Healthy African American Women Research Articles

Abstract A060: Breast cancer-associated leukocyte DNA methylation profile in obese African-American women

Abstract Background: DNA methylation (DNAme) is a stable epigenetic mark leading to reduced gene expression. However, genome-wide DNAme profile is susceptible to disease. Therefore, specific genetic DNAme profiles could potentially serve as biomarkers associated with breast cancer (BC) and obesity as its comorbidity. Incidentally, BC-related mortality is higher in African-American women, causing a significant health disparity. In this study, we profiled obesity and breast cancer-related leukocyte DNAme in African-American women to explore methylation- associated biomarkers in these women. Methods: We used 10 African-American women with confirmed breast cancer diagnosis and 10 otherwise healthy African-American women with known Body Mass Index (BMI) > 30 (Obese). DNA was extracted from the buffy coat of peripheral blood using Qiagen DNA extraction kits. We used the next-generation sequencing technology to perform reduced presentation bisulfite sequencing (RRBS) using the Tecan Ovation RRBS kit. We sequenced the libraries on a NextSeq 550 at our Precision Medicine Unit. Single-end 75bp reads were generated and processed using Bismark and mapped against the GRCh38 human genome, and differentially methylated regions (DMR) were derived using MethylKit using a 1 kb window. Gene Ontology and Disease association studies were conducted using DAVID and relapsed-free survival in Kmplot. Additionally, we compared the gene sets with obese and normal DMRs that had previously been obtained similarly. Results: We found that 83% of the DMRs were in the promoter/upstream regions of the nearest genes, and 96% of DMRs were part of CpG islands, indicating potential regulatory functions of these regions. Gene ontology analysis revealed that the DMR-associated genes were also overrepresented in breast carcinoma, Type 2 Diabetes, Obesity, and Tobacco usage, according to the DisGeNET and GAD disease associations databases. Genes with DMRs in their upstream or promoter regions - include PRDM16, PTBP1, RAB1A (lower methylation in cancer with obesity), and Multiple ribosomal genes along with RRAF, XKR4 (higher methylation in cancer with obesity). We observed lower methylation profiles in multiple genes in samples with cancer, which were higher in obese samples without cancer.Conclusion: Our study suggests that a distinct peripheral DNA methylation profile is associated with minority women suffering from both cancer and obesity. Our data show that showed that breast cancer modulates leucocyte DNA methylation profile in obese individuals towards that of a more normal BMI, causing a partial reversal. This potential reversal is primarily in the upstream regions of the genes detected for methylation. The DMR genes in cancer with obesity are significantly associated with overall survival in breast cancer, thus indicating a potential link in understanding the crosstalk between obesity and cancer. Citation Format: Pranabananda Dutta, Yanyuan Wu, Jaydutt V. Duta. Breast cancer-associated leukocyte DNA methylation profile in obese African-American women [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A060.

Emotional response to perceived racism and nocturnal heart rate variability in young adult African Americans

BackgroundHeightened autonomic nervous system (ANS) arousal is a well-established contributor to the effect of stress on adverse cardiovascular health outcomes which disproportionately affect African Americans. ANS arousal is normally attenuated during sleep and compromise of this shift is associated with multiple adverse cardiovascular outcomes. Parasympathetic nervous system (PNS) dominance during sleep can be altered by stress. Racism has been recognized to have many negative health consequences in African Americans. Perceived racism has been linked to ANS activity, however, we are not aware of prior research on racism and nocturnal ANS balance. Objective: To examine relationships between perceived racism and nocturnal ANS activity indexed by heart rate variability (HRV) in healthy African American men and women age 18–35. MethodsFifty-four participants completed the Perceived Racism Scale and had 24-hour ambulatory electrocardiogram recordings in their homes. Power spectral analysis was used to derive normalized high frequency (nHF) to index PNS activity which was computed by 5-minute epochs during wake and sleep. ResultsEndorsement of racism and negative emotional reactions during the past year were inversely related to nHF during time in bed. Multiple regression analysis indicated that negative emotional reactions were a significant predictor of nHF during the sleep period F(2,54) = 4.213, p = .020, R2 = 0.135 (adjusted R2 = 0.103). Relationships during wake were not statistically significant. ConclusionFindings suggest that perseverative thoughts triggered by negative emotional reactions to racism influencing nocturnal ANS activity may be a pathway by which perceived racism affects health.Support: 3UL1TR001409-02S1 and R01HL087995 to Dr. Mellman.

