bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different Patterns of Insulin Resistance in Relatives of Type 1 Diabetic Patients With Retinopathy or Nephropathy
Authors: Hadjadj Samy , Péan Franck , Gallois Yves , Passa Philippe , Aubert Robert , Weekers Laurent , Rigalleau Vincent , Bauduceau Bernard , Bekherraz Amine , Roussel Ronan , Dussol Bernard , Rodier Michel , Marechaud Richard , Lefebvre Pierre J. , Marre Michel ,   for the Genesis France-Belgium Study
Published: March 2007

OBJECTIVE—Insulin resistance may be a risk factor for diabetic microangiopathy, which may have a familial component. We carried out a family-based study to determine which components of the insulin resistance syndrome are associated with diabetic retinopathy and nephropathy in type 1 diabetes.
RESEARCH DESIGN AND METHODS—The Genesis France-Belgium Study is a multicenter binational study designed to investigate the genetic factors involved in the microvascular complications of type 1 diabetes using a family-based design. Probands were type 1 diabetic patients with diabetic retinopathy (classified as background, preproliferative, or proliferative) and possibly diabetic nephropathy (absent, incipient, established, or advanced). The insulin resistance score of their first-degree relatives was calculated according to their BMI and history of arterial hypertension, lipid disorders, and type 2 diabetes.
RESULTS—The insulin resistance score of relatives was positively correlated with the albumin excretion rate (P = 0.0009) and fasting plasma glucose (P = 0.0003) and HbA1c (P &lt; 0.0001) concentrations. This score was higher in the relatives of probands with than in those without diabetic nephropathy (P = 0.0370). Similarly, it was higher in relatives of subjects with proliferative diabetic retinopathy than in those of probands without, even after controlling for subjects with versus without diabetic nephropathy (P = 0.0379). However, the components of the insulin resistance score in relatives differed according to the severity of diabetic retinopathy or nephropathy in the probands. Obesity and history of arterial hypertension were most common in relatives of probands with proliferative diabetic retinopathy, whereas obesity and history of lipid disorders were most common in the relatives of probands with diabetic nephropathy.
CONCLUSIONS—Familial insulin resistance segregates with diabetic complications: lipid disorders and obesity segregate with diabetic nephropathy, whereas arterial hypertension and obesity segregate with diabetic retinopathy.
Blood Glucose and Risk of Cardiovascular Disease in the Asia Pacific Region
Authors:   Asia Pacific Cohort Studies Collaboration
Published: March 2007

OBJECTIVE—To assess the shape and strength of the association between usual blood glucose and cardiovascular disease (CVD) in Asian and Australasian cohorts and to determine the impact of adjusting for other determinants of CVD risk and excluding people with diabetes.
RESEARCH DESIGN AND METHODS—Relative risk estimates and 95% CIs were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk on individual participant data from 17 cohort studies. Repeat measurements of blood glucose were used to adjust for regression dilution bias.
RESULTS—Fasting blood glucose data were available for 237,468 participants, and during ∼1.2 million person-years of follow-up, there were 1,661 stroke and 816 ischemic heart disease (IHD) events. Data were also available on 27,996 participants with nonfasting glucose measurements. Continuous positive associations were demonstrated between usual fasting glucose and the risks of CVD down to at least 4.9 mmol/l. Overall, each 1 mmol/l lower usual fasting glucose was associated with a 21% (95% CI 18–24%) lower risk of total stroke and a 23% (19–27%) lower risk of total IHD. The associations were similar in men and women, across age-groups, and in Asian compared with Australasian (Australia and New Zealand) populations. Adjusting for potential confounders or removing those with diabetes as baseline did not substantially affect the associations. Associations for nonfasting glucose were weaker than those with fasting glucose.
CONCLUSIONS—Fasting blood glucose is an important determinant of CVD burden, with considerable potential benefit of usual blood glucose lowering down to levels of at least 4.9 mmol/l.
Noninvasive Angiography and Assessment of Left Ventricular Function Using Multislice Computed Tomography in Patients With Type 2 Diabetes
Authors: Schuijf Joanne D. , Bax Jeroen J. , Jukema J. Wouter , Lamb Hildo J. , Vliegen Hubert W. , Salm Liesbeth P. , de Roos Albert , van der Wall Ernst E. 
Published: March 2007

