bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Glucose Intolerance and Diabetes in Hemipancreatectomized Donors Selected for Normal Preoperative Glucose Metabolism
Authors: Kumar Anjali F. , Gruessner Rainer W.G. , Seaquist Elizabeth R. 
Published: June 2008

OBJECTIVE—Hemipancreatectomy (HPx) for the purpose of organ donation has been associated with a 25% risk of developing abnormal glucose tolerance or diabetes in the year after surgery. Since 1997, the University of Minnesota has imposed criteria to prevent potential donors with clinical features associated with an increased diabetes risk from undergoing HPx. We recently assessed glucose tolerance in hemipancreatectomized donors selected since the adoption of the new criteria to determine whether the risk of developing abnormal glucose tolerance was reduced below the 25% rate previously demonstrated.
RESEARCH DESIGN AND METHODS—Individuals who underwent HPx for the purpose of pancreas donation between 1997 and 2003 were contacted and interviewed about their health status. Those not taking diabetes medications were invited to undergo an assessment of their glucose tolerance.
RESULTS—Successful contact was made with 15 of 21 donors who underwent HPx during this period. Two donors reported use of oral diabetic medications and were not studied further. Of the remaining 13, 2 had impaired fasting glucose (fasting blood glucose 100–125 mg/dl), 1 had impaired glucose tolerance (2-h postglucose load blood glucose 140–199 mg/dl), and 3 displayed both. One donor met the diagnostic criteria for diabetes. Six donors had normal glucose values.
CONCLUSIONS—Despite the use of stringent criteria to exclude those at risk for developing abnormalities in glucose metabolism, 43% of healthy humans who underwent HPx between 1997 and 2003 have impaired fasting glucose, impaired glucose tolerance, or diabetes on follow-up. The current preoperative criteria are insufficient to predict those who will develop abnormal glucose metabolism after HPx.
Economic Benefits of Intensive Insulin Therapy in Critically Ill Patients
Authors: Sadhu Archana R. , Ang Alfonso C. , Ingram-Drake Leslie A. , Martinez Dorothy S. , Hsueh Willa A. , Ettner Susan L. 
Published: June 2008

OBJECTIVE—The purpose of this study was to analyze the economic outcomes of a clinical program implemented to achieve strict glycemic control with intensive insulin therapy in patients admitted to the intensive care unit (ICU).
RESEARCH DESIGN AND METHODS—A difference-in-differences (quasi-experimental) study design was used to examine the associations of an intensive insulin therapy intervention with changes in hospital length of stay (ICU and total), costs (ICU and total), and mortality. Hospital administrative data were obtained for 6,719 adult patients admitted between 2003 and 2005 to one of five intervention or four comparison ICUs in a large academic medical center. Linear regression models with log transformations and appropriate retransformations were used to estimate length of stay (LOS) and costs; logistic regressions were used to estimate mortality.
RESULTS—After adjustment for observable patient characteristics and secular time trends, the intervention was consistently associated with lower average glucose levels and a trend toward shorter LOS, lower costs, and lower mortality. However, associations with resource use and outcomes were statistically significant in only ICU LOS, with an average reduction of 1.19 days of ICU care per admission. Other associations, although large in magnitude and in the hypothesized directions, were not estimated with sufficient precision to rule out other net effects. The associations with ICU days and costs were larger in magnitude than total days and costs.
CONCLUSIONS—A clinical team focused on hyperglycemia management for ICU patients can be a valuable investment with significant economic benefits for hospitals.
Lifetime Risk of Cardiovascular Disease Among Individuals With and Without Diabetes Stratified by Obesity Status in the Framingham Heart Study
Authors: Fox Caroline S. , Pencina Michael J. , Wilson Peter W.F. , Paynter Nina P. , Vasan Ramachandran S. , D’Agostino Ralph B. 
Published: June 2008

OBJECTIVE—We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes.
RESEARCH DESIGN AND METHODS—Participants were drawn from the original and offspring cohorts of the Framingham Heart Study. Lifetime (30-year) risk of CVD was assessed using a modified Kaplan-Meier approach adjusting for the competing risk of death, beginning from age 50 years.
RESULTS—Over 30 years, the lifetime risk of CVD among women with diabetes was 54.8% among normal-weight women and 78.8% among obese women. Among normal-weight men with diabetes, the lifetime risk of CVD was 78.6%, whereas it was 86.9% among obese men.
CONCLUSIONS—The lifetime risk of CVD among individuals with diabetes is high, and this relationship is further accentuated with increasing adiposity.
Periodontal Disease and Incident Type 2 Diabetes
Authors: Demmer Ryan T. , Jacobs David R. , Desvarieux Moïse 
Published: June 2008

