bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective Study on the Prevalence of Metabolic Syndrome Among Healthy French Families
Authors: Maumus Sandy , Marie Bérangère , Siest Gérard , Visvikis-Siest Sophie 
Published: March 2007

OBJECTIVE—The purpose of this study was to estimate the longitudinal variation of prevalence of metabolic syndrome within French families and to observe biological parameters involved in cardiovascular disease among their offspring.
RESEARCH DESIGN AND METHODS—Three hundred seventy-one apparently healthy families (1,366 individuals) taken from the STANISLAS cohort were studied. The subjects were examined at two time points with a 5-year interval (t0 and t+5). The crude prevalence of metabolic syndrome was assessed among parents according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP) definition.
RESULTS—The prevalence of metabolic syndrome was 5.9% in men and 2.1% in women at t0, rising to 7.2 and 5.4% in men and women, respectively, at t+5. Children of parents having metabolic syndrome showed higher levels of tumor necrosis factor-α (TNF-α), whereas their HDL cholesterol and apolipoprotein (apo) E concentrations were lower compared with those of age- and sex-matched control subjects (P ≤ 0.05). When applying NCEP ATP definitions that included either antihypertensive drugs only or all the drugs involved in metabolic syndrome, we found that the three parameters shared by the three different versions of the definition were TNF-α, HDL cholesterol, and an interaction between alcohol consumption and parental metabolic syndrome on HDL cholesterol concentration.
CONCLUSIONS—Metabolic syndrome increases with age in supposedly healthy families from the STANISLAS cohort. In offspring of affected people, it seems to be predictive of higher values of TNF-α and low HDL cholesterol levels, which are two major cardiovascular factors. Therefore, in terms of prevention, it is important to identify and follow subjects with metabolic syndrome as well as their offspring, even in apparently healthy populations, to enable early disease management.
Can Adoption of Regular Exercise Later in Life Prevent Metabolic Risk for Cardiovascular Disease?
Authors: Petrella Robert John , Lattanzio Chastity Nina , Demeray Amy , Varallo Vincent , Blore Rachel 
Published: March 2007

OBJECTIVE—To determine the impact of chronic exercise training initiated later in life upon development of metabolic markers of cardiovascular disease risk.
RESEARCH DESIGN AND METHODS—Two inception cohorts of previously sedentary healthy adults aged 55–75 years at baseline (1989), one initiating regular supervised physical exercise training and the other a geographical similar sedentary control, were assessed for anthropometric, biochemical, and clinical markers of the metabolic syndrome and comorbidity over 10 years.
RESULTS—At baseline, active individuals aged 68 years compared with sedentary individuals aged 67 years had similar fitness levels (5.7 vs. 5.8 metabolic equivalents). At follow-up, complete data were obtained for 161 active and 136 sedentary subjects. Drop out occurred primarily because of failure to adhere to the exercise regimen and poor physical health for active and sedentary individuals, respectively. More metabolic abnormalities were seen in the sedentary group than in the active group for one or two (64 vs. 36%, P &lt; 0.001) and three or more (35 vs. 22%, P &lt; 0.003) abnormalities, respectively. In those assessed at follow-up, the sedentary group compared with the active group had lower fitness levels (5.0 [13.8% decrease] vs. 5.9 [3.5% increase] metabolic equivalents), had a greater likelihood of a positive exercise electrocardiogram or symptom (32 vs. 10%, P &lt; 0.001), and had more comorbid conditions (Charlson Comorbidity Index score 0.9 vs. 0.4, P &lt; 0.01).
CONCLUSIONS—Higher fitness achieved over 10 years of regular exercise training in older adults was associated with reduced development of metabolic risk factors for cardiovascular disease, fewer exercise-induced cardiac abnormalities, and reduced comorbidity.
Effect of Sibutramine on Weight Management and Metabolic Control in Type 2 Diabetes
Authors: Vettor Roberto , Serra Roberto , Fabris Roberto , Pagano Claudio , Federspil Giovanni 
Published: March 2007

