bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation of Resting Energy Expenditure Considering Effects of Race and Diabetes Status
Authors: Martin Kelley , Wallace Penny , Rust Philip F. , Garvey W. Timothy 
Published: March 2007

OBJECTIVE—To evaluate the impact of diabetes status and race, in addition to other covariables, on the estimation of resting energy expenditure (REE).
RESEARCH DESIGN AND METHODS—Demographic, anthropometric, and clinical parameters were assessed in 166 adults of varying weights. Subjects were categorized by race (white versus black) and into three subgroups based on glucose tolerance (normoglycemia, impaired glucose tolerance, and type 2 diabetes), termed the diabetes status index (DSI). REE was measured by indirect calorimetry. A multiple regression model was established for optimal prediction of REE based on covariables.
RESULTS—An average decrease in REE of 135 kcal/day independent of all other variables was observed in blacks (P &lt; 0.001). DSI was found to be a significant covariable (P = 0.002) in predicting REE, which was observed to be higher in diabetic women. Therefore, race and DSI entered the multiple regression equation to predict REE as significant independent variables, together with lean body mass (LBM) and age × BMI interaction (P &lt; 0.001). Overall, REE prediction resulted in an R2 of 0.79 and a root mean square error of 136 kcal/day. These values indicate that the resultant equations could offer advantages over other key published prediction equations. The equations are: 1) REEfemale = 803.8 + 0.3505 × age × (BMI − 34.524) − 135.0 × race + 15.866 × LBM + 50.90 × DSI; and 2) REEmale = 909.4 + 0.3505 × age × (BMI –34.524) –135.0 × race + 15.866 × LBM –9.10 × DSI. The predictive value of the equations did not diminish substantially when fat-free mass estimated by skinfold calipers was substituted for dual-energy X-ray absorptiometry scan measurements of LBM.
CONCLUSIONS—Race and diabetes status are important when predicting REE, coupled with LBM, age, BMI, and sex. Race and DSI have not been considered in equations commonly used to predict REE. Their inclusion could improve individualization of dietary prescriptions for type 2 diabetic subjects and heterogeneous populations.
Effect of Alendronate on Bone Mineral Density and Biochemical Markers of Bone Turnover in Type 2 Diabetic Women
Authors: Keegan Theresa H.M. , Schwartz Ann V. , Bauer Douglas C. , Sellmeyer Deborah E. , Kelsey Jennifer L. 
Published: March 2007

OBJECTIVE—Alendronate sodium (ALN) increases bone mineral density (BMD) in heterogeneous populations of postmenopausal women, but its effect is unknown in women with type 2 diabetes. The objective of this project was to compare changes in BMD during 3 years of ALN treatment versus placebo in diabetic women.
RESEARCH DESIGN AND METHODS—We used data from the Fracture Intervention Trial, a randomized blinded placebo-controlled trial conducted at 11 centers in which 6,458 women aged 54–81 years with a femoral neck BMD of ≤0.68 g/cm2 were randomly assigned to either placebo or 5 mg/day ALN for 2 years, followed by 10 mg/day for the remainder of the trial. BMD was measured by dual-energy X-ray absorptiometry. Type 2 diabetes (n = 297) was defined by self-report, use of insulin or other hypoglycemic agents, or a random nonfasting glucose value ≥200 mg/dl.
RESULTS—In diabetic women, 3 years of ALN treatment was associated with increased BMD at all sites studied, including 6.6% at the lumbar spine and 2.4% at the hip, whereas women in the placebo group experienced a decrease in BMD at all sites except the lumbar spine. The safety/tolerability of ALN was similar to placebo, except for abdominal pain, which was more likely in the ALN group.
CONCLUSIONS—ALN increased BMD relative to placebo in older women with type 2 diabetes and was generally well tolerated as a treatment for osteoporosis. Increases in BMD with ALN therapy compared with placebo were similar between women with and without diabetes.
Tuberculosis and Diabetes in Southern Mexico
Authors: Ponce-de-Leon Alfredo , Garcia-Garcia Ma. de Lourdes , Garcia-Sancho Ma. Cecilia , Gomez-Perez Francisco J. , Valdespino-Gomez Jose Luis , Olaiz-Fernandez Gustavo , Rojas Rosalba , Ferreyra-Reyes Leticia , Cano-Arellano Bulmaro , Bobadilla Miriam , Small Peter M. , Sifuentes-Osornio Jose 
Published: March 2007

