bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prediction of Major Outcomes of Type 1 Diabetes: a 12-Year Prospective Evaluation of Three Separate Definitions of the Metabolic Syndrome and Their Components and Estimated Glucose Disposal Rate
Authors: Pambianco Georgia , Costacou Tina , Orchard Trevor J. 
Published: April 2007

OBJECTIVE—The metabolic syndrome has been shown to confer an increased risk of cardiovascular disease in both the general and type 2 diabetic populations, but few studies have assessed the metabolic syndrome in type 1 diabetic patients. In a type 1 diabetic cohort, we assessed the prevalence and value of the metabolic syndrome in improving the prediction of major complication outcomes compared with its components and a surrogate measure of insulin resistance, estimated glucose disposal rate (eGDR).
RESEARCH DESIGN AND METHODS—A total of 514 (78%) subjects participating in the Pittsburgh Epidemiology of Diabetes Complications Study with complete 12-year follow-up clinical data were classified by baseline metabolic syndrome status according to three definitions: those of the National Cholesterol Education Program Adult Treatment Panel III (modified by the American Heart Association), the International Diabetes Federation (IDF), and the World Health Organization (WHO). The complication outcomes included coronary artery disease, renal failure, diabetes-related death, and the aggregate of these three major outcomes of diabetes (MOD).
RESULTS—Metabolic syndrome prevalence ranged from 8% (IDF) to 21% (WHO). All definitions showed reasonable specificity (≥83%) for each outcome, while the WHO definition had the highest sensitivity for all outcomes except renal failure, for which eGDR was most sensitive. However, the components of each definition predicted better than the overall syndrome. Microalbuminuria was clearly the strongest predictor of all individual measures, yielding hazard ratios of 9 and 6 for mortality and MOD, respectively.
CONCLUSIONS—Though the three metabolic syndrome classifications predict major complication outcomes in type 1 diabetes, their individual components predict better. Of the variables studied, including HbA1, microalbuminuria appears to be the best single predictor of MOD.
Noninvasive Assessment of Plaque Characteristics With Multislice Computed Tomography Coronary Angiography in Symptomatic Diabetic Patients
Authors: Pundziute Gabija , Schuijf Joanne D. , Jukema J. Wouter , Boersma Eric , Scholte Arthur J.H.A. , Kroft Lucia J.M. , van der Wall Ernst E. , Bax Jeroen J. 
Published: April 2007

OBJECTIVE—Cardiovascular events are high in patients with type 2 diabetes, whereas their risk stratification is more difficult. The higher risk may be related to differences in coronary plaque burden and composition. The purpose of this study was to evaluate whether differences in the extent and composition of coronary plaques in patients with and without diabetes can be observed using multislice computed tomography (MSCT).
RESEARCH DESIGN AND METHODS—MSCT was performed in 215 patients (86 [40%] with type 2 diabetes). The number of diseased coronary segments was determined per patient; each diseased segment was classified as showing obstructive (≥50% luminal narrowing) disease or not. In addition, plaque type (noncalcified, mixed, and calcified) was determined. Plaque characteristics were compared in patients with and without diabetes. Regression analysis was performed to assess the correlation between plaque characteristics and diabetes.
RESULTS—Patients with diabetes showed significantly more diseased coronary segments than nondiabetic patients (4.9 ± 3.5 vs. 3.9 ± 3.2, P = 0.03) with more nonobstructive (3.7 ± 3.0 vs. 2.7 ± 2.4, P = 0.008) plaques. Relatively more noncalcified (28 vs. 19%) and calcified (49 vs. 43%) and less mixed (23 vs. 38%) plaques were observed in patients with diabetes (P &lt; 0.0001). Diabetes correlated with the number of diseased segments and nonobstructive, noncalcified, and calcified plaques.
CONCLUSIONS—Differences in coronary plaque characteristics on MSCT were observed between patients with and without diabetes. Diabetes was associated with higher coronary plaque burden. More noncalcified and calcified plaques and less mixed plaques were observed in diabetic patients. Thus, MSCT may be used to identify differences in coronary plaque burden, which may be useful for risk stratification.
Prandial Insulin Dosing Using Run-to-Run Control
Authors: Palerm Cesar C. , Zisser Howard , Bevier Wendy C. , Jovanovič Lois , Doyle Francis J. 
Published: April 2007

