Higher Odds Of Obesity Research Articles

Abstract 4134877: Sexual Minorities Cardiovascular Health Disparities Compared to Heterosexual Adults in the US: A Systematic Review and Meta-Analysis of Nearly 2 Million Cohort Patients

Background: Cardiovascular disease (CVD) remains a leading cause of death globally, yet disparities in CVD outcomes among sexual minorities compared to heterosexual adults are under-researched. Sexual minorities face unique stressors, discrimination, and barriers to healthcare, which may contribute to higher CVD risk. This meta-analysis synthesizes evidence on health disparities between sexual minorities and heterosexual adults. Methods: We searched MEDLINE, Cochrane, and Embase databases for studies published between 2002 to 2024 that compared cardiovascular health disparities between sexual minorities and their heterosexual counterparts. Outcomes were CVD, Diabetes, Hypertension, and Obesity. We pooled odds ratios (OR) for binary endpoints with 95% confidence intervals (CI) using a random-effects model. Statistical analyses were performed using R software version 4.3.2. Results: We included 9 Cross-sectional studies after minimizing population overlap, comprising 1,938,814 patients with a mean age of 47 years. There were no significant differences in the odds of CVD (OR 1.10; 95% CI 0.87 to 1.39; Figure 1 A), Diabetes (OR 0.88; 95% CI 0.74 to 1.04; Figure 1 B), hypertension (OR 1.07; 95% CI 0.97 to 1.19; Figure 2 A) and Obesity (OR 1.01; 95% CI 0.76 to 1.35; Figure 2 B) between groups. In subgroup analysis, there were higher odds of obesity in the sexual minority population when compared to their heterosexual counterparts (OR 1.29; 95 % CI 1.15 to 1.45) and higher hypertension odds in sexual minority men (OR 1.35; 95% CI 1.12 to 1.63). Conclusion: In this meta-analysis, we found no statistically significant difference in the prevalence of CVD, diabetes, and obesity between sexual minorities and heterosexuals, meaning that more studies are necessary to assess this difference. Subgroup analyses revealed sexual minority men had higher odds of hypertension and sexual minority women for obesity.

Prevalence of and factors associated with overweight and obesity in patients with severe mental disorders in Shenzhen: results from the urban Chinese population.

To determine the prevalence of overweight and obesity in patients with severe mental disorders (SMD) and the factors associated with their socio-demographic and disease characteristics in a cross-sectional population-based study. This analysis examined the prevalence of overweight and obesity in 14 868 managed SMD patients in an urban area of Shenzhen city based on data from the health information monitoring system in 2021. Multivariate logistic regression were used to identify the factors associated with the prevalence of overweight and obesity in patients with SMD. China. 14 868 patients with SMD. The prevalence of overweight and obesity in patients with SMD in this study was 32·6 % and 16·1 %, respectively. In multivariate analysis, married status, Shenzhen household registration, management durations of 5-10 years and >10 years, participation in family physician services, taking clozapine or aripiprazole, FPG > 6·1 mmol/l, hypertension, TC ≥ 5·2 mmol/l, TG ≥ 1·7 mmol/l, and more frequent follow-ups in the past year were associated with higher odds of overweight and obesity. Compared to their respective reference categories, living with parents, spouse and children, taking risperidone, aripiprazole, amisulpride and perphenazine, FPG > 6·1 mmol/l, hypertension, TC ≥ 5·2 mmol/l, TG ≥ 1·7 mmol/l, and more frequent follow-ups in the past year were associated with higher odds of obesity. We observed a high prevalence of overweight and obesity in patients with SMD in this study. The findings highlight the need for integrated management of overweight and obesity risk factors among patients with SMD.

Adiposity and metabolic health in Asian populations: an epidemiological study using dual-energy x-ray absorptiometry in Singapore

