bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Type 2 Diabetes on 12-Year Cognitive Change
Authors: Spauwen Peggy J.J. , Köhler Sebastian , Verhey Frans R.J. , Stehouwer Coen D.A. , van Boxtel Martin P.J. 
Published: December 2012

OBJECTIVE
To examine the effects of baseline and incident diabetes on change in cognitive function over 12 years.

RESEARCH DESIGN AND METHODS
A sample of 1,290 individuals aged ≥40 years at baseline, participating in the Maastricht Aging Study, were cognitively tested at baseline, after 6 years, and after 12 years. Of these, 68 participants had type 2 diabetes at baseline, and 54 and 57 had incident diabetes at the 6- and 12-year follow-up, respectively. Changes in performance on tests of information-processing speed, executive function, and verbal memory from baseline to 6- and 12-year follow-up were compared between groups using linear mixed models. Effects of diabetes on cognitive decline were adjusted for demographic variables, history of smoking, alcohol intake, and comorbid conditions, including hypertension, cardiovascular disease, BMI, and depression.

RESULTS
Participants with baseline diabetes showed larger decline in information-processing speed (estimate −7.64; P &lt; 0.01), executive function (21.82; P &lt; 0.01), and delayed word recall (−1.35; P &lt; 0.05) over the 12-year follow-up compared with control subjects. No significant difference in decline was observed for immediate word recall. Compared with control subjects, participants with incident diabetes showed subtle early decline in information-processing speed only. Interestingly, they did not show larger decline in any other cognitive domain.

CONCLUSIONS
Individuals with baseline type 2 diabetes show accelerated cognitive decline, particularly in information-processing speed and executive function, compared with individuals without diabetes. In incident diabetes, decline in speed becomes detectable first, and cognitive decline seems to increase with increasing exposure time.
Predicting Development of Proliferative Diabetic Retinopathy
Authors: Harris Nwanyanwu Kristen , Talwar Nidhi , Gardner Thomas W. , Wrobel James S. , Herman William H. , Stein Joshua D. 
Published: December 2012

OBJECTIVEIdentifying individuals most at risk for diabetic retinopathy progression and intervening early can limit vision loss and reduce the costs associated with managing more advanced disease. The purpose of this study was to identify factors associated with progression from nonproliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR).RESEARCH DESIGN AND METHODSThis was a retrospective cohort analysis using a claims database of all eye care recipients age ≥30 years enrolled in a large managed-care network from 2001 to 2009. Individuals with newly diagnosed NPDR were followed longitudinally. Multivariable Cox regression analyses identified factors associated with progression to PDR. Three- and five-year probabilities of retinopathy progression were determined.RESULTSAmong the 4,617 enrollees with incident NPDR, 307 (6.6%) developed PDR. After adjustment for confounders, every 1-point increase in HbA1c was associated with a 14% (adjusted hazard ratio 1.14 [95% CI 1.07–1.21]) increased hazard of developing PDR. Those with nonhealing ulcers had a 54% (1.54 [1.15–2.07]) increased hazard of progressing to PDR, and enrollees with nephropathy had a marginally significant increased hazard of progressing to PDR (1.29 [0.99–1.67]) relative to those without these conditions. The 5-year probability of progression for low-risk individuals with NPDR was 5% (range 2–8) and for high-risk patients was 38% (14–55).CONCLUSIONSAlong with glycemic control, nonophthalmologic manifestations of diabetes mellitus (e.g., nephropathy and nonhealing ulcers) are associated with an increased risk of diabetic retinopathy progression. Our retinopathy progression risk score can help clinicians stratify patients who are most at risk for disease progression.
Zinc-α2-Glycoprotein Is Associated With Insulin Resistance in Humans and Is Regulated by Hyperglycemia, Hyperinsulinemia, or Liraglutide Administration
Authors: Yang Mengliu , Liu Rui , Li Shu , Luo Yu , Zhang Yali , Zhang Lili , Liu Dongfang , Wang Yaxu , Xiong Zhengai , Boden Guenther , Chen Shirong , Li Ling , Yang Gangyi 
Published: December 2012

OBJECTIVE
Zinc-α2-glycoprotein (ZAG) has been proposed to play a role in the pathogenesis of insulin resistance. Previous studies in humans and in rodents have produced conflicting results regarding the link between ZAG and insulin resistance. The objective of this study was to examine the relationships between ZAG and insulin resistance in cross-sectional and interventional studies.

