bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of Insulin Resistance Indexes in a Stable Renal Transplant Population
Authors: Oterdoom Leendert H. , de Vries Aiko P.J. , van Son Willem J. , van der Heide Jaap J. Homan , Ploeg Rutger J. , Gansevoort Ron T. , de Jong Paul E. , Gans Rijk O.B. , Bakker Stephan J.L. 
Published: March 2007

OBJECTIVE—The purpose of this study was to investigate the validity of established insulin resistance indexes, based on fasting blood parameters, in a stable renal transplant population.
RESEARCH DESIGN AND METHODS—Fasting insulin, homeostasis model assessment (HOMA), the quantitative insulin sensitivity check index (QUICKI), and McAuley’s index were assessed for correlation and agreement with whole-body glucose uptake (M value) divided by prevailing serum insulin concentrations (I value) assessed during a hyperinsulinemic-euglycemic clamp in 51 stable renal transplant recipients, who were at a median of 7.5 years after transplant. Multivariate linear regression analyses were used to determine independent risk factors for insulin resistance.
RESULTS—The M/I value correlated with fasting insulin concentration (r = −0.56), HOMA (r = −0.53), QUICKI (r = 0.52), and McAuley’s index (r = 0.61) (all P &lt; 0.01). Linear regression showed agreement between all indexes and insulin resistance. However, McAuley’s index showed the strongest agreement irrespective of age, sex, renal allograft function, and obesity. In multivariate analysis, fasting insulin concentration (β = −0.59, P = 0.002), fasting triglyceride concentration (β = −0.33, P = 0.04), and BMI (β = −1.22, P = 0.05) were independently associated with the M/I value.
CONCLUSIONS—All investigated insulin resistance indexes were valid estimates of insulin resistance in the long-term stable renal transplant population. However, correlation and agreement were strongest for McAuley’s index. In addition to fasting insulin and triglyceride concentrations, of which McAuley’s index is composed, only BMI seemed to be independently associated with insulin resistance in this population.
A Prevalent Amino Acid Polymorphism at Codon 98 (Ala98Val) of the Hepatocyte Nuclear Factor-1α Is Associated With Maturity-Onset Diabetes of the Young and Younger Age at Onset of Type 2 Diabetes in Asian Indians
Authors: Anuradha Shekher , Radha Venkatesan , Deepa Raj , Hansen Torben , Carstensen Bendix , Pedersen Oluf , Mohan Viswanathan 
Published: March 2007

OBJECTIVE—Among Europeans, mutations in the hepatocyte nuclear factor-1α (HNF1α) gene are associated with the most common form of maturity-onset diabetes of the young (MODY)3. In Asian Indians, type 2 diabetes occurs earlier and often overlaps with MODY, but the genetics of the latter are unknown. The aim of this study was to estimate the prevalence of Ala98Val polymorphism of the HNF1α gene in different types of diabetes in Asian Indians.
RESEARCH DESIGN AND METHODS—Genotyping of Ala98Val was done by the PCR–restriction fragment–length polymorphism method in the following groups: 1) MODY, defined as non–insulin-dependent diabetes (age at onset &lt;25 years) and vertical transmission of diabetes through at least three generations (n = 122); 2) very-early-onset type 2 diabetes (age at onset &lt;25 years) without family history (n = 23); 3) early-onset type 2 diabetes (age at onset between 26 and 40 years, n = 171); 4) late-onset type 2 diabetes (age at onset &gt;40 years, n = 133); 5) type 1 diabetes (n = 150); and 6) normal glucose tolerance (n = 130). The frequency of the Val genotypes was compared in the diabetic and control groups.
RESULTS—The frequency of the Val allele was significantly higher in MODY patients (P = 0.0013) compared with control groups. Furthermore, in the total group of patients with type 2–like diabetes (groups 1–4), the Val allele was associated with an earlier diagnosis of diabetes (P = 0.0002).
CONCLUSIONS—Among Asian Indians, the Ala98Val polymorphism of HNF1α gene is associated with MODY and with earlier age at onset of type 2 diabetes.
The Influence of Age, Duration of Diabetes, Cataract, and Pupil Size on Image Quality in Digital Photographic Retinal Screening
Authors: Scanlon Peter Henry , Foy Chris , Malhotra Raman , Aldington Stephen J. 
Published: March 2007

