Abstract Body: Introduction
Adverse psychosocial factors worsen cardiovascular risk through chronic inflammation and dysregulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis. Social determinants of health are closely related to psychosocial risk in underserved populations within the United States, though few studies have examined relationships between psychosocial factors and lipoproteins in communities with elevated social risks. We hypothesized that higher psychosocial risk would be associated with less favorable lipid profiles among African American women living in resource-limited Washington, DC neighborhoods.

Methods
African American women with overweight or obesity aged 21-75 years residing in Wards 5, 7, and 8 of Washington, D.C. and Prince George’s County in Maryland were recruited for the Step It Up study. Principal component analysis of baseline psychosocial survey data was performed and identified high loadings for depression, social isolation, and loneliness. Participants were assigned psychosocial risk based on sums of these survey scores, with higher scores indicating greater psychosocial adversity. Fasting lipid profiles were measured using Nuclear Magnetic Resonance spectroscopy, quantifying lipoprotein particle concentrations, numbers, and sizes as well as apolipoprotein (Apo) A/B levels. Associations between psychosocial risk and lipid profiles were assessed using linear regression models, adjusting for demographic, socioeconomic, and comorbidity covariates.

Results
Participants with psychosocial survey data were included in analyses (n=165, age 57.4±12.6 years, BMI 36.2±6.7). Women in the high psychosocial risk tertile had higher BMI and systolic blood pressure and greater proportions of lipid-lowering therapy compared to those in the low risk tertile. High-risk individuals also had lower Healthy Eating Index scores and lower socioeconomic status. Increased psychosocial risk was associated with low density lipoprotein (LDL) concentration (β= 4.75, p=0.01), LDL particle numbers (β= 68.61, p=0.01) and ApoB concentrations (β= 3.50, p=0.01) (Table). Psychosocial factor scores were not associated with lipid size.

Conclusions
Psychosocial adversity was associated with more atherogenic lipid profiles, including higher LDL concentration and particle numbers and ApoB concentrations. These findings suggest that psychosocial risk factors among at-risk populations may contribute to cardiovascular risk through lipid dysregulation.