bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in the Prognostic Importance of Diabetes in Patients With Ischemic Heart Disease Undergoing Coronary Angiography
Authors: Graham Michelle M. , Ghali William A. , Faris Peter D. , Galbraith P. Diane , Norris Colleen M. , Knudtson Merril L. ,   APPROACH Investigators
Published: March 2007

OBJECTIVE—Women with ischemic heart disease have poorer outcomes than men and are suggested to have greater risk associated with diabetes. We evaluated the prognosis associated with diabetes, in analyses stratified by sex, to determine whether similar differences are seen in a large unselected cohort of patients.
RESEARCH DESIGN AND METHODS—Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), a clinical data collection and follow-up initiative capturing all patients undergoing cardiac catheterization in Alberta, Canada, the relative significance of diabetes on long-term survival in 13,152 men and 4,249 women was evaluated in patients presenting with or without myocardial infarction and according to first treatment received.
RESULTS—The 1-year mortality rates were 4.7% and 6.8% in men and women (P &lt; 0.001), 4.1% and 7.4% in nondiabetic and diabetic men (P &lt; 0.001), and 5.8% and 9.6% in nondiabetic and diabetic women, respectively (P &lt; 0.001). The risk-adjusted Cox proportional hazard ratios associated with diabetes in myocardial infarction were 1.03 in men and 1.20 in women. The diabetes hazard ratios for percutaneous coronary intervention were 1.28 in men and 1.40 in women, 1.23 in men and 1.32 in women for bypass surgery, and 1.26 in men and 1.31 in women for medical therapy (P = NS for all diabetes hazard ratio comparisons between men and women).
CONCLUSIONS—Hazard ratios quantifying the adverse prognosis associated with diabetes in patients undergoing angiography are consistently higher among women than men, but the differences across sexes are not statistically significant. These slight sex differences noted in the APPROACH registry are similar to previously reported findings and may be clinically important.
Adiponectin in a Native Canadian Population Experiencing Rapid Epidemiological Transition
Authors: Hanley Anthony J.G. , Connelly Philip W. , Harris Stewart B. , Zinman Bernard 
Published: March 2007

OBJECTIVE—Adiponectin is emerging as an important protein in the etiology of obesity and related metabolic disorders. The objectives of this study were to determine cross-sectional and prospective associations of adiponectin concentration with adiposity, type 2 diabetes, and cardiovascular disease (CVD) risk factors in a population-based study of Native Canadians, a group experiencing dramatic increases in diabetes and CVD.
RESEARCH DESIGN AND METHODS—During the 1993–1995 baseline survey, samples for glucose, insulin, adiponectin, and lipids were collected after an overnight fast. Waist circumference and percent body fat were measured, and a 75-g oral glucose tolerance test was administered: n = 505 with normal glucose tolerance (NGT), 74 with impaired glucose tolerance (IGT), and 149 with diabetes. In 1998, 95 high-risk subjects, defined as those who, at baseline, had either IGT or NGT with an elevated 2-h glucose concentration (≥7.0 mmol/l), participated in a follow-up examination using the protocol used at baseline.
RESULTS—After adjustment for covariates including percent body fat and homeostasis model assessment of insulin resistance (HOMA-IR), adiponectin concentrations were significantly lower among men versus women (10.8 vs. 15.0 μg/ml, P &lt; 0.0001) and among diabetic versus NGT subjects (11.1 vs. 13.1 μg/ml, P &lt; 0.05). Adiponectin was inversely correlated with percent body fat, waist circumference, HOMA-IR, and triglyceride and positively correlated with HDL (r = |0.30|–|0.44|, all P &lt; 0.0001). In multivariate linear regression analysis in nondiabetic subjects, HDL and percent body fat were significantly related to adiponectin variation among both men and women (R2 = 28–29%). Factor analysis returned three underlying factors among these variables, with adiponectin loading on the second factor along with insulin, waist circumference, triglyceride, and HDL. In the follow-up study, higher adiponectin at baseline was significantly associated with increases in HDL (r = 0.24, P = 0.03) and decreases in HOMA-IR (r = −0.29, P = 0.009) after adjustment for covariates, including age, adiposity, and diabetes status at baseline and follow-up.
CONCLUSIONS—These population-based findings support the hypothesis that low circulating levels of adiponectin are an important determinant of risk of CVD.
In Utero Dietary Exposures and Risk of Islet Autoimmunity in Children
Authors: Fronczak Carolyn M. , Barón Anna E. , Chase H. Peter , Ross Colleen , Brady Heather L. , Hoffman Michelle , Eisenbarth George S. , Rewers Marian , Norris Jill M. 
Published: March 2007