Expectations of Racism and Carotid Intima-Media Thickness in African American Women.

Several researchers have argued that racism-related stressors play an important role in adverse cardiovascular outcomes among African American women. However, studies have primarily focused on experiences of racism; thus, the role of expectations of racism is insufficiently understood. The current proof-of-concept study was designed to examine associations among expectations of racism, self-reported experiences of racism, and carotid intima-media thickness (IMT), a marker of cardiovascular risk, in African American women. Participants were 52 healthy African American women, aged 30 to 50 years (M (SD) = 40.8 (4.3)). Expectations of racism were assessed with a modified version of the Race-Based Rejection Sensitivity Questionnaire, experiences of racism were assessed with the Schedule of Racist Events, and carotid IMT was measured using B-mode ultrasound. In linear regression analyses adjusted for age, expectations of racism were associated with higher levels of carotid IMT (b = .04, SE = .014, p = .013), after adjusting for experiences of racism. Findings remained significant after additional adjustments for cardiovascular risk factors (b = .03, SE = .014, p = .032). Associations were not confounded by additional stressors, hostility, or negative affect (depressive symptoms). Independent of actual reports of racism, "expectations" of racism may be associated with increased cardiovascular risk in African American women. In addition, although experiences of discrimination were associated with depressive symptoms, expectations of racism were not, suggesting that other negative emotions likely play a role. Future studies are needed to replicate these results in larger samples and to explore the psychological and physiological pathways through which expectations of racism might affect cardiovascular disease risk across a range of populations.

Cognition and Vitamin D in Older African-American Women- Physical performance and Osteoporosis prevention with vitamin D in older African Americans Trial and Dementia.

To examine the effect of 25-hydroxyvitamin D (25(OH)D) levels recommended by Endocrine Society guidelines (>30 ng/mL) on cognition in healthy older African-American women over 3 years. Randomized, double-blind, placebo-controlled clinical trial. Bone Mineral Research Center at New York University Winthrop Hospital. Healthy postmenopausal African American women aged 65 and older (N=260; mean age 68.2 ± 4.9; 46% college education or higher). Half of the women were randomized to receive vitamin D (adjusted to achieve a serum level > 30 ng/mL) with calcium (diet and supplement total of 1,200 mg), and half were randomized to receive placebo with calcium (1,200 mg). Cognitive assessments every 6 months using the Mini-Mental State Examination (MMSE) to detect cognitive decline. Mean MMSE scores were calculated over time for both groups. Those with MMSE scores less than 21 at baseline were excluded. The average dose of vitamin D3 was 3,490 ± 1,465 IU per day, and average serum 25(OH)D at 3 years was 46.8 ± 1.2 ng/mL in the active group and 20.7 ± 1.1 ng/mL in the placebo group. Serum 25(OH)D concentration was maintained at greater than 30 ng/mL in 90% of the active group. Over the 3-year period, MMSE scores increased in both groups (p < .001), although change over time was not significantly different between the groups. No adverse events associated with vitamin D were observed. There was no difference in cognition over time between older African-American women with serum concentrations of 25(OH)D of 30 ng/mL and greater than those taking placebo. There is no evidence to support vitamin D intake greater than the recommended daily allowance in this population for preventing cognitive decline. J Am Geriatr Soc 67:81-86, 2019.

Abstract P130: Acute Hyperlipidemia Increases Vasodilation in Conduit Arteries but Has No Effect on Microvascular Recruitment in African American Women

African Americans have one of the highest prevalence of hypertension in the United States. Impaired endothelial function has been implicated in the pathophysiology of hypertension in this group. We previously reported that brachial artery diameter increases from 3.9±0.14 to 4.1± 0.14 at 4 hours after ingestion of a high fat meal, suggesting vasodilation of conduit arteries. Considering that oral fat ingestion stimulates the release of gastrointestinal peptides with vasoactive properties, we aimed to isolate the vascular effect of fat on conduit artery and microvasculature by inducing an acute elevation of triglycerides and free fatty acids with an infusion of 20% intralipid® and heparin. To assess endothelial function we measured changes in the diameter of the brachial artery to hyperemia with a continuous edge detection and wall tracking software. Effect on microvasculature was obtained with contrast-enhanced ultrasonography (CEU) of the brachioradialis muscle with lipid-perflutren microbubbles infusion. We studied 14 obese healthy African American women, age 39± 10, BMI 38.7± 3.4 kg/m. 2 Triglycerides increased from 60.7±30.5 to 523.3±231 mg/dL at the end of the 4 h infusion. Brachial artery diameters were 3.6±0.16 and 3.9±0.18 mm at baseline, and 4-h, P=0.109, respectively. Flow mediated dilation improved at the end of the 4-h infusion period (4.3±0.95 to 6.2±1.21%, P=0.016), figure . Microvascular blood volume did not change with the intervention 5.8±4.9 vs. 5.9±3.6, P=0.55. In conclusion, IV acute hyperlipidemia did not increase brachial artery diameter nor microvascular circulation, however it potentiates vascular reactivity in conduit arteries.

