bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interaction Between Dietary Lipids and Physical Inactivity on Insulin Sensitivity and on Intramyocellular Lipids in Healthy Men
Authors: Stettler Rodrigue , Ith Michael , Acheson Kevin J. , Décombaz Jacques , Boesch Chris , Tappy Luc , Binnert Christophe 
Published: March 2007

OBJECTIVE—To assess the effect of a possible interaction between dietary fat and physical inactivity on whole-body insulin sensitivity and intramyocellular lipids (IMCLs).
RESEARCH DESIGN AND METHODS—Eight healthy male volunteers were studied on two occasions. After 2 days of an equilibrated diet and moderate physical activity, participants remained inactive (bed rest) for 60 h and consumed either a high–saturated fat (45% fat, of which ∼60% was saturated fat [BR-HF]) or a high-carbohydrate (70% carbohydrate [BR-HCHO]) diet. To evaluate the effect of a high-fat diet alone, six of the eight volunteers were restudied after a 2-day equilibrated diet followed by 60 h on a high–saturated fat diet and controlled physical activity (PA-HF). Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp and IMCL concentrations by 1H-magnetic resonance spectroscopy.
RESULTS—Insulin-mediated glucose disposal was decreased by BR-HF condition (−24 ± 6%, P &lt; 0.05) but did not change with BR-HCHO (+19 ± 10%, NS). BR-HF and BR-HCHO increased IMCL levels (+32 ± 7%, P &lt; 0.05 and +17 ± 8%, P &lt; 0.0011, respectively). Although the increase in IMCL levels with PA-HF (+31 ± 19%, P = 0.12) was similar to that during BR-HF, insulin-mediated glucose disposal (−7 ± 9%, NS) was not decreased.
CONCLUSIONS—These data indicate that physical inactivity and a high–saturated fat diet may interact to reduce whole-body insulin sensitivity. IMCL content was influenced by dietary lipid and physical inactivity but was not directly associated with insulin resistance.
Magnesium Intake, C-Reactive Protein, and the Prevalence of Metabolic Syndrome in Middle-Aged and Older U.S. Women
Authors: Song Yiqing , Ridker Paul M. , Manson JoAnn E. , Cook Nancy R. , Buring Julie E. , Liu Simin 
Published: March 2007

OBJECTIVE—The aim of this study was to examine whether and to what extent magnesium intake is related to systemic inflammation and the metabolic syndrome.
RESEARCH DESIGN AND METHODS—We performed a cross-sectional analysis on data from 11,686 women ≥45 years of age participating in the Women’s Health Study who were initially free of cardiovascular disease and cancer and had no use of postmenopausal hormones.
RESULTS—In age- and BMI-adjusted analyses, magnesium intake was inversely associated with plasma C-reactive protein (CRP) concentrations; CRP concentrations were 12% lower in the highest intake quintile than in the lowest (P for trend &lt;0.0001). This association was not appreciably altered by further adjustment for other potential confounding variables including dietary factors; the mean CRP concentrations for ascending quintiles of magnesium intake were 1.50, 1.39, 1.35, 1.34, and 1.31 mg/l (P for trend = 0.0003). This inverse association was stronger for women with a BMI ≥25 kg/m2 (P &lt; 0.0001 for interaction) and those who were current or past smokers (P = 0.0009 for interaction). After adjustment for confounding lifestyle and dietary factors, women in the highest quintile of magnesium intake had 27% lower risk of the metabolic syndrome (defined according to the National Cholesterol Education Program criteria) compared with those in the lowest quintile of intake (odds ratio 0.73 [95% CI 0.60–0.88], P for trend = 0.0008).
CONCLUSIONS—Our results suggest that magnesium intake is inversely associated with systemic inflammation and the prevalence of the metabolic syndrome in middle-aged and older women.
Metabolic Syndrome and Diabetes Are Associated With an Increased Likelihood of Inducible Myocardial Ischemia Among Patients With Subclinical Atherosclerosis
Authors: Wong Nathan D. , Rozanski Alan , Gransar Heidi , Miranda-Peats Romalisa , Kang Xingping , Hayes Sean , Shaw Leslee , Friedman John , Polk Donna , Berman Daniel S. 
Published: March 2007