OBJECTIVE—To determine the impact of diabetes on the rates of tuberculosis in a region where both diseases are prevalent.
RESEARCH DESIGN AND METHODS—Data from a population-based cohort of patients with pulmonary tuberculosis undergoing clinical and mycobacteriologic evaluation (isolation, identification, drug-susceptibility testing, and IS6110-based genotyping and spoligotyping) were linked to the 2000 National Health Survey (ENSA2000), a national probabilistic, polystage, stratified, cluster household survey of the civilian, noninstitutionalized population of Mexico.
RESULTS—From March 1995 to March 2003, 581 patients with Mycobacterium tuberculosis culture and fingerprint were diagnosed, 29.6% of whom had been diagnosed previously with diabetes by a physician. According to the ENSA2000, the estimated prevalence of diabetes in the study area was 5.3% (95% CI 4.1–6.5). The estimated rates of tuberculosis for the study area were greater for patients with diabetes than for nondiabetic individuals (209.5 vs. 30.7 per 100,000 person-years, P &lt; 0.0001).
CONCLUSIONS—In this setting, the rate of tuberculosis was increased 6.8-fold (95% CI 5.7–8.2, P &lt; 0.0001) in patients with diabetes due to increases in both reactivated and recently transmitted infection. Comorbidity with diabetes may increase tuberculosis rates as much as coinfection with human immunodeficiency virus (HIV), with important implications for the allocation of health care resources.
Health-Related Social Disengagement in Elderly Diabetic Patients
Authors: Kuo Yong-Fang , Raji Mukaila A. , Peek M. Kristen , Goodwin James S. 
Published: March 2007

OBJECTIVE—We examined the relationship between health-related social disengagements, as opposed to disengagements related to financial and other non–health-related factors, and subsequent risk of disability and death among initially nondisabled elderly diabetic patients enrolled in Medicare Managed Care plans.
RESEARCH DESIGN AND METHODS—We used data from the Medicare Health Outcomes Survey (HOS) Cohort 1 Baseline (1998) and Cohort 1 Follow-Up (2000). Through mail and telephone surveys, trained interviewers collected information on sociodemographic variables, physical and mental health functioning (using Medical Outcomes Study Short Form-36 [SF-36]), activities of daily living (ADL), and medical conditions. This study reported on diabetic subjects aged ≥65 years with no ADL disability at baseline (n = 8,949). Health-related social disengagement (degree to which physical health or emotional problems interfere with social activities) was derived from the social functioning subscale of SF-36 (range 0–100; higher scores depicting better social functioning).
RESULTS—For each 10-point increase in social functioning score at baseline, older diabetic subjects in our study experienced an 18% less chance of any ADL disability (odds ratio [OR] 0.82, 95% CI 0.75–0.89; P &lt; 0.001) and a 12% less chance of death (0.88, 0.78–1.00; P = 0.043) over a 2-year period, adjusting for demographic factors, comorbidities, depression, and general health (assessed by the SF-36).
CONCLUSIONS—Among initially nondisabled older diabetic subjects, health-related interferences with social activities at baseline may be early warning signs of subsequent ADL disability and premature death, independent of other measures of health status.
Sensory Function and Albumin Excretion According to Diagnostic Criteria for Diabetes
Authors: Sosenko Jay M. , Kato Martha , Goldberg Ronald B. 
Published: March 2007

