Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters
Creator:
Yehuda, R., Orbach, R., Singer, B., McEwen, B., Hale, C., Kirkpatrick, B., Svendsen, E., Cochran, D., Collier, T., Scott, G., Yoskowitz, D., Rowles, T., Partyka, M., Morris, G., Tincher, T., Ebi, K., Seeman, T., Solo-Gabriele, H., Harville, E., Yip, F., Farrington, J., Prather, A.A., Finucane, M., Hswen, Y., Trtanj, J., Halpern, D., Caffey, R., Engel, L.S., Walker, A.H., Manley, R., Abramson, D., Hart, L., Sandifer, P., Knapp, L., Lichtveld, M., Porter, D., and Palinkas, L.
Date of publication:
2020
Abstract Tesim:
The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.
Resource type:
Article
Affiliation Label Tesim:
Department of Epidemiology
DOI:
https://doi.org/10.17615/qy95-cv79
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fpubh.2020.578463
ISSN:
2296-2565
Journal Title:
Frontiers in Public Health
Journal Volume:
8
Keyword:
cohort studies, stress, disasters, Gulf of Mexico, COVID-19, allostatic load, health surveillance, and health observing system
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
Icahn School of Medicine at Mount Sinai, University of Texas, Austin, University of Florida, Rockefeller University, Texas A&M University-Corpus Christi, Texas A&M University, Centers for Disease Control and Prevention, University of Southern Mississippi, Western Washington University, University of South Carolina, National Oceanic and Atmospheric Administration, Mississippi-Alabama Sea Grant Consortium, University of Washington, University of California, Los Angeles, University of Miami, Tulane University, Woods Hole Oceanographic Institution, University of California, San Francisco, Rand Corporation, Scripps Institution of Oceanography, Louisiana State University, , SEA Consulting Group, College of Charleston, New York University, and University of Southern California
Person:
Yehuda, R., Orbach, R., Singer, B., McEwen, B., Hale, C., Kirkpatrick, B., Svendsen, E., Cochran, D., Collier, T., Scott, G., Yoskowitz, D., Rowles, T., Partyka, M., Morris, G., Tincher, T., Ebi, K., Seeman, T., Solo-Gabriele, H., Harville, E., Yip, F., Farrington, J., Prather, A.A., Finucane, M., Hswen, Y., Trtanj, J., Halpern, D., Caffey, R., Engel, L.S., Walker, A.H., Manley, R., Abramson, D., Hart, L., Sandifer, P., Knapp, L., Lichtveld, M., Porter, D., and Palinkas, L.
Background: Maternal diet during pregnancy has been shown to influence the child neuro-developmental outcomes. Studies examining effects of dietary patterns on offspring behavior are sparse. Objective: Determine if maternal adherence to a Mediterranean diet is associated with child behavioral outcomes assessed early in life, and to evaluate the role of differentially methylated regions (DMRs) regulating genomically imprinted genes in these associations. Methods: Among 325 mother/infant pairs, we used regression models to evaluate the association between tertiles of maternal periconceptional Mediterranean diet adherence (MDA) scores derived from a Food Frequency Questionnaire, and social and emotional scores derived from the Infant Toddler Social and Emotional Assessment (ITSEA) questionnaire in the second year of life. Methylation of nine genomically imprinted genes was measured to determine if MDA was associated with CpG methylation. Results: Child depression was inversely associated with maternal MDA (Bonferroni-corrected p = 0.041). While controlling for false-discovery, compared to offspring of women with the lowest MDA tertile, those with MDA scores in middle and high MDA tertiles had decreased odds for atypical behaviors [OR (95% CI) = 0.40 (0.20, 0.78) for middle and 0.40 (0.17, 0.92) for highest tertile], for maladaptive behaviors [0.37 (0.18, 0.72) for middle tertile and 0.42 (0.18, 0.95) for highest tertile] and for an index of autism spectrum disorder behaviors [0.46 (0.23, 0.90) for middle and 0.35 (0.15, 0.80) for highest tertile]. Offspring of women with the highest MDA tertile were less likely to exhibit depressive [OR = 0.28 (0.12, 0.64)] and anxiety [0.42 (0.18, 0.97)] behaviors and increased odds of social relatedness [2.31 (1.04, 5.19)] behaviors when compared to low MDA mothers. Some associations varied by sex. Perinatal MDA score was associated with methylation differences for imprinted control regions of PEG10/SGCE [females: Beta (95% CI) = 1.66 (0.52, 2.80) - Bonferroni-corrected p = 0.048; males: -0.56 (-1.13, -0.00)], as well as both MEG3 and IGF2 in males [0.97 (0.00, 1.94)] and -0.92 (-1.65, -0.19) respectively. Conclusion: In this ethnically diverse cohort, maternal adherence to a Mediterranean diet in early pregnancy was associated with favorable neurobehavioral outcomes in early childhood and with sex-dependent methylation differences of MEG3, IGF2, and SGCE/PEG10 DMRs.