OBJECTIVE—Early identification of coronary artery disease (CAD) in patients with diabetes is important because these patients are at increased risk for CAD and have worse outcome than nondiabetic patients after CAD is diagnosed. Recently, noninvasive coronary angiography and assessment of left ventricular function has been demonstrated with multislice computed tomography (MSCT). The purpose of the present study was to validate this approach in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—MSCT was performed in 30 patients with confirmed type 2 diabetes. From the MSCT images, coronary artery stenoses (≥50% luminal narrowing) and left ventricular function (left ventricular ejection fraction, regional wall motion) were evaluated and compared with results of conventional angiography and two-dimensional echocardiography.
RESULTS—Two hundred twenty of 256 coronary artery segments (86%) were interpretable with MSCT. In these segments, sensitivity and specificity for detection of coronary artery stenoses were 95%. Including the uninterpretable segments, sensitivity and specificity were 81 and 82%, respectively. Bland-Altman analysis in the comparison of left ventricular ejection fractions demonstrated a mean difference of −0.48 ± 3.8% for MSCT and echocardiography, which was not significantly different from 0. Agreement between the two modalities for assessment of regional contractile function was excellent (91%, κ statistic 0.81).
CONCLUSIONS—Accurate noninvasive evaluation of both the coronary arteries and left ventricular function with MSCT is feasible in patients with type 2 diabetes. This noninvasive approach may allow optimal identification of high-risk patients.
Relation Between Development of Nephropathy and the p22phox C242T and Receptor for Advanced Glycation End Product G1704T Gene Polymorphisms in Type 2 Diabetic Patients
Authors: Matsunaga-Irie Seiko , Maruyama Taro , Yamamoto Yukihiro , Motohashi Yoshiko , Hirose Hiroshi , Shimada Akira , Murata Mitsuru , Saruta Takao 
Published: March 2007

OBJECTIVE—The development of diabetic nephropathy is considered to be associated with oxidative stress. NADPH oxidase and the receptor for advanced glycation end products (RAGE) have attracted attention as mechanisms of generating oxidative stress. We studied the relation between the genotypes of the NADPH p22phox C242T and RAGE G1704T polymorphisms and the development of diabetic nephropathy in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—Using a retrospective review of clinical data, we allocated 181 Japanese type 2 diabetic patients to one of two groups: patients without diabetic nephropathy (group N; n = 108) and patients developing diabetic nephropathy (group D; n = 73) for 10 years or more. The p22phox C242T and RAGE G1704T polymorphisms were examined by Taqman PCR methods.
RESULTS—The frequency of the p22phox CC genotype was significantly higher in group D than in group N (90 vs. 79%; P = 0.0427). The frequency of the RAGE GT + TT genotype was significantly higher in group D than in group N (26 vs. 13%; P = 0.0313). The frequency of the combination of p22phox CC and RAGE GT + TT genotypes was significantly higher in group D than in group N (22 vs. 8%; P = 0.0057). In multiple logistic regression analysis, systolic blood pressure, HbA1c, triglycerides, and the combination of polymorphisms were shown to be independent variables.
CONCLUSIONS—These results suggest that assessment of the combination of NADPH p22phox C242T and RAGE G1704T polymorphisms may be useful in identifying the risk for developing diabetic nephropathy in type 2 diabetic patients.
Indexes of Insulin Resistance and Secretion in Obese Children and Adolescents
Authors: Conwell Louise S. , Trost Stewart G. , Brown Wendy J. , Batch Jennifer A. 
Published: March 2007

OBJECTIVE—To assess the concurrent validity of fasting indexes of insulin sensitivity and secretion in obese prepubertal (Tanner stage 1) children and pubertal (Tanner stages 2–5) adolescents using estimates from the modified minimal model frequently sampled intravenous glucose tolerance test (FSIVGTT) as a criterion measure.
RESEARCH DESIGN AND METHODS—Eighteen obese children and adolescents (11 girls and 7 boys, mean age 12.2 ± 2.4 years, mean BMI 35.4 ± 6.2 kg/m2, mean BMI-SDS 3.5 ± 0.5, 7 prepubertal and 11 pubertal) participated in the study. All participants underwent an insulin-modified FSIVGTT on two occasions, and 15 repeated this test a third time (mean 12.9 and 12.0 weeks apart). Si measured by the FSIVGTT was compared with homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose-to-insulin ratio (FGIR), and fasting insulin (estimates of insulin sensitivity derived from fasting samples). The acute insulin response (AIR) measured by the FSIVGTT was compared with HOMA of percent β-cell function (HOMA-β%), FGIR, and fasting insulin (estimates of insulin secretion derived from fasting samples).
RESULTS—There was a significant negative correlation between HOMA-IR and Si (r = −0.89, r = −0.90, and r = −0.81, P &lt; 0.01) and a significant positive correlation between QUICKI and Si (r = 0.89, r = 0.90, and r = 0.81, P &lt; 0.01) at each time point. There was a significant positive correlation between FGIR and Si (r = 0.91, r = 0.91, and r = 0.82, P &lt; 0.01) and a significant negative correlation between fasting insulin and Si (r = −90, r = −0.90, and r = −0.88, P &lt; 0.01). HOMA-β% was not as strongly correlated with AIR (r = 0.60, r = 0.54, and r = 0.61, P &lt; 0.05).
CONCLUSIONS—HOMA-IR, QUICKI, FGIR, and fasting insulin correlate strongly with Si assessed by the FSIVGTT in obese children and adolescents. Correlations between HOMA-β%, FGIR and fasting insulin, and AIR were not as strong. Indexes derived from fasting samples are a valid tool for assessing insulin sensitivity in prepubertal and pubertal obese children.
Obesity and the Development of Insulin Resistance and Impaired Fasting Glucose in Black and White Adolescent Girls
Authors: Klein David J. , Aronson Friedman Lisa , Harlan William R. , Barton Bruce A. , Schreiber George B. , Cohen Robert M. , Harlan Linda C. , Morrison John A. 
Published: March 2007