Type 2 diabetes, cardiovascular disease, and related cardiometabolic disturbances are increasing rapidly in the Asia-Pacific region. We investigated the contribution of excess adiposity, a key determinant of type 2 diabetes and cardiovascular risk, to unfavourable cardiometabolic profiles among Asian ethnic subgroups. The Health for Life in Singapore (HELIOS) Study is a population-based cohort comprising multiethnic Asian men and women living in Singapore, aged 30-84 years. We performed a cross-sectional analysis of data from individuals who had assessment of body composition by dual-energy x-ray absorptiometry and metabolic characterisation. In a subset of participants on no medication for type 2 diabetes, hypertension, and hypercholesterolaemia, we tested the relationship of BMI and visceral fat mass index (vFMI) with cardiometabolic phenotypes (glycaemic indices, lipid levels, and blood pressure), disease outcomes (type 2 diabetes, hypercholesterolaemia, and hypertension), and metabolic syndrome score with multivariable regression analyses. Between April 2, 2018, and Jan 28, 2022, 10 004 individuals consented to be part of the HELIOS cohort, of whom 9067 were included in the study (5404 [59·6%] female, 3663 [40·4%] male; 6224 [68·6%] Chinese, 1169 [12·9%] Malay, 1674 [18·5%] Indian; mean age 52·8 years [SD 11·8]). The prevalence of type 2 diabetes, hypercholesterolaemia, and hypertension was 8·2% (n=744), 27·2% (n=2469), and 18·0% (n=1630), respectively. Malay and Indian participants had 3-4-times higher odds of obesity and type 2 diabetes, and showed adverse metabolic and adiposity profiles, compared with Chinese participants. Excess adiposity was associated with adverse cardiometabolic health indices including type 2 diabetes (p<0·0001). However, while vFMI explained the differences in triglycerides and blood pressure between the Asian ethnic groups, increased vFMI did not explain higher glucose levels, reduced insulin sensitivity, and increased risk of type 2 diabetes among Indian participants. Visceral adiposity is an independent risk factor for metabolic disease in Asian populations, and accounts for a large fraction of type 2 diabetes cases in each of the ethnic groups studied. However, the variation in insulin resistance and type 2 diabetes risk between Asian subgroups is not consistently explained by adiposity, indicating an important role for additional mechanisms underlying the susceptibility to cardiometabolic disease in Asian populations. Nanyang Technological University-the Lee Kong Chian School of Medicine, National Healthcare Group, and National Medical Research Council, Singapore.

Chronic Conditions and Multimorbidity Among Middle-Aged and Elderly Peri-Urban Dwellers in Dar es Salaam, Tanzania.

Chronic conditions and multimorbidity affect care needs and prevention opportunities. We studied 2,246 men and women aged ≥40 years within the Dar es Salaam Urban Cohort Study from June 2017 to July 2018. Seventeen chronic conditions were assessed based on self-report, body and blood pressure measurement, blood tests, and screening instruments. Hypertension (51.3%), anemia (34.1%), obesity (32.2%), diabetes (31.6%), depressive symptoms (31.5%), low grip strength (21.2%), and ischemic heart disease (11.9%) were widespread. Multimorbidity was common (73.7%). Women had higher odds of obesity, ischemic heart disease, and high cholesterol (adjusted OR: 2.08-4.16) and lower odds of underweight, low grip strength, alcohol problems, and smoking (adjusted OR: 0.04-0.45). Ten years of age were associated with higher odds of low grip strength, cognitive problems, hypertension, kidney disease, chronic cough, diabetes, high cholesterol, ischemic heart disease, and multimorbidity (adjusted OR: 1.21-1.81) and lower odds of HIV infection (adjusted OR: 0.51). We found a higher prevalence of multimorbidity than previously estimated for middle-aged and elderly people in sub-Saharan Africa. The chronic conditions underlying multimorbidity differed by sex.

Serum copper and obesity among healthy adults in the National Health and Nutrition Examination Survey.

Copper (Cu) homeostasis are important processes in the cause of metabolic diseases, but the association between Cu and obesity remains unclear. Participants were drawn from the 2011-2016 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression assessed the associations of serum Cu concentrations (tertiles) with obesity and central obesity in individuals without comorbidities. Obesity was defined as a BMI ≥30.0 kg/m2, and central obesity was defined as a waist circumference ≥80 cm for women and ≥95 cm for men. This cross-sectional study included 1,665 adults without comorbidities, representing 24,744,034 people (mean age 35.1 years, 48.5% female). High serum Cu levels (tertile 3: ≥19.19 μmol/L) were associated with higher odds of obesity (adjusted odds ratio [OR]: 4.48, 95% CI[confidence interval]: 2.44-8.32) and central obesity (OR: 2.36, 95% CI: 1.19-4.66) compared to low serum Cu levels (tertile 1: ≤15.64 μmol/L). The dose-response curve showed a nonlinear association between Cu levels and obesity (P-nonlinear = 0.02) and a linear association with central obesity (P-nonlinear = 0.21). This study suggests that higher serum Cu levels are associated with increased odds of obesity in healthy American adults.