OBJECTIVE—Type 2 diabetes and periodontal disease are known to be associated, but the temporality of this relationship has not been firmly established. We investigated whether baseline periodontal disease independently predicts incident diabetes over two decades of follow-up.
RESEARCH DESIGN AND METHODS—A total of 9,296 nondiabetic male and female National Health and Nutrition Examination Survey (NHANES I) participants aged 25–74 years who completed a baseline dental examination (1971–1976) and had at least one follow-up evaluation (1982–1992) were studied. We defined six categories of baseline periodontal disease using the periodontal index. Of 7,168 dentate participants, 47% had periodontal index = 0 (periodontally healthy); the remaining were classified into periodontal index quintiles. Incident diabetes was defined by 1) death certificate (ICD-9 code 250), 2) self-report of diabetes requiring pharmacological treatment, or 3) health care facility stay with diabetes discharge code. Multivariable logistic regression models assessed incident diabetes odds across increasing levels of periodontal index in comparison with periodontally healthy participants.
RESULTS—The adjusted odds ratios (ORs) for incident diabetes in periodontal index categories 1 and 2 were not elevated, whereas the ORs in periodontal index categories 3 through 5 were 2.26 (95% CI 1.56–3.27), 1.71 (1.0–2.69), and 1.50 (0.99–2.27), respectively. The OR in edentulous participants was 1.30 (1.00–1.70). Dentate participants with advanced tooth loss had an OR of 1.70 (P &lt; 0.05) relative to those with minimal tooth loss.
CONCLUSIONS—Baseline periodontal disease is an independent predictor of incident diabetes in the nationally representative sample of NHANES I.
Adipokines and Incident Type 2 Diabetes in an Aboriginal Canadian Population
Authors: Ley Sylvia H. , Harris Stewart B. , Connelly Philip W. , Mamakeesick Mary , Gittelsohn Joel , Hegele Robert A. , Retnakaran Ravi , Zinman Bernard , Hanley Anthony J.G. 
Published: June 2008

OBJECTIVE—The aim of this study was to investigate associations of adiponectin, leptin, C-reactive protein (CRP), interleukin (IL)-6, and serum amyloid A (SAA), individually or in combinations, with risk of incident type 2 diabetes in an Aboriginal Canadian population.
RESEARCH DESIGN AND METHODS—Of the 606 Sandy Lake Health and Diabetes Project cohort subjects who were free of diabetes at baseline, 540 (89.1%) participated in 10-year follow-up assessments. Concentrations of fasting adiponectin, leptin, CRP, IL-6, SAA, and covariates were measured at baseline. Fasting glucose and a 75-g oral glucose tolerance test were obtained at baseline and follow-up to determine incident type 2 diabetes, defined as clinically diagnosed type 2 diabetes or as fasting plasma glucose ≥7.0 mmol/l or 2-h postload plasma glucose ≥11.1 mmol/l at follow-up.
RESULTS—Low adiponectin, high leptin, and low adiponectin-to-leptin ratio at baseline were associated with increased risk of incident type 2 diabetes after adjustment for age, sex, triglycerides, HDL cholesterol, hypertension, and impaired glucose tolerance (odds ratio 0.63 [95% CI 0.48–0.83], 1.50 [1.02–2.21], and 0.54 [0.37–0.77], respectively). When the models were additionally adjusted for waist circumference or BMI, however, only low adiponectin remained significantly associated with increased incident diabetes (0.68 [0.51–0.90]). Combinations of leptin, CRP, IL-6, and/or SAA with adiponectin, assessed using either the ratio or joint effects, did not improve diabetes prediction.
CONCLUSIONS—Low baseline adiponectin is associated with increased risk of incident type 2 diabetes independent of leptin, CRP, IL-6, SAA, and metabolic syndrome variables including obesity.
Assessment of Aortic Pulse Wave Velocity and Cardiac Diastolic Function in Subjects With and Without the Metabolic Syndrome
Authors: Roes Stijntje D. , Alizadeh Dehnavi Reza , Westenberg Jos J.M. , Lamb Hildo J. , Mertens Bart J.A. , Tamsma Jouke T. , de Roos Albert 
Published: June 2008

