Abstract MP057: Associations of CD4+ Memory and Naïve T Lymphocytes and Subclinical Atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Nels C Olson ◽  
Nancy S Jenny ◽  
Sally A Huber ◽  
Richard A Kronmal ◽  
Bruce M Psaty ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
African Americans ◽  
T Lymphocytes ◽  
Subclinical Atherosclerosis ◽  
Chinese Americans ◽  
Agatston Score ◽  
Memory Cells ◽  
Ethnic Study ◽  
European Americans ◽  
H Pylori

Background: Atherosclerosis is a chronic inflammatory disease involving both innate and adaptive immune responses, characterized by the accumulation of T lymphocytes throughout the atherosclerotic plaque. Therefore, we hypothesized that increased CD4+ memory cells and decreased CD4+ naïve cells would be associated with atherosclerosis. To date, no multi-ethnic population-based studies have examined this question. Methods: Peripheral blood memory and naive subpopulations were measured by flow cytometry and defined by the markers CD4+CD45RO+ and CD4+CD45RA+, respectively. Data were analyzed as a proportion of CD4+ cells. Associations were explored with demographic and cardiovascular disease-related variables, and markers of infection, inflammation and subclinical atherosclerosis in a random subset (n=914 participants, composed of European Americans (n=397), Chinese Americans (n=96), African Americans (n=187) and Hispanics (n=234); mean age 66 years) of the Multi-Ethnic Study of Atherosclerosis (MESA). Agatston score, a measure of coronary calcification, was evaluated by cardiac computed tomography (CT) scan; serologies representing past exposure to pathogens were measured in serum by immunoassays. CD4+ cell indices were measured at Exam 4 (2005-2007); cardiovascular disease variables were obtained at the nearest previous exam; some measures, such as serologies, were available only at baseline (2000-2002). Results: Mean levels of circulating naïve, but not memory, CD4+ T cells were higher in woman than men (30.0% and 26.3%, respectively; P<0.0001) and negatively associated with age (P<0.0001). European Americans (EAs) had higher levels of naïve cells compared with African Americans and Hispanics (30.7%, 26.0% and 25.0%, respectively) and lower levels of memory cells compared with the same groups (50.7%, 55.7% and 58.0%, respectively; P<0.05); Chinese Americans were similar to EAs. Adjusting for age, gender and race/ethnicity, CD4+ naïve cells were inversely associated with past exposure to cytomegalovirus (CMV), Hepatitis A and H. Pylori (P<0.001), while memory cells were positively associated with CMV and H. Pylori (P<0.01). Using standardized linear regression models, CD4+ naïve cells were inversely associated with BMI (β= -1.62 ± 0.48), the inflammatory markers C-reactive protein (CRP) (β= -1.21 ± 0.48) and IL-6 (β= -1.79 ± 0.48) and with a positive Agatston score (β= -1.53 ± 0.65) (P<0.05); memory cells were positively associated with these same variables, after adjusting for age, gender and ethnicity. Conclusion: Differences in CD4+ T lymphocytes, including increased populations of memory cells and decreased populations of naïve cells, are associated with atherosclerosis as estimated by Agatston scores. These findings suggest that excess immune activation, as reflected by these differences, may contribute to atherosclerotic calcification.

Abstract P104: Higher Leptin Levels Are Associated With Increased Odds Of Coronary Artery Calcium Progression: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Ct Scans ◽  
Agatston Score ◽  
Cvd Risk ◽  
Ethnic Study ◽  
History Of

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk

scholarly journals NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis

Heart ◽  
2019 ◽  
Vol 105 (20) ◽  
pp. 1590-1596 ◽  
Author(s):  
Sushan Yang ◽  
Shi Huang ◽  
Lori B Daniels ◽  
Joseph Yeboah ◽  
Joao A C Lima ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Endothelial Function ◽  
Racial Differences ◽  
Asian American ◽  
Vascular Function ◽  
Chinese Americans ◽  
Mediation Effect ◽  
Linear Regression Models ◽  
Ethnic Study

ObjectiveNatriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function.MethodsIn this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method.ResultsAmong African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: −0.03(95% CI: −0.05 to −0.01); Chinese-Americans, mediation effect: −0.03(95% CI: −0.05 to −0.01)).ConclusionsLower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

Abstract 043: Health Insurance and the Risk of Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Matthew T Crim ◽  
Joe X Xie ◽  
Yi-An Ko ◽  
Roger S Blumenthal ◽  
Michael J Blaha ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Insurance ◽  
Lower Risk ◽  
Cox Regression ◽  
Subclinical Atherosclerosis ◽  
Private Insurance ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk ◽  
Ethnic Study

