South Asian Cohort Research Articles

The development and progression of albuminuria in South Asians with type 2 diabetes compared with Western Europeans. Results from the HinDu the Hague diabetes study.

Although South Asians have an increased risk to develop diabetes, data on the difference in development and progression of diabetic nephropathy between ethnic groups are not consistent. The aim of this study was to evaluate possible differences in the development and progression of albuminuria in South Asians and Western Europeans (WE) with type 2 diabetes in a large closed cohort of South Asians with type 2 diabetes. Data on 1269 South Asians and 2272 Dutch adults with type 2 diabetes who were treated in our diabetes clinic in 2006 or referred thereafter were extracted from electronic medical records. Microalbuminuria and macroalbuminuria were defined separately for men and women based on albumin/creatinine ratios in early morning urine samples. We defined 3 outcomes: (1) no albuminuria, (2) persistent microalbuminuria and (3) macroalbuminuria at the end of follow-up. Cox proportional hazard models were used to discriminate differences in time from diabetes diagnosis until development and progression of albuminuria between the two ethnic groups, adjusted for retinopathy, hypertension, smoking and age at diabetes diagnosis. South Asians have a higher adjusted risk for developing microalbuminuria: HR 1.4, (95% CI 1.2, 1.6) and macroalbuminuria: HR: 1.2 (1.0, 1.4) compared to Western Europeans. However, mean time to progress from micro- to macroalbuminuria was not different between the ethnic groups (3.9 ± 4.0 yrs vs. 3.4 ± 3.9 yrs respectively). South Asians have a higher adjusted risk to develop micro- and macroalbuminuria compared with Western Europeans. When microalbuminuria is present, time to progression from micro- to macroalbuminuria is not different between the two groups.

Multi-Omics Mendelian Randomization Study Investigating the Impact of PCSK9 and HMGCR Inhibition on Type 2 Diabetes Across Five Populations.

The prevalence of type 2 diabetes (T2D) varies among populations of different race/ethnicity. The influence of genetically-proxied lipoprotein cholesterol (LDL-C) lowering through proprotein convertase subtilisin/kexin 9 (PCSK9) and HMG-CoA Reductase (HMGCR) on T2D in non-European populations is not well established.A drug-target Mendelian randomization (MR) approach was used to assess the effects of PCSK9 and HMGCR inhibition on T2D risk and glycemic traits in five populations: East Asian (EAS), South Asian (SAS), Hispanic (HISP), African (AFR), and European (EUR). Our study did not find relationships between genetically-proxied PCSK9 inhibition and T2D risk in EAS (odds ratio [OR]=1.02, [0.95-1.10]), SAS (OR=1.05, [0.97-1.14]), HISP (OR=1.03, [0.94-1.12]), or EUR (OR=1.04, [0.98-1.11]). However, in AFR, primary analyses suggested an increased risk of T2D due to PCSK9 inhibition (OR=1.53, [1.058-2.22], P-value=0.024), although this was not supported in sensitivity analyses. Genetically-proxied HMGCR inhibition was associated with an increased risk of T2D in SAS (OR=1.44, [1.30-1.61], P-value=9.8×10-12), EAS (OR=1.36, [1.22-1.51], P-value=4.2×10-10), and EUR (OR=1.52, [1.21-1.90], P-value=3.3×10-4). These results were consistent across various sensitivity analyses, including colocalization, indicating a robust finding. The findings indicate a neutral impact of long-term PCSK9 inhibition on T2D and glycemic markers in most non-European populations, with a potential increased risk in AFR cohorts. By contrast, HMGCR inhibition increased the risk of T2D in South Asian, East Asian, and European cohorts, underscoring the need to consider diversity in genetic research on metabolic diseases.

Genetic architecture of routinely acquired blood tests in a British South Asian cohort

Understanding the genetic basis of routinely-acquired blood tests can provide insights into several aspects of human physiology. We report a genome-wide association study of 42 quantitative blood test traits defined using Electronic Healthcare Records (EHRs) of ~50,000 British Bangladeshi and British Pakistani adults. We demonstrate a causal variant within the PIEZO1 locus which was associated with alterations in red cell traits and glycated haemoglobin. Conditional analysis and within-ancestry fine mapping confirmed that this signal is driven by a missense variant - chr16-88716656-G-TT - which is common in South Asian ancestries (MAF 3.9%) but ultra-rare in other ancestries. Carriers of the T allele had lower mean HbA1c values, lower HbA1c values for a given level of random or fasting glucose, and delayed diagnosis of Type 2 Diabetes Mellitus. Our results shed light on the genetic basis of clinically-relevant traits in an under-represented population, and emphasise the importance of ancestral diversity in genetic studies.