OBJECTIVE—To evaluate the effect of age, duration of diabetes, cataract, and pupil size on the image quality in digital photographic screening.
RESEARCH DESIGN AND METHODS—Randomized groups of 3,650 patients had one-field, nonmydriatic, 45° digital retinal imaging photography before mydriatic two-field photography. A total of 1,549 patients were then examined by an experienced ophthalmologist. Outcome measures were ungradable image rates, age, duration of diabetes, detection of referable diabetic retinopathy, presence of early or obvious central cataract, pupil diameter, and iris color.
RESULTS—The ungradable image rate for nonmydriatic photography was 19.7% (95% CI 18.4–21.0) and for mydriatic photography was 3.7% (3.1–4.3). The odds of having one eye ungradable increased by 2.6% (1.6–3.7) for each extra year since diagnosis for nonmydriatic, by 4.1% (2.7–5.7) for mydriatic photography irrespective of age, by 5.8% (5.0–6.7) for nonmydriatic, and by 8.4% (6.5–10.4) for mydriatic photography for every extra year of age, irrespective of years since diagnosis. Obvious central cataract was present in 57% of ungradable mydriatic photographs, early cataract in 21%, no cataract in 9%, and 13% had other pathologies. The pupil diameter in the ungradable eyes showed a significant trend (P &lt; 0.001) in the three groups (obvious cataract 4.434, early cataract 3.379, and no cataract 2.750).
CONCLUSIONS—The strongest predictor of ungradable image rates, both for nonmydriatic and mydriatic digital photography, is the age of the person with diabetes. The most common cause of ungradable images was obvious central cataract.
The Prevalence of the Metabolic Syndrome Did Not Increase in Mexico City Between 1990–1992 and 1997–1999 Despite More Central Obesity
Authors: Lorenzo Carlos , Williams Ken , Gonzalez-Villalpando Clicerio , Haffner Steven M. 
Published: March 2007

OBJECTIVE—Trends in the metabolic syndrome might follow trends in obesity. We examined this hypothesis in the Mexico City Diabetes Study (MCDS), a study that showed rising trends in obesity, and the effect of the metabolic syndrome on the risk of coronary heart disease (CHD).
RESEARCH DESIGN AND METHODS—Designed as a population-based study, the MCDS enrolled subjects in 1990–1992 (n = 2,282). Follow-up visits were held in 1993–1995 (n = 1,764) and 1997–1999 (n = 1,754). We used the revised metabolic syndrome definition of the National Cholesterol Education Program and the Framingham equations to estimate the 10-year CHD risk.
RESULTS—In men, the age-adjusted prevalence of the metabolic syndrome was 38.9% in 1990–1992, 43.4% in 1993–1995, and 39.9% in 1997–1999; in women, the prevalences were 65.4, 65.7, and 59.9%, respectively. The prevalence did not change in men (P = 0.349) between 1990–1992 and 1997–1999, but decreased in women (P &lt; 0.001). A prevalence increase was demonstrated for elevated waist circumference (men, P &lt; 0.001; women, P &lt; 0.050), elevated fasting glucose value (men and women, P &lt; 0.001), and low HDL cholesterol level (men, P &lt; 0.050; women, P &lt; 0.010); a prevalence decrease was seen for high blood pressure (men and women, P &lt; 0.001) and hypertriglyceridemia (men, P &lt; 0.001; women, P &lt; 0.010). CHD risk decreased marginally in men (P &lt; 0.050) but did not change in women (P = 0.943).
CONCLUSIONS—Neither the prevalence of the metabolic syndrome nor CHD risk has increased in Mexico City. Lower blood pressure and triglyceride values appear to have counteracted increases in central obesity and fasting glucose.
High Plasma Level of Remnant-Like Particle Cholesterol in the Metabolic Syndrome
Authors: Satoh Akira , Adachi Hisashi , Tsuruta Makoto , Hirai Yuji , Hiratsuka Akiko , Enomoto Mika , Furuki Kumiko , Hino Asuka , Takeuchi Tomohiro , Imaizumi Tsutomu 
Published: March 2007