Abstract B33: Motivating African American women with hereditary breast cancer risk to participate in genetic counseling

Abstract Background: The emerging precision health paradigm for breast cancer control will base screening and prevention on individual level of risk. An important element of this approach is cancer genetic risk assessment and genetic counseling for women with familial breast cancer risk. Despite a referral from their primary care physician (PCP), prior work from our group demonstrated poor uptake of genetic counseling among African American (AA) women with a family history of breast/ovarian cancer who meet national guidelines for genetic counseling. This is consistent with other reports of poor utilization of BRCA testing among AA women. We found a strong desire among both PCPs and AA women for culturally sensitive educational material tailored to AA women at risk for hereditary breast cancer to help them understand the purpose of genetic counseling. In response to that finding, we are developing an educational animation delivered on a mobile device platform that is designed to motivate AA women to attend genetic counseling. Content for the animation will be informed by constructs from a theoretical model of health behavior and by themes identified in semistructured interviews with women who were recommended for genetic counseling by their PCP in our formative work. Methods: We conducted key informant interviews with healthy AA women without a personal history of cancer who all met criteria established by the National Comprehensive Cancer Network for genetic counseling based on a family history of breast/ovarian cancer. Potential participants were identified from a cohort of women who participated in an earlier study of cancer genetic risk assessment performed as part of routine care in a Federally Qualified Health Center in Chicago, IL. All potential participants were referred for genetic counseling by their PCP and provided consent for re-contact for future research. Recruitment letters were mailed to all eligible women, followed 2 weeks later by phone contact. The study group includes both women who did and who did not attend the counseling session. The semistructured interview guide was based on constructs from the Integrative Model of Behavioral Prediction (IMBP). Standard qualitative data analysis techniques were used, including an iterative process to develop a codebook and use of 2 coders to analyze each interview transcript. An inductive methodology using a modified version of constant comparative analysis was the key methodologic strategy for analyzing the qualitative interviews data. Results: A total of 60 AA women who were age 25-69 at the time of the prior study were eligible to participate in the interviews. Eleven of these women (18%) attended a genetic counseling session. The mean age of eligible participants was 45 years; 25% reported either a high school diploma or a GED as their highest level of attained education, and 73% completed some education beyond high school; 55% reported receiving their health insurance from Medicaid; and the majority (70%) reported annual household income of less than $30,000. Of 60 eligible women, 16 (27%) were not available for a recruitment phone call (13 had an invalid address or phone number, 2 declined a recruitment phone call, and 1 moved out of the area). Twenty interviews will be completed by the end of June, 2017, and themes from IMBP constructs that emerge as key motivators of attendance at a genetic counseling session will be reported. Conclusion: The findings from this study will provide data to inform interventions that will be necessary to ensure that underserved AA women with familial breast cancer risk receive genetic counseling. In the absence of effective interventions to increase utilization of cancer genetic services, the emergence of precision health care is likely to exacerbate cancer disparities in underserved AA communities. Citation Format: DeLawnia Comer-HaGans, Zo Ramamonjiarivelo, Shirley Spencer, Beverly Chukwudozie, Vida Henderson, Karriem Watson, Catherine Balthazar, Rupert Evans, Robert Winn, Angela Odoms-Young, Kent Hoskins. Motivating African American women with hereditary breast cancer risk to participate in genetic counseling [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B33.