OBJECTIVE—The aim of this study was to provide a comprehensive meta-analysis of randomized controlled clinical studies on the effects of sibutramine on weight loss and glycemic control in obese subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Controlled clinical trials assessing the effect sizes of sibutramine on weight loss effects on glycemia in obese subjects with type 2 diabetes were identified and reviewed using the Cochrane Library, Medline, EMBASE, and a manual search.
RESULTS—Eight placebo-controlled, double-blind, randomized trials of sibutramine were included. After sibutramine treatment, the decrease in body weight and waist circumference was significantly greater than in the placebo group. Fasting blood glucose and HbA1c significantly decreased after sibutramine treatment. Treatment benefits were seen in plasma triglycerides and HDL, without significant variations in serum total and LDL cholesterol. No differences in systolic blood pressure between the sibutramine and the placebo groups were seen, while recording of diastolic blood pressure and heart rate showed that sibutramine produced a small increase relative to placebo.
CONCLUSIONS—A pharmacological approach in a weight management program for patients with type 2 diabetes may be helpful in glycemic control and in the management of other risk factors. Sibutramine may help improve glucose control because it is conducive to weight loss. The reviewed data on the effect of sibutramine further enforce the recommendations that weight management may be the most important therapeutic task for most obese subjects with type 2 diabetes.
Eliminating Inpatient Sliding-Scale Insulin
Authors: Baldwin David , Villanueva Griselda , McNutt Robert , Bhatnagar Sarika 
Published: March 2007

OBJECTIVE—We studied a systematic program to reeducate our medical house officers on how to manage inpatient hyperglycemia without the use of sliding-scale insulin (SSI).
RESEARCH DESIGN AND METHODS—Patients admitted to the general medical service with diabetes or a blood glucose &gt;140 mg/dl were included. HbA1c was measured in all patients, and therapy was modified if the HbA1c was &gt;7.0%. For each 24 h on call, two house officers were responsible for all glucose management for their team’s patients and rounded with a teaching endocrinologist twice daily for 2 weeks. Oral agent or insulin therapy was modified using blood glucoses and HbA1c. All patients who required insulin therapy were treated with basal and bolus insulin, usually NPH and regular, adjusted twice daily.
RESULTS—During 8 weeks, 88 patients were identified and 16 house officers were instructed. The mean duration of diabetes was 10.4 years. Mean HbA1c level was 8.7%, and 48% of patients had HbA1c &gt;8%. All patients with HbA1c &gt;7% had diabetes therapy intensified. Overall 80% had their diabetes therapy changed by discharge. Compared with 98 historical control subjects, significantly fewer study patients had episodes of hyperglycemia, and a subgroup followed for 12 months showed a decrease in HbA1c from 10.1 to 8%.
CONCLUSIONS—Medical history, blood glucose, and HbA1c testing can effectively identify patients with inpatient hyperglycemia. Using direct ward-based teaching and a widely disseminated pocket set of guidelines, house officers can be taught to effectively and safely manage inpatient hyperglycemia without the use of SSI.
End-Stage Renal Disease due to Diabetes Among Southwestern American Indians, 1990–2001
Authors: Burrows Nilka Ríos , Narva Andrew S. , Geiss Linda S. , Engelgau Michael M. , Acton Kelly J. 
Published: March 2007