Environmental antibiotics exposure and childhood obesity: A cross-sectional case-control study

Children’s exposures to environmental antibiotics are a major public health concern. However, limited data are available on the effects of environmental antibiotic exposures on childhood obesity. Our study aimed to explore this relationship. We conducted a cross-sectional case-control study nested in a population-based survey of primary school students, including 1855 obese and 1875 random selected control children. A total of 10 antibiotics in urine samples were measured by liquid chromatography-tandem mass spectrometry. Multivariable survey logistic regression was used to assess the associations between environmental antibiotics exposures and childhood obesity. After adjusting for potential confounders, increased odds of obesity were observed in children exposed to tetracycline (OR = 1.31, 95% CI: 1.09–1.57) and sulfamonomethoxine (OR = 1.43, 95% CI: 1–2.05). Comparing none (<LODs), low-, middle-, and high-exposure groups, the low- sulfamonomethoxine exposure was associated with an increased odds of obesity (OR = 1.91, 95% CI: 1.05–3.47). Higher odds of obesity were associated with middle-level exposures to tetracycline (OR = 1.96, 95% CI: 1.05–3.66), doxycycline (OR = 1.56, 95% CI: 1–2.46), and lincomycin (OR = 1.35, 95% CI: 1.05–1.74). However, no significant association was found in any high-level antibiotic exposure groups. The significant associations were mainly observed in boys. The associations between environmental antibiotics exposures and childhood obesity are non-linear. Low- to middle-level exposures to certain environmental antibiotics may increase the risk of childhood obesity, especially in boys.

Abstract P215: Activity Behaviors and Cardiometabolic Health Outcomes in People Living With HIV

Introduction: Physical activity (PA) and sedentary behavior (SB) are independently associated with cardiometabolic health; data on activity behaviors and cardiometabolic health among people living with HIV (PWH) are limited. Hypothesis: Activity behaviors would differ by age and that not meeting PA Guidelines would be associated with an increased risk of cardiometabolic diseases among PWH. Methods: Using NHANES 2007-08 through 2017-18, PWH (n=125; age 44.3 yrs) were characterized as emerging (18-29 yrs), early (30-44 yrs) and middle (45-59 yrs) adulthood. Achieving Guidelines (≥150 min/wk) was derived from self-reported PA across three domains. SB was reported as time spent sitting. Chronic conditions were high cholesterol, obesity, hypertension, and chronic kidney disease. Prevalence estimates of joint high SB (≥8 h/day) and inactivity (&lt;10 min/wk) were calculated, and regression models were used to estimate differences in behaviors by age and investigate the association between achieving Guidelines and chronic conditions. Results: PWH reported 395.8 min/day of SB with 37.5% spending over 8 h/day sitting. There was no significant difference in SB across lifestage. A total of 67.2% achieved Guidelines although 14% were jointly inactive and highly sedentary. Compared with early adult PWH, middle adult PWH spent more time performing transport-related PA (β= 102.7 min/wk, p =0.009) and less time performing leisure-time PA (β= -211 min/wk, p =0.044) ( Figure ). Compared with PWH meeting Guidelines , those that did not meet Guidelines had higher diastolic blood pressure (β= 6.1 mmHg [CI: 2.6, 9.6]) and higher odds of obesity (OR=2.5[CI: 1.0, 6.4]). Conclusions: Domain-specific differences occurred in transportation and leisure time PA among PWH - a high-risk group for cardiovascular disease. Not meeting the Guidelines resulted in greater odds of obesity and higher diastolic blood pressure. Future research should incorporate device-based measures of movement to understand its relation to chronic disease in PWH.

Dentition and weight status in community-dwelling older adults.

Tooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults. This was a cross-sectional study of data from a convenience sample of older adults (65-89 years) treated at an urban U.S. dental school clinic. Clinical and demographic data were obtained from electronic health records. Dentition status was determined based on data from odontograms. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of having a non-normal weight status for each measure of dentition status, after adjusting for covariates. Patients (n = 1765) were 54.1% female, 51.5% White, 41.6% African American and 22.5% Hispanic/Latino. The median (interquartile range [IQR]) age was 71 (67.0-75.0) years; the mean (±SD) BMI was 28.5 (±5.7) kg/m2 ; 72.5% were overweight or obese. The median (IQR) number of remaining teeth was 20.0 (13.0-24.0); the median numbers of anterior and posterior occluding pairs of teeth were 5.0 (2.0-6.0) and 2.0 (0.0-5.0), respectively; and 44.9% had a functional dentition (≥21 teeth). Having a higher number of remaining teeth and more posterior occluding pairs were associated with lower odds of obesity (OR = 0.980, 95% CI = 0.964, 0.997, p = .022 and OR = 0.931, 95% CI = 0.885, 0.980, p = .006, respectively). Lack of a functional dentition was associated with higher odds of obesity (OR = 1.400, 95% CI = 1.078, 1.818, p = .012), after controlling for covariates. Older adults with tooth loss - especially loss of posterior occlusion and lack of a functional dentition - were more likely to be obese than of normal weight.