OBJECTIVE—The purpose of this study was to examine sensory function and albumin excretion according to categories of glucose tolerance in individuals undergoing screening for diabetes.
RESEARCH DESIGN AND METHODS—Sensory function and albumin excretion measurements were obtained in 636 individuals at the time of screening for diabetes according to American Diabetes Association glucose tolerance criteria. Sensory thresholds were measured by forced-choice techniques. Albumin-to-creatinine ratios were calculated from spot urine samples.
RESULTS—Of 90 individuals whose glucose levels were in the range for diabetes, 65 had fasting glucose values ≥126 mg/dl, whereas 25 had 2-h glucose values ≥200 mg/dl, with fasting glucose values &lt;126 mg/dl. In covariance analyses, those with fasting glucose levels ≥126 mg/dl had higher vibration (P &lt; 0.01) and thermal (P &lt; 0.05 for cool and warm) thresholds than those with normal glucose tolerance. This pattern was also evident for albumin-to-creatinine ratios (P &lt; 0.001). In contrast, those with 2-h glucose values ≥200 mg/dl and fasting glucose values &lt;126 mg/dl had sensory threshold and albumin-to-creatinine ratio values similar to those of the normal group. Individuals with fasting glucose levels ≥126 mg/dl had higher vibration threshold and albumin-to-creatinine ratio values (&lt;0.05 and &lt;0.01, respectively) than those with levels &lt;126 mg/dl.
CONCLUSIONS—Sensory threshold and albumin excretion values already tend to be greater than normal at screening in individuals with fasting glucose levels ≥126 mg/dl, but not in those with levels &lt;126 mg/dl. A reliance on fasting glucose levels ≥126 mg/dl for screening might not be sufficient for early intervention and the optimal prevention of diabetes complications.
Lowering the Criterion for Impaired Fasting Glucose
Authors: Tai E. Shyong , Goh Su Yen , Lee Jeannette J.M. , Wong Moh-Sim , Heng Derrick , Hughes Kenneth , Chew Suok Kai , Cutter Jeffery , Chew William , Gu Ken , Chia Kee Seng , Tan Chee Eng 
Published: March 2007

OBJECTIVE—To determine the effect of lowering the fasting plasma glucose (FPG) criterion for impaired fasting glucose (IFG) on the prevalence of IFG, the risks of diabetes, and cardiovascular disease (CVD) associated with IFG.
RESEARCH DESIGN AND METHODS—Three studies were used: 1) the 1998 National Health Survey (NHS98), a randomly selected cross-sectional sample of 4,723 subjects; 2) the Singapore Impaired Glucose Tolerance (IGT) Follow-up Study, a cohort study comprising 295 IGT and 292 normal glucose tolerance subjects (frequency matched for age, sex, and ethnic group) followed up from 1992 to 2000; and 3) the Singapore CVD Cohort Study, comprising 5,920 subjects from three cross-sectional studies in whom the first ischemic heart disease (IHD) event was identified through linkage to registry databases. Risk of diabetes (Singapore IGT Follow-up study) was estimated using logistic regression adjusted for age, sex, and ethnicity. Risk of IHD (Singapore CVD cohort) was estimated using stratified (by study, from which data were derived) Cox’s proportional hazards models adjusted for age, sex, and ethnicity.
RESULTS—Lowering the criterion for diagnosing IFG to 5.6 mmol/l increased the prevalence of IFG from 9.5 to 32.3% in the NHS98. The lower cutoff identified more subjects at risk of diabetes and IHD, but the relative risk was lower than that for IGT.
CONCLUSIONS—Greater efforts to identify those with IGT, or a group at similar risk of diabetes and CVD, may be a more efficient public health measure than lowering the FPG criterion for diagnosing IFG.
The Incidence of Congestive Heart Failure in Type 2 Diabetes
Authors: Nichols Gregory A. , Gullion Christina M. , Koro Carol E. , Ephross Sara A. , Brown Jonathan B. 
Published: March 2007