OBJECTIVE—We propose a novel algorithm to adjust prandial insulin dose using sparse blood glucose measurements. The dose is adjusted on the basis of a performance measure for the same meal on the previous day. We determine the best performance measure and tune the algorithm to match the recommendations of experienced physicians.
RESEARCH DESIGN AND METHODS—Eleven subjects with type 1 diabetes, using continuous subcutaneous insulin infusion, were recruited (seven women and four men, aged 21–65 years with A1C of 7.1 ± 1.3%). Basal insulin infusion rates were optimized. Target carbohydrate content for the lunch meal was calculated on the basis of a weight-maintenance diet. Over a period of 2–4 days, subjects were asked to measure their blood glucose according to the algorithm's protocol. Starting with their usual insulin-to-carbohydrate ratio, the insulin bolus dose was titrated downward until postprandial glucose levels were high (180–250 mg/dl [10–14 mmol/l]). Subsequently, physicians made insulin bolus recommendations to normalize postprandial glucose concentrations. Graphical methods were then used to determine the most appropriate performance measure for the algorithm to match the physician's decisions. For the best performance measure, the gain of the controller was determined to be the best match to the dose recommendations of the physicians.
RESULTS—The correlation between the clinically determined dose adjustments and those of the algorithm is R2 = 0.95, P &lt; 1e − 18.
CONCLUSIONS—We have shown how engineering methods can be melded with medical expertise to develop and refine a dosing algorithm. This algorithm has the potential of drastically simplifying the determination of correct insulin-to-carbohydrate ratios.
Masked Hypertension, Urinary Albumin Excretion Rate, and Echocardiographic Parameters in Putatively Normotensive Type 2 Diabetic Patients
Authors: Leitão Cristiane B. , Canani Luís H. , Kramer Caroline K. , Boza Juliana C. , Pinotti Antônio F. , Gross Jorge L. 
Published: April 2007

OBJECTIVE—To evaluate the impact of masked hypertension in normotensive type 2 diabetic patients on microvascular complications and echocardiographic parameters.
RESEARCH DESIGN AND METHODS—A cross-sectional study was conducted in 135 normotensive patients with type 2 diabetes. Patients underwent urinary albumin excretion rate (UAER) measurement, echocardiography, and 24-h ambulatory blood pressure monitoring (ABPM). Patients with increased daytime blood pressure levels (≥135/85 mmHg) were classified as having masked hypertension.
RESULTS—The prevalence of masked hypertension was 30% (n = 41). Normotensive and masked hypertensive subjects, based on ambulatory blood pressure, were not different in terms of age, diabetes duration, smoking status, BMI, waist circumference, serum creatinine, glycemic, or lipid profiles. The office systolic blood pressure was higher in those with masked hypertension (127.8 ± 7.5 vs. 122.9 ± 10.2 mmHg, P = 0.003) than in the normotensive group. UAER also was increased in the group with masked hypertension (21.3 μg/min [range 2.5–1,223.5] vs. 8.1 μg/min [1.0–1,143.0], P = 0.001), as was the interventricular septum (1.01 ± 0.15 vs. 0.94 ± 0.13 cm, P = 0.015) and posterior wall (0.96 ± 0.12 vs. 0.90 ± 0.10 cm, P = 0.006) thickness. After adjustments for diabetes duration, sex, smoking, LDL cholesterol, and A1C values, all associations were sustained for daytime systolic blood pressure but not for office systolic blood pressure.
CONCLUSIONS—Type 2 diabetic patients with masked hypertension have higher UAER as well as enlargement of ventricular walls compared with the normotensive patients, according to ABPM. Therefore, ABPM is important to identify this high-risk group so as to be able to take interventionist measures.
High-Viscosity Hydroxypropylmethylcellulose Blunts Postprandial Glucose and Insulin Responses
Authors: Maki Kevin C. , Carson Michael L. , Miller Marvin P. , Turowski Maciej , Bell Marjorie , Wilder Donna M. , Reeves Matthew S. 
Published: April 2007

