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  1. Article ; Online: Added sugar intake is associated with weight gain and risk of developing obesity over 30 years: The CARDIA study.

    Endy, Emily J / Yi, So-Yun / Steffen, Brian T / Shikany, James M / Jacobs, David R / Goins, Rae K / Steffen, Lyn M

    Nutrition, metabolism, and cardiovascular diseases : NMCD

    2023  Volume 34, Issue 2, Page(s) 466–474

    Abstract: Background and aims: Numerous prospective studies have examined sugar sweetened beverage (SSB) intake associated with weight gain or incident obesity. Because SSB accounts for only 33 % of added sugar (AS) intake, we investigated the associations of AS ... ...

    Abstract Background and aims: Numerous prospective studies have examined sugar sweetened beverage (SSB) intake associated with weight gain or incident obesity. Because SSB accounts for only 33 % of added sugar (AS) intake, we investigated the associations of AS intake with change in weight and waist circumference and risk of developing obesity.
    Methods and results: At baseline (1985-86) Black and White women and men, aged 18-30 years, enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study and were followed for 30 years (2015-16). A diet history assessed dietary intake 3 times over 20 years. Multivariable linear regression evaluated the associations of change in weight (n = 3306) and waist circumference (n = 3296) across quartiles of AS, adjusting for demographics, lifestyle factors, and anthropometrics. Proportional hazards regression analysis evaluated the associations of time-varying cumulative AS intake with risk of incident obesity (n = 4023) and abdominal obesity (n = 3449), adjusting for the same factors. Over 30 years of follow-up, greater AS intake was associated with gaining 2.3 kg more weight (p
    Conclusion: Our findings are consistent with recommendations from the 2020-2025 U S. Dietary Guidelines for Americans to limit daily AS intake.
    MeSH term(s) Male ; Young Adult ; Humans ; Female ; Prospective Studies ; Obesity, Abdominal/complications ; Coronary Vessels ; Obesity/diagnosis ; Obesity/epidemiology ; Obesity/etiology ; Weight Gain ; Sugars
    Chemical Substances Sugars
    Language English
    Publishing date 2023-10-24
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1067704-5
    ISSN 1590-3729 ; 0939-4753
    ISSN (online) 1590-3729
    ISSN 0939-4753
    DOI 10.1016/j.numecd.2023.10.022
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  2. Article ; Online: Decoding emotions: Exploring the validity of sentiment analysis in psychotherapy.

    Eberhardt, Steffen T / Schaffrath, Jana / Moggia, Danilo / Schwartz, Brian / Jaehde, Martin / Rubel, Julian A / Baur, Tobias / André, Elisabeth / Lutz, Wolfgang

    Psychotherapy research : journal of the Society for Psychotherapy Research

    2024  , Page(s) 1–16

    Abstract: Objective: Given the importance of emotions in psychotherapy, valid measures are essential for research and practice. As emotions are expressed at different levels, multimodal measurements are needed for a nuanced assessment. Natural Language Processing ...

    Abstract Objective: Given the importance of emotions in psychotherapy, valid measures are essential for research and practice. As emotions are expressed at different levels, multimodal measurements are needed for a nuanced assessment. Natural Language Processing (NLP) could augment the measurement of emotions. The study explores the validity of sentiment analysis in psychotherapy transcripts.
    Method: We used a transformer-based NLP algorithm to analyze sentiments in 85 transcripts from 35 patients. Construct and criterion validity were evaluated using self- and therapist reports and process and outcome measures via correlational, multitrait-multimethod, and multilevel analyses.
    Results: The results provide indications in support of the sentiments' validity. For example, sentiments were significantly related to self- and therapist reports of emotions in the same session. Sentiments correlated significantly with in-session processes (e.g., coping experiences), and an increase in positive sentiments throughout therapy predicted better outcomes after treatment termination.
    Discussion: Sentiment analysis could serve as a valid approach to assessing the emotional tone of psychotherapy sessions and may contribute to the multimodal measurement of emotions. Future research could combine sentiment analysis with automatic emotion recognition in facial expressions and vocal cues via the Nonverbal Behavior Analyzer (NOVA). Limitations (e.g., exploratory study with numerous tests) and opportunities are discussed.
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1080323-3
    ISSN 1468-4381 ; 1050-3307
    ISSN (online) 1468-4381
    ISSN 1050-3307
    DOI 10.1080/10503307.2024.2322522
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  3. Article ; Online: Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study.