OBJECTIVE—To evaluate the influence of lipid and glucose metabolism in the metabolic syndrome on aortic pulse wave velocity (PWV) and left ventricular (LV) diastolic function using magnetic resonance imaging (MRI).
RESEARCH DESIGN AND METHODS—Aortic PWV and LV diastolic function were assessed using MRI in 16 subjects with the metabolic syndrome and 16 subjects without the metabolic syndrome matched for age, waist circumference, and blood pressure. The groups were compared using the unpaired t test or Mann-Whitney U test, and linear regression analysis was applied.
RESULTS—Aortic PWV was increased and LV diastolic function was decreased in subjects with compared with those without the metabolic syndrome. HDL cholesterol was independently associated with aortic PWV (R = −0.470, P &lt; 0.01) and LV diastolic function (R = −0.421, P = 0.02).
CONCLUSIONS—Increased aortic PWV and decreased LV diastolic function is observed in subjects with the metabolic syndrome, regardless of blood pressure. Moreover, HDL cholesterol is independently associated with aortic PWV and LV diastolic function.
Adipose Tissue Lipolysis Is Upregulated in Lean and Obese Men During Acute Resistance Exercise
Authors: Chatzinikolaou Athanasios , Fatouros Ioannis , Petridou Anatoli , Jamurtas Athanasios , Avloniti Alexandra , Douroudos Ioannis , Mastorakos George , Lazaropoulou Christina , Papassotiriou Ioannis , Tournis Symeon , Mitrakou Asimina , Mougios Vassilis 
Published: June 2008

OBJECTIVE—To investigate the effect of acute resistance exercise on adipose tissue triacylglycerol lipase activity (TGLA) in lean and obese men.
RESEARCH DESIGN AND METHODS—Nine lean and eight obese men performed 30 min of circuit resistance exercise. Adipose tissue and blood were sampled during exercise for TGLA, metabolite, and hormone determinations. Respiratory exchange ratio (RER) was measured throughout exercise.
RESULTS—Energy expenditure of exercise relative to body mass was higher in the lean and RER was higher in the obese men, suggesting lower fat oxidation. TGLA increased 18-fold at 5 min of exercise in the lean men and 16-fold at 10 min of exercise in the obese men. The delayed lipolytic activation in the obese men was reflected in serum nonesterified fatty acid and glycerol concentrations. Plasma insulin increased in the obese but did not change in the lean men.
CONCLUSIONS—Resistance exercise upregulated adipose tissue lipolysis and enhanced energy expenditure in lean and obese men, with a delayed lipolytic activation in the obese men.
Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women
Authors: Bazzano Lydia A. , Li Tricia Y. , Joshipura Kamudi J. , Hu Frank B. 
Published: June 2008

OBJECTIVE—The purpose of this study was to examine the association between fruit, vegetable, and fruit juice intake and development of type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 71,346 female nurses aged 38–63 years who were free of cardiovascular disease, cancer, and diabetes in 1984 were followed for 18 years, and dietary information was collected using a semiquantitative food frequency questionnaire every 4 years. Diagnosis of diabetes was self-reported.
RESULTS—During follow-up, 4,529 cases of diabetes were documented, and the cumulative incidence of diabetes was 7.4%. An increase of three servings/day in total fruit and vegetable consumption was not associated with development of diabetes (multivariate-adjusted hazard ratio 0.99 [95% CI 0.94–1.05]), whereas the same increase in whole fruit consumption was associated with a lower hazard of diabetes (0.82 [0.72–0.94]). An increase of 1 serving/day in green leafy vegetable consumption was associated with a modestly lower hazard of diabetes (0.91 [0.84–0.98]), whereas the same change in fruit juice intake was associated with an increased hazard of diabetes (1.18 [1.10–1.26]).
CONCLUSIONS—Consumption of green leafy vegetables and fruit was associated with a lower hazard of diabetes, whereas consumption of fruit juices may be associated with an increased hazard among women.
Preanalytical, Analytical, and Computational Factors Affect Homeostasis Model Assessment Estimates
Authors: Manley Susan E. , Luzio Stephen D. , Stratton Irene M. , Wallace Tara M. , Clark Penelope M.S. 
Published: June 2008