OBJECTIVE—The aims of this study were to update previous estimates of the congestive heart failure (CHF) incidence rate in patients with type 2 diabetes, compare it with an age- and sex-matched nondiabetic group, and describe risk factors for developing CHF in diabetic patients over 6 years of follow-up.
RESEARCH DESIGN AND METHODS—We performed a retrospective cohort study of 8,231 patients with type 2 diabetes and 8,845 nondiabetic patients of similar age and sex who did not have CHF as of 1 January 1997, following them for up to 72 months to estimate the CHF incidence rate. In the diabetic cohort, we constructed a Cox regression model to identify risk factors for CHF development.
RESULTS—Patients with diabetes were much more likely to develop CHF than patients without diabetes (incidence rate 30.9 vs. 12.4 cases per 1,000 person-years, rate ratio 2.5, 95% CI 2.3–2.7). The difference in CHF development rates between persons with and without diabetes was much greater in younger age-groups. In addition to age and ischemic heart disease, poorer glycemic control (hazard ratio 1.32 per percentage point of HbA1c) and greater BMI (1.12 per 2.5 units of BMI) were important predictors of CHF development.
CONCLUSIONS—The CHF incidence rate in type 2 diabetes may be much greater than previously believed. Our multivariate results emphasize the importance of controlling modifiable risk factors for CHF, namely hyperglycemia, elevated blood pressure, and obesity. Younger patients may benefit most from risk factor modification.
Are We Underestimating Diabetes-Related Lower-Extremity Amputation Rates?
Authors: Rayman Gerry , Krishnan Singhan T.M. , Baker Neil R. , Wareham Alison M. , Rayman Anne 
Published: March 2007

OBJECTIVE—The objective of this study was to accurately determine the incidence of lower-extremity amputation using prospective data collection and to compare the results with those obtained by retrospective methods.
RESEARCH DESIGN AND METHODS—The study was carried out over a 3-year period in a large district general hospital covering a clearly defined and relatively static population. All diabetic inpatients with foot problems were identified and followed-up until discharge or death. The demographic and admission details, medical history, investigations, procedures, and history and etiology of the foot lesion were collected twice weekly by a specialist nurse and podiatrist from all relevant wards. Thus, all subjects who underwent amputation could be identified. For comparison, retrospective data were collected from the hospital coding activities database, operating theater log books, anesthetic database, and limb-fitting records.
RESULTS—The total population of the region in 2000 was 337,859, of which 9,183 were known to have diabetes. The total number of amputations during the 3-year survey period was 79, of which 45 were major and 34 minor. In our local population, the mean incidence during the survey period (1997–2000) equates to 7.8/100,000 general population and 2.85/1,000 diabetic population for all amputations, 4.5/100,000 general population and 1.62/1,000 diabetic population for major amputations, and 3.3/100,000 general population and 1.23/1,000 diabetic population for minor amputations. The prospective survey detected all lower-extremity amputations identified by the various retrospective methods; however, for the reverse, this was not the case. All of the retrospective methods, including the most commonly used (ICD-9 and OPCS-4 coding), failed to detect all of the cases revealed by the prospective survey (error rate ranging from 4.2 to 90.6%), and between 4.5 and 17.4% of amputations were misclassified.
CONCLUSIONS—This study demonstrates the advantages of prospective data collection as a means of determining the incidence of lower-extremity amputations and highlights the limitations of retrospective data collection methods, which underestimate the incidence. In particular, the operating theater records, which have been the gold standard for many surveys, were found to be unreliable. Moreover, we have shown a 47% reduction in the major amputations during the survey period. Thus, we recommend that a prospective audit be incorporated into the activities of the specialist foot care team as a means of assessing and improving clinical care.
Distinct Diagnostic Criteria of Fulminant Type 1 Diabetes Based on Serum C-Peptide Response and HbA1c Levels at Onset
Authors: Tanaka Shoichiro , Endo Toyoshi , Aida Kaoru , Shimura Hiroki , Yokomori Norihiko , Kaneshige Masahiro , Furuya Fumihiko , Amemiya Shin , Mochizuki Mie , Nakanishi Koji , Kobayashi Tetsuro 
Published: March 2007