Predictive Ability of Rule of 3 in Parathyroid Cancer: Outcomes from a South Asian Cohort

Background: Preoperative diagnosis of parathyroid cancer (PC) where possible allows for en-bloc resection of the tumour, which is associated with excellent prognosis. The rule of >3 (size of tumour larger than 3 cm; corrected calcium more than 3 mmol/L) as proposed by Schulte and Talat has a specificity of 95% in predicting malignancy in parathyroid neoplasms. We looked at the impact of rule of 3 in predicting malignancy and outcomes on intervention in a South Asian cohort. Methods: Patients who underwent parathyroid surgery between 2010 and 2023 at two tertiary referral centres were assessed. Patients with PC were selected and their clinicopathological parameters, treatment modalities, and outcomes were analysed. Results: Thirteen of 336 (3.8%) patients with a mean age of 61.8 (±17.5) years were diagnosed with PC during the study period. The highest mean preoperative values were PTH (92.4 ± 66.27 pmol/L), highest corrected calcium (3.21 ± 0.28 mmol/L), and alkaline phosphatase (419 IU/mL). Nine patients underwent en-bloc excision while the other had focussed parathyroidectomy. Recurrences were recorded in 2 (28.5%) patients over a mean follow-up period of 69 (±48.6) months. One patient with lung metastasis underwent video-assisted thoracic surgery. There was no disease specific mortality in this cohort during the study period. Conclusions: In our experience, the predictive rule of 3 has low sensitivity to suspect PC preoperatively, resulting in limited usefulness in clinical practice. Outcomes appear to be less favourable with higher recurrence rates in cases where less than en-bloc resection is performed.

Associations between accurate measures of adiposity and fitness, blood proteins, and insulin sensitivity among South Asians and Europeans.

South Asians (SAs) may possess a unique predisposition to insulin resistance (IR). We explored this possibility by investigating the relationship between 'gold standard' measures of adiposity, fitness, selected proteomic biomarkers, and insulin sensitivity among a cohort of SAs and Europeans (EURs). A total of 46 SAs and 41 EURs completed 'conventional' (lifestyle questionnaires, standard physical exam) as well as 'gold standard' (dual energy X-ray absorptiometry scan, cardiopulmonary exercise test, and insulin suppression test) assessments of adiposity, fitness, and insulin sensitivity. In a subset of 28 SAs and 36 EURs, we also measured the blood-levels of eleven IR-related proteins. We conducted Spearman correlation to identify correlates of steady-state plasma glucose (SSPG) derived from the insulin suppression test, followed by multivariable linear regression analyses of SSPG, adjusting for age, sex and ancestral group. Sixteen of 30 measures significantly associated with SSPG, including one conventional and eight gold standard measures of adiposity, one conventional and one gold standard measure of fitness, and five proteins. Multivariable regressions revealed that gold standard measures and plasma proteins attenuated ancestral group differences in IR, suggesting their potential utility in assessing IR, especially among SAs. Ancestral group differences in IR may be explained by accurate measures of adiposity and fitness, with specific proteins possibly serving as useful surrogates for these measures, particularly for SAs.

Spectrum of Auto-antibodies in NMO and MOG Associated CNS Demyelination- The SANMAD Study

This observational study explored coexisting organ-specific and non-organ-specific autoantibodies in Neuromyelitis optica spectrum disorder(NMOSD) and Myelin oligodendrocyte glycoprotein-IgG-1(MOG-IgG1) associated central nervous system demyelination(MOGAD) in a South Asian cohort from March 2017–2023. Of the 250 cases, 148 were MOGAD(82pediatric) and 102 were NMOSD(15 pediatric). 17.6 % tested positive for ≥1 antibody, with NMOSD showing a higher positivity rate (25.5 %) than MOGAD(12.2 %,p = 0.011). Double antibody positivity occurred more in NMOSD (5.9 %vs.MOGAD,1.4 %,p = 0.045). Three NMOSD cases had Sjogren syndrome with higher Anti-Ro-52 prevalence(12.7 %vs.4.1 %,p = 0.014). NMOSD patients with ≥1 antibody positivity had more constitutional symptoms (45.5 %vs.23.1 %,p = 0.045). Significant associations were found between NMOSD and female gender, having ≥1 antibody-positive status, and testing positive for Anti-Ro-52 and SS-A antibodies (p < 0.05).

