor to group B when compared with group A, with no significant differences in BMI between both groups (p = 0.443), showing that VM group (B) is more effective than group (A) on biochemical analysis (p &lt; 0.05). Conclusion. Using visceral manipulation with a standard program of hypocaloric Mediterranean diet has more beneficial effects on hormonal profile in women with PCO.

Abstract P475: Adherence to the EAT-Lancet Planetary Health Diet and Cardiometabolic Risk Markers in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

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

Abstract MP71: Novel Association Between Parity and Skeletal Muscle Adiposity in Middle-Aged and Older African Caribbean Women

Objective: Pregnancy and parity (number of children born to a women) are associated with alterations in metabolism and lifestyle, which may affect women’s short- and long-term cardiometabolic health. Greater skeletal muscle adiposity (myosteatosis) is recognized as a major risk factor for cardiometabolic diseases, especially in African ancestry individuals. While lifetime parity has been previously associated with greater central obesity years after childbearing ceased, it remains unclear whether parity is associated with myosteatosis. Methods: We examined the association of parity (0, 1, 2, 3, 4+) with myosteatosis and general and central obesity among 1,119 African Caribbean women, aged 40-84 years, recruited from 2019 to 2023 without regard to health status. Calf myosteatosis area was measured by CT-derived intermuscular adipose tissue (IMAT, mm 2 ) and skeletal muscle density (mg/cm 3 , with a lower density indicating more adiposity). Multivariable linear regression models were used to estimate the adjusted means of IMAT, muscle density, BMI, and waist circumference for each parity group. Results: The mean age of women who reported ever being pregnant (N=969) was 55.8 (SD=9.0) years. They were obese on average (BMI=32.1 (SD=6.8) kg/m 2 ), and had given birth to an average of 3 (SD=2.3) children. In multivariable models, higher parity was significantly associated with higher IMAT and lower muscle density, after accounting for age, BMI, physical activity, and comorbidities (see Table). Parity showed no associations with BMI or waist circumference. Conclusions: Parity may be associated with greater accumulation of adiposity in skeletal muscle, despite no link with general or central adiposity among African Caribbean women. Our novel findings, if confirmed in prospective studies, might highlight the need for tailored strategies for maintaining healthy muscles in multiparous women of African ancestry. Table. Adjusted population marginal means (95% CI) for myosteatosis by parity groups in African Caribbean women a

Abstract MP37: Insomnia is Associated With Fatty Acid and Oxylipin Inflammatory Biomarkers in the Hispanic Community Health Study/Study of Latinos

Introduction: Insomnia symptoms are prevalent in Hispanic/Latino adults, and insomnia is a risk factor for cardiometabolic disease, possibly through dysregulated inflammatory pathways. However, existing evidence has largely focused on non-specific and downstream inflammatory biomarkers. Informed by prior research, we hypothesized that insomnia promotes chronic low-grade inflammation by disrupting the physiological balance between upstream bioactive fatty acids and oxylipins. Objective: To evaluate associations between insomnia and 81 upstream bioactive fatty acid and oxylipin inflammatory biomarkers in the population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: After excluding night and rotating shift workers, participants were 14,439 HCHS/SOL adults (mean age: 46 y, 61% female, 62% with education ≥ high school degree). Insomnia was measured using the Women’s Health Initiative Insomnia Rating Scale (WHIIRS). We used the WHIIRS score as a continuous (range 0-20, with higher scores indicating greater severity) and categorical variable (WHIIRS ≥ 9, indicating clinically significant insomnia). The 81 oxylipins and fatty acids were profiled in fasting blood samples using non-targeted liquid chromatography-mass spectrometry and annotated based on mass-to-charge ratio, retention time, and spectra. Cross-sectional associations between rank normalized oxylipins and fatty acids with insomnia were assessed using survey-weighted multivariable linear regression adjusting for confounders (age, sex, center, Hispanic background group, education, smoking, alcohol use, the alternative healthy eating index, physical activity, and body mass index). We addressed multiple comparisons using a false discovery rate &lt;0.05. Results: The mean WHIIRS score was 7.1 (standard deviation: 5.4) and 36% displayed clinically significant insomnia. The WHIIRS showed statistically significant positive associations with 7 fatty acids (nervonic, docosadienoic, palmitoleic, eicosanoic, docosaenoic, behenic, and lignoceric acid) and 4 oxylipins (HpODE, leukotriene/HpETE/DiHETE/prostaglandin, HOTrE/oxoODE, and an oxylipin with unknown biological pathway). Clinically significant insomnia defined categorically showed statistically significant positive associations with 3 fatty acids and 3 oxylipins, all of which were also identified in the continuous WHIIRS analysis (see above). Identified fatty acids and oxylipins included both putative pro-inflammatory (e.g., HpODE) and anti-inflammatory (e.g., nervonic acid) compounds. Conclusions: Insomnia, like cardiometabolic disease, is associated with low-grade inflammation. The directionality of these relationships and degree to which associations between chronic inflammation with cardiometabolic disease and insomnia reflects overlapping pathways warrants further investigation.

