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Wen X, Fretts AM, Miao G, Malloy KM, Zhang Y, Umans JG, Cole SA, Best LG, Fiehn O, Zhao J. Plasma lipidomic markers of diet quality are associated with incident coronary heart disease in American Indian adults: the Strong Heart Family Study. Am J Clin Nutr 2024; 119:748-755. [PMID: 38160800 DOI: 10.1016/j.ajcnut.2023.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Identifying lipidomic markers of diet quality is needed to inform the development of biomarkers of diet, and to understand the mechanisms driving the diet- coronary heart disease (CHD) association. OBJECTIVES This study aimed to identify lipidomic markers of diet quality and examine whether these lipids are associated with incident CHD. METHODS Using liquid chromatography-mass spectrometry, we measured 1542 lipid species from 1694 American Indian adults (aged 18-75 years, 62% female) in the Strong Heart Family Study. Participants were followed up for development of CHD through 2020. Information on the past year diet was collected using the Block Food Frequency Questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI). Mixed-effects linear regression was used to identify individual lipids cross-sectionally associated with AHEI. In prospective analysis, Cox frailty model was used to estimate the hazard ratio (HR) of each AHEI-related lipid for incident CHD. All models were adjusted for age, sex, center, education, body mass index, smoking, alcohol drinking, level of physical activity, energy intake, diabetes, hypertension, and use of lipid-lowering drugs. Multiple testing was controlled at a false discovery rate of <0.05. RESULTS Among 1542 lipid species measured, 71 lipid species (23 known), including acylcarnitine, cholesterol esters, glycerophospholipids, sphingomyelins and triacylglycerols, were associated with AHEI. Most of the identified lipids were associated with consumption of ω-3 (n-3) fatty acids. In total, 147 participants developed CHD during a mean follow-up of 17.8 years. Among the diet-related lipids, 10 lipids [5 known: cholesterol ester (CE)(22:5)B, phosphatidylcholine (PC)(p-14:0/22:1)/PC(o-14:0/22:1), PC(p-38:3)/PC(o-38:4)B, phosphatidylethanolamine (PE)(p-18:0/20:4)/PE(o-18:0/20:4), and sphingomyelin (d36:2)A] were associated with incident CHD. On average, each standard deviation increase in the baseline level of these 5 lipids was associated with 17%-23% increased risk of CHD (from HR: 1.17; 95% CI: 1, 1.36; to HR: 1.23; 95% CI: 1.05, 1.43). CONCLUSIONS In this study, lipidomic markers of diet quality in American Indian adults are found. Some diet-related lipids are associated with risk of CHD beyond established risk factors.
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Affiliation(s)
- Xiaoxiao Wen
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States; Center for Genetic Epidemiology and Bioinformatics, University of Florida, Gainesville, FL, United States
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Guanhong Miao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States; Center for Genetic Epidemiology and Bioinformatics, University of Florida, Gainesville, FL, United States
| | - Kimberly M Malloy
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ying Zhang
- Center for American Indian Health Research, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jason G Umans
- Biomarker, Biochemistry, and Biorepository Core, MedStar Health Research Institute, Hyattsville, MD, United States; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, United States
| | - Shelley A Cole
- Population Health, Texas Biomedical Research Institute, San Antonio, TX, United States
| | - Lyle G Best
- Missouri Breaks Industries Research, Timber Lake, SD, United States
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California-Davis, Davis, CA, United States
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States; Center for Genetic Epidemiology and Bioinformatics, University of Florida, Gainesville, FL, United States.
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Abstract
Background American Indian adults have a higher risk of atrial fibrillation (AF) compared with other racial groups. We implemented opportunistic screening to detect silent AF in American Indian adults attending a tribal health system using a mobile, single-lead ECG device. Methods and Results American Indian patients aged ≥50 years followed in a tribal primary care clinic with no history of AF underwent a 30-second ECG. A cardiologist overread all tracings to confirm the diagnosis of AF. After AF was confirmed, patients were referred to their primary care physician for initiation of anticoagulation. Patients seen over the same time period, who were not undergoing screening, served as controls. A total of 1019 patients received AF screening (mean age, 61.5±8.9 years, 62% women). Age and sex distribution of those screened was similar to the overall clinic population. New AF was diagnosed in 15 of 1019 (1.5%) patients screened versus 4 of 1267 (0.3%) patients who were not screened (mean difference, 1.2%; 95% CI, 0.3%-2.2%, P=0.002). Eight of 15 with new screen-detected AF were aged <65 years. Those with screen-detected AF were slightly older and had a higher CHA2DS2-VASc score than those without AF. Fourteen of 15 patients diagnosed with new AF had a CHA2DS2-VASc score ≥1 and initiated anticoagulation. Conclusions Opportunistic, mobile single-lead ECG screening for AF is feasible in tribal clinics, and detects more AF than usual care, leading to appropriate initiation of anticoagulation. AF develops at a younger age in American Indian adults who would likely benefit from earlier AF screening. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03740477.
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Affiliation(s)
- Stavros Stavrakis
- Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City OK
| | - Khaled Elkholey
- Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City OK
| | | | - Zain U A Asad
- Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City OK
| | - Lancer D Stephens
- Oklahoma Shared Clinical and Translational Resources Center Oklahoma City OK
| | - Ben Freedman
- Heart Research Institute Charles Perkins Centre University of Sydney Australia
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Hirchak KA, Hernandez-Vallant A, Herron J, Cloud V, Tonigan JS, McCrady B, Venner K. Aligning three substance use disorder interventions among a tribe in the Southwest United States: Pilot feasibility for cultural re-centering, dissemination, and implementation. J Ethn Subst Abuse 2020; 21:1-17. [PMID: 33135985 PMCID: PMC8095342 DOI: 10.1080/15332640.2020.1836701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this article we describe cultural re-centering, dissemination, and implementation activities in partnership between an American Indian reservation community and a university in the Southwest United States. We offer examples of cultural adaptation and implementation of evidence-based treatments (e.g., Motivational Interviewing, Community Reinforcement Approach and the Community Reinforcement and Family Training) using the Interactive Systems Framework. Facilitators and barriers are described within each study including recruitment strategies, training, and sustainability of counselors in the community. Through this Tribal-university partnership, we offer insight on the cultural adaptation and implementation process that will be translatable and clinically meaningful to other rural and reservation communities.
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Affiliation(s)
- Katherine A. Hirchak
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - Jalene Herron
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - Violette Cloud
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
| | - J. Scott Tonigan
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Barbara McCrady
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Kamilla Venner
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Revitalzing Indigenous Values in Empirical Research (RIVER) Lab, Albuquerque, NM, USA
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