Biplab Kumar Datta

Background: Cardiovascular-Kidney-Metabolic Syndrome (CKMS) is defined as a cluster of disease conditions that are highly prevalent in the U.S. population. This study aims to assess psychosocial adversities at different CKMS stages in a large survey of U.S. adults, measured by lack of emotional support, low life satisfaction, and loneliness. Methods: This cross-sectional study used data on 159,511 adults from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) survey. Proxy CKMS stages (0, 1, 2/3, and 4) were determined using self-reported health conditions. Separate multivariable logistic regression models were estimated to obtain the predictive margins of respective psychosocial attributes across proxy CKMS stages. Results: Compared to adults at lower CKMS stages (Stages 0 and 1), adults at advanced CKMS stages (Stages 2/3 and 4) generally reported having higher psychosocial toll. At CKMS stage 4, the predicted probabilities of lack of emotional support, low life satisfaction, and loneliness were 6.96, 3.24, and 10.10 percentage points (pp) higher, respectively, than at stage 0. Compared to stage 1, the corresponding differences were 5.92, 2.89, and 9.65 pp. At CKMS stage 2/3, the corresponding differences were 4.36, 1.66, and 5.69 pp compared to stage 0 and 3.33, 1.32, and 5.25 pp compared to stage 1. The high burden at advanced CKMS stages was generally evident across sex, and different socioeconomic status conditions manifested by income and education. Conclusions: Findings of this study suggest that adults with advanced CKMS stages were more likely to experience a psychosocial toll. Further research is warranted to facilitate strategies for improving psychosocial wellbeing of CKMS patients. What is Known: Loneliness and social isolation have been associated with adverse cardiovascular outcomes. Prior research has examined loneliness and CKM stage together in relation to depression and anxiety, but evidence across other psychosocial outcomes remains limited. What the Study Adds: Adults at advanced proxy CKMS stages had higher adjusted predicted probabilities of lacking emotional support, having low life satisfaction, and feeling lonely. These patterns were observed across sex, income, and education groups.

Women have a higher risk of Long COVID, defined as symptoms persisting for three or more months after SARS-CoV-2 infection. This study examines whether the elevated risk of Long COVID among women varies across income subgroups in a nationally representative sample of the U.S. population. Using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), we estimated adjusted odds ratios for Long COVID associated with female sex, stratified by four age categories and 11 income groups. We conducted random-effects meta-analyses of income subgroup estimates within each age category and assessed heterogeneity using Cochran's Q, I² statistics, prediction intervals, and Galbraith plots. Among younger age groups (18-34, 35-49, and 50-64 years), Cochran's Q ranged from 7.70 to 10.98 (p > 0.10), and I² was 0.00%, indicating no significant heterogeneity across income groups. In the ≥65 age group, Cochran's Q was 18.35 (p = 0.0494), and I² was 21.96%, suggesting modest heterogeneity. The 95% prediction interval for the ≥65 group (1.121-1.978) was wider than those for younger groups: 1.437-1.975 (18-34 years), 1.551-2.019 (35-49 years), and 1.355-1.766 (50-64 years).

While the association between neighborhood disadvantages and firearm-related injuries and deaths is well documented, our knowledge is limited about the influence of neighborhood safety on firearm ownership and storage practices. This study intends to examine how perceived neighborhood safety is associated with having firearms in or around home and firearm storage practices among firearm owners in the United States. Using data from the 2024 Behavioral Risk Factor Surveillance System (BRFSS) survey on 61,315 U.S. adults residing in 13 states, we estimated multivariable generalized linear models with log link and Poisson distribution to assess the likelihood of firearm ownership by level of neighborhood safety. Next, multivariable multinomial logistic models were estimated to assess the risk of mutually exclusive firearm storage practices. Robustness of the relationship was checked by sex, household income, and education sub-groups. No differential likelihood of keeping firearms in or around the home was found by perceived levels of neighborhood safety after accounting for demographic and socioeconomic attributes. However, living in a perceived unsafe neighborhood was found to be associated with a higher likelihood of having firearms loaded and unlocked. Compared to firearm owners in extremely safe neighborhoods, firearm owners in unsafe neighborhoods were 10.61 percentage points (95% CI: 5.70, 15.52) more likely to have firearms loaded and unlocked. By showing a link between perceived neighborhood safety and firearm storage practices, this study may help initiate concerted efforts to improve neighborhood safety and promote safe firearm storage practices.