OBJECTIVE—The goal of this study was to examine whether maternal dietary intake of vitamin D, ω-3 fatty acids, and ω-6 fatty acids during pregnancy is associated with the appearance of islet autoimmunity (IA) in offspring.
RESEARCH DESIGN AND METHODS—The Diabetes Autoimmunity Study in the Young (DAISY) is recruiting at birth and following children at increased risk for type 1 diabetes, as determined by HLA-DR genotype or by family history of type 1 diabetes. A total of 233 mothers of newly recruited DAISY subjects were asked to recall their intake of food and nutritional supplements during the third trimester of pregnancy using the Willett food frequency questionnaire. Children were followed for an average of 4 years (range 0.8–7.3 years) for the appearance of insulin, GAD65, and IA-2 autoantibodies. Sixteen children developed at least one autoantibody during this period. Unadjusted and adjusted hazard ratios (HRs) for the development of IA were estimated with survival analysis using a Weibull distribution.
RESULTS—Maternal intake of vitamin D via food was significantly associated with a decreased risk of IA appearance in offspring, independent of HLA genotype, family history of type 1 diabetes, presence of gestational diabetes mellitus, and ethnicity (adjusted HR = 0.37; 95% CI 0.17–0.78). Vitamin D intake via supplements, ω-3 fatty acids, and ω-6 fatty acids intake during pregnancy were not associated with appearance of IA in offspring.
CONCLUSIONS—Our findings suggest that maternal intake of vitamin D through food during pregnancy may have a protective effect on the appearance of IA in offspring.
Premenopausal Advantages in Postprandial Lipid Metabolism Are Lost in Women With Type 2 Diabetes
Authors: Masding Michael G. , Stears Anna J. , Burdge Graham C. , Wootton Stephen A. , Sandeman Derek D. 
Published: March 2007

OBJECTIVE—Women with type 2 diabetes appear to lose the protection against cardiovascular disease afforded by estrogens. We examined the effects of menopausal status on postprandial clearance of dietary fat in healthy and diabetic women.
RESEARCH DESIGN AND METHODS—Fasting subjects (premenopausal and postmenopausal control subjects, premenopausal and postmenopausal diabetic women, all n = 8) were given a meal containing the stable isotope 1,1,1-13C-tripalmitin, with blood and breath sampled for 6 and 24 h, respectively, in the postprandial period. Lower levels of 13C-palmitic acid (13C-PA) in the triglyceride fraction implies more efficient chylomicron clearance, lower levels of 13C-PA in the nonesterified fatty acid (NEFA) fraction implies improved dietary NEFA entrapment, and higher levels of 13CO2 in the breath denote more efficient of oxidation of dietary-derived lipid.
RESULTS—In diabetic women, there were no differences between the pre- and postmenopausal groups for any of these parameters. In contrast, premenopausal control subjects, compared with postmenopausal control subjects, had lower 13C-PA in the triglyceride fraction area under the curve (AUC) (premenopausal median [range] 25.2 [12.1–49.4 mmol/l] per 6 h, postmenopausal 48.5 [15.5–77.2 mmol/l] per 6 h; P &lt; 0.01) and higher 13CO2 levels in the breath AUC (premenopausal 22.5 [18.0–31.5%] of administered dose, postmenopausal 17.2 [11.2–31.5%] of administered dose; P &lt; 0.01) with no difference between groups in levels of 13C-PA in the NEFA fraction AUC.
CONCLUSIONS—The premenopausal advantage in clearance of dietary lipid is not seen in premenopausal diabetic women. This is likely to promote an atherogenic lipoprotein profile and may contribute to the loss of cardiovascular disease protection seen in diabetic women.
Plasma Adiponectin Plays an Important Role in Improving Insulin Resistance With Glimepiride in Elderly Type 2 Diabetic Subjects
Authors: Tsunekawa Taku , Hayashi Toshio , Suzuki Yusuke , Matsui-Hirai Hisako , Kano Hatsuyo , Fukatsu Akiko , Nomura Noriko , Miyazaki Asaka , Iguchi Akihisa 
Published: March 2007