Abstract P268: Predictive Abilities of Anthropometric Indicators for Cardiometabolic Risk Factors and Diseases: The UK Whitehall II Study

Introduction: Obesity is an accepted risk factor for cardiometabolic diseases. Body mass index (BMI) is the most commonly-used anthropometric measurement for accessing healthy weight. However, some studies suggested that other adiposity indices may be better predictors of cardiometabolic risks and diseases. Our study aimed to compare the predictive abilities of 5 indices [BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-by-height0.5 (WHT.5R), and a body shape index (ABSI)]. Hypothesis: BMI is not good enough for accessing and predicting healthy condition. WHtR may be a more effective index for predicting cardiometabolic risk factors and diseases. Methods: Based on the UK Whitehall II study, we included participants with full records of weight, height, and waist circumference in Phase 3 (1991-1994). Our study indices, BMI, WC, WHtR, WHT.5R, and ABSI, were calculated from measured weight, height, or waist circumference. The outcomes were coronary heart disease (CHD), abnormal blood pressure (BP), insulin resistance (IR), hyperglycemia, and hyperlipidaemia. Receiver operator characteristic (ROC) curve analysis and logistic regression analysis were used to assess the predictive values of the study indices to the cardiometabolic risk factors and diseases. Results: A total of 7979 participants were included [mean age: 50.1 ± 6.0 years; 2468 (30.9%) females; 7188 (90.4%) whites]. Cross-sectionally, except for the association between ABSI and CHD, a significantly-positive association was observed between the all indices and all outcomes (all P&lt;0.001) in Phase 3. All 5 indicators showed the highest predictive ability when the outcome was IR [all the areas under the curve (AUC)&gt;0.714], and among them, WHT.5R had highest predictive value (AUC: 0.770, sensitivity: 76.5%, specificity: 65.1%). For other outcomes, WHtR showed the best prediction for hyperlipidaemia (AUC: 0.719, sensitivity: 54.7%, specificity: 79.6%) relative to the other 4 measurements, whereas WC had higher AUC for predicting abnormal BP (AUC: 0.704, sensitivity: 64.6%, specificity: 65.8%) than any other indices. However, among all of the study outcomes, these 5 indices had the relatively weak ability to predict CHD (all AUCs&lt;0.654). Conclusions: Some indices may provide a more accurate insight into cardiometabolic risk factors and diseases than BMI. WHT.5R appears to be an effective predictor of IR. WHtR has a better prediction for hyperlipidaemia. WC seems to be a good indicator for abnormal BP. We should pay more attention to waist circumference and its derived adiposity indices in the practice of preventing cardiometabolic diseases.