Serologic features of cohorts with variable genetic risk for systemic lupus erythematosus

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease with genetic, hormonal, and environmental influences. In Western Europe and North America, individuals of West African descent have a 3–4 fold greater incidence of SLE than Caucasians. Paradoxically, West Africans in sub-Saharan Africa appear to have a low incidence of SLE, and some studies suggest a milder disease with less nephritis. In this study, we analyzed sera from African American female SLE patients and four other cohorts, one with SLE and others with varying degrees of risk for SLE in order to identify serologic factors that might correlate with risk of or protection against SLE.MethodsOur cohorts included West African women with previous malaria infection assumed to be protected from development of SLE, clinically unaffected sisters of SLE patients with high risk of developing SLE, healthy African American women with intermediate risk, healthy Caucasian women with low risk of developing SLE, and women with a diagnosis of SLE. We developed a lupus risk index (LRI) based on titers of IgM and IgG anti-double stranded DNA antibodies and levels of C1q.ResultsThe risk index was highest in SLE patients; second highest in unaffected sisters of SLE patients; third highest in healthy African-American women and lowest in healthy Caucasian women and malaria-exposed West African women.ConclusionThis risk index may be useful in early interventions to prevent SLE. In addition, it suggests new therapeutic approaches for the treatment of SLE.

Elevated PBMC‐derived oxidative stress in healthy young African American women

Several studies have demonstrated that African Americans (AA) exhibit elevations in systemic oxidative stress compared to Caucasian Americans (CA). Peripheral blood mononuclear cells (PBMCs) have been identified as one of the primary contributors to systemic reactive oxygen species (i.e. oxidative stress) and may be an underlying mechanism for the development of hypertension and cardiovascular diseases. Previous work demonstrates that young healthy AA men have elevated PBMC‐derived superoxide production when compared to CA men. However, whether PBMC‐derived superoxide production is also elevated in young healthy AA women remains unknown. This is important because AA women are also more likely to develop hypertension and cardiovascular diseases than women of any other race. Accordingly, this study investigated PBMC‐derived superoxide production in young healthy AA and CA women. We tested the hypothesis that, relative to CA women, AA women would exhibit greater levels of PBMC‐derived oxidative stress. In ten normotensive AA women and ten age‐matched normotensive CA women, resting intracellular superoxide levels were assessed from freshly isolated PBMCs using dihydroethidium fluorescence. Subjects arrived to the lab following an overnight fast. Resting blood pressure was measured following a 10‐minute rest period and a 50‐mL venous blood sample was then drawn. PBMCs were isolated from whole blood using density gradient centrifugation and intracellular superoxide was assessed using dihydroethidium fluorescence. Resting mean arterial pressure was similar between groups (AA 82.9±1.7 vs. CA 79.4±2.4 mmHg; P =0.26) however the resting intracellular superoxide production was elevated in AA women compared to CA (AA 4.1±1.9 vs. CA 2.7±1.0 Relative Fluorescent Units; P=0.025). These preliminary findings suggest that young AA women exhibit greater resting PBMC‐derived superoxide production. Thus, PBMCs may represent a source of elevated oxidative stress in AA women.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Association of early pregnancy body mass index with post-partum weight change among African-American women.

Post-partum weight retention is relatively common and increases the risk for future obesity. Women who are overweight or obese prior to pregnancy, or who gain excessively during pregnancy, are more likely to retain weight post-partum. Much of the existing research is limited by a single post-partum body-weight measure and therefore cannot distinguish post-partum weight retention from post-partum weight accrual. This study tested the hypothesis that early pregnancy body mass index (BMI) is positively associated with post-partum weight change, independent of gestational weight gain (GWG) and breastfeeding (BF) among African-American women, a demographic group with greater risk for obesity. Healthy African-American women (n = 32) were weighed at 2 weeks and 3 months post-partum to derive post-partum weight change. Data from prenatal care records were retrieved to calculate BMI at the first prenatal care visit and GWG. BF status at 2 weeks post-partum was self-reported. Early pregnancy BMI was positively associated with post-partum weight change (partial r = 0.53, P < 0.005), independent of GWG and BF status at 2 weeks post-partum. These results extend the literature by suggesting that the association between early pregnancy BMI and post-partum weight retention may be at least partially attributable to the accrual of new weight during the post-partum period. Future research in a larger and more diverse cohort is warranted and should explore potential mechanisms contributing to post-partum weight change.

The Feasibility of Using Facebook, Craigslist, and Other Online Strategies to Recruit Young African American Women for a Web-Based Healthy Lifestyle Behavior Change Intervention.