OBJECTIVE—We investigated the effect of glimepiride, a third-generation sulfonylurea hypoglycemic agent, on insulin resistance in elderly patients with type 2 diabetes, in connection with plasma adiponectin and 8-epi-prostagrandin F2α (8-epi-PGF2α), an oxidative stress marker.
RESEARCH DESIGN AND METHODS—A total of 17 elderly patients with type 2 diabetes received 12 weeks of treatment with glimepiride. Homeostasis assessment model of insulin resistance (HOMA-IR), homeostasis assessment model of β-cell function, HbA1c, C-peptide in 24-h pooled urine (urine CPR), and plasma concentrations of 8-epi-PGF2α, tumor necrosis factor-α (TNF-α), plasminogen activator inhibitor type 1, and adiponectin were measured at various times. The metabolic clearance rate of glucose (MCR-g) was also assessed by a hyperinsulinemic-euglycemic clamp.
RESULTS—After 8 weeks of glimepiride treatment, significant reductions were observed in HbA1c (from 8.4 ± 1.9 to 6.9 ± 1.0%), HOMA-IR (from 2.54 ± 2.25 to 1.69 ± 0.95%), and plasma TNF-α concentrations (from 4.0 ± 2.0 to 2.6 ± 2.5 pg/ml). MCR-g was significantly increased from 3.92 ± 1.09 to 5.73 ± 1.47 mg · kg−1 · min−1. Plasma adiponectin increased from 6.61 ± 3.06 to 10.2 ± 7.14 μg/ml. In control subjects, who maintained conventional treatment, no significant changes were observed in any of these markers.
CONCLUSIONS—Glimepiride remarkably improved insulin resistance, suggested by a significant reduction in HOMA-IR, an increase in MCR-g, and a reduction in HbA1c without changing extrapancreatic β-cell function and urine CPR. Increased plasma adiponectin and decreased plasma TNF-α may underlie the improvement of insulin resistance with glimepiride.
Diabetes as a Predictor of Change in Functional Status Among Older Mexican Americans
Authors: Wu Jasmanda H. , Haan Mary N. , Liang Jersey , Ghosh Debashis , Gonzalez Hector M. , Herman William H. 
Published: March 2007

OBJECTIVE—Epidemiological studies have demonstrated that older Mexican Americans are at high risk for type 2 diabetes and its complications. Type 2 diabetes leads to a more rapid decline in functional status among older Mexican Americans with diabetes. This study was designed to examine the impact of diabetes on change in self-reported functional status over a 2-year period among older Mexican Americans with diabetes.
RESEARCH DESIGN AND METHODS—We performed a longitudinal analysis with repeated measurements of functional limitations in a cohort of Mexican Americans aged ≥60 years in the Sacramento Area Latino Study on Aging (SALSA). Diabetes was diagnosed on the basis of self-report of physician diagnosis, medication use, and fasting plasma glucose. Functional status was measured by assessment of activities of daily living (ADL) and instrumental activities of daily living (IADL) at baseline and 1 and 2 years.
RESULTS—Of 1,789 SALSA participants, 585 (33%) had diabetes at baseline. Diabetic subjects reported 74% more limitations than nondiabetic subjects in ADL (summary score for number of limitations, 0.99 vs. 0.57; P = 0.002) and 50% more limitations in IADL (summary score for number of limitations, 7.83 vs. 5.25; P &lt; 0.0001). The annual rate of increase in limitations of ADL and IADL was 0.046 and 0.033 (log scale) on each scale among diabetic subjects compared with 0.013 and 0.003 (log scale) among nondiabetic subjects (P &lt; 0.0005). Complications of diabetes were found to increase ADL and IADL limitations among diabetic subjects. Longer duration of diabetes was also associated with an increase in ADL and IADL limitations.
CONCLUSIONS—There was lower baseline functional status and a more rapid decline in functional status among older Mexican Americans with diabetes versus those without diabetes.
The Effects of Diabetes on the Risks of Major Cardiovascular Diseases and Death in the Asia-Pacific Region
Authors:   Asia Pacific Cohort Studies Collaboration
Published: March 2007

OBJECTIVE—To provide reliable age- and region-specific estimates of the associations between diabetes and major cardiovascular diseases and death in populations from the Asia-Pacific region.
RESEARCH DESIGN AND METHODS—Twenty-four cohort studies from Asia, Australia, and New Zealand (median follow-up, 5.4 years) provided individual participant data from 161,214 people (58% from Asia) of whom 4,873 had a history of diabetes at baseline. The associations of diabetes with the risks of coronary heart disease, stroke, and cause-specific mortality during follow-up were estimated using time-dependent Cox models, stratified by study cohort and sex and adjusted for age at risk.
RESULTS—In all, 9,277 deaths occurred (3,635 from cardiovascular disease). The hazard ratio (95% CI) associated with diabetes was 1.97 (1.72–2.25) for fatal cardiovascular disease; there were similar hazard ratios for fatal coronary heart disease, fatal stroke, and composites of fatal and nonfatal outcomes. For all cardiovascular outcomes, hazard ratios were similar in Asian and non-Asian populations and in men and women, but were greater in younger than older individuals. For noncardiovascular death, the hazard ratio was 1.56 (1.38–1.77), with separately significant increases in the risks of death from renal disease, cancer, respiratory infections, and other infective causes. The hazard ratio for all-causes mortality was 1.68 (1.55–1.84), with similar ratios in Asian and non-Asian populations, but with significantly higher ratios in younger than older individuals.
CONCLUSIONS—The relative effect of diabetes on the risks of cardiovascular disease and death in Asian populations is much the same as that in the largely Caucasian populations of Australia and New Zealand. Hazard ratios were severalfold greater in younger people than older people. The rapidly growing prevalence of diabetes in Asia heralds a large increase in the incidence of diabetes-related death in the coming decades.
Self-Reported Diabetes and Health Behaviors in Remote Indigenous Communities in Northern Queensland, Australia
Authors: McCulloch Brad , McDermott Robyn , Miller Geoff , Leonard Dympna , Elwell Michelle , Muller Reinhold 
Published: March 2007