Abstract P490: The Oral Microbiome and Prospective Risks of All-Cause and Cardiometabolic Mortality: The National Health and Nutrition Examination Survey

Background: Dysbiosis of the oral microbiome and periodontitis (an inflammatory disease induced by dysbiosis) are plausible risk factors for cardiometabolic (CM) diseases. The relationship between the oral microbiome and CM mortality is less known. Hypothesis: Greater oral microbial diversity is associated with lower risks of all-cause and CM mortality, while poorer periodontal health is associated with greater mortality risk. Methods: We included n=5,255 adults aged 30+ from the National Health and Nutrition Examination Survey (NHANES) who had periodontal examinations and provided saliva samples at baseline. Baseline enrollment occurred in the 2009-2010 (n=2,681) and 2011-2012 (n=2,574) study cycles. Salivary microbiome data were generated in NHANES via 16s gene sequencing. Shannon and Inverse Simpson alpha diversity metrics were used to quantify oral microbial diversity for each participant. Clinical attachment loss (CAL) and probing depths from periodontal exams were included as historic and active measures of periodontitis, respectively. All-cause (non-accident deaths) and CM mortality (due to cardiovascular disease, cerebrovascular disease, diabetes, nephritis) through 2019 were ascertained via National Death Index linkages. We used multivariable Cox regression to compute hazard ratios and 95% confidence intervals (HR [95%CI]) of all-cause and CM mortality among 2 nd and 3 rd tertiles (vs 1 st tertile) of alpha diversity, CAL, and probing depth. We adjusted for study cycle, demographics, CM risk factors. Results: Mean age (SE) of participants was 48.1(0.2) years and 50% were men. Across 8.8 years of median follow-up, 193 all-cause deaths and 85 CM deaths occurred. Higher alpha diversity were associated with lower risks of all-cause and CM mortality, although non-significant. Relative risk of CM mortality in CAL Tertiles 3 vs. 1 is 1.81 (1.05, 3.09) (see Table ). Conclusion: Lower oral microbiome diversity and poorer indicators of periodontitis were not associated with all-cause and CM mortality.

The Association of Total Meat Intake with Cardio-Metabolic Disease Risk Factors and Measures of Sub-Clinical Atherosclerosis in an Urbanising Community of Southern India: A Cross-Sectional Analysis for the APCAPS Cohort.

Meat is commonly consumed in India; however, in comparison to Western settings, it is eaten in relatively lower quantities and with minimal processing. The association between meat intake and cardio-metabolic diseases (CMDs) and their risk factors in India is currently uncertain. We examined whether meat intake is associated with risk factors for CMDs and the measures of subclinical atherosclerosis in urbanising villages in southern India. We conducted a cross-sectional analysis of 6012 adults (52.3% male) participating in the Andhra Pradesh Children and Parents' Study (APCAPS), which is a large prospective, intergenerational cohort study in Southern India that began with the long-term follow-up of the Hyderabad Nutrition Trial (1987-1990). We used cross-sectional data from the third wave of data collection conducted in 2010-2012, where total meat intake was assessed using 100-item, semi-quantitative validated food frequency questionnaires (FFQ). The FFQs were validated using multiple weighed 24 h dietary recalls. The main predictor, 'total meat intake', was calculated as the sum of chicken, red meat, and fish consumption. The risk factors for CMDs [systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC), fasting glucose, total cholesterol, homeostasis model assessment insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, and C-reactive protein] and measures of subclinical atherosclerosis [Carotid Intima-Media Thickness, Pulse Wave Velocity, and Augmentation Index] were assessed using standardised clinical procedures. Stratified by gender, the association of meat intake with the risk factors of CMDs and measures of subclinical atherosclerosis was examined using linear multilevel models with random intercept at the household level. The mean (SD) age of the male (n = 3128) and female participants (n = 2828) was 34.09 years (15.55) and 34.27 years (12.73), respectively. The median (IQR) intake of meat was 17.79 g/day (8.90, 30.26) in males and 8.90 g/day (4.15, 18.82) in females. In males, a 10 g increase in total meat intake/1000 Kcal/day was positively associated with DBP, BMI, WC, total cholesterol, LDL-C, and triglycerides, whereas in females, a 10 g increase in total meat intake/1000 Kcal/day was positively associated with SBP, DBP, fasting glucose, HOMA-IR, total cholesterol, LDL-C, and triglycerides. There was no relationship between meat consumption and measures of subclinical atherosclerosis. Meat intake had a linear positive association with CMD risk factors among the relatively younger Indian population who were consuming meat at lower levels compared to their European counterparts.