OBJECTIVE—Age at onset of type 2 diabetes has decreased during the past 20 years, especially in black women. Studies of factors associated with insulin resistance and hyperglycemia in preadolescent and adolescent populations are essential to understanding diabetes development.
RESEARCH DESIGN AND METHODS—The National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (NGHS) is a 10-year cohort study of the development of obesity in black and white girls. Two NGHS centers examined the associations of obesity, puberty, and race with fasting insulin, glucose, and homeostasis model assessment of insulin resistance (HOMA-IR; a calculated index of insulin resistance) measures at 9–10 years of age (baseline) and 10 years later.
RESULTS—Black girls had greater baseline and year-10 BMI than white girls, with a greater 10-year incidence of obesity. BMI-insulin correlations were positive in both black and white girls at both visits, but insulin remained higher in black girls after controlling for BMI. In black girls, insulin and HOMA-IR were higher in the prepubertal period (before the emergence of racial differences in BMI), increased more during puberty, and decreased less with its completion. Baseline BMI predicted year-10 glucose and the development of impaired fasting glucose (IFG) in black girls. In white girls, the rate of BMI increase during follow-up predicted these outcomes. The 10-year incidence of diabetes in black girls was 1.4%.
CONCLUSIONS—Black-white differences in insulin resistance are not just a consequence of obesity, but precede the pubertal divergence in BMI. The development of IFG appears to be a function of the rate of increase of BMI in white girls and early obesity in black girls.
Risk Factors for Coronary Heart Disease in Type 1 Diabetic Patients in Europe
Authors: Soedamah-Muthu Sabita S. , Chaturvedi Nish , Toeller Monika , Ferriss Barry , Reboldi Paolo , Michel Georges , Manes Christos , Fuller John H. ,   the EURODIAB Prospective Complications Study Group
Published: March 2007

OBJECTIVE—The goal of the study was to examine risk factors in the prediction of coronary heart disease (CHD) and differences in men and women in the EURODIAB Prospective Complications Study.
RESEARCH DESIGN AND METHODS—Baseline risk factors and CHD at follow-up were assessed in 2,329 type 1 diabetic patients without prior CHD. CHD was defined as physician-diagnosed myocardial infarction, angina pectoris, coronary artery bypass graft surgery, and/or Minnesota-coded ischemic electrocardiograms or fatal CHD.
RESULTS—There were 151 patients who developed CHD, and the 7-year incidence rate was 8.0 (per 1,000 person-years) in men and 10.2 in women. After adjustment for age and/or duration of diabetes, the following risk factors were related to CHD in men: age, GHb, waist-to-hip ratio (WHR), HDL cholesterol, smoking, albumin excretion rate (AER), and autonomic neuropathy. The following risk factors were related to CHD in women: age, systolic blood pressure (BP), fasting triglycerides, AER, and retinopathy. Multivariate standardized Cox proportional hazards models showed that age (hazard ratio 1.5), AER (1.3 in men and 1.6 in women), WHR (1.3 in men), smoking (1.5 in men), fasting triglycerides (1.3 in women) or HDL cholesterol (0.74 in women), and systolic BP (1.3 in women) were predictors of CHD.
CONCLUSIONS—This study supports the evidence for a strong predictive role of baseline albuminuria in the pathogenesis of CHD in type 1 diabetes. Furthermore, sex-specific risk factors such as systolic BP, fasting triglycerides (or HDL cholesterol), and WHR were found to be important in the development of CHD.
Transdermal 17-β-Estradiol and Risk of Developing Type 2 Diabetes in a Population of Healthy, Nonobese Postmenopausal Women
Authors: Rossi Rosario , Origliani Giorgia , Modena Maria G. 
Published: March 2007

