bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing Prevalence of the Metabolic Syndrome Among U.S. Adults
Authors: Ford Earl S. , Giles Wayne H. , Mokdad Ali H. 
Published: March 2007

OBJECTIVE—The prevalence of the metabolic syndrome is high among U.S. adults. Our purpose was to determine whether the prevalence of this syndrome has changed since 1988–1994.
RESEARCH DESIGN AND METHODS—A total of 6,436 men and women aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and 1,677 participants from NHANES 1999–2000 were included in the analyses. We used the definition of the metabolic syndrome developed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.
RESULTS—The unadjusted prevalence of the metabolic syndrome was 23.1% in NHANES III and 26.7% in NHANES 1999–2000 (P = 0.043), and the age-adjusted prevalences were 24.1 and 27.0% (P = 0.088), respectively. The age-adjusted prevalence increased by 23.5% among women (P = 0.021) and 2.2% among men (P = 0.831). Increases in high blood pressure, waist circumference, and hypertriglyceridemia accounted for much of the increase in the prevalence of the metabolic syndrome, particularly among women.
CONCLUSIONS—The increased prevalence of the metabolic syndrome is likely to lead to future increases in diabetes and cardiovascular disease.
IDDM1 and Multiple Family History of Type 1 Diabetes Combine to Identify Neonates at High Risk for Type 1 Diabetes
Authors: Bonifacio Ezio , Hummel Michael , Walter Markus , Schmid Sandra , Ziegler Anette-G. 
Published: March 2007

OBJECTIVE—Children of affected probands are at increased risk for type 1 diabetes. The objective of this study was to determine and stratify the risk for islet autoimmunity and childhood diabetes in newborn offspring of affected parents using family history and HLA genetic markers.
RESEARCH DESIGN AND METHODS—Antibodies to islet autoantigens were measured at ages 9 months, 2 years, 5 years, and 8 years in 1,610 offspring of parents with type 1 diabetes participating in the German BABYDIAB study. HLA DR and DQ genetic typing was performed. Family history of type 1 diabetes was obtained from questionnaires.
RESULTS—Extensive family history of type 1 diabetes and HLA DR/DQ genotyping were associated with islet autoantibody and diabetes risks. Significant contributions to the child’s risk for developing islet autoantibodies and type 1 diabetes were conferred by a multiple first-degree family history of type 1 diabetes (two parents or one parent and a sibling; adjusted hazard [HR] ratio, 6.2 for multiple islet autoantibodies and 7.8 for type 1 diabetes), high-risk HLA genotypes (adjusted HR, 11 and 10.9), and moderate-risk HLA genotypes (adjusted HR, 6.3 and 4.3) in a multivariate analysis. Combining these factors stratified the risk for islet autoantibodies from 1 to 46% and for type 1 diabetes from 0 to 19.5% by 5 years of age.
CONCLUSIONS—Risk of childhood diabetes in affected families can be stratified using a combination of genetic and family history markers very early in life.
Diabetes Incidence in 0- to 14-Year Age-Group in Italy
Authors: Carle Flavia , Gesuita Rosaria , Bruno Graziella , Coppa Giovanni V. , Falorni Alberto , Lorini Renata , Martinucci Marco E. , Pozzilli Paolo , Prisco Francesco , Songini Marco , Tenconi Maria T. , Cherubini Valentino ,   for the RIDI Study Group
Published: March 2007