Comparison of metabolic and neurological comorbidities in Asian patients with psoriasis and atopic dermatitis

Although various comorbidities have been noted to be associated with atopic dermatitis (AD) and psoriasis, few studies have compared comorbidities between the two diseases, and little is known about whether these comorbidities vary by the subtypes of psoriasis. In this study of 1:1 age- and sex-matched pair analysis between patients diagnosed with either psoriasis or AD at Asan Medical Center between 1991 and 2020, comorbidities, as determined by the International Classification of Diseases-10 codes, and likelihood ratios of metabolic and neurologic comorbidities in psoriasis compared with AD were studied using a logistic regression model. Among a total of 14,128 patients, the psoriasis group had higher odds of obesity (odds ratio [95% confidence interval]: 1.49 [1.34–1.66]), hypertension (1.14 [1.03–1.26]), diabetes mellitus (1.46 [1.29–1.66]), chronic kidney disease (1.59 [1.22–2.08]), and Parkinson's disease (2.1 [1.15–3.83]) than the AD group. Subgroup analysis revealed that patients with plaque psoriasis had higher odds of obesity (1.18 [1.05–1.33]), hypertension (1.18 [1.06–1.32]), diabetes mellitus (1.53 [1.34–1.75]), chronic kidney disease (1.66 [1.26–2.17]), and Parkinson’s disease (2.12 [1.16–3.88]) compared with AD. Meanwhile, guttate psoriasis was associated with higher odds of dementia (3.63 [1.06–12.40]) and patients with generalized pustular psoriasis showed higher odds of diabetes mellitus (5.42 [1.56–18.83]) compared with AD. In conclusion, Asian patients with all types of psoriasis should be closely monitored for the development of metabolic and neurologic diseases, especially men and those aged ≥ 40 years.

Caregiving and Obesity among Black American Adults.

Black American adults often report higher rates of obesity and caregiving compared with other racial or ethnic groups. Consequently, many Black American caregivers and care recipients are obese or have obesity-related chronic conditions (e.g., diabetes, hypertension). This study investigated associations between caregiving and obesity among Black Americans, including the role of health behaviors and chronic conditions. The sample included data from 2015 and 2017 Behavioral Risk Factor Surveillance System for non-Hispanic Black (NHB) or African American adult caregivers (n = 2,562) and noncaregivers (n = 7,027). The association between obesity (dependent variable) and caregiving status, fruit consumption, vegetable consumption, physical activity, and number of chronic conditions (independent variables) were evaluated using hierarchical binomial logistic regressions. Caregiving, being female, and chronic conditions were associated with higher odds of obesity, while physical activity was associated with lower odds of obesity. Physical activity, diet, and chronic conditions did not account for differences in obesity among caregiving and noncaregiving Black Americans. Increasing understanding of health behaviors and chronic disease burden of NHB caregivers has implications for programs aiming to improve obesity-related outcomes for caregivers and recipients. Future research should investigate multilevel factors that contribute to observed differences.

Rotating shift and BMI increase among healthcare workers in a military hospital: pre- and post-pandemic analysis in Taiwan.

