bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Onset Problem Behavior, Young Adult Psychopathology, and Contextual Risk
Authors: Keyes Margaret A. , Iacono William G. , McGue Matt 
Published: February 2007

AbstractA prospective study of 692 male twins was undertaken to investigate the relationships among early adolescent problem behavior, contextual risk, and disinhibitory psychopathology. Early adolescent problem behavior was assessed by the number of the following behaviors engaged in by the time of the age-14 assessment: (1) tobacco use, (2) alcohol use, (3) marijuana use, (4) other illicit drug use, (5) sexual intercourse, and (6) police contact. Contextual risk was assessed as a composite of measures of peer models, parent-offspring conflict, and academic engagement from the age-14 assessment. Disinhibitory psychopathology was assessed by symptoms of nicotine dependence, alcohol dependence, drug dependence, and adult antisocial behavior at the age-18 assessment. Early adolescent problem behavior and contextual risk were strongly correlated (r = .53) and both were strongly and independently associated with symptoms of disinhibitory psychopathology (r from .35 to .60). The association of early adolescent problem behavior with both contextual risk and disinhibitory psychopathology was mediated entirely by genetic factors while the association between contextual risk and disinhibitory psychopathology was mediated by both genetic and nonshared environmental factors. The results are discussed in the context of emerging research on the prognostic significance of early adolescent problem behavior for risk of adult psychopathology.
Effects of Medical Therapy on Insulin Resistance and the Cardiovascular System in Polycystic Ovary Syndrome
Authors: Meyer Caroline , McGrath Barry P. , Teede Helena Jane 
Published: February 2007

OBJECTIVE—We aimed to determine the impact of medical therapy for symptom management on insulin resistance, metabolic profiles, and surrogate markers of cardiovascular disease in polycystic ovary syndrome (PCOS), an insulin-resistant pre-diabetes condition.
RESEARCH DESIGN AND METHODS—One hundred overweight women (BMI &gt;27 kg/m2), average age 31 years, who were nonsmokers, were not pregnant, did not have diabetes, and were off relevant medications for 3 months completed this 6-month open-label controlled trial. Randomization was to a control group (higher-dose oral contraceptive [OCP] 35 μg ethinyl estradiol [EE]/2 mg cyproterone acetate, metformin [1 g b.d.] or low-dose OCP [20 μg EE/100 μg levonorgestrel + aldactone 50 mg b.d.]). Primary outcome measures were insulin resistance (area under curve on oral glucose tolerance test) and surrogate markers of cardiovascular disease including arterial stiffness (pulse wave velocity [PWV]) and endothelial function.
RESULTS—All treatments similarly and significantly improved symptoms including hirsutism and menstrual cycle length. Insulin resistance was improved by metformin and worsened by the high-dose OCP. Arterial stiffness worsened in the higher-dose OCP group (PWV 7.46 vs. 8.03 m/s, P &lt; 0.05), related primarily to the increased insulin resistance.
CONCLUSIONS—In overweight women with PCOS, metformin and low- and high-dose OCP preparations have similar efficacy but differential effects on insulin resistance and arterial function. These findings suggest that a low-dose OCP preparation may be preferable if contraception is needed and that metformin should be considered for symptomatic management, particularly in women with additional metabolic and cardiovascular risk factors.
Circulating Soluble Transferrin Receptor According to Glucose Tolerance Status and Insulin Sensitivity
Authors: Fernández-Real José Manuel , Moreno José Maria , López-Bermejo Abel , Chico Berta , Vendrell Joan , Ricart Wifredo 
Published: February 2007

OBJECTIVE—The relationships between iron metabolism and type 2 diabetes are bidirectional: iron affects glucose metabolism and glucose metabolism impinges on several iron metabolic pathways. The mechanisms of these interactions depend on poorly known factors. We aimed to study the contribution of the serum soluble transferrin receptor (sTfR).
RESEARCH DESIGN AND METHODS—Circulating sTfR was evaluated in 221 men (97 with normal glucose tolerance [NGT], 36 with impaired glucose tolerance, and 88 with type 2 diabetes). In a subset of these subjects, glucose tolerance (oral glucose tolerance test [OGTT]), minimal model–derived insulin sensitivity, and sTfR during the OGTT were also evaluated.
RESULTS—Men with altered glucose tolerance showed significantly increased sTfR (9.4 ± 4.4 vs. 8.2 ± 2.6 μg/ml, P = 0.02) and higher serum ferritin than men with NGT. Serum sTfR was negatively associated with serum ferritin (r = −0.16, P = 0.02). sTfR correlated with several clinical and metabolic variables such as systolic blood pressure, glycated hemoglobin, and glucose and insulin values during OGTT. Insulin sensitivity was also negatively associated with sTfR in NGT and nonobese subjects. BMI (P = 0.01), serum ferritin (P = 0.025), and insulin sensitivity (P &lt; 0.0001) contributed independently to 21% of sTfR variance. Serum sTfR concentration did not significantly change during the OGTT.
CONCLUSIONS—Both insulin sensitivity and glucose tolerance status are significantly associated with serum sTfR concentrations, although insulin sensitivity predicts independently circulating sTfR, mainly in subjects with NGT. The implications of the interrelationships between iron and glucose metabolism should be investigated further.
Does Dairy Calcium Intake Enhance Weight Loss Among Overweight Diabetic Patients?
Authors: Shahar Danit R. , Abel Relly , Elhayany Asher , Vardi Hillel , Fraser Drora 
Published: February 2007