OBJECTIVE—Coronary artery calcification (CAC) is associated with cardiac events and the likelihood of inducible myocardial ischemia. Because metabolic syndrome contributes to atherosclerosis, we assessed whether it also influences the relationship between CAC levels and myocardial ischemia.
RESEARCH DESIGN AND METHODS—We evaluated 1,043 patients without known coronary artery disease (CAD) who underwent stress myocardial perfusion scintigraphy (MPS) and computed tomography. Metabolic syndrome was defined by modified National Cholesterol Education Program criteria. Metabolic abnormalities were present in 313 patients (30%), including 140 with diabetes (with or without metabolic syndrome) and 173 who had metabolic syndrome without diabetes.
RESULTS—Although CAC scores &lt;100 identified a low likelihood (∼2%) of ischemia, the presence (versus absence) of metabolic abnormalities (metabolic syndrome or diabetes) was a predictor of more frequent ischemia among patients with CAC scores of 100–399 (13.0 vs. 3.6%, P &lt; 0.02) and CAC scores ≥400 (23.4 vs. 13.6%, P = 0.03). Similar trends were observed when patients with metabolic syndrome and diabetes were considered separately. Multiple logistic regression revealed the odds of MPS ischemia to be 4.3-fold greater per SD of log CAC (P &lt; 0.001) and 2.0-fold greater in the presence of metabolic abnormalities (P &lt; 0.01).
CONCLUSIONS— Among patients with CAC scores ≥100, metabolic abnormalities, and even metabolic syndrome in the absence of diabetes predicted a higher likelihood of inducible ischemia. These findings suggest the need for assessment of metabolic status when interpreting the results of CAC imaging among patients undergoing such testing because of suspected CAD.
A Comparison of Lipid and Glycemic Effects of Pioglitazone and Rosiglitazone in Patients With Type 2 Diabetes and Dyslipidemia
Authors: Goldberg Ronald B. , Kendall David M. , Deeg Mark A. , Buse John B. , Zagar Anthony J. , Pinaire Jane A. , Tan Meng H. , Khan Mehmood A. , Perez Alfonso T. , Jacober Scott J. ,   for the GLAI Study Investigators
Published: March 2007

OBJECTIVE—Published reports suggest that pioglitazone and rosiglitazone have different effects on lipids in patients with type 2 diabetes. However, these previous studies were either retrospective chart reviews or clinical trials not rigorously controlled for concomitant glucose- and lipid-lowering therapies. This study examines the lipid and glycemic effects of pioglitazone and rosiglitazone.
RESEARCH DESIGN AND METHODS—We enrolled subjects with a diagnosis of type 2 diabetes (treated with diet alone or oral monotherapy) and dyslipidemia (not treated with any lipid-lowering agents). After a 4-week placebo washout period, subjects randomly assigned to the pioglitazone arm (n = 400) were treated with 30 mg once daily for 12 weeks followed by 45 mg once daily for an additional 12 weeks, whereas subjects randomly assigned to rosiglitazone (n = 402) were treated with 4 mg once daily followed by 4 mg twice daily for the same intervals.
RESULTS—Triglyceride levels were reduced by 51.9 ± 7.8 mg/dl with pioglitazone, but were increased by 13.1 ± 7.8 mg/dl with rosiglitazone (P &lt; 0.001 between treatments). Additionally, the increase in HDL cholesterol was greater (5.2 ± 0.5 vs. 2.4 ± 0.5 mg/dl; P &lt; 0.001) and the increase in LDL cholesterol was less (12.3 ± 1.6 vs. 21.3 ± 1.6 mg/dl; P &lt; 0.001) for pioglitazone compared with rosiglitazone, respectively. LDL particle concentration was reduced with pioglitazone and increased with rosiglitazone (P &lt; 0.001). LDL particle size increased more with pioglitazone (P = 0.005).
CONCLUSIONS—Pioglitazone and rosiglitazone have significantly different effects on plasma lipids independent of glycemic control or concomitant lipid-lowering or other antihyperglycemic therapy. Pioglitazone compared with rosiglitazone is associated with significant improvements in triglycerides, HDL cholesterol, LDL particle concentration, and LDL particle size.
Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application
Authors: Gerber Ben S. , Brodsky Irwin G. , Lawless Kimberly A. , Smolin Louanne I. , Arozullah Ahsan M. , Smith Everett V. , Berbaum Michael L. , Heckerling Paul S. , Eiser Arnold R. 
Published: March 2007

