bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Lipoprotein(a) and Insulin-Like Growth Factor I During Puberty and the Relationship to Microalbuminuria in Children and Adolescents With IDDM
Authors: Rudberg Susanne , Persson Bengt 
Published: March 2007

OBJECTIVE
To study pubertal changes in serum lipoprotein(a) [Lp(a)] and insulin-like growth factor I (IGF-I) in insulin-dependent diabetes mellitus (IDDM) and the relationship to microalbuminuria.

RESEARCH DESIGN AND METHODS
Seventy-nine children and adolescents (59 with normoalbuminuria, 20 with microalbuminuria) with ≥ 5 years of IDDM were investigated together with 54 healthy control subjects in a cross-sectional study. Fasting serum Lp(a); apolipoprotein (apo) A-1 and B; total, low-density lipoprotein (LDL), and high-density lipoprotein cholesterol; triglycerides; and IGF-I were analyzed as were HbA1c and overnight albumin excretion rate (AER). Pubertal development was assessed by Tanner staging.

RESULTS
Lp(a), apoB, triglycerides, and total and LDL cholesterol were higher (P &lt; 0.001) and apoA-1 was lower (P = 0.03) in normoalbuminuric IDDM patients than in healthy control subjects. Lp(a) was increased during puberty (stages 2–4) in IDDM patients but not in healthy subjects, whereas IGF-I was significantly increased during puberty in healthy control subjects only. In IDDM patients Lp(a) correlated to insulin dose, total cholesterol, and LDL cholesterol, but not to IGF-I, HbA1c, systolic and diastolic blood pressure, diabetes duration, age, or sex. In multiple regression analysis with Lp(a) as the dependent variable, puberty was the only significant contributor to the regression (r2 = 0.33, P = 0.008). Microalbuminuria was seen only in the pubertal stage 4–5. Lp(a) tended to be higher (P = 0.06) as did apoB, whereas IGF-I was lower (P &lt; 0.001) in this group than in normoalbuminuric patients of the same pubertal stages. In multivariate analysis, with log AER as the dependent variable, apoB/apoA-1, systolic blood pressure, age, and IGF-I but not Lp(a) added to the regression (r2 = 0.47, P &lt; 0.0001).

CONCLUSIONS
Lp(a) is elevated during puberty in normoalbuminuric subjects with IDDM, independent of metabolic control and IGF-I. Lp(a) tends to be further increased in microalbuminuria but does not seem to be a contributing determinant of log AER whereas low IGF-I does. Prospective studies are required to establish the temporal relationship between increased Lp(a) and microalbuminuria in children and adolescents with IDDM.
Antibodies Against Bovine Albumin and Other Diabetes Markers in French Children
Authors: Lévy-Marchal Claire , Karjalainen Jukka , Dubois Frédéric , Karges Wolfram , Czernichow Paul , Dosch Hans-Michael 
Published: March 2007

OBJECTIVE
Findings in epidemiology and animal experimentation suggest that autoimmunity in insulin-dependent diabetes mellitus (IDDM) may be triggered by dietary cow-milk protein, particularly bovine serum albumin (BSA). Elevated IgG anti-BSA antibodies were found in children from Finland with newly onset diabetes; Finland has the highest incidence of diabetes and cow's milk consumption in the world. We now analyze BSA serology and other diabetes markers in school-age children from France, where diabetes incidence and cow's milk consumption are low.

RESEARCH DESIGN
Sera were obtained from three groups: newly diagnosed diabetic (n = 43), islet cell antibody-positive (ICA+) nondiabetic (n = 98), and ICA− healthy control children (n = 267). IgG anti-BSA antibody levels were measured blindly using particle concentration fluoroimmunoassays and analyzed in comparison with ICA titers and human leukocyte antigen-DQB genotypes.