OBJECTIVE—This study examines associations between self-reported diabetes and self-reported smoking, alcohol consumption, fruit consumption, and participation in adequate exercise in remote indigenous communities, using data from the Well Persons’ Health Check (WPHC).
RESEARCH DESIGN AND METHODS—The WPHC was a cross-sectional survey of 2,862 indigenous individuals (1,602 Aborigines, 1,074 Torres Strait Islanders, and 186 persons of joint descent) aged ≥15 years. The study was conducted in 26 remote communities in northern Queensland, Australia, between March 1998 and October 2000.
RESULTS—A total of 32% of individuals with self-reported diabetes and 25% of other individuals reported eating enough fruit, according to National Health and Medical Research Council criteria: odds ratio (OR) 1.407 (95% CI 1.108–1.786), P = 0.006. After adjustment for age, sex, and ethnicity, no significant difference could be observed: adjusted OR 1.22 (0.944–1.574), P = 0.128. A total of 58% of participants who reported diabetes and 51% of others reported adequate exercise: OR 0.761 (0.609–0.952), P = 0.018. This difference was not significant after adjustment for age, sex, and ethnicity: adjusted OR 0.896 (0.705–1.14), P = 0.370. A total of 43% of individuals who reported diabetes and 72% of others reported consuming alcohol: OR 0.295 (0.235–0.369), P &lt; 0.001. After adjustment for age, sex, and ethnicity, this difference was still significant: adjusted OR 0.550 (0.428–0.709), P &lt; 0.001. Diabetic drinkers consumed alcohol at harmful levels similar to those of nondiabetic drinkers (P = 0.691). A total of 40% of individuals who reported diabetes and 63% of other persons were tobacco smokers: OR 0.403 (0.322–0.505), P &lt; 0.001. Although this crude difference was attenuated by adjustment for age, sex, and ethnicity, persons with self-reported diabetes were still significantly less likely to smoke tobacco than other participants: adjusted OR 0.666 (0.521–0.852), P = 0.001. Smoking prevalence among the diabetic indigenous participants was more than double that in nondiabetic nonindigenous Australians.
CONCLUSIONS—This study suggests that indigenous individuals with diabetes living in rural and remote communities are not adopting lifestyle changes required for optimal self-management of the disease. This contributes to the large excess of mortality and morbidity experienced by this population.
Association of NAD(P)H Oxidase p22 phox Gene Variation With Advanced Carotid Atherosclerosis in Japanese Type 2 Diabetes
Authors: Hayaishi-Okano Rieko , Yamasaki Yoshimitsu , Kajimoto Yoshitaka , Sakamoto Ken’ya , Ohtoshi Kentaro , Katakami Naoto , Kawamori Dan , Miyatsuka Takeshi , Hatazaki Masahiro , Hazama Yoji , Hori Masatsugu 
Published: March 2007