OBJECTIVE—The Registry for Type 1 Diabetes Mellitus in Italy (RIDI) Study Group was established to coordinate the registries of type 1 diabetes in Italy. This report is based on 3,606 children younger than 15 years diagnosed with type 1 diabetes and prospectively registered during 1990–1999 by nine centers, covering &gt;35% of the Italian population.
RESEARCH DESIGN AND METHODS—Registries were pooled in four geographic macro-areas: north, central, south, and insular. The completeness of registration was assessed by the capture-recapture method. Poisson regression analysis was used to evaluate temporal trend in incidence.
RESULTS—Large variations in incidence were confirmed not only between Sardegna and the mainland but also among peninsular areas. In Sardegna, there was an excess of boys (the boy-to-girl incidence ratio was 1.4). The overall incidence showed average increases of 3.6% (P &lt; 0.001) and 3.7% (P &lt; 0.001) per year in peninsular Italy and in Sardegna, respectively. Significant increases in incidence rates were found in boys aged 10–14 years (6.7%, 95% CI 0.5–13.3) and in girls aged 5–9 years (6.6%, 0.5–13.1) living in the southern area. The incidence rate also increased in boys aged 10–14 years (5.0%, 0.3–10) and in girls aged 0–4 years (4.9%, 0.8–9.1) living in Sardegna.
CONCLUSIONS—Italy is a country with large geographical variations in incidence rates of type 1 diabetes. However, the rates are evenly increasing both in the mainland and Sardegna, suggesting that similar environmental factors are operating over populations that have different genetic backgrounds.
Dose-Response Effect of a Single Administration of Oral Hexyl-Insulin Monoconjugate 2 in Healthy Nondiabetic Subjects
Authors: Wajcberg Estela , Miyazaki Yoshinori , Triplitt Curtis , Cersosimo Eugenio , DeFronzo Ralph A. 
Published: March 2007

OBJECTIVE—1) To evaluate the effect of a single oral dose of hexyl-insulin monoconjugate 2 (HIM2) on the rate of whole-body glucose disposal (Rd) and endogenous glucose production (EGP) in healthy nondiabetic subjects, 2) to examine the reproducibility of HIM2 on glucose metabolism, and 3) to compare the results obtained with HIM2 with those using a bioequivalent dose of subcutaneous lispro insulin.
RESEARCH DESIGN AND METHODS—Six healthy subjects ([means ± SE] aged 31 ± 5 years and BMI 23.1 ± 3.9 kg/m2) participated in four studies performed in random order on separate days. Subjects ingested a single dose of HIM2 (0.125, 0.5, and 0.75 mg/kg) or received subcutaneous lispro insulin (0.1 units/kg). Studies were performed with [3-3H]glucose, and plasma glucose concentration was maintained at basal levels for 4 h with the euglycemic clamp technique. After 6 weeks, subjects participated in two repeat studies to examine the reproducibility of HIM2 (0.5 mg/kg) and lispro insulin (0.1 units/kg).
RESULTS—Fasting plasma insulin (7 μU/ml) increased to a maximum of 102, 321, and 561 μU/ml at 60 min after all three HIM2 doses (0.125, 0.5, and 0.75 mg/kg, respectively). A dose-related decrease in basal EGP was observed as the HIM2 dosage was increased from 0 to 0.125 to 0.5 mg/kg (P &lt; 0.05 vs. each preceding dose). Suppression of EGP was similar with the 0.5- and 0.75-mg/kg HIM2 doses. A dose-related stimulation of basal Rd was observed as the HIM2 dosage was increased from 0 to 0.125 to 0.5 (P &lt; 0.05 vs. each preceding dose) to 0.75 mg/kg (P &lt; 0.10 vs. preceding dose). Rd (0–240 min) was increased by 0.5 mg/kg oral HIM2 to a value similar to 0.1 units/kg lispro insulin. The 0.125-mg/kg HIM2 dose reduced EGP (0–240 min) to a value that was similar to 0.1 units/kg lispro insulin. The variability in the effect of HIM2 and lispro on Rd (25 ± 7 vs. 27 ± 1%, respectively) and on suppression of EGP (19 ± 1 vs. 19 ± 0.7%, respectively) was similar.
CONCLUSIONS—Oral HIM2 suppresses EGP and increases tissue Rd in a dose-dependent manner. The effects of HIM2 on EGP and Rd persisted at 240 min, even though plasma insulin concentration had returned to basal levels. Oral HIM2 may provide an effective and reproducible means of controlling postprandial plasma glucose excursions in diabetic patients.
Utility of Casual Postprandial Glucose Levels in Type 2 Diabetes Management
Authors: El-Kebbi Imad M. , Ziemer David C. , Cook Curtiss B. , Gallina Daniel L. , Barnes Catherine S. , Phillips Lawrence S. 
Published: March 2007