OBJECTIVE—To evaluate a clinic-based multimedia intervention for diabetes education targeting individuals with low health literacy levels in a diverse population.RESEARCH DESIGN AND METHODS—Five public clinics in Chicago, Illinois, participated in the study with computer kiosks installed in waiting room areas. Two hundred forty-four subjects with diabetes were randomized to receive either supplemental computer multimedia use (intervention) or standard of care only (control). The intervention includes audio/video sequences to communicate information, provide psychological support, and promote diabetes self-management skills without extensive text or complex navigation. HbA1c (A1C), BMI, blood pressure, diabetes knowledge, self-efficacy, self-reported medical care, and perceived susceptibility of complications were evaluated at baseline and 1 year. Computer usage patterns and implementation barriers were also examined.RESULTS—Complete 1-year data were available for 183 subjects (75%). Overall, there were no significant differences in change in A1C, weight, blood pressure, knowledge, self-efficacy, or self-reported medical care between intervention and control groups. However, there was an increase in perceived susceptibility to diabetes complications in the intervention group. This effect was greatest among subjects with lower health literacy. Within the intervention group, time spent on the computer was greater for subjects with higher health literacy.CONCLUSIONS—Access to multimedia lessons resulted in an increase in perceived susceptibility to diabetes complications, particularly in subjects with lower health literacy. Despite measures to improve informational access for individuals with lower health literacy, there was relatively less use of the computer among these participants.
Should Diabetes Be Considered a Coronary Heart Disease Risk Equivalent?
Authors: Whiteley Lucinda , Padmanabhan Sandosh , Hole David , Isles Chris 
Published: March 2007

OBJECTIVE—The purpose of our study was to confirm or refute the view that diabetes be regarded as a coronary heart disease (CHD) risk equivalent and to test for sex differences in mortality.
RESEARCH DESIGN AND METHODS—This was a prospective cohort study of 7,052 men and 8,354 women aged 45–64 years from Renfrew and Paisley, Scotland, who were first screened in 1972–1976 and followed for 25 years. All-cause mortality was calculated as death per 1,000 person-years. A Cox proportional hazards model was used to adjust survival for age, smoking habit, blood pressure, serum cholesterol, BMI, and social class.
RESULTS—There were 192 deaths in 228 subjects with diabetes and 2,016 deaths in 3,076 subjects with CHD. The highest mortality was in the group with both diabetes and CHD (100.2 deaths/1,000 person-years in men, 93.6 in women) and the lowest in the group with neither (29.2 deaths/1,000 person-years in men, 19.4 in women). Men and women with diabetes only and CHD only formed an intermediate risk group. The adjusted hazard ratio (HR) for CHD mortality in men with diabetes only compared with men with CHD only was 1.17 (95% CI 0.78–1.74; P = 0.56). Corresponding HR for women was 1.97 (1.27–3.08; P = 0.003).
CONCLUSIONS—Diabetes without previous CHD carries a lifetime risk of vascular death as high as that for CHD alone. Women may be at particular risk. Our data support the view that cardiovascular risk factors in diabetes should be treated as aggressively as in people with CHD.
Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men
Authors: Pitteloud Nelly , Mootha Vamsi K. , Dwyer Andrew A. , Hardin Megan , Lee Hang , Eriksson Karl-Fredrik , Tripathy Devjit , Yialamas Maria , Groop Leif , Elahi Dariush , Hayes Frances J. 
Published: March 2007