Reports describing successful recruiting of minority participants are available; however, they focus largely on traditional strategies. Internet and mobile devices are widely used, providing alternative approaches, yet less information is available describing the success of these approaches. This article (1) evaluates the feasibility of using online advertising as a recruiting modality for a healthy lifestyle behavior change intervention targeting young African American women and (2) describes lessons learned to better inform researchers for future directions. African American women, aged 18 to 45 years, with untreated prehypertension and Internet access were eligible for a 12-week randomized study providing physical activity or nutrition behavior change education delivered via online modules. Traditional strategies included flyers, tabletop cards, blood pressure screenings, health fairs, and clinics. Online-related strategies included posting ads on Facebook, Craigslist, and on the university Web site, intranet, and "on-hold" telephone line. Descriptive statistics were used to identify frequency of recruitment strategies. χ Analysis was used to assess differences between enrolled and nonenrolled inquiries. Among all 176 inquiries, the most frequented strategies were the university Web site (44%), blood pressure screenings (15%), Facebook/Craigslist (13%), and clinics (12%). Enrollment rates differed across recruitment strategies (χ P = .046). The 3 highest enrollment rates were (1) employee in-services (100%), (2) flyers/tabletop cards (31.6%), and (3) word of mouth/physician referral (25%). Online-related strategies are convenient and have great potential for reaching large numbers of people. However, the actual rate of participants successfully enrolled online was proportionally smaller when compared with traditional recruiting strategies.

Higher Diet Quality Is Inversely Associated with Mortality in African-American Women1–4

Background: Diet quality has been inversely associated with overall mortality in white populations, but the evidence in African-American populations is limited.Objective: The goal of the present study was to assess diet quality in relation to all-cause mortality in the Black Women's Health Study, a follow-up study of African-American women begun in 1995.Methods: Data used in this study were obtained via biennial questionnaires from 1995 to 2011. Based on food-frequency questionnaire data collected in 1995 and 2001, we calculated an index-based diet quality score [Dietary Approaches to Stop Hypertension (DASH)] and derived dietary patterns (prudent and Western) with the use of factor analysis. We followed 37,001 women who were aged 30–69 y and free of cancer, cardiovascular disease, and diabetes at baseline for mortality through 2011. Multivariable Cox regression was used to estimate HRs and 95% CIs. Analyses were conducted in 2014.Results: Based on a total of 1678 deaths during 16 y of follow-up, higher DASH scores were associated with reduced all-cause mortality (HR: 0.75; 95% CI: 0.63, 0.89 for highest vs. lowest quintiles). The DASH components most strongly associated with lower mortality were high intake of whole grains and low intake of red and processed meat. A Western dietary pattern, characterized by high intake of red and processed meat, was associated with increased all-cause mortality rates (HR: 1.37; 95% CI: 1.17, 1.60 for highest vs. lowest quintiles of score); a prudent dietary pattern was not associated with risk.Conclusion: A DASH-style diet high in intake of whole grains and low in consumption of red meat is associated with reduced mortality rates in healthy African-American women.

Trabecular bone score (TBS) in postmenopausal African American women.

Trabecular bone score (TBS) is a newly developed parameter that can be derived from DXA scans of the spine and may reflect bone quality. This study provides TBS values in healthy postmenopausal women of African descent. African American women have a lower risk for osteoporotic fractures as a result of higher bone density and better bone quality. We examined TBS in postmenopausal African American women since there are no previous reports in this population. This was a study of healthy African American volunteers using baseline values prior to their participation in two vitamin D intervention studies conducted at an ambulatory research center of an academic health center. The study population consisted of 518 healthy postmenopausal African American women with a mean age of 66years and a BMI of 30.1. Mean TBS (L1 to L4) was 1.300(.100 SD). Significant negative correlations were found between TBS and age and BMI. None of the biochemical variables were significantly correlated with TBS whereas the various bone density sites were correlated with TBS. TBS values for African American women are higher than those reported in the literature for white women and are inversely related to age and BMI.