OBJECTIVE—Because readily available glycemic indicators are needed to guide clinical decision-making for intensification of diabetes therapy, our goals were to define the relationship between casual postprandial plasma glucose (cPPG) levels and HbA1c in patients with type 2 diabetes and to determine the predictive characteristics of a convenient glucose cutoff.
RESEARCH DESIGN AND METHODS—We examined the relationship between cPPG levels (1–4 h post meal) and HbA1c levels in 1,827 unique patients who had both determinations during a single office visit.
RESULTS—The population studied was predominantly African American and middle-aged, with average cPPG of 201 mg/dl and HbA1c of 8.4%. The prevalence of HbA1c ≥7.0% was 67% and HbA1c &gt;6.5% was 77%. Overall, cPPG and HbA1c were linearly correlated (r = 0.63, P &lt; 0.001). The correlation between cPPG and HbA1c was strongest in patients treated with diet alone (n = 348, r = 0.75, P &lt; 0.001) and weaker but still highly significant for patients treated with oral agents (n = 610, r = 0.64, P &lt; 0.001) or insulin (n = 869, r = 0.56, P &lt; 0.001). A cutoff cPPG &gt;150 mg/dl predicted an HbA1c level ≥7.0% in the whole group, with a sensitivity of 78%, a specificity of 62%, and an 80% positive predictive value. The same cPPG cutoff of 150 mg/dl predicted an HbA1c level &gt;6.5%, with a sensitivity of 74%, a specificity of 66%, and an 88% positive predictive value.
CONCLUSIONS—When rapid-turnaround HbA1c determinations are not available, a single cPPG level &gt;150 mg/dl may be used during a clinic visit to identify most inadequately controlled patients and allow timely intensification of therapy.
Left Ventricular Mass Increases With Deteriorating Glucose Tolerance, Especially in Women: Independence of Increased Arterial Stiffness or Decreased Flow-Mediated Dilation
Authors: Henry Ronald M.A. , Kamp Otto , Kostense Piet J. , Spijkerman Annemieke M.W. , Dekker Jacqueline M. , van Eijck Rosemarie , Nijpels Giel , Heine Robert J. , Bouter Lex M. , Stehouwer Coen D.A. 
Published: March 2007

OBJECTIVE—Type 2 diabetes and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease (CVD) risk. Increased left ventricular mass (LVM) is thought to increase CVD risk through several unfavorable cardiac changes. Type 2 diabetes and IGM are associated with increased LVM, but the underlying mechanism is unclear. We investigated the association between glucose tolerance status (GTS) and LVM and explored whether any such association could be mediated through increased arterial stiffness, impaired endothelial function, or the presence of atherosclerosis.RESEARCH DESIGN AND METHODS—We used ultrasound to measure LVM, carotid and femoral stiffness, carotid-femoral transit time, and flow-mediated vasodilation (FMD) and tonometry to estimate compliance and augmentation index. The study population (n = 780) consisted of 287 individuals with normal glucose metabolism (NGM), 179 with IGM, and 314 with type 2 diabetes, and the mean age was 68.4 years.RESULTS—In women, after adjusting for age, height, BMI, and mean arterial pressure, LVM increased significantly with deteriorating GTS (LVM 157 g in NGM, 155 g in IGM, and 169 g in type 2 diabetes; P for trend &lt;0.018). Additional adjustment for arterial stiffness, FMD, or the presence of atherosclerosis did not materially alter the results, even though these variables were significantly associated with both GTS and LVM. Indexes of hyperglycemia/-insulinemia or insulin resistance explained at most 7% of the association between GTS and LVM. In men, no statistically significant associations were observed.CONCLUSIONS—Our data expand the conceptual view of the pathogenesis of GTS-related changes in LVM because we show that the increase in LVM in women is independent of increased arterial stiffness, impaired FMD, or the presence of atherosclerosis. In addition, we show that this increase in LVM is only minimally explained by indexes of hyperglycemia/-insulinemia or insulin resistance. Our data may, in part, explain the increased CVD risk seen in women with deteriorating GTS.
Impact of Iron Deficiency Anemia on Prevalence of Gestational Diabetes Mellitus
Authors: Lao Terence T. , Ho Lai-Fong 
Published: March 2007

