bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lifestyle Interaction With Fat Mass and Obesity-Associated (FTO) Genotype and Risk of Obesity in Apparently Healthy U.S. Women
Authors: Ahmad Tariq , Lee I-Min , Paré Guillaume , Chasman Daniel I. , Rose Lynda , Ridker Paul M. , Mora Samia 
Published: January 2011

OBJECTIVE
Variation in the fat mass and obesity-associated (FTO) gene is associated with obesity. The extent to which separate and combined effects of physical activity and caloric intake modify this association remains unclear.

RESEARCH DESIGN AND METHODS
FTO polymorphism rs8050136 was measured, and physical activity, caloric intake, and anthropometrics were self-reported in 21,675 apparently healthy Caucasian women.

RESULTS
The effect of the risk allele (A) on BMI was larger among inactive or higher intake women, with additive effects of inactivity and high intake on the associated genetic risk. Specifically, each A allele was associated with mean BMI difference of +0.73 (SE 0.08) kg/m2 among inactive women (≤median, 8.8 MET-hours/week), compared with +0.31 (0.06) kg/m2, P &lt; 0.0001, among active women (&gt;8.8 MET-hours/week). Similarly, each A allele was associated with mean BMI difference of +0.65 (0.07) among high intake women (&gt;median, 1,679 kcals/day), compared with +0.38 (0.07) kg/m2, P = 0.005, among low intake women (≤1,679 kcals/day). Among inactive/high intake women, each A allele was associated with mean BMI difference of +0.97 (0.11) kg/m2 vs. +0.22 (0.08) kg/m2 among inactive/low intake women, P &lt; 0.0001. Among inactive/high intake women, each A allele carried increased risk of obesity (odds ratio 1.39, 95% CI 1.27–1.52) and diabetes (odds ratio 1.36, 95% CI 1.07–1.73).

CONCLUSIONS
In this study, lifestyle factors modified the genetic risk of FTO on obesity phenotypes, particularly among women who were both inactive and had high intake. Healthier lifestyle patterns blunted but did not completely eliminate the associated genetic risk.
Sedentary Activity Associated With Metabolic Syndrome Independent of Physical Activity
Authors: Bankoski Andrea , Harris Tamara B. , McClain James J. , Brychta Robert J. , Caserotti Paolo , Chen Kong Y. , Berrigan David , Troiano Richard P. , Koster Annemarie 
Published: January 2011

OBJECTIVE
This study examined the association between objectively measured sedentary activity and metabolic syndrome among older adults.

RESEARCH DESIGN AND METHODS
Data were from 1,367 men and women, aged ≥60 years who participated in the 2003–2006 National Health and Nutrition Examination Survey (NHANES). Sedentary time during waking hours was measured by an accelerometer (&lt;100 counts per minute). A sedentary bout was defined as a period of time &gt;5 min. A sedentary break was defined as an interruption in sedentary time (≥100 counts per minute). Metabolic syndrome was defined according to the Adult Treatment Panel (ATP) III criteria.

RESULTS
On average, people spent 9.5 h (65% of wear time) as sedentary. Compared with people without metabolic syndrome, people with metabolic syndrome spent a greater percentage of time as sedentary (67.3 vs. 62.2%), had longer average sedentary bouts (17.7 vs. 16.7 min), had lower intensity during sedentary time (14.8 vs. 15.8 average counts per minute), and had fewer sedentary breaks (82.3 vs. 86.7), adjusted for age and sex (all P &lt; 0.01). A higher percentage of time sedentary and fewer sedentary breaks were associated with a significantly greater likelihood of metabolic syndrome after adjustment for age, sex, ethnicity, education, alcohol consumption, smoking, BMI, diabetes, heart disease, and physical activity. The association between intensity during sedentary time and metabolic syndrome was borderline significant.

CONCLUSIONS
The proportion of sedentary time was strongly related to metabolic risk, independent of physical activity. Current results suggest older people may benefit from reducing total sedentary time and avoiding prolonged periods of sedentary time by increasing the number of breaks during sedentary time.
Urbanization, Physical Activity, and Metabolic Health in Sub-Saharan Africa
Authors: Assah Felix K. , Ekelund Ulf , Brage Soren , Mbanya Jean Claude , Wareham Nicholas J. 
Published: January 2011

OBJECTIVE
We examined the independent associations between objectively measured free-living physical activity energy expenditure (PAEE) and the metabolic syndrome in adults in rural and urban Cameroon.

RESEARCH DESIGN AND METHODS
PAEE was measured in 552 rural and urban dwellers using combined heart rate and movement sensing over 7 continuous days. The metabolic syndrome was defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria.