Vitamin D Supplementation in Young White and African American Women

There is limited information on the effects of vitamin D on serum 25 hydroxyvitamin D (25OHD) in young people and none on African Americans. The main objective of this trial was to measure the effect of different doses of vitamin D3 on serum 25OHD and serum parathyroid hormone (PTH) in young women with vitamin D insufficiency (serum 25OHD ≤ 20 ng/mL (50 nmol/L). A randomized double-blind placebo-controlled trial of vitamin D3 was conducted in young white and African American women, age 25 to 45 years. A total of 198 healthy white (60%) and African American (40%) women were randomly assigned to placebo, or to 400, 800, 1600, or 2400 IU of vitamin D3 daily. Calcium supplements were added to maintain a total calcium intake of 1000 to 1200 mg daily. The primary outcomes of the study were the final serum 25OHD and PTH levels at 12 months. The absolute increase in serum 25OHD with 400, 800, 1600, and 2400 IU of vitamin D daily was slightly greater in African American women than in white women. On the highest dose of 2400 IU/d, the mixed model predicted that mean 25OHD increased from baseline 12.4 ng/mL (95% confidence interval [CI], 9.2-15.7) to 43.2 ng/mL (95% CI, 38.2-48.1) in African American women and from 15.0 ng/mL (95% CI, 12.3-17.6) to 39.1 ng/mL (95% CI, 36.2-42.0) in white women. There was no significant effect of vitamin D dose on serum PTH in either race but there was a significant inverse relationship between final serum PTH and serum 25OHD. Serum 25OHD exceeded 20 ng/mL in 97.5% of whites on the 400 IU/d dose and between 800 and 1600 IU/d for African Americans. The recommended dietary allowance (RDA) suggested by the Institute of Medicine for young people is 600 IU daily. The increase in serum 25OHD after vitamin D supplementation was similar in young and old, and in white and African American women.

Central centrifugal cicatricial alopecia severity is associated with cowhage-induced itch

Patients with central centrifugal cicatricial alopecia (CCCA) often suffer from varying degrees of itch, pain and burning sensations. However, the neural component of these skin sensations has not been assessed. To conduct a comprehensive analysis of C nerve fibre function relating to itch and pain perception in patients with CCCA using thermosensory testing and experimental itch models. Fifteen healthy African-American women and 16 African-American female patients with CCCA participated in the study and underwent quantitative computerized thermosensory testing to assess warmth and heat pain thresholds. Itch was induced using histamine iontophoresis and application of cowhage spicules, and the intensity of each itch was assessed. The association between itch intensity and CCCA severity score was examined. A positive correlation between CCCA severity score and peak itch ratings of cowhage on the lesional scalp (crown) was observed (P = 0·023, r = 0·562). Notably, the histamine peak itch rating was not found to have a significant correlation with CCCA severity score (P = 0·913). The crown also had significantly higher warmth and pain thresholds than the occiput in both healthy subjects and patients with CCCA. Our results suggest a putative role for the protease-activated receptor (PAR)-2, which is activated by cowhage, in the pathogenesis of CCCA. Future studies should examine PAR-2-directed therapeutics for patients with CCCA. Examining for itch and other dysaesthesias in patients with CCCA is of vital importance to dermatologists in assessing disease severity.

Health-related quality of life of african american breast cancer survivors compared with healthy African American women.

The diagnosis and treatment of breast cancer can result in an array of late cancer-specific side effects and changes in general well-being. Research has focused on white samples, limiting our understanding of the unique health-related quality of life outcomes of African American breast cancer survivors (BCSs). Even when African American BCSs have been targeted, research is limited by small samples and failure to include comparisons of peers without a history of breast cancer. The purpose of this study was to compare health-related quality of life of African American female BCSs with that of African American women with no history of breast cancer (control group). A total of 140 women (62 BCSs and 78 controls), 18 years or older and 2 to 10 years postdiagnosis, were recruited from a breast cancer clinic and cancer support groups. Participants provided informed consent and completed a 1-time survey based on the proximal-distal health-related quality of life model of Brenner et al (1995). After adjusting for age, education, income, and body mass index, results show that African American BCSs experienced more fatigue (P = .001), worse hot flashes (P < .001), and worse sleep quality (P < .001) but more social support from their partner (P = .028) and more positive change (P = .001) compared with African American female controls. Our results suggest that African American female BCSs may experience unique health-related outcomes that transcend age, education, socioeconomic status, and body mass index. Findings suggest the importance of understanding the survivorship experience for particular racial and ethnic subgroups to proactively assess difficulties and plan interventions.