    Steffen, Brian T / Jacobs, David R / Yi, So-Yun / Lees, Simon J / Shikany, James M / Terry, James G / Lewis, Cora E / Carr, John J / Zhou, Xia / Steffen, Lyn M

    International journal of obesity (2005)

    2023  Volume 47, Issue 10, Page(s) 939–947

    Abstract: Background: Artificial sweetener (ArtSw) intakes have been previously associated with higher BMI in observational studies and may promote visceral and skeletal muscle adipose tissue (AT) accumulation. This study aimed to determine whether habitual, long- ...

    Abstract Background: Artificial sweetener (ArtSw) intakes have been previously associated with higher BMI in observational studies and may promote visceral and skeletal muscle adipose tissue (AT) accumulation. This study aimed to determine whether habitual, long-term ArtSw or diet beverage intakes are related to greater AT depot volumes and anthropometry-related outcomes.
    Methods: A validated diet history questionnaire was administered at baseline, year 7, and year 20 examinations in 3088 men and women enrolled in the Coronary Artery Risk Development in Young Adults cohort (CARDIA), mean age of 25.2 years and mean BMI of 24.5 kg/m
    Results: Total ArtSw, aspartame, saccharin, and diet beverage intakes were positively associated with VAT, SAT, and IMAT volumes (all p
    Conclusions: Results suggest that long-term intakes of aspartame, saccharin, or diet soda may increase AT deposition and risk of incident obesity independent of diet quality or caloric intake. Coupled with previous evidence, alternatives to national recommendations to replace added sugar with ArtSw should be considered since both may have health consequences.
    MeSH term(s) Male ; Young Adult ; Humans ; Female ; Adult ; Aspartame/adverse effects ; Saccharin/adverse effects ; Obesity/epidemiology ; Sweetening Agents/adverse effects ; Adiposity ; Adipose Tissue
    Chemical Substances Aspartame (Z0H242BBR1) ; Saccharin (FST467XS7D) ; Sweetening Agents
    Language English
    Publishing date 2023-07-13
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 752409-2
    ISSN 1476-5497 ; 0307-0565
    ISSN (online) 1476-5497
    ISSN 0307-0565
    DOI 10.1038/s41366-023-01336-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Plasma Neuronal Growth Regulator 1 May Link Physical Activity to Reduced Risk of Type 2 Diabetes: A Proteome-Wide Study of ARIC Participants.

    Steffen, Brian T / McDonough, Daniel J / Pankow, James S / Tang, Weihong / Rooney, Mary R / Demmer, Ryan T / Lutsey, Pamela L / Guan, Weihua / Gabriel, Kelley Pettee / Palta, Priya / Moser, Ethan D / Pereira, Mark A

    Diabetes

    2023  Volume 73, Issue 2, Page(s) 318–324

    MeSH term(s) Humans ; Blood Proteins/genetics ; Diabetes Mellitus, Type 2/complications ; Genome-Wide Association Study ; Mendelian Randomization Analysis ; Polymorphism, Single Nucleotide ; Proteome/genetics ; Risk Factors ; Cell Adhesion Molecules, Neuronal/metabolism
    Chemical Substances Blood Proteins ; Proteome ; NEGR1 protein, human ; Cell Adhesion Molecules, Neuronal
    Language English
    Publishing date 2023-11-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80085-5
    ISSN 1939-327X ; 0012-1797
    ISSN (online) 1939-327X
    ISSN 0012-1797
    DOI 10.2337/db23-0383
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Diet quality is associated with adipose tissue and muscle mass: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

    Isanejad, Masoud / Steffen, Lyn M / Terry, James G / Shikany, James M / Zhou, Xia / So-YunYi / Jacobs, David R / Carr, John Jeffrey / Steffen, Brian T

    Journal of cachexia, sarcopenia and muscle

    2023  Volume 15, Issue 1, Page(s) 425–433

    Abstract: Background: Aging is associated with changes in body composition, and preventing loss of muscle mass and accumulation of excess adipose tissue in middle-aged adults may reduce age-related conditions at older ages. Dietary intake is one lifestyle factor ... ...