, North Carolina State University, Duke University Medical Center, Johns Hopkins Bloomberg School of Public Health, Duke University School of Medicine, University of Pittsburgh, and Virginia Commonwealth University
Untargeted metabolomics on first trimester serum implicates metabolic perturbations associated with BMI in development of hypertensive disorders: a discovery study
Creator:
Pan, Ke, Sumner, Susan C. J., McRitchie, Susan L., Li, Yuanyuan, and Harville, Emily W.
Date of publication:
2023
Abstract Tesim:
GoalBody mass index (BMI) in early pregnancy is a critical risk factor for hypertensive disorders of pregnancy (HDP). The pathobiology of the interplay between BMI and HDP is not fully understood and represents the focus of this investigation.MethodsBMI and 1st-trimester serum samples were obtained from the Global Alliance to Prevent Prematurity and Stillbirth repository for 154 women (105 without HDP and 49 with HDP). Metabotyping was conducted using ultra-high-performance liquid-chromatography high-resolution mass spectrometry (UHPLC HR-MS). Multivariable linear regression and logistic models were used to determine metabolites and pathway perturbations associated with BMI in women with and without HDP, and to determine metabolites and pathway perturbations associated with HDP for women in categories of obese, overweight, and normal weight based on the 1st trimester BMI. These outcome-associated signals were identified or annotated by matching against an in-house physical standards library and public database. Pathway analysis was conducted by the Mummichog algorithm in MetaboAnalyst.ResultVitamin D3 and lysine metabolism were enriched to associate with BMI for women with and without HDP. Tryptophan metabolism enrichment was associated with HDP in all the BMI categories. Pregnant women who developed HDP showed more metabolic perturbations with BMI (continuous) than those without HDP in their 1st-trimester serum. The HDP-associated pathways for women with normal weight indicated inflammation and immune responses. In contrast, the HDP-associated pathways for women of overweight and obese BMI indicated metabolic syndromes with disorders in glucose, protein, and amino acid, lipid and bile acid metabolism, and oxidative and inflammatory stress.ConclusionHigh first-trimester BMI indicates underlying metabolic syndromes, which play critical roles in HDP development. Vitamin D3 and tryptophan metabolism may be the targets to guide nutritional interventions to mitigate metabolic and inflammatory stress in pregnancy and reduce the onset of HDP.
Resource type:
Article
Affiliation Label Tesim:
Department of Nutrition
DOI:
https://doi.org/10.17615/852k-gw25
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fnut.2023.1144131
ISSN:
2296-861X
Journal Title:
Frontiers in Nutrition
Journal Volume:
10
Keyword:
metabolic perturbation, untargeted metabolomics, 1st-trimester, hypertensive disorders in pregnancy, and BMI
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
Tulane University School of Public Health and Tropical Medicine and
Person:
Pan, Ke, Sumner, Susan C. J., McRitchie, Susan L., Li, Yuanyuan, and Harville, Emily W.
State-level clustering in PrEP implementation factors among family planning clinics in the Southern United States
Creator:
Psioda, Matthew A., Sales, Jessica M., McCumber, Micah, Sheth, Anandi N., Ramakrishnan, Aditi, and Enders, Kimberly P.