OBJECTIVE—The metabolic syndrome is associated with a high incidence of cardiovascular disease even when the abnormalities present in the syndrome are mild. The underlying mechanism of the metabolic syndrome has not been elucidated. We investigated whether a strong atherogenic lipoprotein, remnant-like particle (RLP) lipoprotein cholesterol, is elevated in the metabolic syndrome.
RESEARCH DESIGN AND METHODS—We performed a health examination among the residents of a rural community in Japan. Complete datasets, including fasting RLP cholesterol levels, were obtained in 1,261 subjects (509 men and 752 women) without diabetes and who were not taking lipid-lowering drugs. The subjects’ medical history, use of alcohol, and smoking habits were ascertained by a questionnaire.
RESULTS—All of the components of the metabolic syndrome were significantly related to RLP cholesterol by univariate analysis. Total cholesterol and smoking habits were also positively associated with RLP cholesterol. The subjects with the metabolic syndrome showed only mild abnormalities of each component. When RLP cholesterol levels were stratified by the number of the components of the metabolic syndrome, there was a strong association between RLP cholesterol levels and the number of components (P &lt; 0.001 and F = 72.7).
CONCLUSIONS—RLP cholesterol levels are elevated in the metabolic syndrome, and this elevation may underlie the high incidence of cardiovascular disease in the metabolic syndrome.
Restless Legs Syndrome and Quality of Sleep in Type 2 Diabetes
Authors: Lopes Lívia A. , Lins Camila de M.M. , Adeodato Vanessa G. , Quental Diana P. , de Bruin Pedro F.C. , Montenegro Renan M. , de Bruin Veralice M.S. 
Published: March 2007

OBJECTIVE—To investigate the presence of restless legs syndrome (RLS) and the quality of sleep in a population of type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—The study population was composed of 100 consecutive patients regularly attending a diabetes clinic at the University Hospital of the Federal University of Ceará. The subjects’ quality of sleep was assessed by the Pittsburgh Sleep Quality Index, and excessive daytime sleepiness (EDS) was measured by the Epworth Sleepiness Scale. The RLS was diagnosed using the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Other relevant clinical and laboratory parameters were obtained by interview and chart review.
RESULTS—RLS was found in 27% of patients. Poor sleep quality was present in 45% of cases and was associated with age (P = 0.04), peripheral neuropathy (P = 0.001), and RLS (P = 0.000). EDS was found in 26% of patients. Logistic regression analysis revealed an association between RLS and peripheral neuropathy (odds ratio 12.85 [95% CI 2.83–58.40], P = 0.001).
CONCLUSIONS—RLS is common in type 2 diabetic patients and can be a major cause of sleep disruption in these patients.
The Effect of Ruboxistaurin on Nephropathy in Type 2 Diabetes
Authors: Tuttle Katherine R. , Bakris George L. , Toto Robert D. , McGill Janet B. , Hu Kuolung , Anderson Pamela W. 
Published: March 2007