OBJECTIVE—High-viscosity hydroxypropylmethylcellulose (HV-HPMC) is a modified cellulose fiber that produces a viscous gel in the gastrointestinal tract. Clinical trials demonstrate that consumption of HV-HPMC significantly lowers cholesterol, but limited information has been available on the influence of HV-HPMC on postprandial insulin and glucose responses. The objective of this investigation was to assess the influence of HV-HPMC on postprandial glucose and insulin responses in overweight and obese men and women.
RESEARCH DESIGN AND METHODS—Participants were 31 overweight or obese men and women without diabetes who underwent three breakfast meal tests in random order, separated by ≥72 h. Test meals containing 75 g carbohydrate plus 4 or 8 g HV-HPMC or control meals containing 8 g cellulose were delivered in a double-blind fashion.
RESULTS—Peak glucose was significantly lower (P &lt; 0.001) after both HV-HPMC–containing meals (7.4 mmol/l [4 g] and 7.4 mmol/l [8 g]) compared with the control meal (8.6 mmol/l). Peak insulin concentrations and the incremental areas for glucose and insulin from 0 to 120 min were also significantly reduced after both HV-HPMC doses versus control (all P &lt; 0.01).
CONCLUSIONS—These findings indicate that HV-HPMC consumption reduces postprandial glucose and insulin excursions, which may favorably alter risks for diabetes and cardiovascular disease.
Adipokines and Risk of Type 2 Diabetes in Older Men
Authors: Wannamethee S. Goya , Lowe Gordon D.O. , Rumley Ann , Cherry Lynne , Whincup Peter H. , Sattar Naveed 
Published: April 2007

OBJECTIVE—The aim was to assess the relationship between adipokines, including interleukin (IL)-6, leptin, and adiponectin, with development of type 2 diabetes and assess the role of obesity and insulin resistance in these relationships.
RESEARCH DESIGN AND METHODS—We conducted a prospective study of 3,599 nondiabetic men aged 60–79 years and followed up for a mean period of 5 years, during which time there were 108 incident cases of type 2 diabetes.
RESULTS—Elevated IL-6, leptin, and low adiponectin were associated with increased risk of type 2 diabetes even after adjustment for BMI, lifestyle factors, preexisting cardiovascular disease, and systolic blood pressure. The relative risks (RRs) (top vs. bottom third) were 2.02 (95% CI 1.14–3.58) for IL-6, 1.91 (0.97–3.76) for leptin, and 0.40 (0.23–0.70) for adiponectin. Further adjustment for insulin resistance made minor differences to the IL-6 diabetes relationship (adjusted RR 2.12 [1.18–3.81]), weakened the associations with adiponectin (0.59 [0.33–1.04]), and abolished the association between leptin and diabetes (1.12 [0.55–2.26]). The inverse relation between low adiponectin and diabetes was significantly stronger in men who were obese (waist circumference &gt;102 cm or BMI ≥30 kg/m2) (0.30 [0.11–0.79]) relative to leaner men (0.93 [0.44–1.96]) (test for interaction P = 0.04).
CONCLUSIONS—The association between leptin and incident diabetes is mediated by insulin resistance. By contrast, the positive association between IL-6 and diabetes appeared to be independent of obesity and insulin resistance. Finally, the association between low adiponectin and increased risk of diabetes appears to be significantly stronger in obese men than in leaner counterparts.
Impact of Insulin Resistance on Risk of Type 2 Diabetes and Cardiovascular Disease in People With Metabolic Syndrome
Authors: Meigs James B. , Rutter Martin K. , Sullivan Lisa M. , Fox Caroline S. , D'Agostino Ralph B. , Wilson Peter W.F. 
Published: April 2007

OBJECTIVE—Metabolic syndrome increases the risk for type 2 diabetes and cardiovascular disease (CVD) and may be associated with insulin resistance.
RESEARCH DESIGN AND METHODS—We tested the hypothesis that the metabolic syndrome confers risk with or without concomitant insulin resistance among 2,803 Framingham Offspring Study subjects followed up to 11 years for new diabetes (135 cases) or CVD (240 cases). We classified subjects by presence of metabolic syndrome (using the National Cholesterol Education Program's [NCEPs] Third Adult Treatment Panel [ATP III], International Diabetes Federation [IDF], or European Group for the Study of Insulin Resistance [EGIR] criteria) and insulin resistance (homeostasis model assessment of insulin resistance ≥75th percentile) and used separate risk factor–adjusted proportional hazards models to estimate relative risks (RRs) for diabetes or CVD using as referents those without insulin resistance, metabolic syndrome, or without both.
RESULTS—Fifty-six percent of individuals with ATP III, 52% with IDF, and 100% with EGIR definitions of metabolic syndrome had insulin resistance. Insulin resistance increased risk for diabetes (RR 2.6 [95% CI 1.7–4.0]) and CVD (1.8 [1.4–2.3]) as did metabolic syndrome for diabetes (ATP III, 3.5 [2.2–5.6]; IDF, 4.6 [2.7–7.7]; and EGIR, 3.3 [2.1–5.1]) and CVD (ATP III, 1.8 [1.4–2.3]; IDF, 1.7 [1.3–2.3]; and EGIR, 2.1 [1.6–2.7]). Relative to those without either metabolic syndrome or insulin resistance, metabolic syndrome and insulin resistance increased risk for diabetes (ATP III, 6.0 [3.3–10.8] and IDF, 6.9 [3.7–13.0]) and CVD (ATP III, 2.3 [1.7–3.1] and IDF, 2.2 [1.6–3.0]). Any instance of metabolic syndrome without insulin resistance increased risk for diabetes approximately threefold (P &lt; 0.001); IDF metabolic syndrome without insulin resistance (RR 1.6, P = 0.01), but not ATP III metabolic syndrome without insulin resistance (RR 1.3, P = 0.2), increased risk for CVD.
CONCLUSIONS—Metabolic syndrome increased risk for diabetes regardless of insulin resistance. Metabolic syndrome by ATP III criteria may require insulin resistance to increase risk for CVD. The simultaneous presence of metabolic syndrome and insulin resistance identifies an especially high-risk individual.
Recurrence of Gestational Diabetes Mellitus
Authors: Kim Catherine , Berger Diana K. , Chamany Shadi 
Published: April 2007