Background: Health insurance plays an important role in access to medical care and is the focus of extensive policy efforts. We examined the association of health insurance with cardiovascular disease (CVD) incidence. Methods and Results: The Multi-Ethnic Study of Atherosclerosis, sponsored by the National Heart, Lung and Blood Institute of the NIH, followed a US cohort, aged 45-84 without clinical CVD at baseline, for a median of 12.2 years; 788 events occurred among 6,674 individuals. Data were stratified by baseline health insurance status. Kaplan-Meier survival and Cox regression analyses were used to assess the association between health insurance and incident CVD (myocardial infarction, resuscitated cardiac arrest, stroke, CVD death, and angina), adjusting for biomedical CVD risk (traditional risk factors, including age and race/ethnicity, and markers of subclinical atherosclerosis) and socioeconomic status (SES). The majority of individuals had private insurance (51%). Uninsured individuals (9%) were more likely to have untreated hypertension and diabetes, less likely to be on lipid-lowering therapy, and more likely to receive care in an Emergency Department (p < 0.0001). Income, 10-year CVD risk, and 10-year event-free survival varied across insurance groups ( Table ). After adjustment for biomedical CVD risk, individuals with health insurance had a lower risk of incident CVD compared to the uninsured (HR 0.72, p=0.03). However, with additional adjustment for SES (income, education, and employment), insurance was no longer associated with incident CVD (HR 0.78, p=0.12). Among the insurance groups, those with private insurance had a lower risk of incident CVD after adjustment for both biomedical CVD risk and SES (HR 0.70, p=0.03). Medicare and Medicaid coverage were not associated with incident CVD. The military/VA group had a lower risk of incident CVD with adjustment for biomedical CVD risk (HR 0.57, p=0.02) that was no longer significant after adjustment for SES (HR 0.66, p=0.09). Conclusions: The association of health insurance with CVD incidence varied by insurance group, and private insurance was associated with a lower risk of incident CVD. Further exploration of the features of health insurance coverage that impact CVD incidence may facilitate improvements in the primary prevention of CVD.

scholarly journals Association of α2-Heremans-Schmid Glycoprotein Polymorphisms with Subclinical Atherosclerosis

2007 ◽  
Vol 92 (1) ◽  
pp. 345-352 ◽  
Author(s):  
Allison B. Lehtinen ◽  
Kathryn P. Burdon ◽  
Joshua P. Lewis ◽  
Carl D. Langefeld ◽  
Julie T. Ziegler ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Carotid Artery ◽  
Atherosclerotic Plaque ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Fetuin A ◽  
Media Thickness ◽  
European Americans ◽  
Calcified Plaque ◽  
Ahsg Gene

Abstract Context: Cardiovascular disease is significantly increased in individuals with type 2 diabetes mellitus (T2DM), especially in the presence of calcified atherosclerotic plaque. Fetuin A is an important mineralization inhibitor, and polymorphisms in the corresponding α2-Heremans-Schmid glycoprotein (AHSG) gene have been shown to be associated with serum fetuin A levels and free phosphate levels, as well as cardiovascular disease death. Objective: This study investigated whether polymorphisms in AHSG contribute to the development of calcified atherosclerotic plaque in the coronary and carotid arteries and to carotid artery intima-media thickness. Design: Eleven single nucleotide polymorphisms (SNPs) in AHSG were genotyped and evaluated for association with quantitative measures of subclinical atherosclerosis. Participants: Subjects were 829 T2DM-affected European Americans from 368 families in the Diabetes Heart Study. Main Outcome Measures: Participants were phenotyped for cardiovascular risk factors and atherosclerosis traits. The extent of coronary artery calcified plaque (CorCP) and carotid artery calcified plaque (CarCP) was measured using quantitative computed tomography, and carotid artery intima-media thickness was measured using high-resolution B mode ultrasonography. Results: Four SNPs in AHSG were nominally associated with CorCP in European Americans with T2DM (P &lt; 0.05). Two 3-SNP haplotypes in the exon 6–7 region were associated with CorCP in European Americans with T2DM (P &lt; 0.06). Conclusions: Sequence variants in the AHSG gene affect the extent of CorCP in T2DM-affected European Americans, consistent with the known biological role of AHSG in vascular calcification. These data implicate AHSG in the development of vascular calcified plaque in diabetic subjects.