OBJECTIVE—To examine the effect of dairy calcium consumption on weight loss and improvement in cardiovascular disease (CVD) and diabetes indicators among overweight diabetic patients.
RESEARCH DESIGN AND METHODS—This was an ancillary study of a 6-month randomized clinical trial assessing the effect of three isocaloric diets in type 2 diabetic patients: 1) mixed glycemic index carbohydrate diet, 2) low–glycemic index diet, and 3) modified Mediterranean diet. Low-fat dairy product consumption varied within and across the groups by personal choice. Dietary intake, weight, CVD risk factors, and diabetes indexes were measured at baseline and at 6 months.
RESULTS—A total of 259 diabetic patients were recruited with an average BMI &gt;31 kg/m2 and mean age of 55 years. No difference was found at baseline between the intervention groups in CVD risk factors, diabetes indicators, macronutrient intake, and nutrient intake from dairy products. Dairy calcium intake was associated with percentage of weight loss. Among the high tertile of dairy calcium intake, the odds ratio for weight loss of &gt;8% was 2.4, P = 0.04, compared with the first tertile, after controlling for nondairy calcium intake, diet type, and the change in energy intake from baseline. No association was noted between dairy calcium and other health indexes except for triglyceride levels.
CONCLUSIONS—A diet rich in dairy calcium intake enhances weight reduction in type 2 diabetic patients. Such a diet could be tried in diabetic patients, especially those with difficulty adhering to other weight reduction diets.
Circulating Visfatin Is Associated With Parameters of Iron Metabolism in Subjects With Altered Glucose Tolerance
Authors: Fernández-Real José Manuel , Moreno José María , Chico Berta , López-Bermejo Abel , Ricart Wifredo 
Published: February 2007

OBJECTIVE—Visfatin is a novel adipokine that is predominantly secreted by visceral adipose tissue. Accumulation of visceral adipose tissue is also associated with iron metabolism. Despite the coincidence of visfatin expression in iron-rich tissues, no study has investigated the possible interaction of visfatin with parameters of iron metabolism.
RESEARCH DESIGN AND METHODS—We evaluated insulin sensitivity and parameters of iron metabolism in 95 men with normal glucose tolerance (NGT) and 43 men with altered glucose tolerance.
RESULTS—Men with newly diagnosed type 2 diabetes had significantly increased serum visfatin in parallel with increased serum prohepcidin and serum ferritin compared with the other groups. In all subjects as a whole, circulating visfatin was not found to be significantly linked to insulin sensitivity (r = 0.07, P = 0.4) but was significantly associated with serum prohepcidin concentration (r = 0.40, P &lt; 0.0001). Obesity status and glucose tolerance status influenced the relationships among visfatin, insulin sensitivity, and parameters of iron metabolism. Among men with altered glucose tolerance, serum visfatin was strongly associated with serum prohepcidin (r = 0.61, P &lt; 0.0001) and serum soluble transferrin receptor (sTfR) (r = −0.51, P &lt; 0.0001). In nonobese subjects, sTfR (P = 0.02) and prohepcidin (P = 0.04) contributed independently to visfatin variance after controlling for age and BMI. When insulin sensitivity was added to the model, only the latter (P = 0.006) contributed to 17% of visfatin variance. In obese men, however, only sTfR (P = 0.04) contributed independently to visfatin variance in this latter model.
CONCLUSIONS—Serum visfatin concentration is significantly associated with parameters of iron metabolism, especially in subjects with altered glucose tolerance.
Randomized Trial of Behavioral Family Systems Therapy for Diabetes
Authors: Wysocki Tim , Harris Michael A. , Buckloh Lisa M. , Mertlich Debbie , Lochrie Amanda S. , Mauras Nelly , White Neil H. 
Published: February 2007