OBJECTIVE—We investigated how β-cell function and insulin sensitivity or resistance are affected by the type of blood sample collected or choice of insulin assay and homeostatis model assessment (HOMA) calculator (http://www.dtu.ox.ac.uk).
RESEARCH DESIGN AND METHODS—Insulin was measured using 11 different assays in serum and 1 assay in heparinized plasma. Fasting subjects with normoglycemia (n = 12), pre-diabetes, i.e., impaired fasting glucose or impaired glucose tolerance (n = 18), or type 2 diabetes (n = 67) were recruited. Patients treated with insulin or those who were insulin antibody–positive were excluded. HOMA estimates were calculated using specific insulin (SI) or radioimmunoassay (RIA) calculators (version 2.2).
RESULTS—All glucose values were within model (HOMA) limits but not all insulin results, as 4.3% were &lt;20 pmol/l and 1% were &gt;300 pmol/l. β-Cell function derived from different insulin assays ranged from 67 to 122% (median) for those with normoglycemia (P = 0.026), from 89 to 138% for those with pre-diabetes (P = 0.990), and from 50 to 81% for those with type 2 diabetes (P &lt; 0.0001). Furthermore, insulin resistance ranged from 0.8 to 2.0 (P = 0.0007), from 1.9 to 3.2 (P = 0.842), and from 1.5 to 2.9 (P &lt; 0.0001), respectively. This twofold variation in HOMA estimates from the various insulin assays studied in serum may be significant metabolically. Insulin was 15% lower in heparinized plasma (used in the original HOMA study) compared with serum, which is now more commonly used. β-Cell function differed by 11% and insulin resistance by 15% when estimates derived from specific insulin were calculated using the RIA rather than the SI calculator.
CONCLUSIONS—To enable comparison of HOMA estimates among individuals and different research studies, preanalytical factors and calculator selection should be standardized with insulin assays traceable to an insulin reference method procedure.
Hyperinsulinemia in African-American Adolescents Compared With Their American White Peers Despite Similar Insulin Sensitivity
Authors: Hannon Tamara S. , Bacha Fida , Lin Yan , Arslanian Silva A. 
Published: June 2008

OBJECTIVE—African-American (AA) children are hyperinsulinemic and insulin resistant compared with American white (AW) children. Previously, we demonstrated that insulin secretion relative to insulin sensitivity was ∼75% higher in AA compared with AW children, suggesting that hyperinsulinemia in AA children is not merely a compensatory response to lower insulin sensitivity. The aim of the present investigation was to assess whether glucose-stimulated insulin response is higher in AA versus AW adolescents who have comparable in vivo insulin sensitivity.
RESEARCH DESIGN AND METHODS—The hyperinsulinemic-euglycemic and hyperglycemic clamp techniques were utilized to assess first- and second-phase insulin secretion. Insulin secretion relative to insulin sensitivity was calculated as the glucose disposition index.
RESULTS—AA adolescents compared with their AW peers with comparable insulin sensitivity and body composition had higher first-phase insulin concentrations.
CONCLUSIONS—The quantitative relationship between insulin sensitivity and first-phase insulin appears to differ among AA and AW adolescents.
Hemodynamic Effects of Fenofibrate and Coenzyme Q10 in Type 2 Diabetic Subjects With Left Ventricular Diastolic Dysfunction
Authors: Chew Gerard T. , Watts Gerald F. , Davis Timothy M.E. , Stuckey Bronwyn G.A. , Beilin Lawrence J. , Thompson Peter L. , Burke Valerie , Currie Philip J. 
Published: June 2008

OBJECTIVE—To investigate the effects of fenofibrate and coenzyme Q10 (CoQ) on diastolic function, ambulatory blood pressure (ABP), and heart rate (HR) in type 2 diabetic subjects with left ventricular diastolic dysfunction (LVDD).
RESEARCH DESIGN AND METHODS—We randomized, double-blind, 74 subjects to fenofibrate 160 mg daily, CoQ 200 mg daily, fenofibrate 160 mg plus CoQ 200 mg daily, or matching placebo for 6 months. Echocardiography (including tissue Doppler imaging) and 24-h ABP and HR monitoring were performed pre- and postintervention.
RESULTS—Neither fenofibrate nor CoQ, alone or in combination, altered early diastolic mitral annular myocardial relaxation velocity (E′), early-to-late mitral inflow velocity ratio (E/A), deceleration time, isovolumic relaxation time, or the ratio of early mitral flow velocity to early diastolic mitral annular myocardial relaxation velocity (E/E′) compared with placebo (P &gt; 0.05). Fenofibrate and CoQ interactively (P = 0.001) lowered 24-h systolic blood pressure (−3.4 ± 0.09 mmHg, P = 0.010), with a prominent nocturnal effect (−5.7 ± 1.5 mmHg, P = 0.006). Fenofibrate (−1.3 ± 0.5 mmHg, P = 0.013) and CoQ (−2.2 ± 0.5 mmHg, P &lt; 0.001) independently lowered 24-h diastolic blood pressure. Fenofibrate reduced 24-h HR (−3.3 ± 0.5 beats/min, P &lt; 0.001), but CoQ had no effect on HR.
CONCLUSIONS—In type 2 diabetic subjects with LVDD, neither fenofibrate nor CoQ, alone or in combination, improved diastolic function significantly. However, fenofibrate and CoQ independently and interactively lowered 24-h blood pressure, and fenofibrate alone reduced 24-h HR.
Isolated Hyperglycemia at 1 Hour on Oral Glucose Tolerance Test in Pregnancy Resembles Gestational Diabetes Mellitus in Predicting Postpartum Metabolic Dysfunction
Authors: Retnakaran Ravi , Qi Ying , Sermer Mathew , Connelly Philip W. , Zinman Bernard , Hanley Anthony J.G. 
Published: June 2008