The increasing prevalence of high body mass index (BMI) emphasizes the need for action. Understanding of BMI factors among military hospital healthcare workers remains limited. This study aims to address this gap by analyzing BMI risk factors and changes pre- and post-coronavirus 2019 pandemic among military hospital healthcare workers in central Taiwan from 2019 to 2021. Conducted at a military hospital in central Taiwan, this study analyzed anonymized health examination data from 2019 to 2021 for 483 healthcare workers. We performed generalized estimating equations to investigate trends in BMI and its association with various factors, including age, sex, job titles, military status, job tenure, work shifts, and lifestyle habits. The risk of increased BMI was higher in 2021 compared to 2019 (risk ratio [RR]: 1.008, 95% confidence interval [CI]: 1.001-1.014). Individuals on rotating shifts had a higher risk of increased BMI compared to day shift workers (RR: 1.021; 95% CI: 1.008-1.035) and higher odds of obesity (odds ratio: 1.546; 95% CI: 1.099-2.175). Among obese individuals, BMI in soldiers was approximately 4.9% lower than in non-soldiers (RR: 0.951; 95% CI: 0.915-0.988). This study identified a significant post-pandemic increase in BMI among healthcare workers in a Taiwanese military hospital, with rotating shifts being a key risk factor for both increased BMI and obesity. Work-related factors influenced BMI changes among obese individuals, while non-work-related factors were significant for non-obese individuals. These findings highlight the broader effects of the pandemic and the specific impact of work-related factors on obese healthcare workers.

Obesity Prevalence, Associated Factors and Complications among Adult Population Attending Family Medicine Clinic in Hatta Hospital, United Arab Emirates

Background: The United Arab Emirates (UAE) has experienced rapid economic growth in the last few decades, resulting in swift urbanization and an influx of foreign labor. This has facilitated an advanced, yet sedentary lifestyle characterized by increased reliance on technology, unhealthy dietary habits, and a reduction in physical activity levels. These factors significantly contributed to the rise in the prevalence of obesity. Objective: To determine the prevalence of obesity, it is associated factors, and complications among adults presenting to the primary care clinic at Hatta Hospital, located in the Hatta area UAE. Material &amp; Methods: This cross-sectional study enrolled adult Emirati patients aged between 18-55 years. Body Mass Index (BMI) was categorized based on the World Health Organization’s threshold. Patients’ socio-demographic and clinical data was obtained and recorded. Results: A total of 600 Emirati patients were included in this study, with a median age of 33 (IQR=25-45) years. Gender distribution was kept equal with 50.5% male and 49.5% female participants. The median BMI among the participants was 28.2 (IQR=24.3-32.5) kg/m2. The prevalence of underweight, normal weight, overweight, and obesity was found as 4.3%, 23.5%, 33.7% and 38.5% respectively. After adjusting the co-variants in the multivariable model, lower education levels were found to be significantly associated with higher odds of obesity. Conversely, being single and adhering to a healthy lifestyle was associated with lower odds of obesity in the multivariable model. Conclusion: The present study identified that 38.5% of the adult population attending Hatta Hospital family medicine clinics were obese and 33.7% were overweight. Conclusively 72.2% of the adult population of the Hatta area have a BMI above normal, indicating a very high prevalence of obesity and overweight cases. Furthermore, a significant association of obesity was found with lower education levels, being married, having unhealthy dietary habits, and insufficient physical activity.

Socioecologic Factors Associated With Obesity in Adolescents With Epilepsy in the United States.

Obesity among youth with epilepsy has multifactorial etiology, yet socioecologic obesity risk factors (eg, neighborhood factors) have not been examined in this population. This study examined (1) the prevalence of obesity adjusting for relevant covariates and (2) socioecologic correlates of obesity in adolescents with epilepsy aged 10-17 years. This cross-sectional study used 2017-2018 National Survey of Children's Health data (total n = 27,094; epilepsy n = 184). Chi-square tests compared weighted prevalence of obesity with relevant covariates among all adolescents and adolescents with epilepsy. Weighted multiple logistic regression models were conducted to adjust for covariates. The prevalence of obesity in adolescents with epilepsy was 27.8% (95% confidence interval [CI] 15.4%-40.3%) vs 15.1% (95% CI 14.1%-16.2%) for the non-epilepsy group. Adolescents with epilepsy also had higher odds of obesity after adjusting for age, gender, race/ethnicity, household income, physical activity, and medical home (odds ratio [OR] 2.1, 95% CI 1.2-3.8). Adjusting for sociodemographics, anxiety (OR 4.5, 95% CI 1.3-15.6), 2 or more adverse childhood experiences (OR 7.3, 95% CI 1.6-33.4), neighborhood detracting elements (eg, OR 5.2, 95% CI 1.5-18.5 for 1 detracting element), and forgone care (ie, unmet health care needs) (OR 22.4, 95% CI 3.8-132.8) were associated with obesity in adolescents with epilepsy. Adjusting for multiple comparisons, neighborhood detracting elements (P < .0001) and forgone care (P < .0007) remained significant. Variables related to mental health, family functioning, built environment, and forgone care were associated with obesity in adolescents with epilepsy, but the association was not fully explained by these factors. Obesity interventions for this population should consider multiple levels of influence including the community and special health care needs of this population.