OBJECTIVE— The goal of this study was to examine the relationship between serum testosterone levels and insulin sensitivity and mitochondrial function in men.
RESEARCH DESIGN AND METHODS—A total of 60 men (mean age 60.5 ± 1.2 years) had a detailed hormonal and metabolic evaluation. Insulin sensitivity was measured using a hyperinsulinemic-euglycemic clamp. Mitochondrial function was assessed by measuring maximal aerobic capacity (Vo2max) and expression of oxidative phosphorylation genes in skeletal muscle.
RESULTS—A total of 45% of subjects had normal glucose tolerance, 20% had impaired glucose tolerance, and 35% had type 2 diabetes. Testosterone levels were positively correlated with insulin sensitivity (r = 0.4, P &lt; 0.005). Subjects with hypogonadal testosterone levels (n = 10) had a BMI &gt;25 kg/m2 and a threefold higher prevalence of the metabolic syndrome than their eugonadal counterparts (n = 50); this relationship held true after adjusting for age and sex hormone–binding globulin but not BMI. Testosterone levels also correlated with Vo2max (r = 0.43, P &lt; 0.05) and oxidative phosphorylation gene expression (r = 0.57, P &lt; 0.0001).
CONCLUSIONS—These data indicate that low serum testosterone levels are associated with an adverse metabolic profile and suggest a novel unifying mechanism for the previously independent observations that low testosterone levels and impaired mitochondrial function promote insulin resistance in men.
Noninvasive Diagnosis of Coronary Artery Disease in Patients With Diabetes by Dobutamine Stress Real-Time Myocardial Contrast Perfusion Imaging
Authors: Elhendy Abdou , Tsutsui Jeane M. , O’Leary Edward L. , Xie Feng , McGrain Anna C. , Porter Thomas R. 
Published: March 2007

OBJECTIVE—The aim of this study was to assess the accuracy of real-time myocardial contrast perfusion imaging (MCPI) during dobutamine stress in the diagnosis and localization of coronary artery disease (CAD) in patients with diabetes. Myocardial contrast echocardiography is a new technique that allows evaluation of myocardial perfusion. Its utility in diabetic patients has not been defined.RESEARCH DESIGN AND METHODS—Dobutamine-atropine stress test was performed in conjunction with MCPI using Optison or Definity at rest and at peak stress in 128 patients with diabetes and suspected CAD who underwent coronary angiography within 1 month. CAD was defined as ≥50% stenosis in one or more coronary artery. MCPI was considered diagnostic of CAD in the presence of reversible perfusion abnormalities. The normalcy rate of MCPI was additionally determined in 18 asymptomatic nondiabetic patients with low probability.RESULTS—CAD was detected in 101 (79%) patients by angiography. Reversible perfusion abnormalities were detected in 90 patients with and 13 patients without CAD. The overall sensitivity of MCPI was 89% (95% CI 83–95), specificity 52% (33–71), and accuracy 81% (75–88). Reversible abnormalities were detected in two or more vascular distributions in 44 of 56 patients with multivessel CAD and in 8 of 63 patients without (sensitivity 68%, specificity 87%, positive predictive value 84%, and accuracy 79%). Regional sensitivity was 75% (65–85) for left anterior descending CAD, 71% (60–83) for left circumflex, and 67% (55–78) for right CAD. MCPI was normal in 16 of the 18 patients with low clinical probability of CAD (normalcy rate 89%).CONCLUSIONS—MCPI is a useful noninvasive technique for the diagnosis and localization of CAD in diabetic patients. The extent of perfusion abnormalities can identify patients with multivessel CAD with a moderate sensitivity and high specificity.
Clinical, Socioeconomic, and Lifestyle Parameters Associated With Erectile Dysfunction Among Diabetic Men
Authors: Kalter-Leibovici Ofra , Wainstein Julio , Ziv Arnona , Harman-Bohem Ilana , Murad Havi , Raz Itamar ,   for the Israel Diabetes Research Group (IDRG) Investigators
Published: March 2007

