Lipworth, Loren

Introduction: Greater religiosity, or degree of involvement in religious activities, associates with better CV health profiles. Yet, studies of the association between religiosity and incident CV events have yielded mixed results. The southeastern US is characterized by strong religious practice but has among the highest rates of incident heart failure (HF). The relationship between religiosity and incident HF is not well characterized, particularly among low-income populations. Methods: We studied 23,893 Black or White Southern Community Cohort Study participants (median age 53 years, 70% Black, 64% women, 70% annual household income <$15k) without prevalent HF or CAD at enrollment (2002-2009). Religiosity, defined by religious service attendance, was ascertained at enrollment via a single item adapted from the Duke University Religion Index. Incident HF was determined using Centers for Medicare and Medicaid Services Research Identifiable Files (ICD-9/-10 codes 428.x or I50, I110) through December 31, 2016. We quantified the association of religious attendance with incident HF via Cox models adjusted for demographics, HF risk factors (HTN, HLD, DM, BMI, CVA), health behaviors (smoking, alcohol, physical activity, DASH diet), socioeconomic (income, education, employment, neighborhood deprivation, rurality) and psychosocial factors (marital status, social support, depressive symptoms, anti-depressant use). Results: Religious service attendance was common: >1/week (24%), 1/week (27%), <1/week (33%), and never (15%). Participants attending >1/week were more likely to be older and female, had relatively higher SES and more comorbidities, but better health behaviors and psychosocial support. HF developed in 6081 participants (25%; median 10-yr follow-up). Adjusting for demographics and HF risk factors, attendance >1/week associated with lower HF risk (HR 0.88 [0.82,0.94] and HR 0.92 [0.84,1.00] compared to <1/week or never, respectively). Attendance 1/week compared to <1/week showed similar association (HR 0.91 [0.85, 0.97]). Further adjustment for health behaviors, socioeconomic and psychosocial factors attenuated the association to non-significance. There was no interaction between religiosity and race. Conclusion: Greater frequency of religious service attendance associated with lower incident HF risk adjusting for demographics and HF risk factors; however, this association attenuated with adjustment for health behaviors, socioeconomic and psychosocial factors.

Abstract Background: Accumulating evidence suggests a relationship between endometrial cancer and ovarian cancer. Independent genome-wide association studies (GWAS) for endometrial cancer and ovarian cancer have identified 16 and 27 risk regions, respectively, four of which overlap between the two cancers. We aimed to identify joint endometrial and ovarian cancer risk loci by performing a meta-analysis of GWAS summary statistics from these two cancers. Methods: Using LDScore regression, we explored the genetic correlation between endometrial cancer and ovarian cancer. To identify loci associated with the risk of both cancers, we implemented a pipeline of statistical genetic analyses (i.e., inverse-variance meta-analysis, colocalization, and M-values) and performed analyses stratified by subtype. Candidate target genes were then prioritized using functional genomic data. Results: Genetic correlation analysis revealed significant genetic correlation between the two cancers (rG = 0.43, P = 2.66 × 10−5). We found seven loci associated with risk for both cancers (PBonferroni &lt; 2.4 × 10−9). In addition, four novel subgenome-wide regions at 7p22.2, 7q22.1, 9p12, and 11q13.3 were identified (P &lt; 5 × 10−7). Promoter-associated HiChIP chromatin loops from immortalized endometrium and ovarian cell lines and expression quantitative trait loci data highlighted candidate target genes for further investigation. Conclusions: Using cross-cancer GWAS meta-analysis, we have identified several joint endometrial and ovarian cancer risk loci and candidate target genes for future functional analysis. Impact: Our research highlights the shared genetic relationship between endometrial cancer and ovarian cancer. Further studies in larger sample sets are required to confirm our findings.