OBJECTIVE—Diagnostic criteria in fulminant type 1 diabetes, a novel subtype of type 1 diabetes, remain unclear.
RESEARCH DESIGN AND METHODS—We analyzed basal and longitudinal changes of serum C-peptide levels during a 75-g oral glucose tolerance test (OGTT) in 125 consecutively recruited patients with type 1 diabetes including fulminant type 1 diabetes (n = 25) and acute-onset type 1 diabetes (n = 100). Discriminating criteria of fulminant type 1 diabetes were examined using receiver-operating characteristic curve analysis and multiple logistic regression analysis.
RESULTS—The integrated values of serum C-peptide response during OGTT (ΣC-peptide) in fulminant type 1 diabetes at onset, 1 year, and 2 years after onset were markedly lower than those in acute-onset type 1 diabetes. None of the patients with fulminant type 1 diabetes had improvement of C-peptide response to OGTT. Fasting C-peptide values at onset in fulminant type 1 diabetes were significantly lower than those in acute-onset type 1 diabetes. We established diagnostic criteria of serum C-peptide and HbA1c levels at onset that discriminate fulminant type 1 diabetes from acute-onset type 1 diabetes with high sensitivity and specificity: a criterion in which the levels of both the fasting C-peptide is ≤0.033 nmol/l and HbA1c is ≤8.0% or a criterion in which the levels of both the ΣC-peptide is ≤0.540 nmol/l and HbA1c is ≤8.0%.
CONCLUSIONS—Fulminant type 1 diabetes has extremely low β-cell function at onset that rarely recovers after onset. Sensitive and specific diagnostic criteria were established for detection of fulminant type 1 diabetes based on serum C-peptide and HbA1c levels at onset.
Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects
Authors: Wackers Frans J.Th. , Young Lawrence H. , Inzucchi Silvio E. , Chyun Deborah A. , Davey Janice A. , Barrett Eugene J. , Taillefer Raymond , Wittlin Steven D. , Heller Gary V. , Filipchuk Neil , Engel Samuel , Ratner Robert E. , Iskandrian Ami E. ,   for the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Investigators
Published: March 2007

OBJECTIVE—To assess the prevalence and clinical predictors of silent myocardial ischemia in asymptomatic patients with type 2 diabetes and to test the effectiveness of current American Diabetes Association screening guidelines.
RESEARCH DESIGN AND METHODS—In the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study, 1,123 patients with type 2 diabetes, aged 50–75 years, with no known or suspected coronary artery disease, were randomly assigned to either stress testing and 5-year clinical follow-up or to follow-up only. The prevalence of ischemia in 522 patients randomized to stress testing was assessed by adenosine technetium-99m sestamibi single-photon emission–computed tomography myocardial perfusion imaging.
RESULTS—A total of 113 patients (22%) had silent ischemia, including 83 with regional myocardial perfusion abnormalities and 30 with normal perfusion but other abnormalities (i.e., adenosine-induced ST-segment depression, ventricular dilation, or rest ventricular dysfunction). Moderate or large perfusion defects were present in 33 patients. The strongest predictors for abnormal tests were abnormal Valsalva (odds ratio [OR] 5.6), male sex (2.5), and diabetes duration (5.2). Other traditional cardiac risk factors or inflammatory and prothrombotic markers were not predictive. Ischemic adenosine-induced ST-segment depression with normal perfusion (n = 21) was associated with women (OR 3.4). Selecting only patients who met American Diabetes Association guidelines would have failed to identify 41% of patients with silent ischemia.
CONCLUSIONS—Silent myocardial ischemia occurs in greater than one in five asymptomatic patients with type 2 diabetes. Traditional and emerging cardiac risk factors were not associated with abnormal stress tests, although cardiac autonomic dysfunction was a strong predictor of ischemia.
Does the Aspartic Acid to Asparagine Substitution at Position 76 in the Pancreas Duodenum Homeobox Gene (PDX1) Cause Late-Onset Type 2 Diabetes?
Authors: Elbein Steven C. , Karim Mohammad A. 
Published: March 2007