Association between overweight/obesity perception, actual body weight and cardiometabolic risk among healthy Ghanaian adults

BackgroundThe global rise in obesity, particularly among black Africans in developing nations experiencing nutritional transitions, underscores the importance of exploring Overweight/Obesity Perception (OP) as a crucial factor in maintaining an optimal body weight. Incorrect body image perception may impede efforts to achieve the desired body weight, leading to adverse outcomes related to Cardiometabolic Diseases (CMD). This cross-sectional study investigated the interplay between overweight/obesity perception, actual body weight, and CMD risk in a cohort of healthy Ghanaian adults. MethodsA total of 302 apparently healthy adults, aged 25–60 years, with Dagomba ancestry, were recruited from three communities. Participants were screened based on age, ancestry, history of communicable and Non-Communicable Diseases (NCD), and use of antidiabetic, lipid-lowering, and antihypertensive drugs. Anthropometric assessments and blood sample collections for biochemical analysis were conducted. Body image perception was measured using the Stunkard Figure Rating Scale (SFRS). Data were analyzed using descriptive statistics, chi-square tests, correlation analysis, logistic regression, and multivariate analysis. ResultsParticipants had a mean age of 38.28 ± 10.88, with 61.6% being women. While 47% accurately perceived their body weight, 53% had incorrect perceptions. Notably, 47.2% underestimated and 8.5% overestimated their weight status. Among overweight individuals, 33% underestimated and 9.4% overestimated their weight, whereas among the obese, 66.7% and 33.3% respectively had inaccurate perceptions. Gender, serum triglyceride levels, and waist circumference were significantly associated with weight perception. About 55% of overweight/obese participants and 62.1% with high waist circumference did not express a desire to lose weight. Multiple logistic regression revealed that both overweight (AOR = 6, 95% CI (1.8–20.2), p < 0.05) and obesity (AOR = 20.5, 95% CI (5–84.9), p < 0.05) significantly increased the odds of CMD. ConclusionThe findings underscore the association between overweight/obesity and an elevated risk of CMD. This emphasizes the imperative for public health interventions aimed at promoting an ideal body weight and highlighting the impact of overweight/obesity on CMD risk factors.

The higher dietary inflammation is associated with a higher burden of multimorbidity of cardio-metabolic and mental health disorders in an urbanizing community of southern India: A cross-sectional analysis for the APCAPS cohort

Background & aimsHabitual dietary pattern has been shown to be a major modulator of systemic inflammation and is considered a modifiable risk factor for cardio-metabolic diseases (CMDs) and mental health disorders. We examined whether dietary-inflammation is associated with the multimorbidity of CMDs and mental health disorders in urbanizing-villages in southern India. We hypothesized that the participants with higher dietary-inflammation would have a higher burden of multimorbidity. Materials & methodsWe conducted a cross-sectional analysis of 5984 adults (53% male) participating in the Andhra Pradesh Children and Parents' Study. We assessed dietary-inflammation using dietary inflammatory index (DII®) based on intake of 27 micro- and macro-nutrients which were measured using a validated food-frequency-questionnaires. The CMDs and mental health disorders were assessed using standardized clinical procedures and validated questionnaires. ‘Multimorbidity’ was defined as a co-existence of one or more CMDs (hypertension, diabetes, myocardial infarction, heart failure, angina and stroke) and one or more mental health disorders (depression and anxiety). The association of multimorbidity with dietary-inflammation was examined using robust Poisson regression. ResultsThe prevalence of multimorbidity was 3.5% and ∼75% of participants were consuming a pro-inflammatory diet (DII >0.0). As compared to the 1st DII-quartile (least dietary-inflammatory group), the adjusted prevalence ratio (95% confidence interval) for the presence of multimorbidity was 1.46(0.87, 2.46) for 2nd, 1.75(1.05, 2.89) for 3rd, and 1.77(1.06, 2.96) for 4th DII-quartile (p-trend = 0.021). There was no evidence of an interaction between DII and sex on multimorbidity. ConclusionsDietary-inflammation had a positive linear association with the multimorbidity, which suggest that even modest reduction in dietary-inflammation may reduce the multimorbidity burden.