OBJECTIVE—Various observational and randomized studies have demonstrated a reduction in the incidence of type 2 diabetes in postmenopausal women who received estrogen orally. No studies have been performed on the incidence of type 2 diabetes in postmenopausal women treated with transdermal 17-β-estradiol. The purpose of our study was to assess the influence of transdermal 17-β-estradiol on the incidence of type 2 diabetes in a population of healthy, nonobese postmenopausal women.RESEARCH DESIGN AND METHODS—Between January 1998 and December 2002, 673 healthy, nonobese postmenopausal women (mean age 54 ± 5 years) were enrolled: 144 (21.4%) of these took transdermal 17-β-estradiol and 529 (78.6%) had never taken hormones during their postmenopausal period. Final elaboration of the data took place in July 2003, with a mean follow-up of 3.7 ± 0.7 years (ranging from 0.5 to 5 years).RESULTS—Type 2 diabetes developed in 60 patients during the follow-up period, which is the equivalent of 22 cases per 1,000 women-years. In the “hormones nonusers” group, diabetes developed in 10% (54 of 529 women; equivalent of 26.5 cases/1,000 women-years), whereas in the “hormones users” group, diabetes developed in 4.16% (6 of 144 women; equivalent of 12.1 cases/1,000 women-years). Transdermal 17-β-estradiol emerged as a treatment that significantly reduced the risk of developing diabetes (RR 2.19, 95% CI 1.79–3.56; P = 0.006).CONCLUSIONS—Our results suggest a significant reduction in the incidence of type 2 diabetes in our population of nonobese, healthy postmenopausal women who used transdermal 17-β-estradiol. This could suggest that, in some women, the estrogen deficiency that occurs after menopause could represent a fundamental step in the process of diabetogenesis.
The Significant Effect of Diabetes Duration on Coronary Heart Disease Mortality
Authors: Fox Caroline S. , Sullivan Lisa , D’Agostino Ralph B. , Wilson Peter W.F. 
Published: March 2007

OBJECTIVE—The risk of coronary heart disease (CHD) in type 2 diabetes is two- to threefold higher than in the general population, but the effect of diabetes duration on CHD risk has not been well characterized. We hypothesized that duration of diabetes is an important predictor of incident CHD among people with diabetes.
RESEARCH DESIGN AND METHODS—The duration of diabetes (fasting glucose ≥126 mg/dl, random glucose ≥200 mg/dl, or use of an oral hypoglycemic agent or insulin) was assessed in participants with diabetes in the original and offspring cohorts of the Framingham Heart Study. Only subjects with diabetes diagnosed between the ages of 30 and 74 years, without a history of ketoacidosis, and free of cardiovascular disease at the baseline evaluation were included. Cox proportional hazards models were used to estimate the hazard ratio of incident CHD events and mortality over a 12-year follow-up period; models were adjusted for known CHD risk factors.
RESULTS—Among 588 person-exams with diabetes (mean age 58 ± 9 years, 56% men), there were 86 CHD events, including 36 deaths. After adjustment for age, sex, and CHD risk factors, the risk of CHD was 1.38 times higher for each 10-year increase in duration of diabetes (95% CI 0.99–1.92), and the risk for CHD death was 1.86 times higher (1.17–2.93) for the same increase in duration of diabetes.
CONCLUSIONS—Duration of diabetes increases the risk of CHD death independent of coexisting risk factors. Further research is necessary to understand the pathophysiology of this increased risk.
Insulin Sensitivity, Insulinemia, and Coronary Artery Disease
Authors: Rewers Marian , Zaccaro Daniel , D’Agostino Ralph , Haffner Steven , Saad Mohammed F. , Selby Joe V. , Bergman Richard , Savage Peter ,   for the Insulin Resistance Atherosclerosis Study Investigators
Published: March 2007