RESULTS
Urban dwellers had a significantly lower PAEE than rural dwellers (44.2 ± 21.0 vs. 59.6 ± 23.7 kJ/kg/day, P &lt; 0.001) and a higher prevalence of the metabolic syndrome (17.7 vs. 3.5%, P &lt; 0.001). In multivariate regression models adjusted for possible confounders, each kJ/kg/day of PAEE was associated with a 2.1% lower risk of prevalent metabolic syndrome (odds ratio 0.98, P = 0.03). This implies a 6.5 kJ/kg/day difference in PAEE, equivalent to 30 min/day of brisk walking, corresponds to a 13.7% lower risk of prevalent metabolic syndrome. The population attributable fraction of prevalent metabolic syndrome due to being in the lowest quartile of PAEE was 26.3% (25.3% in women and 35.7% in men).

CONCLUSIONS
Urban compared with rural residence is associated with lower PAEE and higher prevalence of metabolic syndrome. PAEE is strongly independently associated with prevalent metabolic syndrome in adult Cameroonians. Modest population-wide changes in PAEE may have significant benefits in terms of reducing the emerging burden of metabolic diseases in sub-Saharan Africa.
Hemoglobin A1c and Mean Glucose in Patients With Type 1 Diabetes
Authors:   Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group
Published: January 2011

OBJECTIVE
To determine the relationship between mean sensor glucose concentrations and hemoglobin A1c (HbA1c) values measured in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications laboratory at the University of Minnesota in a cohort of subjects with type 1 diabetes from the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial.

RESEARCH DESIGN AND METHODS
Near-continuous glucose sensor data (≥4 days/week) were collected for 3 months before a central laboratory–measured HbA1c was performed for 252 subjects aged 8–74 years, the majority of whom had stable HbA1c values (77% within ±0.4% of the patient mean).

RESULTS
The slope (95% CI) for mean sensor glucose concentration (area under the curve) versus a centrally measured HbA1c was 24.4 mg/dL (22.0–26.7) for each 1% change in HbA1c, with an intercept of −16.2 mg/dL (−32.9 to 0.6). Although the slope did not vary with age or sex, there was substantial individual variability, with mean sensor glucose concentrations ranging from 128 to 187 mg/dL for an HbA1c of 6.9–7.1%. The root mean square of the errors between the actual mean sensor glucose concentration versus the value calculated using the regression equation was 14.3 mg/dL, whereas the median absolute difference was 10.1 mg/dL.

CONCLUSIONS
There is substantial individual variability between the measured versus calculated mean glucose concentrations. Consequently, estimated average glucose concentrations calculated from measured HbA1c values should be used with caution.
Weight-Related Quality of Life, Health Utility, Psychological Well-Being, and Satisfaction With Exenatide Once Weekly Compared With Sitagliptin or Pioglitazone After 26 Weeks of Treatment
Authors: Best Jennie H. , Rubin Richard R. , Peyrot Mark , Li Yan , Yan Ping , Malloy Jaret , Garrison Louis P. 
Published: January 2011

OBJECTIVE
To assess change in patient-reported outcomes in subjects with type 2 diabetes treated with exenatide once weekly compared with those treated with sitagliptin or pioglitazone.

RESEARCH DESIGN AND METHODS
In this 26-week randomized, multicenter, double-dummy study, 491 subjects received 2 mg of exenatide once weekly or maximum daily doses of sitagliptin (100 mg) or pioglitazone (45 mg) on a background of metformin. Weight-related quality of life, health utility, psychological well-being, and diabetes treatment satisfaction were assessed at baseline and week 26. Mean group changes from baseline to week 26 were estimated by ANCOVA.

RESULTS
Weight-related quality of life total scores improved significantly in the exenatide once weekly and sitagliptin arms only; the exenatide once weekly group experienced significantly greater improvement than the pioglitazone group in weight-related quality of life total scores and in several domain scores. Health utility scores improved significantly for exenatide once weekly and sitagliptin groups (P &lt; 0.05) with no significant difference between the exenatide once weekly group and either comparison group. All groups experienced significant improvements on the psychological well-being global scale and all six domain scores, with no significant difference between the exenatide once weekly group and either comparator. All groups experienced significant improvements in total diabetes treatment satisfaction scores. The exenatide once weekly group experienced greater improvement than the sitagliptin group in treatment satisfaction total scores.