Because CKMS was only proposed by the American Heart Association in 2023, there has been a paucity of information about the distribution and determinants of the syndrome across population groups. We reviewed published studies of the prevalence of CKMS in the U.S. and other countries and obtained new estimates of the prevalence of this syndrome among U.S. adults by birth decade and sociodemographic attributes using 2019, 2021, and 2023 Behavioral Risk Factor Surveillance System (BRFSS) data. The results of this study indicate that CKMS is widespread in the general U.S. population, especially among older cohorts born before 1940 and during the 1940s, 1950s, and 1960s. Except for the three younger cohorts, born in the 1980s, 1990s, and 2000 or later, the prevalence of CKMS stage 4 was significantly higher among males than in females. Among those born between the 1950s and 1990s, the prevalence was significantly higher among non-Hispanic Blacks compared to their non-Hispanic white counterparts. Across all birth decades, prevalence of CKMS stage 4 was generally higher among those without a college degree, from a low-income household, and residing in rural areas. These prevalence rate estimates will further our understanding of the burden and unique needs of different population groups in improving cardiovascular–kidney–metabolic health across the life course.

Background Previous research has identified several risk factors for Long COVID, including cancer. This study aims to assess whether adults with a family history of cancer had a higher risk for Long COVID. Methods This cross-sectional study used data on 25,389 adults, who were not cancer patients or survivors, from the nationally representative 2023 National Health Interview Survey. Multivariable generalized linear models were estimated to assess the prevalence of Long COVID (i.e., having symptoms for ≥ 3 months) for self-reported family history of cancer by sequentially adjusting for demographic and socioeconomic attributes, health behaviors, and underlying health conditions. Karlson–Holm–Breen (KHB) method was applied to assess potential mediating effects of health conditions. Results Long COVID prevalence in the study population was 8.4%. Adults with a family history of cancer were 1.26 (95% CI 1.15–1.38) times more likely to have Long COVID. The prevalence rate ratio decreased to 1.19 (95% CI 1.08–1.28) when health conditions were accounted for. KHB decomposition suggested that 30.16% of the association was mediated through underlying health conditions. Conclusion These findings suggest that familial or genetic factors associated with cancer susceptibility may also contribute to Long COVID risk. Further research is needed to explore potential biological mechanisms underlying this association.

Background: This study evaluated the impact of diabetes mellitus (DM) and its treatments on cardiovascular outcomes in prostate cancer (PC) patients aged 66 years and older, with or without androgen deprivation therapy (ADT) exposure. Methods: Using the SEER-Medicare database (2009–2017), two cohorts were created: Cohort 1 included all PC patients enrolled in Medicare Parts A and B; Cohort 2 was a subset of Cohort 1 receiving ADT and enrolled in Medicare Part D. Exposures were DM and DM medications. Outcomes included cardiovascular events (CVEs), cardiovascular mortality (CVm), PC-specific mortality (PCsm), and all-cause mortality, analyzed using multivariable Fine-Gray and Cox models. Results: Cohort 1 included 150,647 PC patients (32% with DM, median age 72). DM was associated with higher risk of CVE (subdistribution hazard ratio [sHR] 1.20, 95% CI 1.17–1.22), CVm (sHR 1.35, 1.28–1.43), and all-cause mortality (adjusted HR [aHR] 1.22, 1.19–1.26) (all p < 0.001). Non-Hispanic Blacks (NHBs) and patients from lower socioeconomic (SES) and education areas experienced comparable or worse outcomes. In Cohort 2 (n = 14,938), DM patients on non-metformin therapies had higher all-cause mortality (aHR 1.33, 1.11–1.25; p = 0.002) than those on metformin, particularly in NHB and low education groups. Sensitivity analyses with follow-up limited to two years showed consistent results as overall. Conclusions: Diabetic PC patients, especially NHB, lower SES and lower education subgroups, were associated with worse cardiovascular and all-cause mortality outcomes. Metformin may be associated with better outcomes in these populations, warranting further research on the disparities in PC and diabetes, and cardioprotective effects of DM medications across different subpopulations.