OBJECTIVE—Ruboxistaurin selectively inhibits protein kinase C-β and ameliorates kidney disease in animal models of diabetes. The purpose of this study was to evaluate the effects of ruboxistaurin on diabetic nephropathy in humans.
RESEARCH DESIGN AND METHODS—A randomized, double-blind, placebo-controlled, multicenter, pilot study was performed to evaluate the effects of 32 mg/day ruboxistaurin for 1 year in persons (n = 123) with type 2 diabetes and persistent albuminuria (albumin-to-creatinine ratio [ACR] 200-2,000 mg/g), despite therapy with renin-angiotensin system inhibitors. The primary end point was a change in the ACR. Estimated glomerular filtration rate (eGFR) (four-component equation from the Modification of Diet in Renal Disease study) was also calculated.
RESULTS—At baseline, urinary ACR was 764 ± 427 mg/g (means ± SD), and eGFR was 70 ± 24 ml/min per 1.73 m2. Systolic and diastolic blood pressures were 135 ± 14 and 75 ± 9 mmHg, respectively. HbA1c was 8.0 ± 1.2%. After 1 year, urinary ACR decreased significantly (−24 ± 9%) in participants treated with ruboxistaurin (P = 0.020) and nonsignificantly (−9 ± 11%) in the placebo group (P = 0.430). The ACR-lowering effect of ruboxistaurin appeared by 1 month. eGFR did not decline significantly in the ruboxistaurin group (−2.5 ± 1.9 ml/min per 1.73 m2) (P = 0.185), whereas the placebo group lost significant eGFR over 1 year (−4.8 ± 1.8 ml/min per 1.73 m2) (P = 0.009). Between-group differences for changes in ACR and eGFR were not statistically significant, but this pilot study was underpowered to determine such differences.
CONCLUSIONS—In persons with type 2 diabetes and nephropathy, treatment with ruboxistaurin reduced albuminuria and maintained eGFR over 1 year. Ruboxistaurin may add benefit to established therapies for diabetic nephropathy.
Laparoscopic Gastric Banding Prevents Type 2 Diabetes and Arterial Hypertension and Induces Their Remission in Morbid Obesity
Authors: Pontiroli Antonio E. , Folli Franco , Paganelli Michele , Micheletto Giancarlo , Pizzocri Pierluigi , Vedani Paola , Luisi Francesca , Perego Lucia , Morabito Alberto , Bressani Doldi Santo 
Published: March 2007

OBJECTIVE—Lifestyle modifications and pharmacological interventions can prevent type 2 diabetes in obese subjects with impaired glucose tolerance. The aim of this study was to compare laparoscopic adjustable gastric banding (LAGB) and conventional diet (No-LAGB) in the prevention (primary intervention study; 56 vs. 29 patients) and remission (secondary intervention study; 17 vs. 20 patients) of type 2 diabetes and hypertension in grade 3 obesity in a 4-year study.
RESEARCH DESIGN AND METHODS—The subjects (n = 122; age 48.5 ± 1.05 years; BMI 45.7 ± 0.67 kg/m2) underwent a diagnostic workup, including psychological and psychiatric assessments, in preparation for the LAGB procedure. Of the 122 subjects, 73 had the surgery (LAGB group). The control group (No-LAGB group) consisted of the 49 subjects who refused the surgery but agreed to be followed up; 6 of these subjects dropped out by the 2nd year of the study, so that the final number of patients was 73 and 43 in the LAGB and No-LAGB groups, respectively. All patients had a yearly visit and oral glucose tolerance test.
RESULTS—From baseline to the end of the 4-year follow-up, BMI decreased from 45.9 ± 0.89 at baseline to 37.7 ± 0.71 kg/m2 in the LAGB group and remained steady in the No-LAGB group (from 45.2 ± 1.04 to 46.5 ± 1.37 kg/m2), with no significant differences between the primary and secondary intervention groups. In the primary intervention study, five of the No-LAGB subjects (17.2%) and none of the LAGB subjects (0.0%; P = 0.0001) progressed to type 2 diabetes; in the secondary intervention study, type 2 diabetes remitted in one No-LAGB patient (4.0%) and seven LAGB patients (45.0%; P = 0.0052). Hypertension occurred in 11 No-LAGB patients (25.6%) and 1 LAGB patient (1.4%; P = 0.0001) and remitted in 1 No-LAGB (2.3%) and 15 LAGB patients (20.5%; P = 0.0001). A study of body mass composition revealed a significant reduction of fat mass and a transitory, but not significant, decrease of fat-free mass in LAGB patients.
CONCLUSIONS—In morbid obesity, sustained and long-lasting weight loss obtained through LAGB prevents the occurrence of type 2 diabetes and hypertension and decreases the prevalence of these disorders.
Relative Risk of Mortality Associated With Diabetes as a Function of Birth Weight
Authors: Leibson Cynthia L. , Burke James P. , Ransom Jeanine E. , Forsgren Jessica , Melton Joseph , Bailey Kent R. , Palumbo Pasquale J. 
Published: March 2007