RESULTS
There were highly significant differences in BSA antibody levels between all three groups (P &lt; 0.0001). Diabetic patients had elevated anti-BSA levels in 74.4% of cases, compared with 5.5% of control children. In the group of ICA+ non-diabetic children, 20% were anti-BSA-positive. Neither ICA nor BSA antibody titers were significantly related to DQB genotype or sex. ICA titers (≥4 Juvenile Diabetes Foundation units) were present in 84% of diabetic children. Two-thirds of diabetic children were positive for both ICA and anti-BSA antibodies, and none were negative for both markers.

CONCLUSIONS
Elevated IgG anti-BSA levels are associated with IDDM in the low-incidence French population. In newly diagnosed diabetic children, these antibodies have similar specificity (95 vs. 98%) and slightly lower sensitivity for IDDM than ICA (74.4 vs. 83.7%). Our results may support an immunological role of BSA in diabetic autoimmunity.
Serum Sialic Acid Concentration and Coronary Heart Disease in NIDDM
Authors: Pickup John C , Mattock Martin B , Crook Martin A , Chusney Gary D , Burt Davina , Fitzgerald Anthony P 
Published: March 2007

OBJECTIVE
To examine the association between serum sialic acid concentrations and coronary heart disease (CHD) in a cross-sectional study of non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
NIDDM patients (n = 145) attending a diabetic clinic were studied. CHD status was assessed by questionnaire and electrocardiogram coding, and potential risk factor assessment included measurement of fasting serum lipid and lipoprotein concentrations, blood pressure, and urinary albumin excretion rate (AER).

RESULTS
Male NIDDM patients with CHD had a higher serum sialic acid level than those without CHD: 2.56 (2.24, 2.72) mmol/l vs. 2.24 (2.18, 2.30) mmol/l, P = 0.01, mean (95% confidence interval). They were also older, had a longer duration of diabetes, had a higher AER, had higher total triglyceride, very-low-density lipoprotein triglyceride and cholesterol, and lipoprotein(a) concentrations, and had a lower apolipoprotein A1 concentration. In an age adjusted multiple lipoprotein(a), hypercholesterolemia, and hypertension were associated with CHD. In women, only hypertension treatment was associated with CHD.

CONCLUSIONS
There is a strong univariate association between elevated serum sialic acid and CHD in men (but not women) with NIDDM.
Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type II Diabetes (VA CSDM): Results of the feasibility trial
Authors: Abraira Carlos , Colwell John A , Nuttall Frank Q , Sawin Clark T , Nagel Nancy Johnson , Comstock John P , Emanuele Nicholas V , Levin Seymour R , Henderson William , Lee Hae Sook ,   VA CSDM Group
Published: March 2007

OBJECTIVE
It is not clear whether intensive pharmacological therapy can be effectively sustained in non-insulin-dependent diabetes mellitus (NIDDM). The relative risks and benefits of intensive insulin therapy in NIDDM are not well defined. Accordingly, we designed a feasibility study that compared standard therapy and intensive therapy in a group of NIDDM men who required insulin due to sustained hyperglycemia.

RESEARCH DESIGN AND METHODS
A prospective trial was conducted in five medical centers in 153 men of 60 ± 6 years of age who had a known diagnosis of diabetes for 7.8 ± 4 years. They were randomly assigned to a standard insulin treatment group (one morning injection per day) or to an intensive therapy group designed to attain near-normal glycemia and a clinically significant separation of glycohemoglobin from the standard arm. A four-step plan was used in the intensive therapy group along with daily self-monitoring of glucose: 1) an evening insulin injection, 2) the same injection adding daytime glipizide, 3) two injections of insulin alone, and 4) multiple daily injections. Patient accrual and adherence, glycohemoglobin (HbA1c), side effects, and measurements of endpoints for a prospective long-term trial were assessed.

RESULTS
Accrual goals were met, mean follow-up time was 27 months (range 18–35 months), and patients kept 98.6% of scheduled visits. After 6 months, the mean HbA1c in the intensive therapy group was at or below 7.3% and remained 2% lower than the standard group for the duration of the trial. Most of the decrease in the mean HbA1c in the intensive group was obtained by a single injection of evening intermediate insulin, alone or with daytime glipizide. By the end of the trial, 64% of the patients had advanced to two or more injections of insulin a day, aiming for normal HbA1c. However, only a small additional fall in HbA1c was attained. Severe hypoglycemia was rare (two events per 100 patients per year) and not significantly different between the groups, nor were changes in weight, blood pressure, or plasma lipids. There were 61 new cardiovascular events in 40 patients and 10 deaths (6 due to cardiovascular causes).