Treatment Outcomes and Toxicity Profiles with PORTEC-3 Trial Regimen in South Asian Cohort of High-Risk Endometrial Cancer Patients: A Single-Center Ambispective Analysis

Objectives Adjuvant chemoradiation followed by chemotherapy is the current standard of care in high-risk endometrial cancer after the PORTEC-3 trial. There is a lack of data on this treatment regimen in the South Asian patient cohort. The present study aims to assess toxicity profiles and outcomes in this cohort of patients. Materials and Methods High-risk endometrial cancer patients planned for adjuvant chemoradiation followed by chemotherapy were included. Toxicity was graded using the Radiation Therapy Oncology Group and Common Terminology Criteria for Adverse Events criteria. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Survival curves were compared using the log-rank test. Cox regression analysis was done to find out the predictors of DFS. Results This study included 58 patients treated from October 2016 to August 2022. Median age was 61 years (interquartile range [IQR] 56–66), with Fédération Internationale de Gynécologie et d'Obstétrique Stages I = 26 (44.8%), II = 5 (8.6%), and III = 27 (46.6%). p53 positivity was seen in 38 (65.5%) patients. Intensity-modulated radiotherapy was used in 44 (79.3%) patients. There was no treatment discontinuation during chemoradiation. Acute Grade 2 and above toxicity during chemoradiation were diarrhea in 10 (17.2%) and hematological in 2 (3.4%). For the planned adjuvant chemotherapy in 55 patients, 51 (92.7%) completed four cycles. Grade 2 or above neuropathy was seen in 11 (20%), with 5 (9%) having persisting neuropathy at 1-year follow-up. At a median follow-up of 31 months, 15 (25.8%) patients recurred; distant = 13 and isolated para-aortic = 2. The median time to recurrence was 16 months (IQR 12–22), with 80% (12 out of 15) of recurrence within the first 2 years of follow-up. The actuarial 5-year DFS and OS were 63.8 and 76.5%, respectively. In univariate analysis, p53 positivity and lymphovascular space invasion were predictors for DFS, with p-values 0.031 and 0.027, respectively. There was no significant predictor identified in multivariate analysis. Conclusion There is good tolerance and compliance to adjuvant chemoradiation and chemotherapy in this South Asian cohort of patients with high-risk endometrial cancer, with no toxicity-related treatment breaks during radiation. The majority of the recurrences were seen at distant sites and within the first 2 years of follow-up. These findings are in line with the outcomes of the PORTEC-3 trial.

Impact of Sarcopenia on Post-Liver Transplant Hospitalization: Insights From a South Asian Cohort

BackgroundSarcopenia's impact on post-liver transplant outcomes remains a subject of debate, with limited data from South Asia on its association with post-liver transplant hospital stays. This study aims to investigate sarcopenia's influence on post-transplant hospitalization duration in South Asians. MethodsIn this retrospective study, patients with liver cirrhosis who underwent living-donor liver transplantation at Shifa International Hospital in Islamabad, Pakistan, between January 2022 and January 2023 were included. Computed Tomography (CT) images were used to assess the skeletal muscle index (SMI). The areas of the psoas, erector spinae, multifidus, quadratus lumborum, rectus abdominis, transverse abdominis, and internal/external oblique muscles were quantified at the level of L3. The data was analyzed using SPSS v. 29.0 (IBM Chicago, IL). ResultsThere was a total of 84 patients. Mean age was 47.4 ± 12.0 years. There were 62 (73.8%) males and 22 (26.2%) females. Hepatitis C was noted in 36 (42.9%) patients. 22 (26.2%) patients had hepatocellular carcinoma. Sarcopenia was identified in 58 (69.0%) patients. No significant association was observed between sarcopenia and ICU or general floor stays. Regression analysis identified pre-transplant MELD-Na score as the sole significant factor associated with both ICU and total length of stay (p-value 0.002; p-value 0.009). ConclusionIn our population, sarcopenia did not correlate with post-transplant ICU or overall hospital stay. The pre-transplant MELD-Na score emerged as the most influential predictor of length of stay. Therefore, delaying liver transplant procedures based on muscle mass estimations may not be a practical clinical approach for South Asian patients.