Date of publication:
2023
Abstract Tesim:
Background: Availability of PrEP-providing clinics is low in the Southern U.S., a region at the center of the U.S. HIV epidemic with significant HIV disparities among minoritized populations, but little is known about state-level differences in PrEP implementation in the region. We explored state-level clustering of organizational constructs relevant to PrEP implementation in family planning (FP) clinics in the Southern U.S. Methods: We surveyed providers and administrators of FP clinics not providing PrEP in 18 Southern states (Feb-Jun 2018, N = 414 respondents from 224 clinics) on these constructs: readiness to implement PrEP, PrEP knowledge/attitudes, implementation climate, leadership engagement, and available resources. We analyzed each construct using linear mixed models. A principal component analysis identified six principal components, which were inputted into a K-means clustering analysis to examine state-level clustering. Results: Three clusters (C1–3) were identified with five, three, and four states, respectively. Canonical variable 1 separated C1 and C2 from C3 and was primarily driven by PrEP readiness, HIV-specific implementation climate, PrEP-specific leadership engagement, PrEP attitudes, PrEP knowledge, and general resource availability. Canonical variable 2 distinguished C2 from C1 and was primarily driven by PrEP-specific resource availability, PrEP attitudes, and general implementation climate. All C3 states had expanded Medicaid, compared to 1 C1 state (none in C2). Conclusion: Constructs relevant for PrEP implementation exhibited state-level clustering, suggesting that tailored strategies could be used by clustered states to improve PrEP provision in FP clinics. Medicaid expansion was a common feature of states within C3, which could explain the similarity of their implementation constructs. The role of Medicaid expansion and state-level policies on PrEP implementation warrants further exploration.
Resource type:
Article
Affiliation Label Tesim:
Department of Biostatistics
DOI:
https://doi.org/10.17615/y1m0-r006
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fpubh.2023.1214411
Journal Title:
Frontiers in Public Health
Keyword:
implementation, PrEP, Southern U.S., women, and family planning
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
and Emory University
Person:
Psioda, Matthew A., Sales, Jessica M., McCumber, Micah, Sheth, Anandi N., Ramakrishnan, Aditi, and Enders, Kimberly P.
Sickle Cell Disease (SCD) is a group of inherited hemoglobinopathies. Sickle cell anemia (SCA) is caused by a homozygous mutation in the β-globin generating sickle hemoglobin (HbS). Deoxygenation leads to pathologic polymerization of HbS and sickling of erythrocytes. The two predominant pathologies of SCD are hemolytic anemia and vaso-occlusive episodes (VOE), along with sequelae of complications including acute chest syndrome, hepatopathy, nephropathy, pulmonary hypertension, venous thromboembolism, and stroke. SCD is associated with endothelial activation due to the release of danger-associated molecular patterns (DAMPs) such as heme, recurrent ischemia–reperfusion injury, and chronic thrombin generation and inflammation. Endothelial cell activation is mediated, in part, by thrombin-dependent activation of protease-activated receptor 1 (PAR1), a G protein coupled receptor that plays a role in platelet activation, endothelial permeability, inflammation, and cytotoxicity. PAR1 can also be activated by activated protein C (APC), which promotes endothelial barrier protection and cytoprotective signaling. Notably, the APC system is dysregulated in SCD. This mini-review will discuss activation of PAR1 by APC and thrombin, the APC-EPCR-PAR1 axis, and their potential roles in SCD.
Resource type:
Article
Affiliation Label Tesim:
Department of Medicine
DOI:
https://doi.org/10.17615/1d12-4q20
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fmed.2023.1141020
ISSN:
2296-858X
Journal Title:
Frontiers in Medicine
Journal Volume:
10
Keyword:
thrombin, inflammation, sickle cell anemia, sickle cell disease, activated protein C (APC), vaso-occlusion, endothelial protein C receptor (EPCR), and protease activated receptor 1 (PAR1)
Relationships between internalized stigma and depression and suicide risk among queer youth in the United States: a systematic review and meta-analysis
Creator:
Dawes, Hayden C., Srivastava, Ankur, Chen, Wan-Ting, Hall, William J., Bouchard, D., Williams, Denise Yookong, Ramon, Magdelene, Radtke, Spenser R., and Goldbach, Jeremy T.