CONCLUSIONS
Intense stepped insulin therapy in NIDDM patients who have failed glycemic control on pharmacological therapy is effective in maintaining near-normal glycemic control for &gt; 2 years without excessive severe hypoglycemia, weight gain, hypertension, or dyslipidemia. Cardiovascular event rates are high at this stage of NIDDM. A long-term prospective trial is needed to assess the risk-benefit ratio of intensified treatment of hyperglycemia in NIDDM patients requiring insulin.
Serum Lipids and Lipoprotein(a) Concentrations in Chinese NIDDM Patients: Relation to metabolic control
Authors: Chang Chih-Jen , Kao Jau-Tsuen , Wu Ta-Jen , Lu Feng-Hwa , Tai Tong-Yuan 
Published: March 2007

OBJECTIVE
To compare serum blood lipids and lipoprotein(a) [Lp(a)] levels in Chinese non-insulin-dependent diabetes mellitus (NIDDM) patients and nondiabetic control subjects and also to determine the influence of diabetes control on serum Lp(a) concentration in Chinese individuals.

RESEARCH DESIGN AND METHODS
We compared the serum blood lipids and Lp(a) levels in NIDDM patients (n = 100) and age- and sex-matched nondiabetic subjects (n = 100) who participated in a case-control study. Comparisons of Lp(a) concentrations were made between a normal control group, a group of diabetic patients with HbA1c &lt; 8.0%, and a group of diabetic patients with HbA1c of 8% or higher.

RESULTS
The diabetic patients had higher total triglyceride, apolipoprotein B (apo B), and apo B-to-apo AI ratios, but lower high-density lipoprotein (HDL) cholesterol and apo AI concentrations than nondiabetic controls (P &lt; 0.001, P &lt; 0.01, P &lt; 0.001, P &lt; 0.05, and P &lt; 0.001, respectively). A similar pattern of distribution of Lp(a) levels according to the degree of metabolic control was seen in patients with NIDDM and nondiabetic controls. No correlation was observed between Lp(a) levels and total cholesterol, low-density lipoprotein cholesterol, HDL cholesterol, apo AI, apo B, and triglyceride levels in all diabetic patients. No difference in the Lp(a) levels was noted between diabetic patients and nondiabetic subjects, even in poorly controlled diabetic patients.

CONCLUSIONS
In conclusion, Lp(a) levels are not elevated in diabetic patients, even in poorly controlled metabolic conditions.
Subcutaneous Glucose Concentration in Humans: Real estimation and continuous monitoring
Authors: Sternberg Fabio , Meyerhoff Carsten , Mennel Franz J , Bischof Friederike , Pfeiffer Ernst F 
Published: March 2007

OBJECTIVE
To determine the real subcutaneous glucose concentration in healthy volunteers to help in the development of new calibration methods for subcutaneous glucosensors.

RESEARCH DESIGN AND METHODS
We developed a new method to estimate the real subcutaneous glucose concentration based on the recirculation of phosphate-buffered saline (PBS) in a microdialysis probe inserted into the subcutaneous tissue. Tissue glucose diffuses into the probe until complete equilibration between the glucose concentration outside and inside the microdialysis probe is achieved. Later, the glucose content of the recirculated PBS is assessed in vitro. We applied the method in 10 healthy volunteers under fasting state and during a hyperglycemic clamp. In addition, we monitored the subcutaneous glucose with an enzymatic-amperometric glucosensor combined with a microdialysis probe.

RESULTS
The subcutaneous glucose concentration measured by the recirculation method was 72 ± 6 and 78 ± 6% of the blood glucose measured in the fasting state and during the hyperglycemic clamps, respectively. On the other hand, the glucosensor's signal correlated significantly with the blood glucose.