CONCLUSIONS
In combination with clinical outcomes from this study, these results indicate it is possible for patients treated with metformin to initiate exenatide therapy with potential benefits in both clinical and patient-reported outcomes.
Relationship Between Carotid Intima-Media Thickness and the Presence and Extent of Coronary Stenosis in Type 2 Diabetic Patients With Carotid Atherosclerosis but Without History of Coronary Artery Disease
Authors: Kasami Ryuuichi , Kaneto Hideaki , Katakami Naoto , Sumitsuji Satoru , Yamasaki Keita , Kuroda Tadashi , Tachibana Kouichi , Yasuda Tetsuyuki , Kuroda Akio , Matsuoka Taka-aki , Matsuhisa Munehide , Shimomura Iichiro 
Published: January 2011

OBJECTIVE
We examined the relationship between the presence and extent of coronary stenosis and carotid intima-media thickness (CIMT) in type 2 diabetic patients without history of coronary artery disease (CAD) but with carotid atherosclerosis.

RESEARCH DESIGN AND METHODS
A total of 91 type 2 diabetic patients underwent multi-slice computed tomography coronary angiography.

RESULTS
Max-IMT in the ≥50% stenosis group by multi-slice computed tomography coronary angiography estimation was significantly greater than the 0–25 and 25–50% stenosis group (2.68 ± 0.77 vs. 1.61 ± 0.49 mm, P &lt; 0.0005, and 2.14 ± 0.81 mm, P &lt; 0.05, respectively), and max-IMT in the 25–50% stenosis group was significantly greater than the 0–25% stenosis group (P &lt; 0.05) after adjustment for age, sex, duration of type 2 diabetes, hypertension, and dyslipidemia. In the analysis for trend through the categories of max-IMT, as max-IMT increased, the percentage of ≥50% stenosis increased and the percentage of 0–25% stenosis decreased.

CONCLUSIONS
Our data suggest that max-IMT might be closely associated with the extent of coronary stenosis in type 2 diabetic patients without history of CAD but with carotid atherosclerosis.
Clinical and Genetic Characteristics of Patients With Type 1 Diabetes Associated With Interferon Therapy
Authors: Nakanishi Koji , Saitoh Satoshi 
Published: January 2011

OBJECTIVE
This study clarified characteristics of interferon-associated type 1 diabetes.

RESEARCH DESIGN AND METHODS
The study compared 12 patients with interferon-associated type 1 diabetes with 128 patients with type 1A diabetes with respect to clinical characteristics, and with 10 patients without diabetes despite interferon therapy and 136 normal controls with respect to HLA allele distributions.

RESULTS
Patients with interferon-associated type 1 diabetes retained higher levels of fasting serum C peptide as well as GAD65 antibodies than those with type 1A diabetes until 2 to 4 years after onset. HLA-A*2402 was increased among patients with interferon-associated type 1 diabetes compared with those without diabetes, despite interferon therapy (odds ratio [OR] 4.00 [95% CI 1.09–17.26]). The haplotype of DRB1*1302-DQA1*0102-DQB1*0604 was increased in these two groups combined compared with normal controls (OR 5.64 [95% CI 2.67–11.81]).

CONCLUSIONS
Interferon-associated type 1 diabetes is characterized clinically by high titers of GAD65 antibodies and preserved β-cell function, and genetically by addition of HLA-A*2402to DRB1*1302-DQA1*0102-DQB1*0604.
The Diabeo Software Enabling Individualized Insulin Dose Adjustments Combined With Telemedicine Support Improves HbA1c in Poorly Controlled Type 1 Diabetic Patients
Authors: Charpentier Guillaume , Benhamou Pierre-Yves , Dardari Dured , Clergeot Annie , Franc Sylvia , Schaepelynck-Belicar Pauline , Catargi Bogdan , Melki Vincent , Chaillous Lucy , Farret Anne , Bosson Jean-Luc , Penfornis Alfred ,   on behalf of the TeleDiab Study Group
Published: January 2011

OBJECTIVE
To demonstrate that Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support significantly improves HbA1c in poorly controlled type 1 diabetic patients.

RESEARCH DESIGN AND METHODS
In a six-month open-label parallel-group, multicenter study, adult patients (n = 180) with type 1 diabetes (&gt;1 year), on a basal-bolus insulin regimen (&gt;6 months), with HbA1c ≥8%, were randomized to usual quarterly follow-up (G1), home use of a smartphone recommending insulin doses with quarterly visits (G2), or use of the smartphone with short teleconsultations every 2 weeks but no visit until point end (G3).