Interpersonal- and Community-Level Risk Factors for Adolescent Obesity: An Examination of Sexual Identity, School Violence, and School Climate in a Large Sample of Urban Adolescents.

Sexual minority adolescents are more likely to have obesity compared to their heterosexual peers, but little is known about potential contributors to this disparity that lie outside of individual-level health behaviors, such as diet and exercise. One possible contributor is school violence victimization, a factor associated with overweight/obesity in adolescence. Another possible contributor is school climate, which is associated with feelings of safety and connectedness that can lower the likelihood of school violence victimization. Moreover, even less is known about relationships among all these factors among sexual minority adolescents. This gap in the literature was addressed by analyzing CDC's district-level data from the Youth Risk Behavior Survey and School Health Profiles (N = 60,625; 50.9% female, Mage = 16 years, 84.7% heterosexual, 15.3% sexual minority). Using multilevel mixed effects logistic regression models and controlling for covariates, it was found that among females and males, those with 2+ counts of last 12-month school violence victimization had higher odds of obesity than those with no school violence victimization (AOR = 1.33; AOR = 1.24). Furthermore, females and males in more positive LGBTQ school climates had lower odds of obesity than those in less positive school climates (AOR = 0.84; AOR = 0.85). There were no sexual identity differences in these models. Findings support the careful consideration of school violence victimization and LGBTQ school climate in future obesity prevention initiatives.

Exploring the associations between number of children, multi-partner fertility and risk of obesity at midlife: Findings from the 1970 British Cohort Study (BCS70).

Early parenthood, high parity, and partnership separation are associated with obesity. However, the emergence of non-marital partnerships, serial partnering and childbearing across unions, means that it is important to consider their association to obesity. This paper examined the associations between number of biological children and multi-partner fertility (MPF)-defined as having biological children with more than one partner, with obesity at midlife. The sample consisted of 2940 fathers and 3369 mothers in the 1970 British Cohort Study. The outcome was obesity (BMI 30 or over) at age 46. Fertility and partnership histories ascertained the number of live biological children and MPF status by age 42. The associations were tested using logistic regression adjusting for confounders at birth, age 10 and age 16. Adult factors recorded at age 42 including age at first birth, smoking status, alcohol dependency, educational attainment and housing tenure were considered as mediators. For fathers, obesity odds did not differ according to number of children or MPF. In unadjusted models, mothers with one child (OR 1.24 95%CI 1.01-1.51), mothers who had two children with two partners (OR 1.45 95%CI 1.05-1.99), and mothers who had three or more children with two or more partners (OR 1.51 95%CI 1.18-1.93) had higher odds of obesity. In adjusted models, there remained an association between mothers with one child and odds of obesity (OR 1.30 95%CI 1.05-1.60). All other associations were attenuated when confounders were included. Mothers who had children with multiple partners had higher odds of obesity. However this association was completely attenuated when parental and child confounders were accounted for; suggesting that this association may be explained by confounding. Mothers who had one child only may be at increased odds of obesity, however this could be due to multiple factors including age at first birth.

Relationship between bisphenol A and the cardiovascular disease metabolic risk factors in American adults: A population-based study

BackgroundBisphenol A (BPA) is widely used in personal care and consumer products. However, no study has reported a specific relationship between BPA concentrations and metabolic hazardous elements for cardiovascular diseases (CVDs). Consequently, in this study, we used six years of population-based NHANES data (2011–2016) to analyse the association between BPA concentrations and metabolic risk factors for CVDs. MethodsA total of 1467 participants were enrolled in our project. The participants in the study were divided into quartiles based on BPA levels (Q1: ≤0.6 ng/ml, Q2: 0.7–1.2 ng/ml, Q3: 1.3–2.3 ng/ml, Q4: ≥2.4 ng/ml). This study used multiple linear and multivariate logistic regression models to determine the association among BPA concentrations and CVD metabolic risk factors. ResultsWhen the concentration of BPA was in Q3, fasting glucose concentrations were decreased by 3.87 mg/dl, and 2-h glucose concentrations were decreased by 16.24 mg/dl. When the concentration of BPA was in Q4, fasting glucose concentrations were decreased by 12.15 mg/dl, and diastolic blood pressure was increased by 2.08 mmHg. At the same time, compared to participants in the first quartile (Q1), those from the fourth quartile (Q4) of BPA concentrations had 21% higher odds of hypertension, 30% higher odds of obesity, 30.2% higher odds of central obesity, 4.5% higher odds of elevated HbA1c, 17% higher odds of elevated non-HDL cholesterol, and 60.8% higher odds of diabetes (compared to the lowest quartile, Q1). ConclusionsWe found that higher concentrations of BPA were linked with a higher metabolic risk for CVDs. Further regulation of BPA may need to be considered for the prevention of CVDs in adults.