OBJECTIVE—This study assesses trends in the incidence of diabetes-related end-stage renal disease (ESRD) among southwestern American Indians (SWAIs).
RESEARCH DESIGN AND METHODS—Using the U.S. Renal Data System, we obtained the total number of new cases of treated ESRD in which diabetes was the primary cause of renal failure in 1990 through 2001. The incidence of diabetes-related ESRD was calculated using census population figures and estimates of the SWAI population with diabetes, then age-adjusted to the 2000 U.S. population.
RESULTS—Between 1990 and 2001, the annual number of new patients starting treatment for diabetes-related ESRD in the SWAI total population increased from 154 to 320, and the age-adjusted diabetes-related ESRD incidence per 10,000 population increased 34% (6.2–8.3 per 10,000 people). However, after adjusting for the increasing number of people with diabetes in the SWAI population between 1993 and 2001, the age-adjusted incidence of diabetes-related ESRD among SWAIs with diabetes decreased 31%, from 80.4 to 55.8 per 10,000 people with diabetes. It decreased for both sexes and in all age-groups.
CONCLUSIONS—The increasing incidence of diabetes-related ESRD in the SWAI population parallels the growing prevalence of diabetes. However, since 1993 diabetes-related ESRD incidence decreased in the SWAI population with diabetes, consistent with national trends. This may reflect the reduction in risk factors and improvements in diabetes care practices in Indian communities.
Effect of a Peroxisome Proliferator–Activated Receptor-γ Agonist on Myocardial Blood Flow in Type 2 Diabetes
Authors: McMahon Graham T. , Plutzky Jorge , Daher Edouard , Bhattacharyya Tammy , Grunberger George , DiCarli Marcelo F. 
Published: March 2007

OBJECTIVE—The relationship between coronary endothelial function and insulin resistance remains speculative. We sought to determine whether pioglitazone, an insulin-sensitizing peroxisome proliferator–activated receptor (PPAR)-γ agonist, improves cardiac endothelial function in individuals with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Sixteen subjects with insulin-treated type 2 diabetes and without overt cardiovascular disease were randomly assigned to receive either 45 mg of pioglitazone or matching placebo for 3 months. Rest and adenosine-stimulated myocardial blood flow (MBF) were quantified with [13N]ammonia and positron emission tomography at baseline and study conclusion.
RESULTS—After 3 months, HbA1c levels dropped by 0.68% in the pioglitazone group and increased by 0.17% in the placebo group (P = 0.009 for difference between groups). Triglyceride (−93 vs. −39 mg/dl, P = 0.026) and HDL concentrations (+4.8 vs. −6.0 mg/dl, P = 0.014) improved significantly in the pioglitazone group compared with placebo. Despite these favorable changes, there was no demonstrable change in baseline MBF (−0.05 ± 0.24 vs. −0.09 ± 0.24 ml · min−1 · g−1, P = 0.45), adenosine-stimulated MBF (0.10 ± 0.75 vs. 0.14 ± 0.31 ml · min−1 · g−1, P = 0.25), or coronary flow reserve (0.45 ± 1.22 vs. 0.35 ± 0.72 ml · min−1 · g−1, P = 0.64) after 12 weeks of exposure to pioglitazone or placebo, respectively. Regression analysis revealed that lower glucose concentration at the time of the study was associated with higher coronary flow reserve (P = 0.012).
CONCLUSIONS—Pioglitazone treatment for 12 weeks in subjects with insulin-requiring type 2 diabetes had no demonstrable effect on coronary flow reserve despite metabolic improvements. Higher ambient glucose levels contribute to impaired vascular reactivity in individuals with diabetes.
Is the Diagnosis of Metabolic Syndrome Useful for Predicting Cardiovascular Disease in Asian Diabetic Patients?
Authors: Sone Hirohito , Mizuno Sachiko , Fujii Hitomi , Yoshimura Yukio , Yamasaki Yoshimitsu , Ishibashi Shun , Katayama Shigehiro , Saito Yasushi , Ito Hideki , Ohashi Yasuo , Akanuma Yasuo , Yamada Nobuhiro ,   the Japan Diabetes Complications Study Group
Published: March 2007