OBJECTIVE—Considerable data support an inherited defect in insulin secretion as one component of type 2 diabetes. Coding variants of the pancreas duodenum homeobox gene (PDX1) were proposed to predispose late-onset type 2 diabetes and to decrease transactivation in vitro. We tested the hypothesis that the Asp76Asn (D76N) variant that was identified in several populations predisposed type 2 diabetes and reduced insulin secretion.
RESEARCH DESIGN AND METHODS—We performed a case-control study in 191 control subjects and 190 individuals with type 2 diabetes, all of European descent, then characterized the D76N variant in 704 members of 68 families. We compared the phenotypic characteristics of those with and without the variant by diagnostic status and determined the insulin secretory response to intravenous glucose and tolbutamide among nondiabetic family members.
RESULTS—D76N was not associated with type 2 diabetes, either in our population or when all reported studies in Caucasians were combined. D76N did not segregate with diabetes among the families examined. Among D76N carriers, nondiabetic individuals had a lower waist-to-hip ratio and a trend to lower BMI than their diabetic counterparts. Diabetic carriers of D76N were significantly leaner by BMI (P = 0.012) and tended to be younger than diabetic individuals with the D/D genotype. However, insulin secretion in response to oral and intravenous glucose challenge and to intravenous tolbutamide was not reduced in D76N carriers.
CONCLUSIONS—The D76N variant of PDX1 does not significantly alter insulin secretion or act as a high-risk susceptibility allele for late-onset type 2 diabetes as proposed previously, although we cannot exclude a minor role in increasing risk of diabetes.
The +276 G/T Single Nucleotide Polymorphism of the Adiponectin Gene Is Associated With Coronary Artery Disease in Type 2 Diabetic Patients
Authors: Bacci Simonetta , Menzaghi Claudia , Ercolino Tonino , Ma Xiaowei , Rauseo Anna , Salvemini Lucia , Vigna Carlo , Fanelli Raffaele , Di Mario Umberto , Doria Alessandro , Trischitta Vincenzo 
Published: March 2007

OBJECTIVE—Two single nucleotide polymorphisms (SNPs) at the adiponectin locus (+45T&gt;G and +276G&gt;T) have been associated with low circulating adiponectin levels, insulin resistance, and type 2 diabetes. We investigated whether these genetic markers are determinants of coronary artery disease (CAD) in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—A total of 376 consecutive type 2 diabetic patients were studied: 142 case subjects with coronary stenosis &gt;50% or previous myocardial infarction and 234 control subjects with no symptoms, no electrocardiogram (ECG) signs of myocardial ischemia, and a normal ECG stress test (n = 189) and/or (n = 45) with coronary stenosis ≤50%.
RESULTS—No association with CAD was observed for the +45 SNP (P = 0.48). By contrast, a significant association was observed for the +276 SNP, with T/T homozygotes having a lower risk of CAD than carriers of other genotypes (adjusted odds ratio [OR] 0.13 [95% CI 0.037–0.46], P = 0.002). A similarly protective effect of the +276 T/T genotype was observed in 110 case and 45 control subjects for whom the CAD status had been determined by angiography (0.04 [0.006–0.30], P = 0.002).  Serum adiponectin, although clearly related to several features of the proatherogenic/insulin-resistant phenotype, was not different between control subjects and CAD patients (26 ± 17 vs. 25 ± 13 μg/ml).
CONCLUSIONS—In conclusion, the +276 G&gt;T polymorphism is a determinant of CAD risk in type 2 diabetic patients. This marker may assist in the identification of diabetic individuals at especially high risk of CAD, so that preventive programs can be targeted at these subjects.