OBJECTIVE—The purpose of this study was to examine rates and factors associated with recurrence of gestational diabetes mellitus (GDM) among women with a history of GDM.
RESEARCH DESIGN AND METHODS—We conducted a systematic literature review of articles published between January 1965 and November 2006, in which recurrence rates of GDM among women with a history of GDM were reported. Factors abstracted included recurrence rates, time elapsed between pregnancies, race/ethnicity, diagnostic criteria, and, when available, maternal age, parity, weight or BMI at the initial and subsequent pregnancy, weight gain at the initial or subsequent pregnancy and between pregnancies, insulin use, gestational age at diagnosis, glucose tolerance test levels, baby birth weight and presence of macrosomia, and breast-feeding.
RESULTS—Of 45 articles identified, 13 studies were eligible for inclusion. After the index pregnancy, recurrence rates varied between 30 and 84%. Lower rates were found in non-Hispanic white (NHW) populations (30–37%), and higher rates were found in minority populations (52–69%). Exceptions to observed racial/ethnic variations in recurrence were found in cohorts that were composed of a significant proportion of both NHW and minority women or that included women who had subsequent pregnancies within 1 year. No other risk factors were consistently associated with recurrence of GDM across studies. The rates of future preexisting diabetes in pregnancy, socioeconomic status, postpartum diabetes screening rates after the index pregnancy, and the average length of time between pregnancies were generally not reported.
CONCLUSIONS—Recurrence of GDM was common and may vary most significantly by NHW versus minority race/ethnicity.
Incidence of Coronary Heart Disease in Type 2 Diabetic Men and Women
Authors: Avogaro Angelo , Giorda Carlo , Maggini Marina , Mannucci Edoardo , Raschetti Roberto , Lombardo Flavia , Spila-Alegiani Stefania , Turco Salvatore , Velussi Mario , Ferrannini Ele ,   for the Diabetes and Informatics Study Group, Association of Clinical Diabetologists, Istituto Superiore di Sanità
Published: April 2007

OBJECTIVE—Cardiovascular disease (CVD) is the main cause of morbidity/mortality in diabetes. We set forth to determine incidence and identify predictors (including microvascular complications and treatment) of first coronary heart disease (CHD) event in CVD-free type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—A cohort of 6,032 women and 5,612 men, sampled from a nationwide network of hospital-based diabetes clinics, was followed up for 4 years. Baseline assessment included retinopathy, nephropathy, and foot ulcers. First CHD events (myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, and electrocardiogram-proven angina) were analyzed for 29,069 person-years.
RESULTS—The age-standardized incidence rate (per 1,000 person-years) of first CHD event (n = 881) was 28.8 (95% CI 5.4–32.2) in men and 23.3 (20.2–26.4) in women. Major CHD (myocardial infarction, coronary artery bypass grafting, and percutaneous transluminal coronary angioplasty) was less frequent in women (5.8 [4.3–7.2]) than in men (13.1 [10.9–15.4]; a sex ratio of 0.5 [0.4–0.6]). Incidence rates of all outcomes were higher in patients with microvascular complications (for major CHD, age-adjusted rate ratios were 1.6 [1.2–2.21] in men and 1.5 [1.0–2.2] in women). By multivariate Cox analysis, age and diabetes duration were risk predictors common in both sexes. In men, glycemic control and treated hypertension were additional independent risk factors, but residing in the south was associated with a significant 29% risk reduction. In women, higher triglycerides/lower HDL cholesterol and microvascular complications were independent risk factors.
CONCLUSIONS—In CVD-free patients with type 2 diabetes, risk of first CHD event depends on sex, geographic location, and presence of microvascular disease. Hyperglycemia and hypertension, particularly in men, and diabetic dyslipidemia, especially in women, are risk factors amenable to more aggressive treatment.
Ultrastructural and cytochemical studies on vitellogenesis in the trypanorhynch cestode Parachristianella trygonis Dollfus, 1946 (Eutetrarhynchidae)
Authors: Świderski Zdzisław , Miquel Jordi , Neifar Lassad , Mackiewicz John 
Published: April 2007