CONCLUSION
The recirculation method estimated the real subcutaneous glucose concentration, opening the way to develop new calibration procedures for subcutaneous glucosensors. However, a suitable calibration procedure is still lacking.
Glucose Tolerance and Physical Activity in a Mexican Indigenous Population
Authors: Schulz Lesile O , Weidensee Richard C 
Published: March 2007

OBJECTIVE
To assess diabetes prevalence and physical activity among an indigenous population in Mexico.

RESEARCH DESIGN AND METHODS
A total of 101 adult (mean age = 38 years) Mixtec Indians living on the outskirts of Huajuapan de Leon, Oaxaca, Mexico, volunteered to be measured for height, weight, blood pressure, glucose tolerance, and physical activity.

RESULTS
According to World Health Organization criteria, 2 women were diabetic and 42 subjects (15 men, 27 women) had impaired glucose tolerance (IGT). Although the population was generally lean, with a mean ± SD body mass index (BMI) of 23.0 ± 2.7 kg/m2 for men (n = 47) and 22.8 ± 3.0 kg/m2 for women (n = 54), the group with normal glucose tolerance had a significantly lower BMI than those with abnormal glucose tolerance (IGT or diabetes). Men were significantly more physically active than women, and a larger percentage of women (54%) than men (32%) had abnormal glucose tolerance. However, within gender groups, there was not a significant effect of physical activity on status of glucose tolerance.

CONCLUSIONS
The Mixtec population may be genetically predisposed to non-insulin-dependent diabetes, although their current lifestyle provides a protective effect. Less of a protective effect is seen for females, however. It is expected that further environmental changes impacting energy balance will have the most damaging repercussions for diabetes prevalence among Mixtec women.
Abnormalities of Antroduodenal Motility in Type I Diabetes
Authors: Samsom Melvin , Jebbink Rik J A , Akkermans Louis M A , Van Berge-Henegouwen Gerard P , Smout Andre J P M 
Published: March 2007

OBJECTIVE
In the present study, a recently developed manometric technique was used to study antroduodenal motility in ambulant type I diabetic subjects.

RESEARCH DESIGN AND METHODS
In 12 patients with type I diabetes, antroduodenal manometry was performed for 20 h during the fasting period and the postprandial period after a standardized dinner and breakfast. All patients had evidence of cardiac autonomic neuropathy and complained of dyspeptic symptoms. During the manometric study, the blood glucose levels were frequently monitored and kept close to euglycemia in the diabetic patients. The results were compared with 12 healthy control subjects.

RESULTS
The migrating motor complex cycles observed in the diabetic subjects were longer than in the control subjects, 118.9 ± 46.0 vs. 87.0 ± 21.6 min (P &lt; 0.05). This increase was attributable to a prolonged phase II, 78.0 ± 35.5 vs. 37.7 ± 18.5 min (P &lt; 0.05). In the diabetic subjects, antral phase III was seen significantly &lt; in the control subjects, 16.7 vs. 43.3% (P &lt; 0.005). In 50% of the diabetic patients, total absence of antral phase III was observed-this phenomenon was not seen in the healthy control subjects. After dinner, the antral motility index was less in diabetic subjects compared with the healthy volunteers, indicating antral hypomotility (P &lt; 0.01). Six diabetic patients showed abnormal duodenal activity such as early recurrence of phase III and bursts after dinner. No significant differences in antral motility index or in duodenal motility patterns were observed after breakfast. Six diabetic patients complained of dyspeptic symptoms after dinner, whereas none had dyspeptic symptoms after breakfast. In 67% of the patients, nausea was reported after an early phase III or a burst.