Characterization of Metabolically Unhealthy Overweight/Obese African American Women: Significance of Insulin-Sensitive and Insulin-Resistant Phenotypes

Obesity is often associated with high cardiovascular disease risk factors. Obesity is common in African American women. We investigated the characteristics of metabolically healthy and metabolically unhealthy overweight/obese African American women based on the presence of insulin resistance. We studied 196 apparently healthy overweight/obese African American women with family history of type 2 diabetes. Waist circumference, fasting glucose, insulin, c-peptide, lipids and lipoproteins, and systolic and diastolic blood pressure were obtained in each subject. In addition, insulin sensitivity was calculated using Bergman's Minimal Model Method. We defined insulin-sensitive metabolically healthy African American women as individuals with insulin sensitivity greater than 2.7 x 10(-4) x min(-1) (uU/ mL)(-1) and insulin resistant, metabolically unhealthy as insulin sensitivity less than 2.7 x 10(-4) x min(-1) (uU/mL)(-1). Thirty-three percent of our subjects were metabolically healthy African American women, while 67% were metabolically unhealthy African American women. The metabolically healthy subjects were significantly younger and less obese than the metabolically unhealthy subgroup. Mean fasting serum glucose, insulin, and c-peptide were significantly lower (P = .001) in the metabolically healthy than in metabolically unhealthy subjects. However, the mean blood pressures were within normal in both subgroups. Mean serum cholesterol (p < .05) and triglyceride (p < .001) levels were significantly lower, whereas high-density lipoprotein cholesterol (p < .03) was significantly higher in the metabolically healthy than in the metabolically unhealthy subjects. We found 25.5% of our subjects had metabolic syndrome (30.3% metabolically unhealthy and 15.6% metabolically healthy). We concluded that: (1) despite obesity, metabolically healthy African American women appear to be less prone to type 2 diabetes and cardiovascular disease and (2) in view of the higher prevalence of metabolic syndrome, metabolically unhealthy African American women should be targeted for primary prevention of type 2 diabetes and cardiovascular disease.

Relationship between MRI-Measured Bone Marrow Adipose Tissue and Hip and Spine Bone Mineral Density in African-American and Caucasian Participants: The CARDIA Study

An increasing number of studies suggest that bone marrow adipose tissue (BMAT) might play a role in the pathogenesis of osteoporosis. Our previous study of Caucasian women demonstrated that there is an inverse relationship between BMAT and whole-body bone mineral density (BMD). It is unknown whether visceral adipose tissue (VAT), sc adipose tissue (SAT), and skeletal muscle had an effect on the relationship between BMAT and BMD. In the present study we investigated the relationship between pelvic, hip, and lumbar spine BMAT with hip and lumbar spine BMD in the population-based Coronary Artery Risk Development in Young Adults (CARDIA) sample with adjustment for whole-body magnetic resonance imaging (MRI)-measured VAT, SAT, and skeletal muscle. T1-weighted MRI was acquired for 210 healthy African-American and Caucasian men and women (age 38-52 yr). Hip and lumbar spine BMD were measured by dual-energy x-ray absorptiometry. Pelvic, hip, and lumbar spine BMAT had negative correlations with hip and lumbar spine BMD (r = -0.399 to -0.550, P < 0.001). The inverse associations between BMAT and BMD remained strong after adjusting for demographics, weight, skeletal muscle, SAT, VAT, total adipose tissue (TAT), menopausal status, lifestyle factors, and inflammatory markers (standardized regression coefficients = -0. 296 to -0.549, P < 0.001). Among body composition measures, skeletal muscle was the strongest correlate of BMD after adjusting for BMAT (standardized regression coefficients = 0.268-0.614, P < 0.05), with little additional contribution from weight, SAT, VAT, or total adipose tissue. In this middle-aged population, a negative relationship existed between MRI-measured BMAT and hip and lumbar spine BMD independent of demographics and body composition. These observations support the growing evidence linking BMAT with low bone density.