Maternal smoking DNA methylation risk score associated with health outcomes in offspring of European and South Asian ancestry

Background:Maternal smoking has been linked to adverse health outcomes in newborns but the extent to which it impacts newborn health has not been quantified through an aggregated cord blood DNA methylation (DNAm) score. Here, we examine the feasibility of using cord blood DNAm scores leveraging large external studies as discovery samples to capture the epigenetic signature of maternal smoking and its influence on newborns in White European and South Asian populations.Methods:We first examined the association between individual CpGs and cigarette smoking during pregnancy, and smoking exposure in two White European birth cohorts (n=744). Leveraging established CpGs for maternal smoking, we constructed a cord blood epigenetic score of maternal smoking that was validated in one of the European-origin cohorts (n=347). This score was then tested for association with smoking status, secondary smoking exposure during pregnancy, and health outcomes in offspring measured after birth in an independent White European (n=397) and a South Asian birth cohort (n=504).Results:Several previously reported genes for maternal smoking were supported, with the strongest and most consistent association signal from the GFI1 gene (6 CpGs with p&lt;5 × 10-5). The epigenetic maternal smoking score was strongly associated with smoking status during pregnancy (OR = 1.09 [1.07, 1.10], p=5.5 × 10-33) and more hours of self-reported smoking exposure per week (1.93 [1.27, 2.58], p=7.8 × 10-9) in White Europeans. However, it was not associated with self-reported exposure (p&gt;0.05) among South Asians, likely due to a lack of smoking in this group. The same score was consistently associated with a smaller birth size (–0.37±0.12 cm, p=0.0023) in the South Asian cohort and a lower birth weight (–0.043±0.013 kg, p=0.0011) in the combined cohorts.Conclusions:This cord blood epigenetic score can help identify babies exposed to maternal smoking and assess its long-term impact on growth. Notably, these results indicate a consistent association between the DNAm signature of maternal smoking and a small body size and low birth weight in newborns, in both White European mothers who exhibited some amount of smoking and in South Asian mothers who themselves were not active smokers.Funding:This study was funded by the Canadian Institutes of Health Research Metabolomics Team Grant: MWG-146332.

Maternal smoking DNA methylation risk score associated with health outcomes in offspring of European and South Asian ancestry.

Maternal smoking has been linked to adverse health outcomes in newborns but the extent to which it impacts newborn health has not been quantified through an aggregated cord blood DNA methylation (DNAm) score. Here, we examine the feasibility of using cord blood DNAm scores leveraging large external studies as discovery samples to capture the epigenetic signature of maternal smoking and its influence on newborns in White European and South Asian populations. We first examined the association between individual CpGs and cigarette smoking during pregnancy, and smoking exposure in two White European birth cohorts (n=744). Leveraging established CpGs for maternal smoking, we constructed a cord blood epigenetic score of maternal smoking that was validated in one of the European-origin cohorts (n=347). This score was then tested for association with smoking status, secondary smoking exposure during pregnancy, and health outcomes in offspring measured after birth in an independent White European (n=397) and a South Asian birth cohort (n=504). Several previously reported genes for maternal smoking were supported, with the strongest and most consistent association signal from the GFI1 gene (6 CpGs with p<5 × 10-5). The epigenetic maternal smoking score was strongly associated with smoking status during pregnancy (OR = 1.09 [1.07, 1.10], p=5.5 × 10-33) and more hours of self-reported smoking exposure per week (1.93 [1.27, 2.58], p=7.8 × 10-9) in White Europeans. However, it was not associated with self-reported exposure (p>0.05) among South Asians, likely due to a lack of smoking in this group. The same score was consistently associated with a smaller birth size (-0.37±0.12 cm, p=0.0023) in the South Asian cohort and a lower birth weight (-0.043±0.013 kg, p=0.0011) in the combined cohorts. This cord blood epigenetic score can help identify babies exposed to maternal smoking and assess its long-term impact on growth. Notably, these results indicate a consistent association between the DNAm signature of maternal smoking and a small body size and low birth weight in newborns, in both White European mothers who exhibited some amount of smoking and in South Asian mothers who themselves were not active smokers. This study was funded by the Canadian Institutes of Health Research Metabolomics Team Grant: MWG-146332.