OBJECTIVE—The metabolic syndrome (MetS) is believed to be associated with an increased risk of cardiovascular disease (CVD). Although its prevalence is extremely high among diabetic patients, its prevalence in those with no history of CVD has not been determined. Moreover, prospective studies published on the association between MetS and cardiovascular events in diabetic populations have used only the World Health Organization (WHO) definition of MetS and included only white European subjects. The aim of this study was to determine the prevalence of MetS, as defined by both the WHO and the National Cholesterol Education Program (NCEP), and its predictive value for CVD in Asian diabetic patients in a long-term, prospective setting.
RESEARCH DESIGN AND METHODS—The baseline characteristics and incidence/hazard ratio of cardiovascular events (coronary heart disease and stroke) were determined in 1,424 Japanese type 2 diabetic patients with and without MetS, as defined by WHO (WHO-MetS) or the NCEP.
RESULTS—A high prevalence (38–53%, depending on sex and definition) of MetS was found among diabetic patients, even those with no history of CVD. During the 8-year study period, only WHO-MetS was a predictor for CVD in female patients. In male patients, although both definitions of MetS were significant predictors for CVD, individual components of MetS, such as hyperlipidemia or hypertension, were equivalent or better predictors.
CONCLUSIONS—We found that MetS is relatively common in diabetic patients with no history of CVD. We suggest that the commonly used definitions of MetS, at least in their present forms, have limited clinical usefulness for Asian diabetic patients and may need some ethnic group−specific modifications for global use.
Effect of Raloxifene on Serum Triglycerides in Women With a History of Hypertriglyceridemia While on Oral Estrogen Therapy
Authors: Carr Molly C. , Knopp Robert H. , Brunzell John D. , Wheeler Barbara S. , Zhu Xiaodong , Lakshmanan Mark , Rosen Amy S. , Anderson Pamela W. 
Published: March 2007

OBJECTIVE—Raloxifene hydrochloride is a selective estrogen receptor modulator that to date has not been shown to cause hypertriglyceridemia in normal, diabetic, or hypertriglyceridemic women. This study was designed to assess the effect of raloxifene on serum triglycerides in postmenopausal women who have a history of increased hypertriglyceridemia with oral estrogen therapy.
RESEARCH DESIGN AND METHODS—This was a single-center, uncontrolled, open-label study investigating the effects of 8 weeks of raloxifene (60 mg/day) therapy on plasma lipids. The study subjects were 12 postmenopausal women, ages 49–73 years, with a documented history of oral estrogen–induced hypertriglyceridemia (serum triglycerides ≥3.39 mmol/l [≥300 mg/dl]).
RESULTS—At week 2 of the study, three (25%) of the subjects withdrew from the trial because they developed marked hypertriglyceridemia (≥11.3 mmol/l [≥1,000 mg/dl]) during raloxifene therapy. These three women had higher baseline triglyceride and glucose levels, were not being treated with lipid-lowering agents, and were more likely to have diabetes than the other study subjects. The remaining nine patients (75%) completed the 8-week trial and experienced a nonsignificant increase in mean triglyceride levels from baseline to end point. Raloxifene treatment also resulted in a significant 16% decrease in hepatic lipase activity and a 26% increase in HDL2 levels (P = 0.013 and 0.03, respectively).
CONCLUSIONS—Patients with a previous history of hypertriglyceridemia on oral estrogen therapy should have serum triglyceride levels monitored closely after beginning raloxifene therapy and may even require fibrate therapy before beginning raloxifene.
Insulin-Sensitizing Antihyperglycemic Drugs and Mortality After Acute Myocardial Infarction
Authors: Inzucchi Silvio E. , Masoudi Frederick A. , Wang Yongfei , Kosiborod Mikhail , Foody Joanne M. , Setaro John F. , Havranek Edward P. , Krumholz Harlan M. 
Published: March 2007

