Abstract 11117: Metabolomic Signature of Ideal Cardiovascular Health in Black Adults: Results from the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity

Introduction: Black Americans suffer from disparate levels of CVD and CVD risk factors, but metabolic pathways that underlie cardiometabolic risk in Blacks remain largely unknown. Objective: We defined metabolomic profiles and associated metabolic pathways underlying CVH in a Black community that is richly diverse in ethnic origin and socioeconomic status. Methods: The MECA study cohort consisted of 375 Black adults (age 53 + 10, 39% male) without known CVD. CVH was determined by the AHA Life’s Simple 7 (LS7) score, calculated from measured blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, and self-reported physical activity, diet, and smoking. Plasma metabolites were assessed by high-resolution metabolomics. Metabolome wide association study (MWAS) was used to identify metabolites associated with LS7 after adjusting for age and sex. Metabolic pathways significantly enriched in metabolites associated with LS7 were identified using Mummichog software. Concentrations of metabolites representative of these pathways were compared across clinical domains of LS7 score (ANOVA) and then a multivariable model was developed into a metabolomics risk score for prediction of CVH. Results: MWAS and pathway analysis identified 301 metabolites significantly associated with LS7 score (FDR<0.2) and enriched in pathways responsible for glutathione, alanine, tyrosine and glutamate metabolism. Plasma concentrations of six metabolites (glutamine, glutamate, serine, alanine, tyrosine and urate) were associated with blood pressure, fasting glucose, BMI, and physical activity (p<0.05). Assessed in conjunction, these metabolites were independent predictors of CVH - 1 SD increase in metabolomics risk score was associated with 0.93 increase in LS7 or 12.1% decrease in incident CVD. Conclusions: We identified a novel metabolomic signature of ideal CVH in Blacks without known CVD. This includes five non-essential amino acids and urate, which are known to be central elements of key metabolic processes (i.e. TCA cycle, urea cycle, nucleotide synthesis, one carbon metabolism). These data provide insight into metabolic pathways underlying cardiometabolic risk in Blacks and potential avenues for addressing health disparities.