RESULTS
Six-month mean HbA1c in G3 (8.41 ± 1.04%) was lower than in G1 (9.10 ± 1.16%; P = 0.0019). G2 displayed intermediate results (8.63 ± 1.07%). The Diabeo system gave a 0.91% (0.60; 1.21) improvement in HbA1c over controls and a 0.67% (0.35; 0.99) reduction when used without teleconsultation. There was no difference in the frequency of hypoglycemic episodes or in medical time spent for hospital or telephone consultations. However, patients in G1 and G2 spent nearly 5 h more than G3 patients attending hospital visits.

CONCLUSIONS
The Diabeo system gives a substantial improvement to metabolic control in chronic, poorly controlled type 1 diabetic patients without requiring more medical time and at a lower overall cost for the patient than usual care.
Urinary C-Peptide Creatinine Ratio Is a Practical Outpatient Tool for Identifying Hepatocyte Nuclear Factor 1-α/Hepatocyte Nuclear Factor 4-α Maturity-Onset Diabetes of the Young From Long-Duration Type 1 Diabetes
Authors: Besser Rachel E.J. , Shepherd Maggie H. , McDonald Timothy J. , Shields Beverley M. , Knight Bridget A. , Ellard Sian , Hattersley Andrew T. 
Published: January 2011

OBJECTIVE
Hepatocyte nuclear factor 1-α (HNF1A)/hepatocyte nuclear factor 4-α (HNF4A) maturity-onset diabetes of the young (MODY) is frequently misdiagnosed as type 1 diabetes, and patients are inappropriately treated with insulin. Blood C-peptide can aid in the diagnosis of MODY, but practical reasons limit its widespread use. Urinary C-peptide creatinine ratio (UCPCR), a stable measure of endogenous insulin secretion, is a noninvasive alternative. We aimed to compare stimulated UCPCR in adults with HNF1A/4A MODY, type 1 diabetes, and type 2 diabetes.

RESEARCH DESIGN AND METHODS
Adults with diabetes for ≥5years, without renal impairment, were studied (HNF1A MODY [n = 54], HNF4A MODY [n = 23], glucokinase MODY [n = 20], type 1 diabetes [n = 69], and type 2 diabetes [n = 54]). The UCPCR was collected in boric acid 120 min after the largest meal of the day and mailed for analysis. Receiver operating characteristic (ROC) curves were used to identify optimal UCPCR cutoffs to differentiate HNF1A/4A MODY from type 1 and type 2 diabetes.

RESULTS
UCPCR was lower in type 1 diabetes than HNF1A/4A MODY (median [interquartile range]) (&lt;0.02 nmol/mmol [&lt;0.02 to &lt;0.02] vs. 1.72 nmol/mmol [0.98–2.90]; P &lt; 0.0001). ROC curves showed excellent discrimination (area under curve [AUC] 0.98) and identified a cutoff UCPCR of ≥0.2 nmol/mmol for differentiating HNF1A/4A MODY from type 1 diabetes (97% sensitivity, 96% specificity). UCPCR was lower in HNF1A/4A MODY than in type 2 diabetes (1.72 nmol/mmol [0.98–2.90] vs. 2.47 nmol/mmol [1.4–4.13]); P = 0.007). ROC curves showed a weak distinction between HNF1A/4A MODY and type 2 diabetes (AUC 0.64).

CONCLUSIONS
UCPCR is a noninvasive outpatient tool that can be used to discriminate HNF1A and HNF4A MODY from long-duration type 1 diabetes. To differentiate MODY from type 1 diabetes of &gt;5 years’ duration, UCPCR could be used to determine whether genetic testing is indicated.
Implications of Alternative Definitions of Prediabetes for Prevalence in U.S. Adults
Authors: James Cherie , Bullard Kai McKeever , Rolka Deborah B. , Geiss Linda S. , Williams Desmond E. , Cowie Catherine C. , Albright Ann , Gregg Edward W. 
Published: January 2011

OBJECTIVE
To compare the prevalence of prediabetes using A1C, fasting plasma glucose (FPG), and oral glucose tolerance test (OGTT) criteria, and to examine the degree of agreement between the measures.

RESEARCH DESIGN AND METHODS
We used the 2005–2008 National Health and Nutrition Examination Surveys to classify 3,627 adults aged ≥18 years without diabetes according to their prediabetes status using A1C, FPG, and OGTT. We compared the prevalence of prediabetes according to different measures and used conditional probabilities to examine agreement between measures.