    Abstract Background: Aging is associated with changes in body composition, and preventing loss of muscle mass and accumulation of excess adipose tissue in middle-aged adults may reduce age-related conditions at older ages. Dietary intake is one lifestyle factor shown to improve or maintain body composition. However, few studies have examined the Healthy Eating Index2015 (HEI2015), a measure of diet quality, and the association with body composition in adult men and women.
    Methods: Participant data (n = 3017) from the Coronary Artery Risk Development in Young Adults (CARDIA) study were used to examine the associations of the HEI2015 with body composition measures at Year 25 (Y25), including (1) 25 year-change in weight, body mass index (BMI), and waist circumference and (2) a computed tomography (CT) scan at Y25 measured muscle mass, muscle quality (better quality = less lipid within the muscle), and adipose tissue depots visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and adipose within skeletal muscle (intermuscular adipose tissue; IMAT). Dietary intake was assessed by a diet history three times over 20 years, at years 0, 7, and 20. HEI2015, averaged over three exams, was created and categorized into quintiles. Multiple regression analysis evaluated the associations of body composition stratified across quintiles of HEI2015 adjusted for demographic characteristics, energy intake, lifestyle factors, and baseline anthropometric measures as appropriate. Race-sex interaction was tested (P
    Results: Over 25 years of follow-up, averaged HEI2015 was significantly and inversely associated with weight gain (Quintile 1 (Q1) 37.3 lb vs. 32.9 in Q5; P
    Conclusions: Improving diet quality in young to middle-aged adults is a recommended strategy to promote better measures of body composition. Our study findings suggest that healthier food choices may influence body composition.
    MeSH term(s) Male ; Middle Aged ; Humans ; Female ; Young Adult ; Coronary Vessels ; Adipose Tissue ; Diet ; Muscle, Skeletal/diagnostic imaging ; Lipids
    Chemical Substances Lipids
    Language English
    Publishing date 2023-12-12
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2586864-0
    ISSN 2190-6009 ; 2190-5991
    ISSN (online) 2190-6009
    ISSN 2190-5991
    DOI 10.1002/jcsm.13399
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  6. Article ; Online: Plasma omega-3 and saturated fatty acids are differentially related to pericardial adipose tissue volume across race/ethnicity: the Multi-ethnic Study of Atherosclerosis.

    Steffen, Brian T / Guan, Weihua / Ding, Jingzhong / Nomura, Sarah O / Weir, Natalie L / Tsai, Michael Y

    European journal of clinical nutrition

    2021  Volume 75, Issue 8, Page(s) 1237–1244

    Abstract: Background: Pericardial adipose tissue (PAT) is a cardiometabolic risk factor influenced by race/ethnicity, inflammation, and metabolic dysfunction. Omega-3 fatty acids (FAs) and saturated FAs (SFAs) are known to affect these latter phenomena and may ... ...

    Abstract Background: Pericardial adipose tissue (PAT) is a cardiometabolic risk factor influenced by race/ethnicity, inflammation, and metabolic dysfunction. Omega-3 fatty acids (FAs) and saturated FAs (SFAs) are known to affect these latter phenomena and may influence PAT accumulation. We aimed to determine whether plasma levels of these FAs are related to PAT volume and its rate of change over a median 3-year follow-up.
    Methods: Cardiac computed tomography assessed PAT in 6785 Multi-Ethnic Study of Atherosclerosis participants. Gas chromatography flame-ionization estimated plasma phospholipid FAs. Regression analyses estimated associations of FAs with PAT volume and its rate of change with adjustments for other risk factors. Race-interactions were tested.
    Results: In cross-section, top tertiles of omega-3 FAs and odd-chained SFAs were associated with 2.8 and 4.93 cm
    Conclusions: Cross-sectional and prospective findings provide inconclusive evidence as to whether plasma FAs are related to PAT in healthy individuals. Cohort studies with longer follow-up periods are warranted.
    MeSH term(s) Adipose Tissue ; Atherosclerosis ; Cross-Sectional Studies ; Ethnicity ; Fatty Acids ; Fatty Acids, Omega-3 ; Humans ; Prospective Studies
    Chemical Substances Fatty Acids ; Fatty Acids, Omega-3
    Language English
    Publishing date 2021-01-04
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 639358-5
    ISSN 1476-5640 ; 0954-3007
    ISSN (online) 1476-5640
    ISSN 0954-3007
    DOI 10.1038/s41430-020-00833-x
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  7. Article: Developing A Baseline Metabolomic Signature Associated with COVID-19 Severity: Insights from Prospective Trials Encompassing 13 U.S. Centers.