Ethnic Differences in Atypical Parkinsonism-is South Asian PSP Different?

Progressive supranuclear palsy (PSP) is a progressive atypical parkinsonian condition that results in severe disability. There are few studies of PSP in patients of non-white European ancestry. We aim to perform deep phenotyping in a South Asian PSP cohort to uncover possible ethnic differences in disease characteristics. Consecutive PSP patients had their clinical records reviewed for clinical features operationalized in the Movement Disorder Society (MDS)-PSP diagnostic criteria and relevant investigations, including imaging and genetic tests. Clinical variables were summarized by descriptive statistics and Kaplan-Meier curves were generated for survival analysis. Twenty-seven patients, comprising Indians (78%), Pakistanis (11%) and Sri Lankans (11%) were included. Mean age of symptom onset was 63.8 ± 7.0 years and 22% of patients had an early age of onset (<60 years). The most common presenting symptom was parkinsonism (56%), followed by cognitive dysfunction (37%), falls (33%) and dysarthria (26%). The predominance types at final review were distributed across PSP-RS (67%), PSP-PGF (15%), PSP-P (15%) and PSP-F (4%). Atypical clinical features like cerebellar signs (33%), REM-sleep behavior disorder (RBD) (55%), visual hallucinations (22%), and a family history of parkinsonism (20%) were evident in a proportion of patients. We present a South Asian cohort of PSP patients with a higher than previously reported percentages of early-onset disease, family history and atypical clinical manifestations. These patients do not fit easily into the PSP phenotypes defined by the current MDS criteria. Dedicated clinicopathological and genetic tests are needed in this population to dissect the pathogenesis of clinically-defined PSP.

Predictors of weight and waist gain in US South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study

BackgroundWeight and waist gain are significant concerns in adulthood. Both weight and waist gain are particularly important among South Asians, known to have an increased risk of developing chronic cardiometabolic complications at any body mass index compared to other racial and ethnic groups. The aim of this study was to investigate factors predicting weight and waist gain in a longitudinal cohort of South Asians living in the US (United States). MethodsThis was a prospective analysis using data from exam 1 (2010–2013) and exam 2 (2015–2018) of the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, a prospective cohort study of South Asians (recruited from San Francisco and Chicago), with a mean 4.8 years of follow-up. ResultsOf 634 participants studied (42.7 % women, mean age 55 years, BMI 25.7 kg/m2, weight 70.4 kg at exam 1), 34.7 % had gained ≥5 % weight and 32.3 % gained ≥5 % waist at exam 2. In the adjusted models, older age, higher number of years of US residence, and having diabetes were associated with lower odds of weight gain; being female and having higher adiponectin were associated with higher odds of weight gain. Being female and being employed full/part time or being retired predicted lower likelihood of waist gain. Being single, separated/divorced, having a higher leptin and a higher C-reactive protein level predicted higher likelihood of waist gain. ConclusionsThe current study identified several social, demographic, and clinical factors that can serve as targets for obesity interventions among US South Asians. In addition, this study also raises hypotheses about associations of adipokine levels with weight and waist gain.

Consistent cord blood DNA methylation signatures of gestational age between South Asian and white European cohorts

BackgroundEpigenetic modifications, particularly DNA methylation (DNAm) in cord blood, are an important biological marker of how external exposures during gestation can influence the in-utero environment and subsequent offspring development. Despite the recognized importance of DNAm during gestation, comparative studies to determine the consistency of these epigenetic signals across different ethnic groups are largely absent. To address this gap, we first performed epigenome-wide association studies (EWAS) of gestational age (GA) using newborn cord blood DNAm comparatively in a white European (n = 342) and a South Asian (n = 490) birth cohort living in Canada. Then, we capitalized on established cord blood epigenetic GA clocks to examine the associations between maternal exposures, offspring characteristics and epigenetic GA, as well as GA acceleration, defined as the residual difference between epigenetic and chronological GA at birth.ResultsIndividual EWASs confirmed 1,211 and 1,543 differentially methylated CpGs previously reported to be associated with GA, in white European and South Asian cohorts, respectively, with a similar distribution of effects. We confirmed that Bohlin’s cord blood GA clock was robustly correlated with GA in white Europeans (r = 0.71; p = 6.0 × 10–54) and South Asians (r = 0.66; p = 6.9 × 10–64). In both cohorts, Bohlin’s clock was positively associated with newborn weight and length and negatively associated with parity, newborn female sex, and gestational diabetes. Exclusive to South Asians, the GA clock was positively associated with the newborn ponderal index, while pre-pregnancy weight and gestational weight gain were strongly predictive of increased epigenetic GA in white Europeans. Important predictors of GA acceleration included gestational diabetes mellitus, newborn sex, and parity in both cohorts.ConclusionsThese results demonstrate the consistent DNAm signatures of GA and the utility of Bohlin’s GA clock across the two populations. Although the overall pattern of DNAm is similar, its connections with the mother's environment and the baby's anthropometrics can differ between the two groups. Further research is needed to understand these unique relationships.