Ethnic and sex differences in bone marrow adipose tissue and bone mineral density relationship

The relationship between bone marrow adipose tissue and bone mineral density is different between African Americans and Caucasians as well as between men and women. This suggests that the mechanisms that regulate the differentiation and proliferation of bone marrow stromal cells may differ in these populations. It has long been established that there are ethnic and sex differences in bone mineral density (BMD) and fracture risk. Recent studies suggest that bone marrow adipose tissue (BMAT) may play a role in the pathogenesis of osteoporosis. It is unknown whether ethnic and sex differences exist in the relationship between BMAT and BMD. Pelvic BMAT was evaluated in 455 healthy African American and Caucasian men and women (age 18-88years) using whole-body T1-weighted magnetic resonance imaging. BMD was measured using whole-body dual-energy X-ray absorptiometry. A negative correlation was observed between pelvic BMAT and total body BMD or pelvic BMD (r = -0.533, -0.576, respectively; P < 0.001). In multiple regression analyses with BMD as the dependent variable, ethnicity significantly entered the regression models as either an individual term or an interaction with BMAT. Menopausal status significantly entered the regression model with total body BMD as the dependent variable. African Americans had higher total body BMD than Caucasians for the same amount of BMAT, and the ethnic difference for pelvic BMD was greater in those participants with a higher BMAT. Men and premenopausal women had higher total body BMD levels than postmenopausal women for the same amount of BMAT. An inverse relationship exists between BMAT and BMD in African American and Caucasian men and women. The observed ethnic and sex differences between BMAT and BMD in the present study suggest the possibility that the mechanisms regulating the differentiation and proliferation of bone marrow stromal cells may differ in these populations.

Assessing the Stages of Change Among African American Women in a Weight Management Program.

The objective of this study was to assess the relationship between stage of change (SOC) and behavioral outcomes among African American women entering obesity treatment in two settings. Fifty-five overweight/obese (body mass index = 26.50-48.13), but otherwise healthy African American women, 23 to 56 years old, attended a 13-week weight loss-treatment program that took place at churches (n = 36) or a university (n = 19). Participants were weighed, completed SOC measures, and had a physical fitness test at pre- and posttreatment. Pretreatment measures of SOC placed 47% of the participants as actors, 31% as contemplators, and 22% as maintainers. Of the 45 women who reported posttreatment SOC, 7% regressed, 44% did not change, and 31% progressed in SOC. Pretreatment SOC predicted posttreatment weight loss in the church setting but not in the university setting. At churches, contemplators lost more weight than actors and maintainers. The church may be a more conducive setting for weight change behaviors for African American women who are categorized as contemplators in the SOC model.

Abstract B81: Racial differences in serum adiponectin and leptin before and after weight loss

Abstract Background: In vitro and in vivo data have shown that adiponectin is antiangiogenic and that leptin increases angiogenesis. The divergent roles that these two adipocytokines play in cancer biology may be underlying mechanisms for racial disparities in cancer severity and mortality. The purpose of this study was to determine whether there were differences in serum concentrations of adiponectin and leptin before and after weight loss in healthy premenopausal African-American (AA) and European-American (EA) women. Methods: Sixty-three African-American (AA) and 58 European-American (EA) premenopausal women were weight-reduced from body mass index (BMI) 27-30 kg/m2 to BMI≤24 kg/m2. Body composition measurements and fasting blood samples were collected before and after weight loss. Repeated-measures mixed models were used to assess the change in adiponectin and leptin from baseline to the weight-reduced state and whether there were racial differences after adjusting for covariates. Results: Following weight loss leptin significantly decreased and adiponectin significantly increased similarly in both racial groups. Mix-model analyses indicated that adiponectin differed with race after adjusting for age, time, intra-abdominal fat, interleukin-6, limb fat and trunk fat (p=0.039). Adjusted least squared means (mean 95% confidence interval) showed that AA women had lower adiponectin relative to EA women at baseline [7.64 (6.8, 8.59) µg/ml vs 9.59 (8.61, 10.7) µg/ml, p=0.011] and in the weight-reduced state [9.84 (8.77, 11.0) µg/ml vs 11.5 (10.3, 12.8) µg/ml, p=0.075]. Mixed-model analyses indicated that leptin differed with race after adjusting for age, time, total fat mass, estradiol, testosterone and insulin (p&amp;lt;.0001). According to the adjusted least squared means, AA women had higher leptin relative to EA women at baseline [25.1 (22.8, 27.7) ng/dl vs 19.6 (18.0, 21.4) ng/dl, p=0.0003] and in the weight-reduced state [12.1 (10.6, 13.7) ng/dl vs 8.23 (7.32, 9.24), p&amp;lt;.0001]. Conclusions: Weight reduction may reduce the risk for cancer severity and mortality through increased serum adiponectin and reduced leptin in both AA and EA women. However, AA women may have worse outcomes as a result of cancer compared to EA women due to differences in the serum concentrations of these adipocyte derived factors that influence tumor angiogenesis. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B81.