CONCLUSIONS
This study shows that prolonged ambulatory antroduodenal manometry is a feasible technique in patients. Recording multiple migrating motor complexes showed that interdigestive motor abnormalities of the stomach and duodenum are common in diabetic patients. Furthermore, it shows the occurrence of antral hypomotility and abnormal duodenal motility patterns after a high-calorie meal, with dyspeptic symptoms in diabetic patients being related to the composition of the meal.
Prevalence and Risk Factors for Micro- and Macroalbuminuria in an Italian Population-Based Cohort of NIDDM Subjects
Authors: Bruno Graziella , Cavallo-Perin Paolo , Bargero Giuseppe , Borra Milena , Calvi Valentina , D'Errico Nicola , Deambrogio Piercarlo , Pagano Gianfranco 
Published: March 2007

OBJECTIVE
To determine the prevalence of micro- and macroalbuminuria in NIDDM and their relationship with some known and putative risk factors.

RESEARCH DESIGN AND METHODS
Out of a population-based cohort of 1,967 NIDDM subjects, 1,574 were investigated (80%). Albumin excretion rate (AER) was evaluated on an overnight urine collection, and plasma and urine determinations were centralized.

RESULTS
The prevalences of microalbuminuria (AER 20–200 μg/min), macroalbuminuria (AER &gt; 200 μg/min), and hypertension were 32.1% (95% CI 29.8–34.4), 17.6% (15.7–19.5), and 67% (64.6–69.3), respectively. Apart from prevalence of hypertension, which after adjustment for age, BMI, and duration of diabetes was 2.3 times higher in women, rates were higher in men (odds ratio [OR] 1.31, 95% CI 1.04–1.66 for microalbuminuria and OR 1.63, 1.22–2.17 for macroalbuminuria). In comparison with normoalbuminuric subjects, both micro- and macroalbuminuric diabetic subjects had significantly longer duration of diabetes, higher levels of systolic blood pressure, fasting plasma glucose, HbA1c, triglycerides, and uric acid; in macroalbuminuric subjects only, levels of apolipoprotein B and HDL cholesterol were, respectively, higher and lower than in normo- and microalbuminuric subjects. In logistic regression, variables independently related to both micro- and macroalbuminuria were age, HbA1c, cigarette smoking habits, plasma uric acid, and diastolic blood pressure, after adjustment for plasma creatinine and diabetic treatment. In addition, duration of diabetes and HDL cholesterol levels were associated with macroalbuminuria.

CONCLUSIONS
This population-based study showed high prevalence of micro- and macroalbuminuria in NIDDM subjects, who were characterized by a more adverse pattern of cardiovascular risk factors.
Age-Related Alteration of Pancreatic β-cell Function: Increased proinsulin and proinsulin-to-insulin molar ratio in elderly, but not in obese, subjects without glucose intolerance
Authors: Shimizu M , Kawazu S , Tomono S , Ohno T , Utsugi T , Kato N , Ishii C , Ito Y , Murata K 
Published: March 2007

OBJECTIVE
To determine the secretion of insulin, C-peptide, and proinsulin after oral glucose loading in healthy elderly subjects compared with middle-aged subjects with and without obesity and with NIDDM.

RESEARCH DESIGN AND METHODS
Subjects fell into four groups: nonobese middle-aged normal control subjects (CNT group; n = 38, 40–64 years old); obese normal subjects (OB group; n = 18, 40–64 years old); nonobese NIDDM subjects (NIDDM group; n = 28, 40–64 years old); and nonobese elderly subjects (OL group; n = 17, 65–92 years old). Insulin, C-peptide, and proinsulin were determined by radioimmunoassay in plasma samples taken at 0, 30, 60, and 120 min during a 75-g oral glucose tolerance test (OGTT).

RESULTS
There were no differences in plasma glucose during the OGTT among the three nondiabetic groups. Hyperinsulinemia was significant in the OB and NIDDM groups but not in the OL group. On the other hand, absolute hyperproinsulinemia was significant in the OL and NIDDM groups compared with the CNT group. Increased proinsulin was rather dominant in the OL group, especially late after glucose loading. Molar ratios of proinsulin to insulin or C-peptide thus were significantly higher in the OL and NIDDM groups.