OBJECTIVE—Increased Hb and ferritin have been associated with gestational diabetes mellitus (GDM). This study was performed to determine whether the prevalence of GDM is influenced by iron deficiency anemia.
RESEARCH DESIGN AND METHODS—In a retrospective case-control study, 242 women with iron deficiency anemia (Hb &lt;10 g/dl with features of iron deficiency) were compared with 484 nonanemic women matched for year of birth, who were delivered within the same 24-month period in our hospital, with respect to maternal demographics, infant outcome, and the prevalence of GDM diagnosed according to the World Health Organization criteria.
RESULTS—There was no difference in the prepregnancy weight or BMI, but the anemic group had more multiparas and significantly lower gestational weight and BMI increments and prevalence of GDM (odds ratio [OR] 0.52, 95% CI 0.27–0.97), which was inversely correlated (P = 0.045) with the duration of anemia. To determine the independent effect of anemia on GDM, multiple logistic regression analysis was performed adjusting for the effects of multiparity and BMI, and anemia was confirmed to be significantly associated with decreased prevalence of GDM (adjusted OR 0.46, 95% CI 0.23–0.90).
CONCLUSIONS—The prevalence of GDM is reduced in iron deficiency anemia, which probably served as a surrogate for other factors such as nutritional inadequacy and reduced gestational weight gain. Further studies on the relationship between nutritional improvement and the increasing prevalence of GDM in the developing world are warranted.
Diabetes Care in an Australian Population
Authors: Tapp Robyn J. , Zimmet Paul Z. , Harper C. Alex , de Courten Maximilian P. , Balkau Beverley , McCarty Daniel J. , Taylor Hugh R. , Welborn Timothy A. , Shaw Jonathan E. ,   on behalf of the Australian Diabetes Obesity and Lifestyle Study Group
Published: March 2007

OBJECTIVE—The aim of this work was to study the frequency of examining for diabetic eye and foot complications in an Australian population and to study factors associated with regular screening.
RESEARCH DESIGN AND METHODS—The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) was a population-based study of 11,247 people from randomly selected areas of Australia. Participants identified as having previously diagnosed diabetes (n = 475) were invited to participate in the complications study. Measures included foot examination, retinopathy photography, and self-report use of health care services.
RESULTS—Seventy-seven percent of participants reported having an eye examination within the previous 2 years, and 50% reported having their feet examined by a health professional in the previous year. Type of diabetes treatment (odds ratio 1.46, 95% CI 0.85–2.50 for tablets versus diet alone and 4.17, 1.71–10.17 for insulin or insulin and tablets versus diet alone) and visiting a diabetes nurse educator in the previous 12 months (2.14, 1.18–3.87) were independent predictors of having had an eye examination. Duration of diabetes (1.33, 1.06–1.67 per year) and visiting a diabetes nurse educator in the previous 12 months (1.89, 1.20–2.95) were independent predictors of a foot examination.
CONCLUSIONS—This study has shown that retinopathy screening is performed more frequently than foot screening in Australia. This may be due to the implementation of eye screening programs and awareness campaigns. Foot screening appears to be poor, with less than one-half of the population reporting a regular examination for foot complications. In Australia, diabetes nurse educators play a key role in promoting screening for diabetes complications.
Explanations of Socioeconomic Differences in Excess Risk of Type 2 Diabetes in Swedish Men and Women
Authors: Agardh Emilie E. , Ahlbom Anders , Andersson Tomas , Efendic Suad , Grill Valdemar , Hallqvist Johan , Östenson Claes-Göran 
Published: March 2007