RESEARCH DESIGN AND METHODS
Serum ZAG (determined with ELISA) was compared with various parameters related to insulin resistance in subjects with normal glucose tolerance, impaired glucose tolerance (IGT), and newly diagnosed type 2 diabetes mellitus (T2DM), and in women with or without polycystic ovary syndrome (PCOS). Euglycemic-hyperinsulinemic clamps were performed in healthy and PCOS women. Real-time RT-PCR and Western blotting were used to assess mRNA and protein expression of ZAG. The effect of a glucagon-like peptide-1 agonist on ZAG was studied in a 12-week liraglutide treatment trial.

RESULTS
Circulating ZAG was lower in patients with IGT and newly diagnosed T2DM than in controls. Circulating ZAG correlated positively with HDL cholesterol and adiponectin, and correlated inversely with BMI, waist-to-hip ratio, body fat percentage, triglycerides, fasting blood glucose, fasting insulin, HbA1c, and homeostasis model assessment of insulin resistance (HOMA-IR). On multivariate analysis, ZAG was independently associated with BMI, HOMA-IR, and adiponectin. ZAG mRNA and protein were decreased in adipose tissue of T2DM patients. Moreover, circulating ZAG levels were lower in women with PCOS than in women with high insulin sensitivity. Liraglutide treatment for 12 weeks significantly increased circulating ZAG levels.

CONCLUSIONS
We conclude that ZAG may be an adipokine associated with insulin resistance.
Nicotinuric Acid
Authors: Huang Chun-Feng , Cheng Mei-Ling , Fan Chun-Ming , Hong Chuang-Ye , Shiao Ming-Shi 
Published: December 2012

OBJECTIVE
Metabolic syndrome is a multiplex disorder and puts patients on the road to type 2 diabetes and atherosclerotic cardiovascular diseases. However, a surrogate biomarker in plasma or urine in fully reflecting features of metabolic syndrome has not been explored.

RESEARCH DESIGN AND METHODS
Urine metabolomics has potential utility in metabolic profiling because urine metabolites analysis reflects global outflux of metabolic change. Accordingly, we collected data on subjects (n = 99) with overweight, dyslipidemia, hypertension or impaired glucose tolerance and took a metabolomics approach to analyze the metabolites of urine revealed in metabolic syndrome by high-performance liquid chromatography–time-of-flight mass spectrometry and elicit potential biomarkers to picture metabolic syndrome.

RESULTS
Our results revealed that the urine nicotinuric acid value of subjects with diabetes (HbA1c ≥6.5% or those receiving diabetes medications) (n = 25) was higher than subjects without diabetes (n = 37) (221 ± 31 vs. 152 ± 13 × 103 mAU, P = 0.0268). Moreover, urinary nicotinuric acid level was positively correlated with body mass index, blood pressure, total cholesterol, low-density lipoprotein cholesterol, triacylglycerol and high sensitivity C-reactive protein, but negatively correlated with high-density lipoprotein cholesterol.

CONCLUSIONS
This is the first study, to our knowledge, to propose that nicotinuric acid represents an important pathogenic mechanism in process from metabolic syndrome to diabetes and atherosclerotic cardiovascular disease.
Peripheral Neuropathy Defined by Monofilament Insensitivity and Diabetes Status
Authors: Katon Jodie G. , Reiber Gayle E. , Nelson Karin M. 
Published: December 2012

OBJECTIVE
To determine whether diabetes status, including prediabetes, is associated with increased risk of peripheral neuropathy as defined by monofilament insensitivity.

RESEARCH DESIGN AND METHODS
This study used data from the 1999–2004 National Health and Nutrition Examination Survey (n = 7,818). Peripheral neuropathy was defined as one or more insensate sites detected by a Semmes-Weinstein 10-g monofilament. Generalized linear models were used to directly estimate relative risks (RRs) for the association of diabetes status and peripheral neuropathy.

RESULTS
After adjustment compared with no diabetes, prediabetes [RR 1.11 (95% CI 0.92–1.34)] and undiagnosed diabetes [1.08 (0.73–1.61)] were associated with modest increases in risk of peripheral neuropathy, and diabetes was associated with a 74% higher risk of peripheral neuropathy [1.74 (1.50–2.01)].

CONCLUSIONS
Diabetes is associated with increased risk of peripheral neuropathy defined by monofilament insensitivity, but prediabetes and undiagnosed diabetes may be associated with only a modest increase in risk.
Temporal Validation of the UKPDS Outcomes Model Using 10-Year Posttrial Monitoring Data
Authors: Leal Jose , Hayes Alison J. , Gray Alastair M. , Holman Rury R. , Clarke Philip M. 
Published: December 2012

OBJECTIVE
To evaluate the accuracy of the UK Prospective Diabetes Study Outcomes Model (UKPDS-OM) in predicting clinical outcomes during the UKPDS posttrial monitoring (PTM) period.