OBJECTIVE—Birth weight is a risk factor for both diabetes and mortality. Diabetes is a risk factor for mortality. Whether the excess mortality observed for diabetes varies with birth weight is unclear.
RESEARCH DESIGN AND METHODS—Among all 2,508 Rochester, Minnesota, residents who first met research criteria for adult-onset diabetes in 1960–1995, 171 were born locally in-hospital after 1922 (i.e., birth weights available) as singleton, term infants. Each case subject and two age- and sex-matched nondiabetic control subjects (born locally, residing locally when the case subject met the criteria for diabetes) were followed through 31 December 2000 for vital status.
RESULTS—Of the diabetic case subjects, 16% (27 of 171) died vs. 7% (25 of 342) of control subjects (P = 0.004). The difference was less for normal-birth-weight (NBW) (2,948–&lt;3,856 g) individuals (12% [12 of 102] vs. 8% [20 of 246], P = 0.31) than for abnormal-birth-weight individuals (low birth weight [LBW] 20% [8 of 39] vs. 2% [1 of 46], P = 0.01; high birth weight [HBW] 23% [7 of 30] vs. 8% [4 of 50], P = 0.16), as confirmed with age- and sex-adjusted Cox proportional hazards (diabetes-associated hazard ratio 1.4 [95% CI 0.69–2.90] for NBW vs. 4.8 [1.7–13.3] for abnormal birth weight, test for interaction P = 0.056). The observed diabetes deaths were greater than expected, based on mortality for the general population (27 vs. 13.3, P &lt; 0.001), with 70% of excess deaths occurring among LBW (8 vs. 2.2, P &lt; 0.001) and HBW (7 vs. 3.1, P = 0.03) individuals.
CONCLUSIONS—The excess mortality observed for diabetes appears disproportionately concentrated among abnormal-birth-weight individuals, thus identifying a subset of at-risk diabetic individuals and reinforcing the importance of NBW deliveries.
Rosiglitazone Improves Exercise Capacity in Individuals With Type 2 Diabetes
Authors: Regensteiner Judith G. , Bauer Timothy A. , Reusch Jane E.B. 
Published: March 2007

OBJECTIVE—Although exercise is recommended as a cornerstone of treatment for type 2 diabetes, it is often poorly adopted by patients. We have noted that even in the absence of apparent cardiovascular disease, persons with type 2 diabetes have an impaired ability to carry out maximal exercise, and the impairment is correlated with insulin resistance and endothelial dysfunction. We hypothesized that administration of a thiazolidinedione (TZD) agent would improve exercise capacity in type 2 diabetes.
RESEARCH DESIGN AND METHODS—Twenty participants with uncomplicated type 2 diabetes were randomly assigned in a double-blind study to receive either 4 mg/day of rosiglitazone or matching placebo after baseline measurements to assess endothelial function (brachial artery diameter by brachial ultrasound), maximal oxygen consumption ([Vdot]o2max), oxygen uptake ([Vdot]o2) kinetics, and insulin sensitivity by hyperinsulinemic-euglycemic clamp. Measurements were reassessed after 4 months of treatment.
RESULTS—Participant groups did not differ at baseline in any measure. Rosiglitazone-treated participants (n = 10) had significantly improved [Vdot]o2max (19.8 ± 5.3 ml · kg−1 · min−1 before rosiglitazone vs. 21.2 ± 5.1 ml · kg−1 · min−1 after rosiglitazone, P &lt; 0.01), insulin sensitivity, and endothelial function. A change in [Vdot]o2max correlated with improved insulin sensitivity measured by clamp (r = 0.68, P &lt; 0.05) and with improved brachial artery diameter (r = 0.70, P &lt; 0.05). Placebo-treated participants (n = 10) showed no changes in [Vdot]o2max (19.4 ± 5.2 ml · kg−1 · min−1 before rosiglitazone vs. 18.1 ± 5.3 ml · kg−1 · min−1 after rosiglitazone, NS) or brachial artery diameter.
CONCLUSIONS—This is the first known report showing that a TZD improved exercise function in type 2 diabetes. Whether this is due to the observed improvements in insulin sensitivity and/or endothelial function or to another action of the TZD class requires further exploration.
Hepatic Enzymes, the Metabolic Syndrome, and the Risk of Type 2 Diabetes in Older Men
Authors: Wannamethee Sasiwarang Goya , Shaper Andrew Gerald , Lennon Lucy , Whincup Peter H. 
Published: March 2007