CONCLUSIONS
Alteration of pancreatic β-cell function independent of that seen with NIDDM occurred in relation to aging. This may be a predisposing factor to the development of impaired glucose tolerance or NIDDM in elderly subjects, that is, independent of obesity.
Sex Hormones and DHEA-SO4 in Relation to Ischemic Heart Disease Mortality in Diabetic subjects: The Wisconsin Epidemiologic Study of Diabetic Retinopathy
Authors: Haffner Steven M , Moss Scot E , Klein Barbara EK , Klein Ronald 
Published: March 2007

OBJECTIVE
Sex hormones are associated with atherogenic changes in lipoproteins and changes in glucose and insulin metabolism, yet few data are available on the relationship of sex hormones and dehydroepiandrosterone sulfate (DHEA-SO4) to ischemic heart disease (IHD) in diabetic subjects, a groupwith very high levels of IHD.

RESEARCH DESIGN AND METHODS
We examined the relation of total and free testosterone, sex hormone binding globulin, estrone, estradiol, and DHEA-SO4 to the 5-year IHD mortality in the older-onset diabetic subjects in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) in a matched diabetic subject-control design (two control subjects for every diabetic subject).

RESULTS
In men (n = 123), none of the sex hormones or DHEA-SO4 significantly predicted IHD mortality. In women (n = 120), lower levels of DHEA-SO4 (P &lt; 0.01) and total testosterone (P = 0.07) predicted IHD mortality. These results were essentially unchanged after adjustment for duration of diabetes, GHb, diuretic use, and serum creatinine, which are major predictors of IHD mortality in the WESDR. Finding lower testosterone levels in diabetic subjects of IHD in women is contrary to data on risk factors, which suggests that increased androgen activity may beassociated with worse IHD risk factors.

CONCLUSIONS
This study suggests that alterations in sex hormones and DHEA-SO4 are unlikely to explain a major proportion of the variation in IHD mortality in diabetic subjects.
Demonstration of Regional Sympathetic Denervation of the Heart in Diabetes: Comparison between patients with NIDDM and IDDM
Authors: Turpeinen Anu K , Vanninen Esko , Kuikka Jyrki T , Uusitupa Matti IJ 
Published: March 2007

OBJECTIVE
Global myocardial uptake of 123I-metaiodobenzylguanidine (MIBG) has been shown to be decreased in diabetic patients with autonomic neuropathy, indicating cardiac sympathetic dysfunction. However, possible differences in myocardial MIBG distribution between NIDDM and IDDM diabetic patients are not known.

RESEARCH DESIGN AND METHODS
Regional myocardial distribution of 123I-MIBG was studied in seven male IDDM patients (age 45 ± 2 years, duration of diabetes 30 ± 3 years, means ± SE) and 13 NIDDM patients (8 men, 5 women, age 59 ± 2 years, duration of diabetes 10 ± 1 years). A dual-tracer single-photon emission tomography was carried out with 123I-MIBG and 99mTc-methoxyisobutylisonitrrile to asses simultaneously myocardial sympathetic innervation and perfusion at rest. Conventional autonomic nervous function tests, power spectral analysis of heart rate variability, and echocardiography were performed for assessments of autonomic function and cardiac dimensions and function.

RESULTS
Autonomic nervous function tests and echocardiography showed similar results in IDDM and NIDDM patients. Despite this, global myocardial MIBG uptake (0.43 ± 0.04 vs. 0.59 ± 0.06, P = 0.03) and MIBG heart-to-liver ratio (0.59 ± 0.03 vs. 0.68 = 0.03, P = 0.05) were lower in NIDDM compared with IDDM patients. Regional distribution of MIBG uptake and regional MIBG/perfusion ratio revealed significantly reduced uptake in NIDDM patients especially in the inferoposterior segments of the left ventricle compared with IDDM patients. Difference in age between NIDDM and IDDM patients did not explain the results.

CONCLUSIONS
Reduced myocardial MIBG uptake was found in NIDDM patients compared withthe uptake in IDDM patients, particularly involving inferoposterior segments.Regional sympathetic damage not detectable with conventional autonomic function tests is relatively common in NIDDM.