Abstract 37: Proteomic Signatures of Obesity-Related Heart Failure in the Atherosclerosis Risk in Communities (ARIC) Study

Background: Obesity is a strong risk factor for cardiovascular disease. The excess heart failure (HF) risk associated with obesity is uniquely unexplained by traditional risk mediators. We sought to identify proteomic signatures that reflect mechanistic pathways associated with obesity-related HF. Methods: We quantified 4955 plasma proteins in stored plasma samples of ARIC Visit 2 (1990-1992) participants without HF using an aptamer-based platform (SOMAScan v4.0). We used Cox regression to identify the proteins associated with incident HF, stratified by obesity (BMI≥30 kg/m 2 ). We used Bonferroni-corrected p-values to assess statistical significance in 2/3 discovery and 1/3 validation subsets. We assessed the biological pathways overexpressed by these proteins using a canonical pathway analysis. Results: We included 9940 participants (28% with obesity, mean age 57 years, 55% female, 22% Black adults). Over a median 21-year follow-up, 2,345 HF events (886 in obesity) occurred. In the discovery subset with obesity, we identified 110 proteins associated with incident HF after demographic adjustment, 19 proteins (7 specific to obesity, Figure B) had robust HF associations after additional adjustment for lifestyle and cardiometabolic risk factors (p&lt;10 -5 ) (Figure A). Of 19 proteins, 12 were also linked to prevalent obesity status. Angiopoietin-2 was associated with higher risk of HF and higher odds of obesity. Conversely, ephrin type-A receptor 4 and seizure 6-like protein were linked to lower HF risk and lower odds of obesity. Lipid and bile acid metabolism (inhibited), cytokine signaling and wound healing pathways (activated) were overexpressed by HF-associated proteins in those with obesity. Conclusion: We identified established and novel proteins associated with HF risk in obesity. Many proteins linked to incident HF in obesity are also strongly associated with prevalent obesity. Formal mediation analysis can help elucidate the potential role of these proteins in the development of obesity-related HF.

Abstract P190: Social Determinants of Cardiovascular Health in Sexual Minority Adults: A Systematic Review

Introduction: Sexual minority (e.g., lesbian, gay, bisexual, queer) adults appear to be at higher risk of cardiovascular disease (CVD) than heterosexual adults. Although social determinants of health have been shown to contribute to cardiovascular health (CVH) disparities in the general population, there is a dearth of research examining these determinants in sexual minority adults. Objective: Using the World Health Organization’s definition of social determinants of health, we conducted a systematic literature review to synthesize and critique existing evidence on social determinants of CVH among sexual minority adults. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and performed a comprehensive search of literature published between January 2011 and March 2022. Studies were included if they were peer-reviewed, English-language, and examined associations between social determinants of health and CVH outcomes among sexual minority individuals 18 years old or older. CVH outcomes were CVD risk factors (including diabetes, hypertension, hyperlipidemia, and obesity) and CVD conditions (such as stroke, heart attack, and coronary artery disease). We performed quality appraisal using the Joanna Briggs Institute Critical Appraisal Checklists for Analytical Cross-Sectional Studies and Cohort Studies. Results: Our search retrieved 2,133 studies, of which 18 met the inclusion criteria. Of these, 16 were cross-sectional and two used longitudinal designs. All 18 studies had a low risk of bias. The majority (n = 17) included predominantly White samples. Overall, the findings were mixed. Stressful life events were associated with elevated CVD risk. Individuals who reported living in more supportive environments had lower odds of being overweight; however, greater disclosure of sexual minority status was associated with higher odds of being overweight. Living in rural settings was associated with higher odds of obesity and hypertension. Experiences of discrimination were not associated with any CVH outcomes. Findings for interpersonal trauma (e.g., adulthood trauma, childhood trauma), education, religious activity, and relationship status were mixed. No studies examined social determinants at the structural level. Conclusions/Implications: Findings highlight social determinants that may serve as targets of clinical and public health interventions to improve the CVH of sexual minority adults. Future longitudinal research is needed that includes more diverse samples and examines multi-level social determinants of CVH, including at the social and structural levels.