Comparison of SRK/T with Kane formula for prediction of refractive outcome after phacoemulsification: Insights from a South Asian patient group

BackgroundPhacoemulsification stands as the most commonly conducted ocular procedure. Biometry represents an art with numerous generations of formulas introduced to enhance refractive prediction accuracy. The Sanders Retzlaff Kraff theoretical (SRK/T), a third-generation formula that merges linear regression and a theoretical eye model, and the Kane formula, a fourth-generation formula incorporating theoretical optics, regression, and artificial intelligence, embody our focal points. Our aim is to compare post-operative refractive outcomes utilizing SRK/T and Kane formulae for calculating intraocular lens (IOL) power in senile cataract patients undergoing phacoemulsification featuring a hydrophilic acrylic, monofocal IOL. MethodsThis prospective, interventional institutional study engaged 70 patients, totaling 74 eyes. They were categorized into two groups: Group A employed the SRK/T for IOL power calculation, while Group B used the Kane formula. Quantel Medical® A-scan biometer was employed. A comparison was drawn between both formulae in terms of mean absolute error (MAE) and median absolute error (MedAE), with the utilization of IBM SPSS 20 and a significance level of p < 0.05. ResultsThe MAE for the SRK/T and Kane formulae stood at 0.18 ± 0.82 D and 0.24 ± 0.94 D, respectively, while the MedAE recorded values of 0.16 D and 0.155 D, correspondingly (p < 0.05). ConclusionWithin this South Asian cohort of senile cataract patients, the SRK/T formula demonstrated a marginally improved refractive outcome, evidenced by a reduced mean absolute error.

Choroidal thickness in juvenile open angle glaucoma: insights from a south asian case-control study.

The purpose of this study is to compare choroidal thickness in juvenile open angle glaucoma (JOAG) and healthy controls using spectral domain optical coherence tomography (SD-OCT) and study its correlations. In this case-control study, 56 eyes of 28 JOAG patients and an equal number of controls were recruited. SD-OCT was used to measure the choroidal thickness (ChT), in the macular region at 5 locations: subfoveal, 1500µm and 3000µm nasal and temporal to the foveal center, and in the peripapillary region at 6 locations: up to 1500µm, nasal and temporal to the disc, respectively. The ChT and its correlations with age, intraocular pressure, cup-to-disc ratio, central corneal thickness, mean deviation, and axial length were studied. The average macular ChT in JOAG was 306.30 ± 56.49µm vs. 277.12 ± 64.68µm in controls. The average peripapillary ChT in JOAG was 197.79 ± 44.05µm vs. 187.24 ± 38.89µm in controls. The average total ChT (p = 0.042), the average macular ChT (p = 0.022), the subfoveal ChT (p = 0.022), the ChT 1500µm (p < 0.001), and 3000µm temporal to the fovea (p = 0.002) were significantly thicker in the JOAG group. In the JOAG group, the average macular ChT had a significant negative correlation with age, whereas axial length was positively correlated with the average peripapillary ChT. In this South Asian cohort of JOAG, the average total ChT, average macular ChT, subfoveal ChT, and ChT at 1500µm, and 3000µm temporal to the fovea were significantly thicker when compared to healthy controls.

Do Religion and Spirituality Buffer the Effect of Childhood Trauma on Depressive Symptoms? Examination of a South Asian Cohort from the USA.

