Neighborhood Perceptions Associate with Lipid Biomarkers in African-American Women with Cardiovascular-Kidney-Metabolic Syndrome: Data from the Step It Up Digital Health-Enabled, Community-Engaged Physical Activity Intervention

Authors

• ST Reynolds
• MR Andrews
• Y Baumer
• D Sandler
• S Sharda
• SR Hicks
• EMA Peterson
• A Saurabh
• MA Cintron
• MA Pito
• KJ Tolentino
• M Marah
• FO Baah
• JF Troendle
• C Ayers
• LG Mendelsohn
• S DeGuzman
• AT Redai
• A Wells
• TM Powell-Wiley

Abstract

Background: Cardiovascular-kidney metabolic (CKM) syndrome is increased in individuals' chronic exposure to environmental psychosocial stressors. Neighborhood individual-level increase inflammation resulting in worsened CKM factors such as hyperlipidemia. Associations between neighborhood perceptions (NP) and lipoproteins remain understudied. We examined associations between NP domains and lipid profiles among African-American (AA) women residing resource-limited neighborhoods.

Methods: Participants enrolled Step It Up, technology-enabled, community-engaged physical activity (PA) intervention. Fasting blood samples drawn baseline measure lipoproteins using Nuclear Magnetic Resonance (NMR) spectroscopy. NP identified four perception sub-scores: disorder, social cohesion, violence, safety (higher score=favorable perception). Associations between NP domains lipoprotein particles analyzed using multivariable regression adjusting BMI, ASCVD 10-year risk score, lipid-lowering therapy.

Results: Participants (n=169) had mean age=57.16 ± 12.00 and BMI 35.99 ± 6.57. Perceptions of safety were positively associated with LDLc and L-LDLp (β=4.70 (SD=2.41), p=0.05, β= 43.75 (17.70), p= 0.01), respectively). Perceptions about neighborhood violence were positively associated with both L-LDLp (marginally) and (VLDLz) (β= 7.10 (3.96), p=0.08, β= 0.31 (0.14), p= 0.02, respectively). No associations were found between disorder and social cohesion with lipid biomarkers. Significant associations between safety with LDLc and L-LDLp and between violence and L-LDLp and VLDLz were statistically nonsignificant.

Conclusion: After adjusting for BMI, ASCVD risk, and lipid-lowering therapy, there were significant associations between NP domains and lipoproteins among AA women with CKM syndrome. Violence was associated with L-LDLp, while safety was associated with LDLc and L-LDLp. Future work should examine whether improving neighborhood perceptions may improve CKM health in urban AA women.

Scientific Focus Area: Health Disparities

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