    Yang, Kaifeng / Kang, Zhiyu / Guan, Weihua / Lotfi-Emran, Sahar / Mayer, Zachary J / Guerrero, Candace R / Steffen, Brian T / Puskarich, Michael A / Tignanelli, Christopher J / Lusczek, Elizabeth / Safo, Sandra E

    Metabolites

    2023  Volume 13, Issue 11

    Abstract: Metabolic disease is a significant risk factor for severe COVID-19 infection, but the contributing pathways are not yet fully elucidated. Using data from two randomized controlled trials across 13 U.S. academic centers, our goal was to characterize ... ...

    Abstract Metabolic disease is a significant risk factor for severe COVID-19 infection, but the contributing pathways are not yet fully elucidated. Using data from two randomized controlled trials across 13 U.S. academic centers, our goal was to characterize metabolic features that predict severe COVID-19 and define a novel baseline metabolomic signature. Individuals (n = 133) were dichotomized as having mild or moderate/severe COVID-19 disease based on the WHO ordinal scale. Blood samples were analyzed using the Biocrates platform, providing 630 targeted metabolites for analysis. Resampling techniques and machine learning models were used to determine metabolomic features associated with severe disease. Ingenuity Pathway Analysis (IPA) was used for functional enrichment analysis. To aid in clinical decision making, we created baseline metabolomics signatures of low-correlated molecules. Multivariable logistic regression models were fit to associate these signatures with severe disease on training data. A three-metabolite signature, lysophosphatidylcholine a C17:0, dihydroceramide (d18:0/24:1), and triacylglyceride (20:4_36:4), resulted in the best discrimination performance with an average test AUROC of 0.978 and F1 score of 0.942. Pathways related to amino acids were significantly enriched from the IPA analyses, and the mitogen-activated protein kinase kinase 5 (MAP2K5) was differentially activated between groups. In conclusion, metabolites related to lipid metabolism efficiently discriminated between mild vs. moderate/severe disease. SDMA and GABA demonstrated the potential to discriminate between these two groups as well. The mitogen-activated protein kinase kinase 5 (MAP2K5) regulator is differentially activated between groups, suggesting further investigation as a potential therapeutic pathway.
    Language English
    Publishing date 2023-10-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662251-8
    ISSN 2218-1989
    ISSN 2218-1989
    DOI 10.3390/metabo13111107
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  8. Article ; Online: Stereoptic serious games as a visual rehabilitation tool for individuals with a residual amblyopia (AMBER trial): a protocol for a crossover randomized controlled trial.

    Simon-Martinez, Cristina / Antoniou, Maria-Paraskevi / Bouthour, Walid / Bavelier, Daphne / Levi, Dennis / Backus, Benjamin T / Dornbos, Brian / Blaha, James J / Kropp, Martina / Müller, Henning / Murray, Micah / Thumann, Gabriele / Steffen, Heimo / Matusz, Pawel J

    BMC ophthalmology

    2023  Volume 23, Issue 1, Page(s) 220

    Abstract: Background: Amblyopia is the most common developmental vision disorder in children. The initial treatment consists of refractive correction. When insufficient, occlusion therapy may further improve visual acuity. However, the challenges and compliance ... ...