Asian Americans have been identified as a racial group that is disproportionately affected by childhood trauma. The goal of this study was to assess if religion/spirituality moderate the effects of childhood trauma on adult depressive symptoms among a sample of South Asians in the USA. Our analysis drew from the study on stress, spirituality, and health (SSSH) questionnaire fielded in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 990) during 2016-2018. A series of regression models with multiplicative interaction terms were conducted. Emotional neglect, emotional abuse, and physical neglect were associated with higher depressive symptoms. Higher religious attendance and negative religious coping techniques were found to exacerbate this relationship. There were two findings conditional on gender. Among men, gratitude and positive religious coping also exacerbated the relationship between childhood trauma and depressive symptoms. Negative religious coping also exacerbated the association between childhood trauma and depressive symptoms for women. This is the first community-based study of US South Asians to consider the association between various forms of childhood trauma and depressive symptom outcomes. South Asians remain an understudied group in the religion and health literature, and this study sheds light on the important differences in the function and effectiveness of religion/spirituality for those faced with early life trauma.

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.

Normative retinal nerve fiber layer thickness in a healthy pediatric South Asian cohort: a spectral-domain optical coherence tomography study.

Currently, the normative values for retinal nerve fiber layer (RNFL) thickness in our population have not been widely studied. Our study aimed to assess the peripapillary RNFL thickness (RNFLT) with Optopol Copernicus REVO80® spectral-domain optical coherence tomography (SD-OCT) amongst healthy children and its associations. One hundred eighty-two eyes of 91 consecutive healthy children 3 to 16 years of age with a refractive error ≤ ± 5 D were included after a thorough eye exam including visual acuity, refraction, tonometry, pachymetry, axial length estimation, and slit lamp exam including fundus assessment. RNFLT was measured via Optopol Copernicus REVO80® high resolution SD-OCT by a single experienced observer with 3D disc mode within a circular area of diameter 3.45 mm and the ring further divided into four quadrants: inferior, superior, nasal, and temporal. The mean age was 11.12 ± 3.12 years (range, 3-16). The average RNFLT was 120.13 ± 12.6 μm. The mean superior RNFL was the thickest at 138.21 ± 16.6 μm, next was the mean inferior RNFLT at 137.62 ± 17.2 μm, followed by the nasal 91.61 ± 18.5 μm and then the temporalat 74.58 ± 11.7 μm. No significant differences in RNFLT were noted between the two eyes. The mean RNFLT was significantly higher in males as compared to females, in vertical quadrants and at an average (p < 0.05). No significant relationship was found between the average RNFLT and factors such as age, axial length, corneal thickness, cup-to-disc ratio, intraocular pressure, or refractive error. This study establishes normative values of RNFLT for this subgroup of Pakistani children for the Optopol Copernicus REVO80® SD-OCT device.

The association of red and processed meat with gestational diabetes mellitus: Results from 2 Canadian birth cohort studies.

Red and processed meat is considered risk factors of gestational diabetes mellitus (GDM), but the evidence is inconclusive. We aimed to examine the association between red and processed meat intake and odds of GDM among South Asian and White European women living in Canada. This is a cross-sectional analysis of pregnant women from two birth cohorts: SouTh Asian biRth cohorT (START; n = 976) and Family Atherosclerosis Monitoring In earLY life (FAMILY; n = 581). Dietary intake was assessed using a validated 169-item semi-quantitative food-frequency questionnaire (FFQ). Multivariate logistic regression models were used to examine the associations between gestational diabetes and: 1) total red and processed meat; 2) unprocessed red meat; 3) processed meat and GDM after adjustment for potential confounders. There were 241 GDM cases in START and 91 in FAMILY. The median total red and processed meat intake were 1.5 g/d (START) and 52.8 g/d (FAMILY). In START, the multivariable-adjusted odds ratio (OR) showed neither lower nor higher intakes of unprocessed red meat (p-trend = 0.68), processed meat (p-trend = 0.90), or total red and processed meat (p-trend = 0.44), were associated with increased odds of GDM, when compared with medium intake. Similar results were observed in FAMILY except for processed meat intake [OR = 0.94 (95% CI 0.47-1.91), for medium versus low and OR = 1.51 (95% CI 0.77-2.29) for medium versus high; p-trend = 0.18] after adjusting for additional dietary factors such as the diet quality score, total fiber, saturated fat and glycemic load. Medium compared with low or high red and processed meat intake is not associated with GDM in White Europeans and South Asians living in Canada.

CMR 2-67 - Role of Cardiac MRI in Prognostication of Hypertrophic Cardiomyopathy in a Large Single Center South Asian Cohort

CMR 2-67 - Role of Cardiac MRI in Prognostication of Hypertrophic Cardiomyopathy in a Large Single Center South Asian Cohort