Revisiting an old relationship: the causal associations of the ApoB/ApoA1 ratio with cardiometabolic diseases and relative risk factors-a mendelian randomization analysis.

It has been confirmed that the ApoB/ApoA1 ratio is closely associated with the incidence of cardiometabolic diseases (CMD). However, due to uncontrolled confounding factors in observational studies, the causal relationship of this association remains unclear. In this study, we extracted the ApoB/ApoA1 ratio and data on CMD and its associated risk factors from the largest European Genome-Wide Association Study. The purpose was to conduct Mendelian Randomization (MR) analysis. The causal relationship between the ApoB/ApoA1 ratio and CMD was evaluated using both univariable and multivariable MR analyses. Furthermore, bidirectional MR analysis was performed to estimate the causal relationship between the ApoB/ApoA1 ratio and risk factors for CMD. The final verification confirmed whether the ApoB/ApoA1 ratio exhibits a mediating effect in CMD and related risk factors. In terms of CMD, a noteworthy correlation was observed between the increase in the ApoB/ApoA1 ratio and various CMD, including ischemic heart disease, major adverse cardiovascular events, aortic aneurysm, cerebral ischemic disease and so on (all PFDR<0.05). Meanwhile, the ApoB/ApoA1 ratio was significantly associated with CMD risk factors, such as hemoglobin A1c, fasting insulin levels, waist-to-hip ratio, sedentary behavior, and various others, demonstrating a notable causal relationship (all PFDR<0.05). Additionally, the ApoB/ApoA1 ratio played a mediating role in CMD and relative risk factors. This MR study provides evidence supporting the significant causal relationship between the ApoB/ApoA1 ratio and CMD and its risk factors. Moreover, it demonstrates the mediating effect of the ApoB/ApoA1 ratio in CMD and its risk factors. These findings suggest that the ApoB/ApoA1 ratio may serve as a potential indicator for identifying the risk of developing CMD in participants.

Biological sex-related differences in the postprandial triglyceride response to intermittent hypoxaemia in young adults: a randomized crossover trial.

Obstructive sleep apnoea is characterized by chronic intermittent hypoxaemia and is independently associated with an increased risk of metabolic comorbidities (e.g. type II diabetes and ischaemic heart disease). These comorbidities could be attributable to hypoxaemia-induced alterations in blood lipid profiles. However, it remains unclear whether intermittent hypoxaemia alters triglyceridaemia differently between biological sexes. Therefore, we used a randomized crossover design to examine whether 6h of moderate intermittent hypoxaemia (15hypoxaemic cycles/h, 85% oxyhaemoglobin saturation) alters plasma triglyceride levels differently between men and women after a high-fat meal. Relative to men, women displayed lower levels of total triglycerides, in addition to denser triglyceride-rich lipoprotein triglycerides (TRL-TG; mainly very low-density lipoprotein triglycerides and chylomicron remnant triglycerides) and buoyant TRL-TG (mainly chylomicron triglycerides) during normoxia (ambient air) and intermittent hypoxaemia (sex × time: all P ≤ 0.008). Intermittent hypoxaemia led to higher triglyceride levels (condition: all P ≤ 0.016); however, this effect was observed only in men (sex × condition: all P ≤ 0.002). Compared with normoxia, glucose levels were higher in men and lower in women during intermittent hypoxaemia (sex × condition: P<0.001). The different postprandial responses between biological sexes occurred despite similar reductions in mean oxyhaemoglobin saturation and similar elevations in insulin levels, non-esterified fatty acid levels and mean heart rate (sex × condition: all P ≥ 0.185). These results support growing evidence showing that intermittent hypoxaemia impacts men and women differently, and they might help to explain biological sex-related discrepancies in the rate of certain comorbidities associated with intermittent hypoxaemia. KEY POINTS: Intermittent hypoxaemia is a key characteristic of obstructive sleep apnoea and alters lipid metabolism in multiple tissues, resulting in increased circulating triglyceride levels, an important risk factor for cardiometabolic diseases. Circulating triglyceride levels are regulated differently between biological sexes, with women typically displaying much lower fasting and postprandial triglyceride levels than men, partly explaining why women of all ages experience lower mortality rates from cardiometabolic diseases. In this study, healthy young men and women consumed a high-fat meal and were then exposed to 6h of intermittent hypoxaemia or ambient air. We show that postprandial triglyceride levels are significantly lower in women compared with men and that intermittent hypoxaemia leads to higher postprandial triglyceride levels in men only. These results might help us to understand better why women living with obstructive sleep apnoea experience lower rates of cardiometabolic diseases (e.g. type II diabetes and ischaemic heart disease) than men living with obstructive sleep apnoea.