OBJECTIVE—Erectile dysfunction is frequently observed in diabetes. The current study aims to assess the association of a comprehensive set of clinical, socioeconomic, and lifestyle parameters with erectile dysfunction in diabetic men.
RESEARCH DESIGN AND METHODS—Participants were randomly selected from male patients (age &gt;18 years) treated in 26 diabetes clinics in Israel. Participants completed a self-reported questionnaire on demographic, socioeconomic, and lifestyle characteristics and on erectile function, using the IIEF-15 (International Index of Erectile Function). Information on diabetes type, duration, treatment, and control; microvascular complications and cardiovascular disease; drug therapy; blood pressure; and lipid levels was also obtained.
RESULTS—Information on erectile function was obtained in 1,040 patients. Their mean age was 57 years, and their median diabetes duration was 8 years (range &lt;1–50). Normal erectile function was found in 13.5% of the patients and severe erectile dysfunction in 30.1%. The characteristics found to be significantly associated with erectile dysfunction [associations presented as adjusted odds ratio (95% CI)] were: patient’s age (5-year increments): 1.38 (1.29–1.48); diabetes duration (5-year increments): 1.16 (1.07–1.26); current HbA1c level (1% increment): 1.10 (1.01–1.19); any microvascular disease: 1.43 (1.09–1.88); cardiovascular disease: 1.78 (1.27–2.48); and diuretic treatment: 1.78 (1.09–2.91). Leisure time and work-related physical activity and consumption of small amounts of alcohol were found to be protective: 0.51 (0.36–0.72) and 0.70 (0.51–0.97), respectively.
CONCLUSIONS—In diabetic men, erectile dysfunction severity increases with age and diabetes duration, poor glycemic control, presence of microvascular complications, diuretic treatment, and cardiovascular disease. Physical activity and alcohol intake may be protective. These findings can guide clinicians in taking preventive measures and undertaking early screening and treatment in high-risk patients.
Osteoprotegerin Is Associated With Silent Coronary Artery Disease in High-Risk but Asymptomatic Type 2 Diabetic Patients
Authors: Avignon Antoine , Sultan Ariane , Piot Christophe , Elaerts Stéphane , Cristol Jean Paul , Dupuy Anne Marie 
Published: March 2007

OBJECTIVE—Osteoprotegerin (OPG) is an inhibitor of osteoclastogenesis, which has been recently involved in atherosclerosis. The relationship between coronary atherosclerosis and OPG has never been studied in asymptomatic type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—This is a nested case-control study; 162 asymptomatic type 2 diabetic patients were evaluated for silent myocardial ischemia using stress myocardial perfusion imaging; of 50 patients with positive results, 37 underwent coronary angiography, 20 of whom showed significant coronary artery disease (CAD group). Of 112 patients without silent myocardial ischemia, 20 subjects (NO-CAD group) were selected and matched by age and sex to patients with CAD. OPG, C-reactive protein, adiponectin, lipoprotein(a), albuminuria, and classical risk factors were measured.
RESULTS—The percentages of subjects with OPG levels above median and with nephropathy were higher in the CAD group than in the NO-CAD group (70 vs. 25%, P = 0.004 and 50 vs. 5%, P = 0.001, respectively). LDL cholesterol levels were higher and HDL cholesterol levels lower in the CAD compared with the NO-CAD group (P = 0.033 and P = 0.005, respectively). No other variables were associated with CAD. Logistic regression analysis showed that OPG values above median (odds ratio 8.31 [95% CI 1.18–58.68], P = 0.034) and nephropathy (21.98 [1.24–388.36], P = 0.035) were significant independent predictors of asymptomatic CAD in type 2 diabetic patients.
CONCLUSIONS—Our investigation reports the first evidence of an independent association of OPG with asymptomatic CAD in type 2 diabetic patients. The results of this nested case- control study with 20 cases need to be confirmed in a larger population.
Alcohol Intake Among Women and Its Relationship to Diabetes Incidence and All-Cause Mortality
Authors: Lapidus Leif , Bengtsson Calle , Bergfors Elisabet , Björkelund Cecilia , Spak Fredrik , Lissner Lauren 
Published: March 2007