American Indian Alaska Native (AIAN) adolescents and obesity: the influence of social determinants of health, mental health, and substance use.

To explore the prevalence of obesity among American Indian and Alaska Native (AIAN) adolescents aged 12-19 years in association with social determinants of health (SDOH), and mental health and substance use disorders. Guided by the World Health Organization's Social Determinants of Health Framework, we examined data from the Indian Health Service (IHS) Improving Health Care Delivery Data Project from Fiscal Year 2013, supplemented by county-level data from the U.S. Census and USDA. Our sample included 26,226 AIAN adolescents ages 12-19 years. We described obesity prevalence in relationship to SDOH and adolescents' mental health and substance use disorder status. We then fit a multivariable logit generalized linear mixed model to estimate the relationships after adjusting for other individual and county level characteristics. We observed a prevalence of 32.5% for obesity, 13.8% for mental health disorders, and 5.5% for substance use disorders. Females had lower odds of obesity than males (OR = 0.76, p < 0.001), which decreased with age. Having Medicaid coverage (OR = 1.09, p < 0.01), residing in a county with lower education attainment (OR = 1.17, p < 0.05), and residing in a county with higher rates of poverty (OR = 1.51, p < 0.001) were each associated with higher odds of obesity. Residing in a county with high access to a grocery store (OR = 0.73, p < 0.001) and residing in a county with a higher proportion of AIANs (OR = 0.83, p < 0.01) were each associated with lower odds of obesity. Those with mental health disorders had higher odds of obesity (OR = 1.26, p < 0.001); substance use disorders were associated with decreased odds of obesity (OR = 0.73, p < 0.001). Our findings inform future obesity prevention and treatment programs among AIAN youth; in particular, the need to consider mental health, substance use, and SDOH.

PS-P09-5: DIET QUALITY PARTIALLY MEDIATES THE ASSOCIATION BETWEEN ULTRA-PROCESSED FOOD CONSUMPTION AND OBESITY

Objective: High consumption of ultra-processed food (UPF) is associated with an increased risk of obesity, which at least partly due to the poor nutritional profile of these foods. However, little is known about the magnitude of the direct and indirect effects of UPF consumption on obesity. Thus we evaluated whether the association between UPF consumption and obesity is mediated by overall diet quality. Design and method: This study is a cross-sectional analysis of the baseline data of adults aged 30–64 years (n = 6,894) which participated in the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. Dietary intake was assessed by a validated 112-items food frequency questionnaire. Using the NOVA food classification, 23 FFQ items were classified as UPF. Diet quality was assessed using the Korean Healthy Eating Index (KHEI) based on the 2015 Dietary Reference Intake for Koreans. Height, weight, and waist circumference (WC) were measured and body mass index (BMI, kg/m2) was calculated. Obesity was defined as ≧ 25.0 kg/m2. Abdominal obesity was defined as ≧ 90 cm for male and ≧ 85 cm for female. Single mediation models were used to estimate the mediating effect of UPF consumption (% kcal) on obesity, after adjusting for sex, age, research center, income, education, marital status, smoking, drinking, and sitting time. All analyses were performed using SAS version 9.4. Results: UPF accounted for 17.9% of total energy intake and the mean BMI and WC was 24.1 kg/m2 and 82.3 cm. The prevalence of obesity and abdominal obesity was 35.4% and 30.2%, respectively. UPF consumption (per 10% kcal increase) was associated with higher levels of BMI (0.13 kg/m2, P &lt; 0.001) and WC (0.39 cm, P &lt; 0.001), and also with higher odds of obesity (OR = 1.07, 10.1–1.13) and abdominal obesity (OR = 1.10, 1.04–1.17), after adjustment for confounders. The association of UPF consumption with BMI (14.3%, 95% CI: 1.9–26.8), WC (18.1%, 95% CI: 5.3–30.8), and abdominal obesity (20.9%, 95% CI: 6.0–35.8) were partially mediated by KHEI, but the association between UPF and overall obesity was not mediated by KHEI (17.2%, 95% CI: -1.1–35.4). Conclusions: Our findings suggest that the association between UPF consumption and obesity is partially, but not all, mediated by diet quality. Although our findings have a limitation on causal inference between UPF consumption and obesity, it may help understand the mediational structure between them and seek strategies for prevention of obesity.