RESULTS
In 2005–2008, the crude prevalence of prediabetes in adults aged ≥18 years was 14.2% for A1C 5.7–6.4% (A1C5.7), 26.2% for FPG 100–125 mg/dL (IFG100), 7.0% for FPG 110–125 mg/dL (IFG110), and 13.7% for OGTT 140–199 mg/dL (IGT). Prediabetes prevalence varied by age, sex, and race/ethnicity, and there was considerable discordance between measures of prediabetes. Among those with IGT, 58.2, 23.4, and 32.3% had IFG100, IFG110, and A1C5.7, respectively, and 67.1% had the combination of either A1C5.7 or IFG100.

CONCLUSIONS
The prevalence of prediabetes varied by the indicator used to measure risk; there was considerable discordance between indicators and the characteristics of individuals with prediabetes. Programs to prevent diabetes may need to consider issues of equity, resources, need, and efficiency in targeting their efforts.
Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System
Authors: Lim Soo , Kang Seon Mee , Shin Hayley , Lee Hak Jong , Won Yoon Ji , Yu Sung Hoon , Kim So-Youn , Yoo Soo Young , Jung Hye Seung , Park Kyong Soo , Ryu Jun Oh , Jang Hak C. 
Published: January 2011

OBJECTIVE
To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology.

RESEARCH DESIGN AND METHODS
We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged &gt;60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C &lt;7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient’s mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone.

RESULTS
After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P &lt; 0.001) in the u-healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C &lt;7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P &lt; 0.05).

CONCLUSIONS
The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients.
Improvement and Emergence of Insulin Restriction in Women With Type 1 Diabetes
Authors: Goebel-Fabbri Ann E. , Anderson Barbara J. , Fikkan Janna , Franko Debra L. , Pearson Kimberly , Weinger Katie 
Published: January 2011

OBJECTIVE
To determine the distinguishing characteristics of women who report stopping insulin restriction at 11 years of follow-up from those continuing to endorse insulin restriction as well as those characteristics differing in patients who continue to use insulin appropriately from new insulin restrictors.

RESEARCH DESIGN AND METHODS
This is an 11-year follow-up study of 207 women with type 1 diabetes. Insulin restriction, diabetes self-care behaviors, diabetes-specific distress, and psychiatric and eating disorder symptoms were assessed using self-report surveys.

RESULTS
Of the original sample, 57% participated in the follow-up study. Mean age was 44 ± 12 years, diabetes duration was 28 ± 11 years, and A1C was 7.9 ± 1.3%. At follow-up, 20 of 60 baseline insulin restrictors had stopped restriction. Women who stopped reported improved diabetes self-care and distress, fewer problems with diabetes self-management, and lower levels of psychologic distress and eating disorder symptoms. Logistic regression indicated that lower levels of fear of weight gain with improved blood glucose and fewer problems with diabetes self-management predicted stopping restriction. At follow-up, 34 women (23%) reported new restriction, and a larger proportion of new insulin restrictors, relative to nonrestrictors, endorsed fear of weight gain with improved blood glucose.

CONCLUSIONS
Findings indicate that fear of weight gain associated with improved blood glucose and problems with diabetes self-care are core issues related to both the emergence and resolution of insulin restriction. Greater attention to these concerns may help treatment teams to better meet the unique treatment needs of women struggling with insulin restriction.
Monitoring of Individual Needs in Diabetes (MIND): Baseline Data From the Cross-National Diabetes Attitudes, Wishes, and Needs (DAWN) MIND Study
Authors: Snoek Frank J. , Kersch Nancy Y.A. , Eldrup Ebbe , Harman-Boehm Ilana , Hermanns Norbert , Kokoszka Andrzej , Matthews David R. , McGuire Brian E. , Pibernik-OkanoviĆ Mirjana , Singer Joelle , de Wit Maartje , Skovlund Søren E. 
Published: January 2011

OBJECTIVE
To test the feasibility and impact of implementing the computer-assisted Monitoring of Individual Needs in Diabetes (MIND) procedure, which is aimed at improving recognition and management of the psychological needs of diabetic patients in routine care.

RESEARCH DESIGN AND METHODS
The MIND study was implemented in diabetes clinics across eight countries as part of the annual review. The computerized assessment covered emotional well-being (World Health Organization 5 Well-Being Index), diabetes-related distress (Problem Areas in Diabetes), life events, and the patient’s agenda. Medical data were retrieved from the charts, and agreed-upon actions were recorded.

RESULTS
Of 1,567 patients monitored using the MIND, 24.9% had either likely depression or high diabetes-related distress; 5.4% had both. Over 80% of these patients were newly identified cases, and 41% of patients with depression were referred to a mental health professional.

CONCLUSIONS
Monitoring of well-being and diabetes-related distress as part of routine diabetes care is feasible and helps to identify and discuss unmet psychosocial needs.