    Abstract Background: Amblyopia is the most common developmental vision disorder in children. The initial treatment consists of refractive correction. When insufficient, occlusion therapy may further improve visual acuity. However, the challenges and compliance issues associated with occlusion therapy may result in treatment failure and residual amblyopia. Virtual reality (VR) games developed to improve visual function have shown positive preliminary results. The aim of this study is to determine the efficacy of these games to improve vision, attention, and motor skills in patients with residual amblyopia and identify brain-related changes. We hypothesize that a VR-based training with the suggested ingredients (3D cues and rich feedback), combined with increasing the difficulty level and the use of various games in a home-based environment is crucial for treatment efficacy of vision recovery, and may be particularly effective in children.
    Methods: The AMBER study is a randomized, cross-over, controlled trial designed to assess the effect of binocular stimulation (VR-based stereoptic serious games) in individuals with residual amblyopia (n = 30, 6-35 years of age), compared to refractive correction on vision, selective attention and motor control skills. Additionally, they will be compared to a control group of age-matched healthy individuals (n = 30) to account for the unique benefit of VR-based serious games. All participants will play serious games 30 min per day, 5 days per week, for 8 weeks. The games are delivered with the Vivid Vision Home software. The amblyopic cohort will receive both treatments in a randomized order according to the type of amblyopia, while the control group will only receive the VR-based stereoscopic serious games. The primary outcome is visual acuity in the amblyopic eye. Secondary outcomes include stereoacuity, functional vision, cortical visual responses, selective attention, and motor control. The outcomes will be measured before and after each treatment with 8-week follow-up.
    Discussion: The VR-based games used in this study have been conceived to deliver binocular visual stimulation tailored to the individual visual needs of the patient, which will potentially result in improved basic and functional vision skills as well as visual attention and motor control skills.
    Trial registration: This protocol is registered on ClinicalTrials.gov (identifier: NCT05114252) and in the Swiss National Clinical Trials Portal (identifier: SNCTP000005024).
    MeSH term(s) Child ; Humans ; Amblyopia/therapy ; Vision, Binocular/physiology ; Video Games ; Visual Acuity ; Treatment Outcome ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2023-05-17
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2050436-6
    ISSN 1471-2415 ; 1471-2415
    ISSN (online) 1471-2415
    ISSN 1471-2415
    DOI 10.1186/s12886-023-02944-y
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  9. Article: Validation and application of the Non-Verbal Behavior Analyzer: An automated tool to assess non-verbal emotional expressions in psychotherapy.

    Terhürne, Patrick / Schwartz, Brian / Baur, Tobias / Schiller, Dominik / Eberhardt, Steffen T / André, Elisabeth / Lutz, Wolfgang

    Frontiers in psychiatry

    2022  Volume 13, Page(s) 1026015

    Abstract: Background: Emotions play a key role in psychotherapy. However, a problem with examining emotional states via self-report questionnaires is that the assessment usually takes place after the actual emotion has been experienced which might lead to biases ... ...

    Abstract Background: Emotions play a key role in psychotherapy. However, a problem with examining emotional states via self-report questionnaires is that the assessment usually takes place after the actual emotion has been experienced which might lead to biases and continuous human ratings are time and cost intensive. Using the AI-based software package Non-Verbal Behavior Analyzer (NOVA), video-based emotion recognition of arousal and valence can be applied in naturalistic psychotherapeutic settings. In this study, four emotion recognition models (ERM) each based on specific feature sets (facial: OpenFace, OpenFace-Aureg; body: OpenPose-Activation, OpenPose-Energy) were developed and compared in their ability to predict arousal and valence scores correlated to PANAS emotion scores and processes of change (interpersonal experience, coping experience, affective experience) as well as symptoms (depression and anxiety in HSCL-11).
    Materials and methods: A total of 183 patient therapy videos were divided into a training sample (55 patients), a test sample (50 patients), and a holdout sample (78 patients). The best ERM was selected for further analyses. Then, ERM based arousal and valence scores were correlated with patient and therapist estimates of emotions and processes of change. Furthermore, using regression models arousal and valence were examined as predictors of symptom severity in depression and anxiety.
    Results: The ERM based on OpenFace produced the best agreement to the human coder rating. Arousal and valence correlated significantly with therapists' ratings of sadness, shame, anxiety, and relaxation, but not with the patient ratings of their own emotions. Furthermore, a significant negative correlation indicates that negative valence was associated with higher affective experience. Negative valence was found to significantly predict higher anxiety but not depression scores.
    Conclusion: This study shows that emotion recognition with NOVA can be used to generate ERMs associated with patient emotions, affective experiences and symptoms. Nevertheless, limitations were obvious. It seems necessary to improve the ERMs using larger databases of sessions and the validity of ERMs needs to be further investigated in different samples and different applications. Furthermore, future research should take ERMs to identify emotional synchrony between patient and therapists into account.
    Language English
    Publishing date 2022-10-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2022.1026015
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  10. Article ; Online: Lipoprotein (a) and risk for calcification of the coronary arteries, mitral valve, and thoracic aorta: The Multi-Ethnic Study of Atherosclerosis.