OBJECTIVE—The aim of this study was to evaluate whether low insulin sensitivity (Si) measured using a modified frequently sampled intravenous glucose tolerance test with minimal model analysis is associated with coronary artery disease (CAD) independent of other cardiovascular risk factors.
RESEARCH DESIGN AND METHODS—We studied 1,482 women and men, age 40–69 years old, African American (28%), Hispanic (34%), or non-Hispanic white (38%), with normal (45%), impaired (23%), or diabetic (32%) glucose tolerance. CAD defined as confirmed past myocardial infarction, coronary artery bypass graft, coronary angioplasty, or presence of a major Q-wave was found in 91 participants.
RESULTS—The odds ratio (OR) for CAD was greatest among individuals in the two lowest quintiles of Si (2.4, 95% CI 1.0–5.6 and 4.7, 2.1–10.7) compared with the highest Si quintile. After adjusting for demographic and cardiovascular risk factors, a decrement from the 75th to 25th percentile in Si was associated with a 56% increase in CAD (P = 0.028). Similar increments in fasting or 2-h insulin levels were associated with, respectively, only 15 (NS) and 3% (NS) increases in CAD. The association between Si and CAD was partially mediated by insulin, HDL cholesterol and triglyceride levels, hypertension, diabetes, and obesity, but not LDL cholesterol or cigarette smoking.
CONCLUSIONS—Low Si is associated with CAD independently of and stronger than plasma insulin levels. Part of the association is accounted for by dyslipidemia, hypertension, diabetes, and obesity.
Cardiovascular Autonomic Neuropathy Is Associated With Microalbuminuria in Older Patients With Type 2 Diabetes
Authors: Moran Andrew , Palmas Walter , Field Lesley , Bhattarai Jyoti , Schwartz Joseph E. , Weinstock Ruth S. , Shea Steven 
Published: March 2007

OBJECTIVE—Cardiovascular autonomic neuropathy is associated with microalbuminuria in young and middle-aged patients with type 2 diabetes. We examined this relationship and the potential mediating role of blood pressure in older patients.
RESEARCH DESIGN AND METHODS—At least two of three components of cardiovascular autonomic testing were completed by 132 patients (mean age 70 ± 5.6 years). Relative rankings on each of the components were averaged to create a summary heart rate variability (HRV) measure. The urine microalbumin-to-creatinine ratio (milligrams albumin/grams creatinine) was calculated. Blood pressure was measured at rest and by 24-h ambulatory recording.
RESULTS—Urine microalbumin-to-creatinine ratio was higher in those with lower HRV (mean urine microalbumin-to-creatinine ratio 28, 56, and 191 mg/g from the highest to lowest tertile of HRV; P &lt; 0.0001). Resting and ambulatory blood pressure levels were negatively correlated with HRV and positively correlated with urine microalbumin-to-creatinine ratio. In multivariate analysis adjusting for age, duration of diabetes, HbA1c, and HDL cholesterol, HRV and blood pressure were both independently associated with urine microalbumin-to-creatinine ratio, with no evidence that either mediates the effect of the other.
CONCLUSIONS—Cardiovascular autonomic neuropathy and blood pressure are independently associated with microalbuminuria in older patients with type 2 diabetes.
A Direct Efficacy and Safety Comparison of Insulin Aspart, Human Soluble Insulin, and Human Premix Insulin (70/30) in Patients With Type 2 Diabetes
Authors: Bretzel Reinhard G. , Arnolds Sabine , Medding Jürgen , Linn Thomas 
Published: March 2007

OBJECTIVE—Because there are limited data on the comparison of insulin aspart and mixed insulin in type 2 diabetes, this trial was performed to compare the efficacy and safety of preprandial insulin aspart with human soluble insulin (HI) and human premix (70% NPH/30% regular) insulin (MIX).
RESEARCH DESIGN AND METHODS—A total of 231 type 2 diabetic patients were randomized to insulin aspart (n = 75), HI (n = 80), or MIX (n = 76) for 3 months. Insulin aspart and HI were administered with or without bedtime NPH insulin. A total of 204 patients completed the trial according to protocol. HbA1c, 7-point blood glucose, insulin dosage, and hypoglycemic episodes were recorded. The primary end point was “change of HbA1c” from baseline to last visit. Analysis for equivalence was performed by t tests with three subtests.
RESULTS—HbA1c decreased 0.91 ± 1.00 for insulin aspart, 0.73 ± 0.87 for HI, and 0.65 ± 1.10 for MIX with the following confidence intervals: insulin aspart HI (−0.21 to 0.57, P = 0.025), insulin aspart MIX (−0.17 to 0.69, P = 0.092), and HI-MIX (−0.33 to 0.48, P = 0.006). Postprandial blood glucose decreased in the insulin aspart group: 0.44 mmol/l to &gt;1.67 mmol/l compared with HI and 1.1 mmol/l to &gt;1.67 mmol/l compared with MIX. Preprandial insulin doses were similar in the insulin aspart and HI groups (10–14.5 U). Hypoglycemic events per month were 0.56 HI, 0.40 insulin aspart, and 0.19 MIX.
CONCLUSIONS—Statistically, insulin aspart was not equivalent to another treatment in terms of HbA1c reduction. Insulin aspart treatment resulted in improved HbA1c and postprandial blood glucose. The application of insulin aspart was safe and well tolerated.