OBJECTIVE—We have examined the relationship between hepatic enzymes, the metabolic syndrome, insulin resistance, and type 2 diabetes and assessed the potential of hepatic enzyme measurements in determining diabetes risk.
RESEARCH DESIGN AND METHODS—We conducted a prospective study of 3,500 nondiabetic men aged 60–79 years who were followed-up for a mean period of 5 years and in whom there were 100 incident type 2 diabetes cases.
RESULTS—In cross-sectional analyses, alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) were strongly associated with obesity, insulin resistance, and the metabolic syndrome. Prospectively, the risk of type 2 diabetes significantly increased with increasing levels of ALT and GGT even after adjustment for confounders including BMI (top versus bottom quarter ALT: relative risk 2.72 [95% CI 1.47–5.02]; GGT: 3.68 [1.68–8.04]). Additional adjustment for insulin resistance attenuated the effects, but the relationships with ALT and GGT remained significant (1.91 [1.01–3.60] and 2.69 [1.21–5.97], respectively). Further adjustment for inflammatory markers (C-reactive protein) made minor differences. Among high-risk subjects (obese men or those with the metabolic syndrome), elevated GGT and ALT enhanced the prediction of diabetes risk.
CONCLUSIONS— Elevated levels of ALT and GGT within the normal range are independent predictors of type 2 diabetes in older men and are useful additional measures in identifying those at high risk of diabetes.
Comparison of Basal Insulin Added to Oral Agents Versus Twice-Daily Premixed Insulin as Initial Insulin Therapy for Type 2 Diabetes
Authors: Janka Hans U. , Plewe Gerd , Riddle Matthew C. , Kliebe-Frisch Christine , Schweitzer Matthias A. , Yki-Järvinen Hannele 
Published: March 2007

OBJECTIVE—To compare the efficacy and safety of adding once-daily basal insulin versus switching to twice-daily premixed insulin in type 2 diabetic patients insufficiently controlled by oral antidiabetic agents (OADs).
RESEARCH DESIGN AND METHODS—In a 24-week, multinational, multicenter, open, parallel group clinical trial, 371 insulin-naïve patients with poor glycemic control (fasting blood glucose [FBG] ≥120 mg/dl, HbA1c 7.5–10.5%) on OADs (sulfonylurea plus metformin) were randomized to once-daily morning insulin glargine plus glimepiride and metformin (glargine plus OAD) or to 30% regular/70% human NPH insulin (70/30) twice daily without OADs. Insulin dosage was titrated to target FBG ≤100 mg/dl (both insulins) and predinner blood glucose ≤100 mg/dl (70/30 only) using a weekly forced-titration algorithm.
RESULTS—Mean HbA1c decrease from baseline was significantly more pronounced (−1.64 vs. −1.31%, P = 0.0003), and more patients reached HbA1c ≤7.0% without confirmed nocturnal hypoglycemia (45.5 vs. 28.6%, P = 0.0013) with glargine plus OAD than with 70/30. Similarly, FBG decrease was greater with glargine plus OAD (adjusted mean difference −17 mg/dl [–0.9 mmol/l], P &lt; 0.0001), and more patients reached target FBG ≤100 mg/dl with glargine plus OAD than with 70/30 (31.6 vs. 15.0%, P = 0.0001). Glargine plus OAD patients had fewer confirmed hypoglycemic episodes than 70/30 patients (mean 4.07 vs. 9.87/patient-year, P &lt; 0.0001).
CONCLUSIONS—Initiating insulin treatment by adding basal insulin glargine once daily to glimepiride plus metformin treatment was safer and more effective than beginning twice-daily injections of 70/30 and discontinuing OADs in type 2 diabetic patients inadequately controlled with OADs.