OBJECTIVE—Thiazolidinediones (TZDs) and metformin are insulin-sensitizing antihyperglycemic agents with reported benefits on atherosclerosis. Despite extensive use in patients with diabetes and cardiovascular disease, there is a paucity of outcomes data with metformin and none yet with TZDs. We sought to determine the impact of these insulin sensitizers on outcomes in diabetic patients after hospitalization with acute myocardial infarction (AMI).RESEARCH DESIGN AND METHODS—We conducted a retrospective cohort study of 24,953 Medicare beneficiaries with diabetes discharged after hospitalization with AMI between April 1998 and March 1999 or July 2000 and June 2001. The independent association between discharge prescription for metformin, TZD, or both agents and outcomes at 1 year was assessed in multivariable Cox proportional hazards models, adjusting for patient, physician, and hospital variables. The primary outcome was time to death within 1 year of discharge; secondary outcomes were time to first rehospitalization within 1 year of discharge for AMI, heart failure, and all causes.RESULTS—There were 8,872 patients discharged on an antihyperglycemic agent, of which 819 were prescribed a TZD, 1,273 metformin, and 139 both drugs. After multivariable analysis, compared with patients prescribed an antihyperglycemic regimen that included no insulin sensitizer, mortality rates were not significantly different in patients treated with either metformin (hazard ratio [HR] 0.92 [95% CI 0.81–1.06]) or a TZD (0.92 [0.80–1.05]) but were lower in those prescribed both drugs (0.52 [0.34–0.82]). The results were similar among patients with heart failure. The prescription of a TZD was associated with a borderline higher risk of all-cause readmission (1.09[1.00–1.20]), predominately due to a higher risk for heart failure readmission (1.17 [1.05–1.30]).CONCLUSIONS—Individually, prescription of insulin-sensitizing drugs is not associated with a significantly different risk of death in older diabetic patients within 1 year following AMI compared with other antihyperglycemic agents. Combined, however, metformin and TZDs may exert benefit. TZD prescription is associated with a higher risk of readmission for heart failure after myocardial infarction.
Urinary Incontinence and Diabetes in Postmenopausal Women
Authors: Jackson Sara L. , Scholes Delia , Boyko Edward J. , Abraham Linn , Fihn Stephan D. 
Published: March 2007

OBJECTIVE—This study evaluates diabetes characteristics and other risk factors for urinary incontinence among community-dwelling postmenopausal women.
RESEARCH DESIGN AND METHODS—We performed a cross-sectional analysis of a population-based study of 1,017 postmenopausal women (218 with diabetes), aged 55–75 years, enrolled from a health maintenance organization. Outcomes included any incontinence and severe incontinence in the prior month.
RESULTS—Overall, 60% of women had any incontinence in the prior month and 8% had severe incontinence. Parity and postvoid residual bladder volume were not associated with incontinence. Oral estrogen and vaginal estrogen use were positively associated with a report of any incontinence but not severe incontinence. A history of urinary tract infection (UTI) and measures of general health were associated with both outcomes. Women with diabetes reported disproportionately more severe incontinence, difficulty controlling urination, mixed (stress and urge) incontinence, use of pads, inability to completely empty the bladder, being unaware of leakage, and discomfort with urination (P ≤ 0.06). Diabetes duration, treatment type, peripheral neuropathy, and retinopathy were significantly associated with severe incontinence in multiple regression models adjusted for age, education, and history of UTI (P = 0.01–0.06); however, additional adjustment for BMI diminished the strength of association (P = 0.17–0.52).
CONCLUSIONS—Urinary incontinence is highly prevalent among postmenopausal women. Women with diabetes are more likely to experience severe and symptomatic urinary incontinence. UTI history is a major risk factor, postvoid residual bladder volume plays no demonstrable role, and BMI confounds the relationship between diabetes and incontinence among healthy postmenopausal women.
Liver Enzymes, the Metabolic Syndrome, and Incident Diabetes
Authors: Nannipieri Monica , Gonzales Clicerio , Baldi Simona , Posadas Rosalinda , Williams Ken , Haffner Steven M. , Stern Michael P. , Ferrannini Ele 
Published: March 2007