OBJECTIVE—We investigated to what extent socioeconomic differences in type 2 diabetes risk could be explained by established risk factors (obesity, physical inactivity, smoking, and heredity) and psychosocial factors (low decision latitude at work and low sense of coherence).
RESEARCH DESIGN AND METHODS—This cross-sectional study comprised 3,128 healthy Swedish men and 4,821 women, aged 35–56 years, living in the Stockholm area. An oral glucose tolerance test identified 55 men and 52 women with type 2 diabetes. The relative contribution of established and psychosocial factors to socioeconomic differences in diabetes risk was assessed by comparing analyses with adjustment for different sets of these factors.
RESULTS—The relative risks (RRs) for type 2 diabetes in middle and low socioeconomic groups in men were 2.4 (95% CI 1.0–5.3) and 2.9 (1.5–5.7), respectively, and in women 3.2 (1.5–6.6) and 2.7 (1.3–5.9), respectively. In men, the RRs decreased to 1.9 (0.8–4.4) and 2.1 (1.0–4.2) after adjustment for established risk factors; no further change was found when psychosocial factors were included. In women, the RRs changed to 2.4 (1.1–5.2) and 1.6 (0.7–3.8) by including established risk factors and to 2.3 (1.0–5.1) and 1.9 (0.8–4.3) by inclusion of psychosocial factors. After adjustment for both established and psychosocial factors, the RRs were 1.4 (0.6–3.6) and 1.0 (0.4–2.5), respectively.
CONCLUSIONS—In men, the excess risk of type 2 diabetes was partly explained by established risk factors (36–42%), whereas psychosocial factors had no effect. In women, most of the socioeconomic differences in type 2 diabetes were explained by simultaneous adjustment for established risk factors and psychosocial factors (81–100%).
Early Glycemic Control, Age at Onset, and Development of Microvascular Complications in Childhood-Onset Type 1 Diabetes
Authors: Svensson Maria , Eriksson Jan W. , Dahlquist Gisela 
Published: March 2007

OBJECTIVE—The aim of this work was to study the impact of glycemic control (HbA1c) early in disease and age at onset on the occurrence of incipient diabetic nephropathy (MA) and background retinopathy (RP) in childhood-onset type 1 diabetes.
RESEARCH DESIGN AND METHODS—All children, diagnosed at 0–14 years in a geographically defined area in northern Sweden between 1981 and 1992, were identified using the Swedish Childhood Diabetes Registry. From 1981, a nationwide childhood diabetes care program was implemented recommending intensified insulin treatment. HbA1c and urinary albumin excretion were analyzed, and fundus photography was performed regularly. Retrospective data on all 94 patients were retrieved from medical records and laboratory reports.
RESULTS—During the follow-up period, with a mean duration of 12 ± 4 years (range 5–19), 17 patients (18%) developed MA, 45 patients (48%) developed RP, and 52% had either or both complications. A Cox proportional hazard regression, modeling duration to occurrence of MA or RP, showed that glycemic control (reflected by mean HbA1c) during the follow-up was significantly associated with both MA and RP when adjusted for sex, birth weight, age at onset, and tobacco use as potential confounders. Mean HbA1c during the first 5 years of diabetes was a near-significant determinant for development of MA (hazard ratio 1.41, P = 0.083) and a significant determinant of RP (1.32, P = 0.036). The age at onset of diabetes significantly influenced the risk of developing RP (1.11, P = 0.021). Thus, in a Kaplan-Meier analysis, onset of diabetes before the age of 5 years, compared with the age-groups 5–11 and &gt;11 years, showed a longer time to occurrence of RP (P = 0.015), but no clear tendency was seen for MA, perhaps due to lower statistical power.
CONCLUSIONS—Despite modern insulin treatment, &gt;50% of patients with childhood-onset type 1 diabetes developed detectable diabetes complications after ∼12 years of diabetes. Inadequate glycemic control, also during the first 5 years of diabetes, seems to accelerate time to occurrence, whereas a young age at onset of diabetes seems to prolong the time to development of microvascular complications.
Meta-Analysis of the Effect of Diabetes on Restenosis Rates Among Patients Receiving Coronary Angioplasty Stenting
Authors: Gilbert Jeremy , Raboud Janet , Zinman Bernard 
Published: March 2007