RESEARCH DESIGN AND METHODS
At trial end in 1997, the 4,031 surviving UKPDS patients, of the 5,102 originally enrolled in the study, returned to their usual care providers, with no attempts made to maintain them in their randomized therapy groups. PTM risk factor data were collected for 5 years and clinical outcome data for 10 years. The UKPDS-OM was used firstly to forecast likely progression of HbA1c, systolic blood pressure, total-to-HDL cholesterol ratio, and smoking status and secondly to estimate the likely first occurrence of seven major diabetes-related complications or death from any cause. Model predictions were compared against observed PTM data for risk factor time paths and survival probabilities for major diabetes complications.

RESULTS
UKPDS-OM–forecasted risk factor time paths were similar to those observed for HbA1c (up to 3 years) and total-to-HDL cholesterol ratio but underestimated for systolic blood pressure and smoking status. Predicted 10-year event probabilities were similar to those observed for blindness, ischemic heart disease, myocardial infarction, and renal failure but were higher for heart failure and death from any cause and lower for stroke and amputation.

CONCLUSIONS
The UKPDS-OM has good predictive accuracy for two of four risk factor time paths and for 10-year clinical outcome probabilities with the exception of stroke, amputation, heart failure, and death from any cause. An updated version of the model incorporating PTM data is being developed.
Glucose-Independent Ethnic Differences in HbA1c in People Without Known Diabetes
Authors: Hare Matthew J.L. , Magliano Dianna J. , Zimmet Paul Z. , Söderberg Stefan , Joonas Noorjehan , Pauvaday Vassen , Larhubarbe José , Tuomilehto Jaakko , Kowlessur Sudhir , Alberti K. George M.M. , Shaw Jonathan E. 
Published: December 2012

OBJECTIVE
To determine whether glucose-independent differences in HbA1c exist between people of African, South Asian, and Chinese ethnicities.

RESEARCH DESIGN AND METHODS
Data from 6,701 people aged 19–78 years, without known diabetes, from Mauritius, and participating in the population-based Non-Communicable Disease Surveys of the main island and the island of Rodrigues were included. Participants were African (n = 1,219 from main island, n = 1,505 from Rodrigues), South Asian (n = 3,820), and Chinese (n = 157). Survey data included HbA1c, plasma glucose during oral glucose tolerance testing (OGTT), anthropometry, demographics, and medical and lifestyle history.

RESULTS
Mean HbA1c, after adjustment for fasting and 2-h plasma glucose and other factors known to influence HbA1c, was higher in Africans from Rodrigues (6.1%) than in South Asians (5.7%, P &lt; 0.001), Chinese (5.7%, P &lt; 0.001), or Africans from the main island of Mauritius (5.7%, P &lt; 0.001). The age-standardized prevalence of diabetes among Africans from Rodrigues differed substantially depending on the diagnostic criteria used [OGTT 7.9% (95% CI 5.8–10.0); HbA1c 17.3% (15.3–19.2)]. Changing diagnostic criteria resulted in no significant change in the prevalence of diabetes within the other ethnic groups.

CONCLUSIONS
People of African ethnicity from Rodrigues have higher HbA1c than those of South Asian or African ethnicity from the main island of Mauritius for reasons not explained by plasma glucose during an OGTT or traditional factors known to affect glycemia. Further research should be directed at determining the mechanism behind this disparity and its relevance to clinical outcomes.
Translating the Diabetes Prevention Program Into American Indian and Alaska Native Communities
Authors: Jiang Luohua , Manson Spero M. , Beals Janette , Henderson William G. , Huang Haixiao , Acton Kelly J. , Roubideaux Yvette ,   the Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
Published: December 2012

OBJECTIVE
The landmark Diabetes Prevention Program (DPP) showed that lifestyle intervention can prevent or delay the onset of diabetes for those at risk. We evaluated a translational implementation of this intervention in a diverse set of American Indian and Alaska Native (AI/AN) communities.

RESEARCH DESIGN AND METHODS
The Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented the DPP lifestyle intervention among 36 health care programs serving 80 tribes. A total of 2,553 participants with prediabetes were recruited and started intervention by 31 July 2008. They were offered the 16-session Lifestyle Balance Curriculum and underwent a thorough clinical assessment for evaluation of their diabetes status and risk at baseline, soon after completing the curriculum (postcurriculum), and annually for up to 3 years. Diabetes incidence was estimated. Weight loss, changes in blood pressure and lipid levels, and lifestyle changes after intervention were also evaluated.