Complementary nutritional and health promoting constituents in germinated and probiotic fermented flours from cowpea, sorghum and orange fleshed sweet potato

Germination and fermentation are age-long food processes that beneficially improve food composition. Biological modulation by germination and probiotic fermentation of cowpea, sorghum, and orange-fleshed sweet potato (OFSP) and subsequent effects on the physicochemical (pH and total titratable acidity), nutritional, antinutritional factors and health-promoting constituents/properties (insoluble dietary fibres, total flavonoid and phenolic contents (TFC and TPC) and antioxidant capacity) of the derived flours were investigated in this study. The quantification of targeted compounds (organic acids and phenolic compounds) on an ultra-high performance liquid chromatography (UHPLC) system was also done. The whole cowpea and sorghum were germinated at 35 °C for 48 h. On the other hand, the milled whole grains and beans and OFSP were fermented using probiotic mesophilic culture at 35 °C for 48 h. Among the resultant bioprocessed flours, fermented sorghum and sweet potato (FSF and FSP) showed mild acidity, increased TPC, and improved ferric ion-reducing antioxidant power. While FSF had better slowly digestible and resistant starches and the lowest oxalate content, FSP indicated better hemicellulose, lowest fat, highest luteolin, caffeic and vanillic acids. Germinated cowpea flour exhibited reduced tannin, better lactic acid, the highest crude fibre, cellulose, lignin, protein, fumaric, l-ascorbic, trans-ferulic and sinapic acids. The comparable and complementary variations suggest the considerable influence of the substrate types, followed by the specific processing-based hydrolysis and biochemical transitions. Thus, compositing the bioprocessed flours based on the unique constituent features for developing functional products from climate-smart edibles may partly be the driver to ameliorating linked risk factors of cardiometabolic diseases.

Nutrient Combinations Sensed by L-Cell Receptors Potentiate GLP-1 Secretion.

Obesity is a risk factor for cardiometabolic diseases. Nutrients stimulate GLP-1 release; however, GLP-1 has a short half-life (<2 min), and only <10-15% reaches the systemic circulation. Human L-cells are localized in the distal ileum and colon, while most nutrients are absorbed in the proximal intestine. We hypothesized that combinations of amino acids and fatty acids potentiate GLP-1 release via different L-cell receptors. GLP-1 secretion was studied in the mouse enteroendocrine STC-1 cells. Cells were pre-incubated with buffer for 1 h and treated with nutrients: alpha-linolenic acid (αLA), phenylalanine (Phe), tryptophan (Trp), and their combinations αLA+Phe and αLA+Trp with dipeptidyl peptidase-4 (DPP4) inhibitor. After 1 h GLP-1 in supernatants was measured and cell lysates taken for qPCR. αLA (12.5 µM) significantly stimulated GLP-1 secretion compared with the control. Phe (6.25-25 mM) and Trp (2.5-10 mM) showed a clear dose response for GLP-1 secretion. The combination of αLA (6.25 µM) and either Phe (12.5 mM) or Trp (5 mM) significantly increased GLP-1 secretion compared with αLA, Phe, or Trp individually. The combination of αLA and Trp upregulated GPR120 expression and potentiated GLP-1 secretion. These nutrient combinations could be used in sustained-delivery formulations to the colon to prolong GLP-1 release for diminishing appetite and preventing obesity.