scholarly journals Genetics and geography of leukocyte telomere length in sub-Saharan Africans

2020 ◽  
Vol 29 (18) ◽  
pp. 3014-3020
Author(s):  
Steven C Hunt ◽  
Matthew E B Hansen ◽  
Simon Verhulst ◽  
Michael A McQuillan ◽  
William Beggs ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Genetic Variation ◽  
African Americans ◽  
Telomere Length ◽  
Leukocyte Telomere Length ◽  
Associated Diseases ◽  
European Americans ◽  
Sub Saharan

Abstract Leukocyte telomere length (LTL) might be causal in cardiovascular disease and major cancers. To elucidate the roles of genetics and geography in LTL variability across humans, we compared LTL measured in 1295 sub-Saharan Africans (SSAs) with 559 African–Americans (AAms) and 2464 European–Americans (EAms). LTL differed significantly across SSAs (P = 0.003), with the San from Botswana (with the oldest genomic ancestry) having the longest LTL and populations from Ethiopia having the shortest LTL. SSAs had significantly longer LTL than AAms [P = 6.5(e-16)] whose LTL was significantly longer than EAms [P = 2.5(e-7)]. Genetic variation in SSAs explained 52% of LTL variance versus 27% in AAms and 34% in EAms. Adjustment for genetic variation removed the LTL differences among SSAs. LTL genetic variation among SSAs, with the longest LTL in the San, supports the hypothesis that longer LTL was ancestral in humans. Identifying factors driving LTL variation in Africa may have important ramifications for LTL-associated diseases.

scholarly journals Impact of Subclinical Atherosclerosis on Cardiovascular Disease Events in Individuals With Metabolic Syndrome and Diabetes: The Multi-Ethnic Study of Atherosclerosis

Diabetes Care ◽  
2011 ◽  
Vol 34 (10) ◽  
pp. 2285-2290 ◽  
Author(s):  
S. Malik ◽  
M. J. Budoff ◽  
R. Katz ◽  
R. S. Blumenthal ◽  
A. G. Bertoni ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Subclinical Atherosclerosis ◽  
Ethnic Study

scholarly journals Differences in Diet Quality among Multiple US Racial/Ethnic Groups from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA)

2020 ◽  
Vol 150 (6) ◽  
pp. 1509-1515 ◽  
Author(s):  
Luis A Rodriguez ◽  
Yichen Jin ◽  
Sameera A Talegawkar ◽  
Marcia C de Oliveira Otto ◽  
Namratha R Kandula ◽  
...  
Keyword(s):  
United States ◽  
African Americans ◽  
Ethnic Groups ◽  
South Asian ◽  
Diet Quality ◽  
South Asians ◽  
Chinese Americans ◽  
The United States ◽  
Ethnic Study ◽  
Racial Ethnic

ABSTRACT Background Diet quality is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). Little is known about the diet quality of South Asians in the United States, a group with higher rates of T2D and CVD compared with other racial/ethnic groups. Objective This study determined whether diet quality differs between South Asian adults in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and whites, Chinese Americans, African Americans, and Hispanics in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods Cross-sectional data from 3926 participants free of CVD from MESA visit 5 (2010–2011) and 889 South Asian participants from MASALA visit 1 (2010–2013) were pooled. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010) derived using FFQs. Multivariable linear regression models adjusted for age, sex, and total energy intake were used to compare mean differences in diet quality between the racial/ethnic groups. Results MESA participants were, on average, 14 y older than MASALA participants. The adjusted mean (95% CI) scores for the AHEI-2010 were 70.2 (69.5, 70.9) among South Asians, 66.2 (66.3, 68.2) among Chinese Americans, 61.1 (60.7, 61.6) among whites, 59.0 (58.4, 59.7) among Hispanics, and 57.5 (56.9, 58.1) among African Americans. The mean AHEI scores among South Asians were 3.1 (1.8, 4.3), 9.2 (8.3, 10.1), 11.2 (10.2, 12.3), and 12.8 (11.8, 13.7) points higher compared with Chinese Americans, whites, Hispanics, and African Americans, respectively. Conclusions South Asian adults in the United States have a higher diet quality compared with other racial/ethnic groups. This paradoxical finding is not consistent with the observed higher rates of T2D and CVD compared with other groups. This is further evidence of the importance of studying the South Asian population to better understand the causes of chronic disease not explained by diet quality.