OBJECTIVE—Coronary artery disease is a significant source of morbidity and mortality in patients with diabetes. Angioplasty has been associated with higher rates of restenosis in patients with diabetes. Numerous studies have been performed to determine whether coronary artery stenting would be useful in decreasing rates of restenosis of coronary vessels in patients with diabetes. This meta-analysis was conducted to determine the effect of diabetes on angiographic restenosis in patients undergoing coronary stenting.
RESEARCH DESIGN AND METHODS—Six studies were included comprising 6,236 individuals—1,166 with diabetes and 5,070 without. The relationships between restenosis rates and age, the percentage of the study population that was male, and the percentage of the study population receiving insulin therapy were examined.
RESULTS—The average restenosis rates among patients with and without diabetes were 36.7 and 25.9%, respectively. Restenosis rates were higher among older populations and populations in which a greater percentage of patients with diabetes were treated with insulin, but they did not vary according to the percentage of men in the studies. The odds ratio of coronary artery restenosis associated with diabetes was 1.61 (95% CI 1.21–2.14, P = 0.004) in univariate logistic regression models, but decreased to 1.30 (0.99–1.70, P = 0.055) after controlling for age in multivariate models, suggesting that the higher restenosis rates found in patients with diabetes can in good part be explained by the older ages of patients with diabetes in these studies.
CONCLUSIONS—Although diabetes is a risk factor for restenosis after coronary angioplasty stenting, the apparent effect of diabetes on restenosis rates in the published literature is overstated and was reduced in this meta-analysis by approximately half after adjusting for differences in age.
Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes
Authors: Reaven Peter D. , Sacks Jerome ,   Investigators for the Veterans Affairs Cooperative Study of Glycemic Control and Complications in Diabetes Mellitus Type 2
Published: March 2007

OBJECTIVE—To compare lifestyle factors, cardiovascular risk factors, and coronary artery calcium (CAC) and abdominal aortic calcium (AAC) levels in Hispanic and non-Hispanic white (NHW) individuals with type 2 diabetes.
RESEARCH DESIGN AND METHODS—We recently demonstrated in a small group of nonreferred, healthy, nondiabetic subjects that CAC was reduced in Hispanics compared with NHWs, despite a worse cardiovascular risk factor profile. In this study, we evaluated whether this ethnic disparity in vascular calcification was present in individuals with type 2 diabetes and in several different arterial beds. Hispanic and NHW subjects (n = 245) with type 2 diabetes were evaluated for cardiovascular risk factors using questionnaires and assays of plasma biomarkers. CAC and AAC were measured by electron-beam computer-assisted tomography.
RESULTS—Although Hispanics were slightly younger than NHWs, other standard risk factors and novel cardiovascular risk factors, including plasminogen activator-1 and fibrinogen levels, were similar between the groups. Despite the similar risk factor profile, the prevalence of cardiovascular disease (CVD) and mean and median levels of CAC and AAC were lower in Hispanics. Furthermore, the distribution of these calcium scores differed from that of NHWs (P &lt; 0.05), with significantly fewer Hispanic subjects having high CAC or AAC scores. These differences were not explained by differences in CVD prevalence or any measured lifestyle or risk factor.
CONCLUSIONS—Hispanics with type 2 diabetes have reduced CAC and AAC levels compared with NHW subjects, suggesting a reduction in the overall burden of vascular calcification and atherosclerosis. These data are consistent with the notion that Hispanics are protected against the development of CVD.