OBJECTIVE—Gestational impaired glucose tolerance (GIGT), defined by a single abnormal value on antepartum 3-h oral glucose tolerance test (OGTT), is a metabolically heterogeneous disorder. Indeed, the antepartum metabolic phenotype of women with a single abnormal value at 1 h during the OGTT (1-h GIGT) resembles that of women with gestational diabetes mellitus (GDM), whereas GIGT at 2 or 3 h (2/3-h GIGT) is similar to normal glucose tolerance (NGT). Thus, we hypothesized that 1-h GIGT would be associated with the same adverse outcomes as GDM, i.e., increased infant birth weight and postpartum metabolic dysfunction.
RESEARCH DESIGN AND METHODS—A total of 361 women underwent an antepartum glucose challenge test (GCT) and a 3-h OGTT, assessment of obstetrical outcome at delivery, and metabolic characterization by OGTT at 3 months postpartum. The antepartum GCT/OGTT identified five study groups: GDM (n = 97), 1-h GIGT (n = 28), 2/3-h GIGT (n = 34), abnormal GCT NGT (abnormal GCT with NGT on OGTT) (n = 128), and normal GCT NGT (normal GCT with NGT on OGTT) (n = 74).
RESULTS—Caesarian section rate was higher in women with 1-h GIGT, but birth weight did not differ significantly between the non-GDM groups (P = 0.1978). At 3 months postpartum, glycemia (area under the glucose curve) progressively increased across the groups from normal GCT NGT to abnormal GCT NGT to 2/3-h GIGT to 1-h GIGT to GDM (P &lt; 0.0001), while both insulin sensitivity (ISOGTT) and β-cell function (insulinogenic index/homeostasis model assessment of insulin resistance [HOMA-IR]) progressively decreased (P = 0.002 and P &lt; 0.0001, respectively). The strongest independent negative predictors of insulinogenic index/HOMA-IR were GDM (t = −4.1, P &lt; 0.0001) and 1-h GIGT (t = −3.8, P = 0.0002).
CONCLUSIONS—Like GDM, 1-h GIGT is associated with postpartum glycemia, insulin resistance, and β-cell dysfunction.
Diabetes, Glycemic Control, and Risk of Hospitalization With Pneumonia
Authors: Kornum Jette B. , Thomsen Reimar W. , Riis Anders , Lervang Hans-Henrik , Schønheyder Henrik C. , Sørensen Henrik T. 
Published: June 2008

OBJECTIVE—To examine whether diabetes is a risk factor for hospitalization with pneumonia and to assess the impact of A1C level on such risk.
RESEARCH DESIGN AND METHODS—In this population-based, case-control study we identified patients with a first-time pneumonia-related hospitalization between 1997 and 2005, using health care databases in northern Denmark. For each case, 10 sex- and age-matched population control subjects were selected from Denmark's Civil Registration System. We used conditional logistic regression to compute relative risk (RR) for pneumonia-related hospitalization among subjects with and without diabetes, controlling for potential confounding factors.
RESULTS—The study included 34,239 patients with a pneumonia-related hospitalization and 342,390 population control subjects. The adjusted RR for pneumonia-related hospitalization among subjects with diabetes was 1.26 (95% CI 1.21–1.31) compared with nondiabetic individuals. The adjusted RR was 4.43 (3.40–5.77) for subjects with type 1 diabetes and 1.23 (1.19–1.28) for subjects with type 2 diabetes. Diabetes duration ≥10 years increased the risk of a pneumonia-related hospitalization (1.37 [1.28–1.47]). Compared with subjects without diabetes, the adjusted RR was 1.22 (1.14–1.30) for diabetic subjects whose A1C level was &lt;7% and 1.60 (1.44–1.76) for diabetic subjects whose A1C level was ≥9%.
CONCLUSIONS—Type 1 and type 2 diabetes are risk factors for a pneumonia-related hospitalization. Poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization with pneumonia.