RESULTS
The completion rates of SDPI-DP were 74, 59, 42, and 33% for the postcurriculum and year 1, 2, and 3 assessments, respectively. The crude incidence of diabetes among SDPI-DP participants was 4.0% per year. Significant improvements in weight, blood pressure, and lipid levels were observed immediately after the intervention and annually thereafter for 3 years. Class attendance strongly correlated with diabetes incidence rate, weight loss, and change in systolic blood pressure.

CONCLUSIONS
Our findings demonstrate the feasibility and potential of translating the lifestyle intervention in diverse AI/AN communities. They have important implications for future dissemination and institutionalization of the intervention throughout the Native American health system.
Once-Weekly Exenatide Versus Once- or Twice-Daily Insulin Detemir
Authors: Davies Melanie , Heller Simon , Sreenan Seamus , Sapin Hélène , Adetunji Omolara , Tahbaz Arash , Vora Jiten 
Published: December 2012

OBJECTIVE
This multicenter, open-label, parallel-arm study compared the efficacy and safety of exenatide once weekly (EQW) with titrated insulin detemir in patients with type 2 diabetes inadequately controlled with metformin (with or without sulfonylureas).

RESEARCH DESIGN AND METHODS
Patients were randomized to EQW (2 mg) or detemir (once or twice daily, titrated to achieve fasting plasma glucose ≤5.5 mmol/L) for 26 weeks. The primary outcome was proportion of patients achieving A1C ≤7.0% and weight loss ≥1.0 kg at end point, analyzed by means of logistic regression. Secondary outcomes included measures of glycemic control, cardiovascular risk factors, and safety and tolerability.

RESULTS
Of 216 patients (intent-to-treat population), 111 received EQW and 105 received detemir. Overall, 44.1% (95% CI, 34.7–53.9) of EQW-treated patients compared with 11.4% (6.0–19.1) of detemir-treated patients achieved the primary outcome (P &lt; 0.0001). Treatment with EQW resulted in significantly greater reductions than detemir in A1C (least-square mean ± SE, −1.30 ± 0.08% vs. −0.88 ± 0.08%; P &lt; 0.0001) and weight (−2.7 ± 0.3 kg vs. +0.8 ± 0.4 kg; P &lt; 0.0001). Gastrointestinal-related and injection site–related adverse events occurred more frequently with EQW than with detemir. There was no major hypoglycemia in either group. Five (6%) patients in the EQW group and six (7%) patients in the detemir group experienced minor hypoglycemia; only one event occurred without concomitant sulfonylureas (detemir group).

CONCLUSIONS
Treatment with EQW resulted in a significantly greater proportion of patients achieving target A1C and weight loss than treatment with detemir, with a low risk of hypoglycemia. These results suggest that EQW is a viable alternative to insulin detemir treatment in patients with type 2 diabetes with inadequate glycemic control using oral antidiabetes drugs.
Measurement of Waist Circumference
Authors: Ma Wen-Ya , Yang Chung-Yi , Shih Shyang-Rong , Hsieh Hong-Jen , Hung Chi Sheng , Chiu Fu-Chun , Lin Mao-Shin , Liu Pi-Hua , Hua Cyue-Huei , Hsein Yenh-Chen , Chuang Lee-Ming , Lin Jou-Wei , Wei Jung-Nan , Li Hung-Yuan 
Published: December 2012

OBJECTIVE
Waist circumference (WC) is used to define central obesity. This study aimed to compare the performance of two recommended locations of WC measurement.

RESEARCH DESIGN AND METHODS
A cohort of 1,898 subjects who were without diabetes from 2006 to 2012 were followed for a median of 31 months (Taiwan Lifestyle Study). The WC-IC, recommended by the National Cholesterol Education Program Third Adult Treatment Panel, was measured at the superior border of the iliac crest, and the WC-mid, recommended by World Health Organization and International Diabetes Federation, was measured midway between the lowest ribs and the iliac crest. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) were assessed by computed tomography.

RESULTS
There was greater difference between WC-IC and WC-mid measurements in women than in men (P &lt; 0.001). Both WC-IC and WC-mid correlated significantly with BMI, VFA, and SFA (all P &lt; 0.001). WC-mid was better correlated to VFA than WC-IC, particularly in women, and it correlated more strongly to blood pressure, plasma glucose, hemoglobin A1c, triglyceride levels, HDL cholesterol, and C-reactive protein (all P &lt; 0.05). The association of WC-mid with hypertension, diabetes, and metabolic syndrome was slightly better than that of WC-IC (area under the receiver operator curve 0.7 vs. 0.69, 0.71 vs. 0.68, and 0.75 vs. 0.7, respectively; all age-adjusted P &lt; 0.05). With 90 cm (male)/80 cm (female) as criteria for central obesity, WC-mid, but not WC-IC, predicted the incidence of diabetes development (age-adjusted P = 0.003).