Date of publication:
2023
Abstract Tesim:
Background Queer youth experience high rates of depression and suicidality. These disparities stem from stigma-based stressors, including internalized stigma (i.e., negative social views that minoritized individuals internalize about their own identity). Given the importance of this factor in understanding mental health disparities among queer youth, we completed a systematic review and meta-analysis examining the relationships between internalized stigma and outcomes of depression and suicide risk (i.e., suicidal ideation, non-suicidal self-injury, and suicidal behavior). Methods We followed the PRISMA standards. Six bibliographic databases were searched for studies in the United States from September 2008 to March 2022. Dual independent screening of search results was performed based on a priori inclusion criteria. Results A total of 22 studies were included for data extraction and review. Most studies examined general internalized homophobia, with few examining internalized biphobia or transphobia. Many studies examined depression as an outcome, few studies examined suicidal ideation or behavior, and no studies examined non-suicidal self-injury. Meta-analyses model results show the association between general internalized queer stigma and depressive symptoms ranged r = 0.19, 95% CI [0.14, 0.25] to r = 0.24, 95% CI [0.19, 0.29], the latter reflecting more uniform measures of depression. The association between internalized transphobia and depressive outcomes was small and positive (r = 0.21, 95% CI [−0.24, 0.67]). General internalized queer stigma and suicidal ideation had a very weak positive association (r = 0.07, 95% CI [−0.27, 0.41]) and an even smaller, weaker positive association with suicide attempt (r = 0.02, 95% CI [0.01, 0.03]). Conclusion Implications for clinical practice, policy, and future research are discussed.
Resource type:
Article
Affiliation Label Tesim:
School of Social Work
DOI:
https://doi.org/10.17615/wmfe-wp59
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fpsyt.2023.1205581
ISSN:
1664-0640
Journal Title:
Frontiers in Psychiatry
Journal Volume:
14
Keyword:
adolescents, queer, internalized homophobia, LGB, youth, transgender, sexual minority, and internalized stigma
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
and Washington University, St. Louis
Person:
Dawes, Hayden C., Srivastava, Ankur, Chen, Wan-Ting, Hall, William J., Bouchard, D., Williams, Denise Yookong, Ramon, Magdelene, Radtke, Spenser R., and Goldbach, Jeremy T.
Race and sex differences in dropout from the STRRIDE trials
Creator:
Smith P.J., Siegler I.C., Huffman K.M., Wolever R.Q., Jakicic J.M., Costa P.T., Ross L.M., Collins K.A., and Kraus W.E.
Date of publication:
2023
Abstract Tesim:
Purpose: To determine if race and sex differences exist in determinants and timing of dropout among individuals enrolled in an exercise and/or caloric restriction intervention. Methods: A total of 947 adults with dyslipidemia (STRRIDE I, STRRIDE AT/RT) or prediabetes (STRRIDE-PD) were randomized to either inactive control or to 1 of 10 exercise interventions, ranging from doses of 8–23 kcal/kg/week, intensities of 50%–75% (Formula presented.) peak, and durations of 6–8 months. Two groups included resistance training, and one included a dietary intervention (7% weight loss goal). Dropout was defined as an individual withdrawn from the study, with the reasons for dropout aggregated into determinant categories. Timing of dropout was defined as the last session attended and aggregated into phases (i.e., “ramp” period to allow gradual adaptation to exercise prescription). Utilizing descriptive statistics, percentages were generated according to categories of determinants and timing of dropout to describe the proportion of individuals who fell within each category. Results: Black men and women were more likely to be lost to follow-up (Black men: 31.3% and Black women: 19.6%), or dropout due to work responsibilities (15.6% and 12.5%), “change of mind” (12.5% and 8.9%), transportation issues (6.3% and 3.6%), or reported lack of motivation (6.3% and 3.6%). Women in general noted lack of time more often than men as a reason for dropout (White women: 22.4% and Black women: 22.1%). Regardless of race and sex, most participants dropped out during the ramp period of the exercise intervention; with Black women (50%) and White men (37.1%) having the highest dropout rate during this period. Conclusion: These findings emphasize the importance of targeted retention strategies when aiming to address race and sex differences that exist in determinants and timing of dropout among individuals enrolled in an exercise and/or caloric restriction intervention.
Resource type:
Article
Affiliation Label Tesim:
Department of Psychiatry
DOI:
https://doi.org/10.17615/cfth-3m45
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fspor.2023.1215704
ISSN:
2624-9367
Journal Title:
Frontiers in Sports and Active Living
Journal Volume:
5
Keyword:
non-compliance, health disparity, lifestyle intervention, retention, and adherence
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
, Duke University School of Medicine, Vanderbilt University School of Medicine, and University of Kansas, Medical Center
Person:
Smith P.J., Siegler I.C., Huffman K.M., Wolever R.Q., Jakicic J.M., Costa P.T., Ross L.M., Collins K.A., and Kraus W.E.