AbstractDuring vitellogenesis in Parachristianella trygonis Trypanorhyncha, Eutetrarhynchidae) we distinguished four stages: (1) gonial or stem cell stage; (2) early differentiation stage concentrated on protein synthetic activity and shell-globule formation; (3) advanced differentiation stage with main cell activity concentrated on carbohydrate synthesis (glycogenesis) and massive glycogen storage in the form of α-glycogen rosettes and β-glycogen particles; and finally (4) mature vitellocyte stage. Early vitellocyte maturation is characterised by: (1) an increase in cell volume; (2) extensive development of large, parallel cisternae of GER that produce proteinaceous granules; (3) development of Golgi complexes engaged in packaging this material; (4) continuous enlargement of proteinaceous granules within vacuoles and their transformation into shell-globule clusters composed of heterogeneous material. Cytochemical staining with periodic acid-thiosemicarbazide-silver proteinate for polysaccharides indicated a strongly positive reaction for the presence of α-glycogen rosettes and β-glycogen particles in the advanced stage of vitellocyte maturation. Both protein synthesis for shell-globule formation and carbohydrate synthesis or glycogenesis, important storage of nutritive reserves for the developing embryos, observed during cytodifferentiation of P. trygonis vitellocytes overlap in time to some extent. Mature vitelline cells are very rich in three types of cell inclusions accumulated in large amounts in their cytoplasm: (1) shell-globule clusters, playing an important role in egg-shell formation; (2) numerous large lipid droplets, as well as a high accumulation of lipid and α-glycogen rosettes and β-glycogen particles that undoubtedly represent important nutritive reserves for the developing embryos. Despite the fact that the type of vitellogenesis and ultrastructure of the mature vitellocyte in P. trygonis appears to differ to some extent from those of three other trypanorhynch species, its general pattern and ultrastructure greatly resembles those observed in other lower cestodes. Factors that may have contributed to the qualitative and quantitative variation in lipids during vitellogenesis among the four species of Trypanorhyncha, are identified and discussed.
Surface‐Engineered Nanocontainers for Entrapment of Corrosion Inhibitors
Authors: Shchukin D. G. , Möhwald H. 
Published: April 2007

AbstractThe release properties and reloading ability of polyelectrolyte‐modified halloysite nanotubes, polyelectrolyte‐modified SiO2nanoparticles, and polyelectrolyte capsules are studied. Three containers are distinguished by keeping the low‐molecular‐weight corrosion inhibitor benzotriazole in a hollow lumen inside or within the polyelectrolyte matrix and allowing release in either one direction or into all space dimensions. Polyelectrolyte shells, which modify the outer surface of the nanocontainers, are fabricated by using layer‐by‐layer assembly of poly(diallyldimethylammonium chloride)/poly(styrene sulfonate), poly(allylamine hydrochloride)/poly(styrene sulfonate), and poly(allylamine hydrochloride)/poly(methacrylic acid) polyelectrolyte bilayers. All nanocontainers reveal an increase of the benzotriazole release in aqueous solution at alkaline or acidic pH. The highest reloading efficiency (up to 80 %) is observed for halloysite‐based nanocontainers; however, after five reloading cycles the efficiency decreases to 20 %. The application of appropriate nanocontainers depends on the demands required from feedback‐active anticorrosion coatings. For coatings where the immediate release of the inhibitor is necessary, SiO2‐based or halloysite‐based nanocontainers with a shell consisting of weak polyelectrolytes are preferable. When continuous, gradual release is required, halloysite‐based nanocontainers with a shell consisting of one weak and one or two strong polyelectrolytes are preferable.