CONCLUSIONS
WC-mid is a better measurement to define central obesity than WC-IC, particularly in women.
Impact of Diabetes on Long-Term Outcome After Primary Angioplasty
Authors: De Luca Giuseppe , Dirksen Maurits T. , Spaulding Christian , Kelbæk Henning , Schalij Martin , Thuesen Leif , van der Hoeven Bas , Vink Marteen A. , Kaiser Christoph , Musto Carmine , Chechi Tania , Spaziani Gaia , Diaz de la Llera Luis Salvador , Pasceri Vincenzo , Di Lorenzo Emilio , Violini Roberto , Suryapranata Harry , Stone Gregg W. ,   for the DESERT cooperation
Published: December 2012

OBJECTIVE
Diabetes has been shown to be associated with worse survival and repeat target vessel revascularization (TVR) after primary angioplasty. The aim of the current study was to evaluate the impact of diabetes on long-term outcome in patients undergoing primary angioplasty treated with bare metal stents (BMS) and drug-eluting stents (DES).

RESEARCH DESIGN AND METHODS
Our population is represented by 6,298 ST-segment elevation myocardial infarction (STEMI) patients undergoing primary angioplasty included in the DESERT database from 11 randomized trials comparing DES with BMS.

RESULTS
Diabetes was observed in 972 patients (15.4%) who were older (P &lt; 0.001), more likely to be female (P &lt; 0.001), with higher prevalence of hypertension (P &lt; 0.001), hypercholesterolemia (P &lt; 0.001), and longer ischemia time (P &lt; 0.001), and without any difference in angiographic and procedural characteristics. At long-term follow-up (1,201 ± 441 days), diabetes was associated with higher rates of death (19.1% vs. 7.4%; P &lt; 0.0001), reinfarction (10.4% vs. 7.5%; P &lt; 0.001), stent thrombosis (7.6% vs. 4.8%; P = 0.002) with similar temporal distribution—acute, subacute, late, and very late—between diabetic and control patients, and TVR (18.6% vs. 15.1%; P = 0.006). These results were confirmed in patients receiving BMS or DES, except for TVR, there being no difference observed between diabetic and nondiabetic patients treated with DES. The impact of diabetes on outcome was confirmed after correction for baseline confounding factors (mortality, P &lt; 0.001; repeat myocardial infarction, P = 0.006; stent thrombosis, P = 0.007; TVR, P = 0.027).

CONCLUSIONS
This study shows that among STEMI patients undergoing primary angioplasty, diabetes is associated with worse long-term mortality, reinfarction, and stent thrombosis in patients receiving DES and BMS. DES implantation, however, does mitigate the known deleterious effect of diabetes on TVR after BMS.
Measuring β-Cell Function Relative to Insulin Sensitivity in Youth
Authors: Sjaarda Lindsey , Lee SoJung , Tfayli Hala , Bacha Fida , Bertolet Marnie , Arslanian Silva 
Published: December 2012

OBJECTIVE
To compare β-cell function relative to insulin sensitivity, disposition index (DI), calculated from two clamps (2cDI, insulin sensitivity from the hyperinsulinemic-euglycemic clamp and first-phase insulin from the hyperglycemic clamp) with the DI calculated from the hyperglycemic clamp alone (hcDI).

RESEARCH DESIGN AND METHODS
Complete data from hyperglycemic and hyperinsulinemic-euglycemic clamps were available for 330 youth: 73 normal weight, 168 obese with normal glucose tolerance, 57 obese with impaired glucose tolerance, and 32 obese with type 2 diabetes. The correlation between hcDI and 2cDI and Bland-Altman analysis of agreement between the two were examined.

RESULTS
Insulin sensitivity and first-phase insulin from hcDI showed a hyperbolic relationship. The hcDI correlated significantly with 2cDI in the groups combined (r = 0.85, P &lt; 0.001) and within each group separately (r ≥ 62, P &lt; 0.001). Similar to 2cDI, hcDI showed a declining pattern of β-cell function across the glucose-tolerance groups. Overall, hcDI values were 27% greater than 2cDI, due to the hyperglycemic versus euglycemic conditions, reflected in a positive bias with Bland-Altman analysis.

CONCLUSIONS
β-Cell function relative to insulin sensitivity could be accurately evaluated from a single hyperglycemic clamp, obviating the need for two separate clamp experiments, when lessening participant burden and reducing research costs are important considerations.