02844nas a2200337 4500008004100000022001400041245017600055210006900231260001500300300001400315490000700329520178800336653000902124653002902133653001802162653002202180653001202202653001502214653001102229653002902240653002302269100002402292700002102316700001902337700002202356700002002378700002302398700002502421700002402446856003602470 2022 eng d a1935-554800aThe Association of Measures of Cardiovascular Autonomic Function, Heart Rate, and Orthostatic Hypotension With Incident Glucose Disorders: The Cardiovascular Health Study.0 aAssociation of Measures of Cardiovascular Autonomic Function Hea c2022 10 01 a2376-23820 v453 a

OBJECTIVE: The autonomic nervous system (ANS) innervates pancreatic endocrine cells, muscle, and liver, all of which participate in glucose metabolism. We tested whether measures of cardiovascular ANS function are independently associated with incident diabetes and annual change in fasting glucose (FG) levels as well as with insulin secretion and insulin sensitivity in older adults without diabetes.

RESEARCH DESIGN AND METHODS: Heart rate (HR) and measures of HR variability (HRV) were derived from 24-h electrocardiographic monitoring. Blood pressure, seated and standing, was measured. Cox proportional hazards models and linear mixed models were used to analyze the associations between HRV, HR, and orthostatic hypotension (SBP >20 mmHg decline) and incident diabetes or longitudinal FG change.

RESULTS: The mean annual unadjusted FG change was 1 mg/dL. Higher detrended fluctuation analyses (DFA) values, averaged over 4-11 (DFA1) or 12-20 beats (DFA2)-reflecting greater versus less organization of beat-to-beat intervals-were associated with less FG increase over time (per 1-SD increment: DFA1: -0.49 mg/dL/year [-0.96, -0.03]; DFA2: -0.55 mg/dL/year [-1.02, -0.09]). In mutually adjusted analyses, higher SD of the N-N interval (SDNN) was associated with less FG increase over time (per 1-SD increment: SDNN: -0.62 mg/dL/year [-1.22, -0.03]). Higher values of DFA1, DFA2, and SDNN were each associated with greater insulin secretion and insulin sensitivity but not with incident diabetes. We observed no association of HR or orthostatic hypotension with diabetes or FG change.

CONCLUSIONS: Specific measures of cardiac autonomic function are prospectively related to FG level changes and insulin secretion and action.

10aAged10aAutonomic Nervous System10aBlood Glucose10aDiabetes Mellitus10aGlucose10aHeart Rate10aHumans10aHypotension, Orthostatic10aInsulin Resistance1 aBarzilay, Joshua, I1 aTressel, William1 aBiggs, Mary, L1 aStein, Phyllis, K1 aKizer, Jorge, R1 aShitole, Sanyog, G1 aBene-Alhasan, Yakubu1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/915502596nas a2200217 4500008004100000022001400041245012300055210006900178260001300247300001100260490000700271520191500278100002502193700002402218700001902242700002002261700001902281700001802300700002402318856003602342 2023 eng d a2589-936800aThe determinants of fasting and post-load non-esterified fatty acids in older adults: The cardiovascular health study.0 adeterminants of fasting and postload nonesterified fatty acids i c2023 Dec a1002610 v203 a

AIM: Non-esterified fatty acids (NEFA) are potential targets for prevention of key cardiometabolic diseases of aging, but their population-level correlates remain uncertain. We sought to identify modifiable factors associated with fasting and post-load NEFA levels in older adults.

METHODS: We used linear regression to determine the cross-sectional associations of demographic, anthropometric, and lifestyle characteristics and medication use with serum fasting and post-load NEFA concentrations amongst community-dwelling older adults enrolled in the Cardiovascular Health Study (n = 1924).

RESULTS: Fasting NEFA levels generally demonstrated a broader set of determinants, while post-load NEFA were more consistently associated with metabolic factors. Waist circumference and weight were associated with higher fasting and post-load NEFA. Cigarette smoking and caffeine intake were associated with lower levels of both species, and moderate alcohol intake was associated with higher fasting levels whereas greater consumption was associated with lower post-load levels. Unique factors associated with higher fasting NEFA included female sex, higher age, loop and thiazide diuretic use and calcium intake, while factors associated with lower fasting levels included higher educational attainment, beta-blocker use, and protein intake. Hours spent sleeping during the daytime were associated with higher post-load NEFA, while DASH score was associated with lower levels.

CONCLUSION: Fasting and post-load NEFA have both common and unique modifiable risk factors, including sociodemographics, anthropometric, medications, and diet. Post-load NEFA were particularly sensitive to metabolic factors, while a broader range of determinants were associated with fasting levels. These factors warrant study as targets for lowering levels of NEFA in older adults.

1 aBene-Alhasan, Yakubu1 aSiscovick, David, S1 aIx, Joachim, H1 aKizer, Jorge, R1 aTracy, Russell1 aDjoussé, Luc1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/958202747nas a2200241 4500008004100000022001400041245010200055210006900157260001600226520198100242100002502223700002302248700002102271700002202292700001902314700002002333700002402353700002302377700002702400700001802427700002402445856003602469 2025 eng d a1945-719700aNon-Esterified Fatty Acid Profiles and Cause-Specific Mortality: The Cardiovascular Health Study.0 aNonEsterified Fatty Acid Profiles and CauseSpecific Mortality Th c2025 Mar 243 a

CONTEXT: Total fasting non-esterified fatty acid (NEFA) levels have been associated with mortality. The corresponding associations with NEFA levels following an oral glucose tolerance test (OGTT) and with individual fasting NEFA species are unclear.

OBJECTIVE: We evaluated the associations of post-load NEFA, fasting subclasses and individual NEFA with mortality.

DESIGN AND SETTING: The Cardiovascular Health Study is a population-based cohort study of community-dwelling adults over 64 years from four US communities that began in 1989-1990. Participants had total NEFA measured enzymatically before and two hours after an OGTT from archived serum samples collected in 1996-1997. Fasting individual NEFA were also measured using gas chromatography. Cox proportional hazard models were used to evaluate adjusted hazard ratios (aHR) for mortality associated with fasting and post-load total NEFA, and fasting individual and fatty acid subclasses (saturated, monounsaturated, n-3 and n-6 polyunsaturated, and trans).

RESULTS: The final population included 1996 participants with a mean age of 78 years. 60.5% were female. Over a median 11-year follow-up period, 1678 participants died. Total fasting NEFA was associated with higher risk of all-cause mortality (aHR per standard deviation: 1.17, 95% CI [1.10-1.23]). Total post-load NEFA was not associated with mortality. Among subclasses, only monounsaturated fatty acid (MUFA) was associated with total mortality (aHR 1.24, 95% CI [1.09-1.41]). For individual NEFAs, nervonic acid (aHR 1.06, 95% CI [1.01-1.12]), petroselaidic acid (aHR 1.21, 95% CI [1.03-1.42]) and eicosapentaenoic acid (aHR 0.90, 95% CI [0.82-0.99]) were associated with all-cause mortality.

CONCLUSION: Individual fasting NEFAs represent attractive candidates for medical and public health interventions aimed at improving survivorship in older adults and should be investigated further.

1 aBene-Alhasan, Yakubu1 aShitole, Sanyog, G1 aBůzková, Petra1 aHirsch, Calvin, H1 aIx, Joachim, H1 aKizer, Jorge, R1 aSiscovick, David, S1 aMatthan, Nirupa, R1 aLichtenstein, Alice, H1 aDjoussé, Luc1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/9905