NeuroBridge ontology: computable provenance metadata to give the long tail of neuroimaging data a FAIR chance for secondary use
Creator:
Ambite, Jose Luis, Wang, Yue, Appaji, Abhishek, Turner, Matthew D., Turner, Jessica A., Sahoo, Satya S., Wang, Lei, Lander, Howard M., and Rajasekar, Arcot
Date of publication:
2023
Abstract Tesim:
Background Despite the efforts of the neuroscience community, there are many published neuroimaging studies with data that are still not findable or accessible. Users face significant challenges in reusing neuroimaging data due to the lack of provenance metadata, such as experimental protocols, study instruments, and details about the study participants, which is also required for interoperability. To implement the FAIR guidelines for neuroimaging data, we have developed an iterative ontology engineering process and used it to create the NeuroBridge ontology. The NeuroBridge ontology is a computable model of provenance terms to implement FAIR principles and together with an international effort to annotate full text articles with ontology terms, the ontology enables users to locate relevant neuroimaging datasets. Methods Building on our previous work in metadata modeling, and in concert with an initial annotation of a representative corpus, we modeled diagnosis terms (e.g., schizophrenia, alcohol usage disorder), magnetic resonance imaging (MRI) scan types (T1-weighted, task-based, etc.), clinical symptom assessments (PANSS, AUDIT), and a variety of other assessments. We used the feedback of the annotation team to identify missing metadata terms, which were added to the NeuroBridge ontology, and we restructured the ontology to support both the final annotation of the corpus of neuroimaging articles by a second, independent set of annotators, as well as the functionalities of the NeuroBridge search portal for neuroimaging datasets. Results The NeuroBridge ontology consists of 660 classes with 49 properties with 3,200 axioms. The ontology includes mappings to existing ontologies, enabling the NeuroBridge ontology to be interoperable with other domain specific terminological systems. Using the ontology, we annotated 186 neuroimaging full-text articles describing the participant types, scanning, clinical and cognitive assessments. ConclusionThe NeuroBridge ontology is the first computable metadata model that represents the types of data available in recent neuroimaging studies in schizophrenia and substance use disorders research; it can be extended to include more granular terms as needed. This metadata ontology is expected to form the computational foundation to help both investigators to make their data FAIR compliant and support users to conduct reproducible neuroimaging research.
Resource type:
Article
Affiliation Label Tesim:
University of North Carolina at Chapel Hill
DOI:
https://doi.org/10.17615/rzrs-5k79
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fninf.2023.1216443
ISSN:
1662-5196
Journal Title:
Frontiers in Neuroinformatics
Journal Volume:
17
Keyword:
ontology text annotation, NeuroBridge ontology, computable provenance metadata, W3C PROV ontology, and FAIR neuroimaging data
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
University of Southern California, , BMS College of Engineering, Ohio State University Wexner Medical Center, and Case Western Reserve University
Person:
Ambite, Jose Luis, Wang, Yue, Appaji, Abhishek, Turner, Matthew D., Turner, Jessica A., Sahoo, Satya S., Wang, Lei, Lander, Howard M., and Rajasekar, Arcot
Mucolytic treatment of chronic rhinosinusitis in a murine model of primary ciliary dyskinesia
Creator:
Yin, Weining, Golliher, Hannah L., Livraghi-Butrico, Alessandra, Ferguson, Amy J., Grubb, Barbara R., Kimple, Adam J., Ostrowski, Lawrence E., Rogers, Troy D., and Kimbell, Julia S.
Date of publication:
2023
Abstract Tesim:
Background: Genetic defects in motile cilia cause primary ciliary dyskinesia (PCD), a rare disease with no specific therapeutics. Individuals with PCD often have impaired fertility and laterality defects and universally suffer from upper and lower airway diseases. Chronic rhinosinusitis is a universal feature of PCD, and mucus accumulation and subsequent infections of the sinonasal cavity cause significant morbidity in individuals with PCD. Despite this, there are no approved treatments that specifically target mucus.Objective: The goals of this study were to determine whether computed tomography (CT) imaging could be used to quantify mucus accumulation and whether the use of a mucolytic agent to reduce disulfide cross-links present in mucins would improve the effectiveness of nasal lavage at removing mucus in a murine model of PCD.Methods: Adult mice with a deletion of the axonemal dynein Dnaic1 were imaged using CT scanning to characterize mucus accumulation. The animals were then treated by nasal lavage with saline, with/without the disulfide-reducing agent tris(2-carboxyethyl)phosphine. Post-treatment CT scans were used to quantify improvement in the sinonasal cavity.Results: Mucus accumulation in the nasal cavity was readily quantified by CT. Compared to sham-treated control animals, nasal lavage with/without a mucolytic agent resulted in a significant reduction of accumulated mucus (p < 0.01). Treatment with the mucolytic agent showed a greater reduction of accumulated mucus than treatment with saline alone.Conclusion: The results suggest that inclusion of a mucolytic agent may increase the effectiveness of nasal lavage at reducing mucus burden in PCD.