OBJECTIVE—To evaluate the association between the C242T polymorphism of the p22 phox gene, an essential component of NAD(P)H oxidase in the vasculature, with intima-media thickness (IMT) of the carotid artery and risk factors for atherosclerosis in type 2 diabetic subjects.
RESEARCH DESIGN AND METHODS—C242T polymorphism of the p22 phox gene was detected by polymerase chain reaction-restriction fragment-length polymorphism in 200 Japanese type 2 diabetic subjects and 215 nondiabetic subjects. We examined the association with this mutation and carotid atherosclerosis as well as the patients’ clinical characteristics and the level of 8-hydroxy-2′deoxyguanosine (8-OHdG) as an index of oxidative DNA damage.
RESULTS—The diabetic subjects with the TC+TT genotypes displayed a significantly lower average IMT (1.13 ± 0.31 vs. 1.31 ± 0.34 mm; P = 0.0099) and a not significantly lower serum 8-OHdG level than those with the CC genotype, despite no difference in the risk factors. Stepwise multiple regression analysis showed that the risk factors for increased IMT in the diabetic subjects were systolic blood pressure (P = 0.0042) and p22 phox CC genotype (P = 0.0151). In nondiabetic subjects, the average IMT of the TC+TT group was not different from that of the CC group (0.85 ± 0.14 vs. 0.94 ± 0.30 mm, P = 0.417). Fasting plasma insulin concentration (41.4 ± 15.6 vs. 64.2 ± 59.4 pmol/l, P = 0.0098) and insulin resistance index of homeostasis model assessment (HOMA-R) (1.58 ± 0.66 vs. 2.60 ± 2.56, P = 0.0066) were significantly lower in the TC+TT group than in the CC group.
CONCLUSIONS—These results show that the C242T mutation in the p22 phox gene is associated with progression of asymptomatic atherosclerosis in the subjects with type 2 diabetes and is also associated with insulin resistance in nondiabetic subjects.
Insulin Sensitivity and Lipid Metabolism in Human CD36 Deficiency
Authors: Furuhashi Masato , Ura Nobuyuki , Nakata Tomoaki , Shimamoto Kazuaki 
Published: March 2007

OBJECTIVE—CD36 has been proposed as a fatty acid translocase and a receptor for HDL and oxidized LDL. The association between CD36 deficiency and insulin resistance remains controversial. We investigated glucose and lipid metabolism in human CD36 deficiency.
RESEARCH DESIGN AND METHODS—A total of 61 type I CD36-deficient patients and 25 control subjects were examined. Diabetes was defined as fasting glucose level ≥7 mmol/l or use of hypoglycemic agents. A homeostasis model assessment (HOMA) index was evaluated in patients without diabetes. Insulin resistance was defined as a HOMA index ≥1.73 (sensitivity 64.3%, specificity 78.9%; J Japan Diab Soc, 2000).
RESULTS—Diabetes was identified in 12 (20%) of the 61 CD36-deficient patients. Fasting glucose, HbA1c, and total cholesterol levels in the diabetic CD36-deficient patients were significantly higher than in the control subjects and the nondiabetic CD36-deficient patients. Regardless of diabetes, HDL cholesterol concentrations in the CD36-deficient patients were significantly higher than in the control subjects. The nondiabetic CD36-deficient patients had higher triglyceride concentrations than the control subjects, and triglyceride concentrations were higher in the diabetic CD36-deficient patients than in the nondiabetic CD36-deficient patients. The prevalence of insulin resistance in the nondiabetic CD36-deficient patients was similar to that in the control subjects.
CONCLUSIONS—Human CD36 deficiency is not necessarily responsible for insulin resistance. Lipid abnormalities in CD36 deficiency may partly depend on the presence of diabetes, and increased levels of triglyceride and HDL cholesterol may be due to impaired binding of fatty acids and HDL to CD36 and subsequent clearance.
Amputation and Mortality in New-Onset Diabetic Foot Ulcers Stratified by Etiology
Authors: Moulik Probal K. , Mtonga Robert , Gill Geoffrey V. 
Published: March 2007

OBJECTIVE—Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. The present study aims to examine the long-term outcome in terms of amputations and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology.
RESEARCH DESIGN AND METHODS—Patients presenting with new ulcers (duration &lt;1 month) to a dedicated diabetic foot clinic between 1994 and 1998 were studied. Outcomes were determined until March 2000 (or death) from podiatry, hospital, and district registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic, or neuroischemic. Five-year amputation and mortality rates were derived from Kaplan-Meier survival analysis curves.
RESULTS—Of the 185 patients studied, 41% had peripheral vascular disease (PVD) and 61% had neuropathy; 45%, 16%, and 24% of patients had neuropathic, ischemic, and neuroischemic ulcers, respectively. The mean follow-up period was 34 months (range 1–65) including survivors and patients who died during the study period. Five-year amputation rates were higher for ischemic (29%) and neuroischemic (25%) than neuropathic (11%) ulcers. Five-year mortality was 45%, 18%, and 55% for neuropathic, neuroischemic, and ischemic ulcers, respectively. Mortality was higher in ischemic ulcers than neuropathic ulcers. On multivariate regression analysis, only increasing age predicted shorter survival time.
CONCLUSIONS—All types of diabetic foot ulcers are associated with high morbidity and mortality. The increased mortality appears to be independent of factors increasing ulcer risk—that is, neuropathy and PVD—in patients with established foot ulcers.