Abstract 13999: The Relationship Between Neighborhood Deprivation, Diabetes, and Extracellular Vesicles in African American Women at Risk for CVD: Data From a Pilot Study of the Step It Up Physical Activity Intervention

Abstract

Background: African American women (AA) are at disproportionally high risk for diabetes and cardiovascular disease (CVD) which is accelerated when residing in resource-limited neighborhoods. Extracellular vesicles (EV) are emerging to be of importance in CVD development and progression, but little is known about a potential impact of neighborhood socioeconomic deprivation (NSD). In this study we examined associations between NSD, plasma EV, and markers of diabetes risk in a community-based cohort of AA women at risk for CVD from resource-limited neighborhoods in Washington, DC. Methods: Participants were enrolled in pilot testing of Step It Up, a community engaged physical activity intervention. Blood samples were drawn to measure clinical labs during participants’ baseline visit to the NIH Clinical Center. EV were isolated from heparinized plasma using size exclusion chromatography with size and numbers determined by nanoparticle tracking analysis. NSD was calculated using 2018 US Census tract data as a measure of neighborhood deprivation. Associations between NSD, EV, and diabetes-related clinical measures were analyzed using multivariable regressions adjusted for BMI and ASCVD 10-year risk score. Results: The study cohort was a convenience sample of AA women at risk for CVD (N=24, Age: 57±12, BMI: 35±6, ASCVD: 9±5). NSD associated with fasting glucose (β=0.54, p=0.007) and Hemoglobin A1c (HA1c) (β=0.51, p=0.007). Additionally, NSD associated with lower EV size (β=-0.42, p=0.03), with no association with EV concentration. Fasting glucose and HA1c associated negatively with EV size (β=-0.48, p=0.03 and β=-0.50, p=0.02, respectively) but no association was found with EV concentration. Conclusions: Thus, our data show that higher neighborhood deprivation is associated with lower EV size which, in turn, is associated with higher diabetes risk markers. More research is needed to understand the role of EV in diabetes and CVD development and progression. While larger studies further evaluating these observations are needed, our data highlight the importance of increased diabetes screening and multi-level interventions in patients residing in under-resourced communities to reduce existing health disparities.