OBJECTIVE— The purpose of the study was to explore the predictive value of women’s alcohol habits in relation to incidence of diabetes and all-cause mortality. Special attention was paid to potential confounding factors such as age, heredity, education, socioeconomic group, physical inactivity, smoking, blood pressure, serum lipids, and, in particular, obesity.
RESEARCH DESIGN AND METHODS— A longitudinal population study consisting of a representative sample of 1,462 women aged 38–60 started in Göteborg, Sweden, in 1968–1969 monitoring for diabetes and mortality over 32 years.
RESULTS— Alcohol intake, expressed as intake of wine, hard liquor, or total grams of alcohol, was significantly negatively associated to 32-year diabetes incidence independent of age. However, the apparently protective effect of the alcohol variables was attenuated when BMI was included as a covariate. The inverse relationship between wine intake and diabetes did not remain after adjustment for physical activity or socioeconomic group. Beer and wine intake were significantly negatively associated to mortality. Increase of alcohol intake between the examination in 1968–1969 and 1980–1981 was significantly inversely related to the mortality between 1980–1981 and 2000–2001 and independent of all covariates. No relationship was observed between an increase in alcohol intake and diabetes incidence. However, after adjustment for age, family history, and basal alcohol consumption altogether, a significant inverse relationship was observed between increase of alcohol and diabetes incidence.
CONCLUSIONS— The initially significant inverse associations observed between alcohol and diabetes as well as mortality were dependent on a number of confounding factors, of which BMI seems to be the most important.
Asymptomatic Myocardial Ischemia in Diabetes and Its Relationship to Diabetic Neuropathy: An Exercise Electrocardiography Study in Middle-Aged Diabetic Men
Authors: Hume L , Oakley G P , Boulton A J M , Hardisty C , Ward J D 
Published: March 2007

The incidence of painless ischemic heart disease is increased in diabetic patients, and it has been suggested that this may be partly due to diabetic neuropathy involving cardiac afferent nerves. We have performed exercise electrocardiography in middle-aged diabetic men without cardiac symptoms to see if silent myocardial ischemia is more common in patients with neuropathy. Thirty patients had diabetic neuropathy (group 1), and 30 did not (group 2). The groups were matched for age and duration of diabetes. The exercise test was abnormal in 14 patients. A positive test was no more common in patients with diabetic neuropathy.
During a mean follow-up period of 50 mo, five patients developed clinical heart disease, four of whom had a positive exercise test. An abnormal exercise ECG is common in diabetic men without cardiac symptoms, but our study does not suggest that the high incidence of silent myocardial ischemia in diabetic patients is related to the presence of diabetic neuropathy. In patients with diabetes a positive exercise test is associated with a high risk of developing clinical heart disease in subsequent years.
Is There a Need for a Better Basal Insulin?
Authors: Guthrie Richard 
Published: March 2007

IN BRIEFBasal insulin therapy is an integral part of intensive management of type 1 diabetes and is often used in conjunction with oral agent therapy for type 2 diabetes. Currently available insulins do not always provide adequate background coverage. Insulin glargine, a new product that will soon be available for commercial use, addresses this need by providing 24-h coverage without peaks or valleys.