    Garg, Parveen K / Guan, Weihua / Karger, Amy B / Steffen, Brian T / Budoff, Matthew / Tsai, Michael Y

    Journal of cardiovascular computed tomography

    2020  Volume 15, Issue 2, Page(s) 154–160

    Abstract: Background: Lipoprotein (a) [Lp(a)] is a risk factor for coronary heart disease and calcific aortic valve disease. We determined the relationships of Lp(a) with prevalence and progression of coronary artery calcification (CAC), mitral annular ... ...

    Abstract Background: Lipoprotein (a) [Lp(a)] is a risk factor for coronary heart disease and calcific aortic valve disease. We determined the relationships of Lp(a) with prevalence and progression of coronary artery calcification (CAC), mitral annular calcification (MAC), and thoracic aortic calcification (TAC) in a multi-ethnic cohort of middle to older-aged adults.
    Methods: This analysis included 6705 Multi-Ethnic Study of Atherosclerosis participants. Lp(a) was measured with a turbidimetric immunoassay. CAC, MAC, and TAC were assessed by cardiac computed tomography both at baseline and once during follow-up.
    Results: In adjusted relative risk regression cross-sectional analysis, a Lp(a) level ≥50 ​mg/dL was associated with a 22% higher prevalence of MAC (relative risk (RR) ​= ​1.22, 95% confidence interval (CI) 1.00, 1.49). No significant associations were observed for prevalent CAC or TAC. In adjusted prospective analyses, participants with Lp(a) ≥50 ​mg/dL were at significantly higher risk for rapid CAC progression (median follow-up ​= ​8.9 years), defined as ≥100 units/year, compared to those with lower Lp(a) levels (RR ​= ​1.67, 95% CI ​= ​1.23, 2.27). The association between higher Lp(a) levels and incident CHD was no longer significant after adjusting for CAC progression. No significant associations were observed for MAC or TAC progression (median follow-up ​= ​2.6 years).
    Conclusions: Higher Lp(a) levels are associated with more rapid CAC progression. Additional study is needed to better understand how this relationship can further improve the ability of Lp(a) to enhance cardiovascular disease risk prediction.
    MeSH term(s) Aged ; Aged, 80 and over ; Aorta, Thoracic/diagnostic imaging ; Aortic Diseases/blood ; Aortic Diseases/diagnostic imaging ; Aortic Diseases/ethnology ; Biomarkers/blood ; Calcinosis/blood ; Calcinosis/diagnostic imaging ; Calcinosis/ethnology ; Coronary Artery Disease/blood ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/ethnology ; Cross-Sectional Studies ; Female ; Heart Valve Diseases/blood ; Heart Valve Diseases/diagnostic imaging ; Heart Valve Diseases/ethnology ; Humans ; Incidence ; Lipoprotein(a)/blood ; Male ; Middle Aged ; Mitral Valve/diagnostic imaging ; Prevalence ; Prognosis ; Prospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; United States/epidemiology ; Vascular Calcification/blood ; Vascular Calcification/diagnostic imaging ; Vascular Calcification/ethnology
    Chemical Substances Biomarkers ; LPA protein, human ; Lipoprotein(a)
    Language English
    Publishing date 2020-06-21
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2394360-9
    ISSN 1876-861X ; 1934-5925
    ISSN (online) 1876-861X
    ISSN 1934-5925
    DOI 10.1016/j.jcct.2020.06.002
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