Resource type:
Article
Affiliation Label Tesim:
Marsico Lung Institute/UNC Cystic Fibrosis Center, Department of Otolaryngology/Head and Neck Surgery, and Department of Pediatrics
Yin, Weining, Golliher, Hannah L., Livraghi-Butrico, Alessandra, Ferguson, Amy J., Grubb, Barbara R., Kimple, Adam J., Ostrowski, Lawrence E., Rogers, Troy D., and Kimbell, Julia S.
Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV
Creator:
Mack W.J., Fox E., Appleton A.A., Adimora A.A., Plankey M.W., Tien P.C., Vásquez E., Holman S., Gustafson D.R., Sharma A., Rubin L.H., Fischl M.A., Moran C.A., Weber K.M., Kuniholm M.H., and Minkoff H.
Date of publication:
2023
Abstract Tesim:
Background and objective: Observations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV. We examined cross-sectional and longitudinal associations between body mass index (BMI) and waist circumference (WC) and NP. Methods: Four hundred thirty two 432 virologically-suppressed WLWH and 367 WWOH, ≥40 years in the Women’s Interagency HIV Study (WIHS) with anthropometry and NP assessments every two years from 2009-2019 were included in the study. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV status were used to examine cross-sectional associations of BMI and WC by NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Covariates included sociodemographic, behavioral, and HIV-related characteristics. Results: At baseline among all women, the median age was 45 years, 65% were Non-Latinx Black women, and 45% were obese women. Obese WLWH (BMI≥30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07]) versus WLWH with healthy BMI (18.5–24.9 kg/m2). Longitudinally over ~8 years, obese versus overweight WWOH improved on memory (β=2.19, 95%CI [0.13, 4.26]), however overweight versus healthy WWOH experienced declining memory (β= -2.67, 95%CI [-5.40, -0.07]). Increasing WC was associated with declining executive, processing speed, and motor function (p’s<0.05); an at-risk WC was associated with improved memory (β=1.81, 95%CI [0.19, 3.44]) among WWOH. Among WLWH, increasing BMI was associated with improved learning (β=0.07, 95%CI [0.00, 0.15]. Conclusion: Our cross-sectional and longitudinal analyses evaluating the associations of BMI and WC and NP were mixed compared to previous reports. This illustrates the importance of sociodemographic characteristics, baseline levels of exposures and outcomes, HIV status, temporality of measurements, and other factors when evaluating aging HIV epidemiology study results.
Resource type:
Article
Affiliation Label Tesim:
Department of Medicine
DOI:
https://doi.org/10.17615/jrbs-4z12
Edition:
Publisher
Identifier:
https://dx.doi.org/10.3389/fendo.2023.1108313
ISSN:
1664-2392
Journal Title:
Frontiers in Endocrinology
Journal Volume:
14
Keyword:
waist circumference, HIV, obesity, aging, women, body mass index, and neuropsychological performance
Language Label:
English
License Label:
Attribution 4.0 International
ORCID:
Other Affiliation:
University of Southern California, University of Mississippi Medical Center, University at Albany School of Public Health State University of New York, , Georgetown University, University of California, San Francisco, State University of New York Health Sciences University, State of New York Downstate Health Sciences University, Albert Einstein College of Medicine, Johns Hopkins University, University of Miami Miller School of Medicine, Emory University School of Medicine, and Cook County Health/Hektoen Institute of Medicine
Person:
Mack W.J., Fox E., Appleton A.A., Adimora A.A., Plankey M.W., Tien P.C., Vásquez E., Holman S., Gustafson D.R., Sharma A., Rubin L.H., Fischl M.A., Moran C.A., Weber K.M., Kuniholm M.H., and Minkoff H.