OBJECTIVE—To test the hypothesis that enzymes conventionally associated with liver dysfunction (aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase [GGT], and alkaline phosphatase) may predict diabetes.RESEARCH DESIGN AND METHODS—From a population-based diabetes survey, we selected 1,441 men and women in whom serum enzyme levels were ≤3 SDs of the mean population value, alcohol intake was &lt;250 g/week, and hepatitis B and C virus testing was negative. At follow-up (7 years), 94 subjects developed diabetes and 93 impaired glucose tolerance (IGT).RESULTS—At baseline, all four enzymes were related to most of the features of the metabolic syndrome. After controlling for sex, age, adiposity/fat distribution, alcohol intake, serum lipids, and blood pressure, higher alanine aminotransferase and GGT values were significantly (P &lt; 0.01) associated with both IGT and diabetes, whereas alkaline phosphatase was associated with diabetes only (P = 0.0004) and aspartate aminotransferase with IGT only (P = 0.0001). Raised GGT alone was associated with all the features of the metabolic syndrome. Raised GGT was a significant predictor of either IGT or diabetes (odds ratio 1.62 [95% CI 1.08–2.42] top quartile vs. lower quartiles, P &lt; 0.02) after controlling for sex, age, adiposity/fat distribution, alcohol consumption, fasting plasma insulin and proinsulin levels, and 2-h postglucose plasma glucose concentrations.CONCLUSIONS—Although mild elevations in liver enzymes are associated with features of the metabolic syndrome, only raised GGT is an independent predictor of deterioration of glucose tolerance to IGT or diabetes. As GGT signals oxidative stress, the association with diabetes may reflect both hepatic steatosis and enhanced oxidative stress.
Improved Meal-Related β-Cell Function and Insulin Sensitivity by the Dipeptidyl Peptidase-IV Inhibitor Vildagliptin in Metformin-Treated Patients With Type 2 Diabetes Over 1Year
Authors: Ahrén Bo , Pacini Giovanni , Foley James E. , Schweizer Anja 
Published: March 2007

OBJECTIVE—To examine the effects of dipeptidyl peptidase-IV (DPP-4) inhibition on meal-related β-cell function and insulin sensitivity over 52 weeks in type 2 diabetes.
RESEARCH DESIGN AND METHODS—In a 12-week core study, placebo (n = 51) or vildagliptin (n = 56; 50 mg OD) was added to metformin treatment (1.5–3.0 mg/day). A 40-week extension followed in 71 patients. Meal tests were performed at 0, 12, 24, and 52 weeks; glucose, insulin, and C-peptide were evaluated.
RESULTS—In subjects completing 52 weeks with participation in all meal tests (n = 57), HbA1c (A1C) decreased in the vildagliptin/metformin group (VM group, n = 31) but increased in the placebo/metformin group (PM group, n = 26; between-group difference −1.0 ± 0.2%; P &lt; 0.001; baseline of all subjects combined 7.7 ± 0.1%). Also, fasting glucose decreased in the VM group but increased in the PM group (difference −0.9 ± 0.3 mmol/l, P = 0.016; baseline 9.8 ± 0.3 mmol/l). Insulin secretion (postmeal suprabasal area under the 0- to 30-min C-peptide curve divided by the 30-min increase in glucose) was increased in the VM group but was reduced in the PM group (difference +0.011 ± 0.03 pmol/l 30 min/mmol/l, P = 0.018; baseline 0.036 ± 0.02). Insulin sensitivity during meal ingestion (oral glucose insulin sensitivity) increased in the VM group but was not altered in the PM group (difference +27 ± 4 ml · min−1 · m−2, P = 0.036; baseline 246 ± 6). Insulin secretion related to insulin sensitivity (adaptation index) increased in the VM group but decreased in the PM group (difference +3.2 ± 1.0, P = 0.040; baseline 9.1 ± 0.5). The change in adaptation index correlated to the change in A1C (r = −0.39, P = 0.004).
CONCLUSIONS—This study presents evidence that DPP-4 inhibition by vildagliptin when added to metformin in type 2 diabetes over 52 weeks improves β-cell function along with improved postmeal insulin sensitivity.