Abstract 13418: Inter-relation of Parity and Coronary Artery Calcium With Cardiovascular Disease Events: The Multi-ethnic Study of Atherosclerosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kimberly Vu ◽  
Khoa Nguyen ◽  
Jonathan Evans ◽  
WENJUN FAN ◽  
Morgana Mongraw-chaffin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Subclinical Atherosclerosis ◽  
Cvd Risk ◽  
Ethnic Study ◽  
Live Births ◽  
A Prospective Study

Introduction: Coronary artery calcium (CAC) is a measure of subclinical atherosclerosis and predicts cardiovascular disease (CVD) events. Greater parity, or number of live births, has been shown to relate to CVD. We examined whether the relation of parity to CVD events may depend on the presence and extent of subclinical atherosclerosis measured by CAC. Methods: We studied 3151 women free of CVD at baseline in the Multi-Ethnic Study of Atherosclerosis, a prospective study of CVD. Participants were stratified by parity categories of 0-1 (reference), 2-3, and ≥4 and by baseline CAC categories of 0, 1-99, and 100+. We compared the incidence of CVD (myocardial infarction, stroke, resuscitated cardiac arrest, and coronary heart disease deaths) per 1000 years based on parity across levels of CAC over 13 years. Cox regression determined the joint association of parity and CAC on the incidence of CVD. Results: Women with greater parity had a higher prevalence of any CAC and CAC≥100 (p<0.01); among those with CAC, parity related to greater mean CAC scores (175, 184, and 284, respectively) (p<0.01). Women with greater parity also had greater incident CVD (7.1%, 8.7%, and 11.3% for 0-1, 2-3, and ≥4 live births, respectively, p-trend =0.01) and extent of CAC directly related to the incidence of CVD within parity groups. However, the association of parity with CAC was attenuated after adjustment for age, race, income, smoking and other risk factors. Parity also directly related to the incidence of CVD within CAC categories ( Figure ); however, from Cox regression analyses, these relations were attenuated when adjusted for age, ethnicity and other risk factors. Conclusion: In unadjusted analyses, we show parity to be associated with the prevalence of any or significant CAC, extent of CAC among those with CAC>0, as well as the incidence of CVD events, overall and according to the presence and extent of CAC. However, the association of parity with CVD risk was attenuated after adjustment for other factors.

Abstract P102: Menthol Cigarette Use and Subclinical Cardiovascular Disease in African Americans in the Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Wendy B White
Keyword(s):  
Cardiovascular Disease ◽  
African Americans ◽  
Reference Group ◽  
Smoking Status ◽  
Subclinical Atherosclerosis ◽  
Cigarette Use ◽  
Jackson Heart Study ◽  
Menthol Cigarette ◽  
Menthol Cigarettes ◽  
Heart Study

Background: African Americans smoke menthol cigarettes at higher rates than other races and have a disproportionate burden of cardiovascular disease (CVD). Whereas smoking is a well described risk factor for CVD, it is unclear if menthol cigarettes are associated with more or less risk. Therefore, our aim was to evaluate the association between menthol cigarette use and subclinical atherosclerosis in the Jackson Heart Study (JHS). Methods: JHS participants (n=5,301) were classified by self-reported smoking status as current, past (smoked ≥400 cigarettes/life), or never smokers at Visit 1 (V1, 2000-2004). Menthol cigarette use data were captured at Visit 3 (V3, 2009-2013). We used multivariable logistic and robust linear regression models to examine the associations between cigarette type and measures of subclinical atherosclerosis [carotid intimal medial thickness (CIMT, Visit 1) and coronary artery calcium (CAC) or aorto-iliac calcium (AIC) by computed tomography (Visit 2, V2, 2005-2008)] to estimate β-coefficients (adjusted differences) comparing menthol to non-menthol (reference group) smoking. Results: There were 401 current smokers with available data on cigarette preference including 326 menthol (81%) and 75 non-menthol (19%) smokers at V3. Menthol cigarette preference in current smokers was not associated with significant differences in measures of subclinical atherosclerosis: CIMT (β -0.003, 95% CI -0.053, 0.046, p=0.90); CAC (β -0.20, 95% CI -1.09, 0.69, p=0.66) or AIC (β -0.32, 95% CI -1.23, 0.59, p=0.48). Conclusion: Our study provides no evidence for an association of menthol cigarette use with subclinical atherosclerosis in African Americans. These findings warrant replication by studies that address the limitations of this study, including the assumption that menthol smokers in V3 were long-term menthol smokers before V1 and V2, potential selection by exclusions of deaths related to smoking and CVD among participants at V3 and lack of longitudinal data on outcomes after the collection of menthol use data at V3.

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