OBJECTIVE—Studies showing that family communication and conflict resolution are critical to effective management of type 1 diabetes in adolescents have stimulated interest in evaluating psychological treatments targeting these processes. Previous trials have shown that Behavioral Family Systems Therapy (BFST) improved parent-adolescent relationships but not treatment adherence or glycemic control. This study evaluates a revised intervention, BFST for Diabetes (BFST-D), modified to achieve greater impact on diabetes-related family conflict, treatment adherence, and metabolic control.
RESEARCH DESIGN AND METHODS—A sample of 104 families of adolescents with inadequate control of type 1 diabetes was randomized to either remain in standard care (SC) or to augmentation of that regimen by 12 sessions of either a multifamily educational support (ES) group or 12 sessions of BFST-D over 6 months. Pertinent measures were collected at baseline and at follow-up evaluations at 6, 12, and 18 months.
RESULTS—BFST-D was significantly superior to both SC and ES in effects on A1C, while effects on treatment adherence and family conflict were equivocal. Improvement in A1C appeared to be mediated by improvement in treatment adherence. A significantly higher percentage of BFST-D youth achieved moderate or greater improvement (&gt;0.5 SD) in treatment adherence compared with the SC group at each follow-up and the ES group at 6 and 18 months. Change in treatment adherence correlated significantly with change in A1C at each follow-up.
CONCLUSIONS—These results support the efficacy of BFST-D in improving A1C, but further research is needed to identify the mechanisms of this effect and to achieve cost-effective dissemination of the intervention.
Clinical Depression Versus Distress Among Patients With Type 2 Diabetes
Authors: Fisher Lawrence , Skaff Marilyn M. , Mullan Joseph T. , Arean Patricia , Mohr David , Masharani Umesh , Glasgow Russell , Laurencin Grace 
Published: February 2007

OBJECTIVE—We sought to determine differences between structured interviews, symptom questionnaires, and distress measures for assessment of depression in patients with diabetes.
RESEARCH DESIGN AND METHODS—We assessed 506 diabetic patients for major depressive disorder (MDD) by a structured interview (Composite International Diagnostic Interview [CIDI]), a questionnaire for depressive symptoms (Center for Epidemiological Studies Depression Scale [CESD]), and on the Diabetes Distress Scale. Demographic characteristics, two biological variables (A1C and non-HDL cholesterol), and four behavioral management measures (kilocalories, calories of saturated fat, number of fruit and vegetable servings, and minutes of physical activity) were assessed. Comparisons were made between those with and without depression on the CIDI and the CESD.
RESULTS—Findings showed that 22% of patients reached CESD ≥16, and 9.9% met a CIDI diagnosis of MDD. Of those above CESD cut points, 70% were not clinically depressed, and 34% of those who were clinically depressed did not reach CESD scores ≥16. Those scoring ≥16, compared with those &lt;16 on the CESD, had higher A1C, kilocalories, and calories of saturated fat and lower physical activity. No differences were found using the CIDI. Diabetes distress was minimally related to MDD but substantively linked to CESD scores and to outcomes.
CONCLUSIONS—Most patients with diabetes and high levels of depressive symptoms are not clinically depressed. The CESD may be more reflective of general emotional and diabetes-specific distress than clinical depression. Most treatment of distress, however, is based on the depression literature, which suggests the need to consider different interventions for distressed but not clinically depressed diabetic patients.
Serum Zinc Level and Coronary Heart Disease Events in Patients With Type 2 Diabetes
Authors: Soinio Minna , Marniemi Jukka , Laakso Markku , Pyörälä Kalevi , Lehto Seppo , Rönnemaa Tapani 
Published: February 2007

OBJECTIVE—Low serum zinc level may predispose nondiabetic subjects to cardiovascular diseases. Our aim was to investigate whether serum zinc level predicts coronary heart disease (CHD) events in subjects with type 2 diabetes
RESEARCH DESIGN AND METHODS—The original study population consisted of 1,059 patients with type 2 diabetes, aged 45–64 years. Mean duration of diabetes was 8 years. Serum zinc values were available from 1,050 subjects. CHD mortality and the incidence of nonfatal myocardial infarction (MI) were assessed in a 7-year follow-up.
RESULTS—During the follow-up, 156 patients died from CHD and 254 patients had a fatal or nonfatal MI. Patients with serum zinc concentration ≤14.1 μmol/l at baseline had a higher risk for death from CHD than patients with serum zinc level &gt;14.1 μmol/l (20.8 and 12.8%, respectively; P = 0.001) The risks for fatal or nonfatal MI were 30.5 and 22.0%, respectively (P = 0.005). In Cox regression analyses, low serum zinc concentration was significantly associated with CHD mortality (relative risk [RR] 1.7, P = 0.002) and all CHD events (RR 1.37, P = 0.030), even after adjustment for confounding variables.
CONCLUSIONS—In this large cohort of type 2 diabetic patients, low serum zinc level was an independent risk factor for CHD events.
Perceptions of Psychosocial Factors and the Insulin Pump
Authors: Ritholz Marilyn D. , Smaldone Arlene , Lee Jarim , Castillo Astrid , Wolpert Howard , Weinger Katie 
Published: February 2007

OBJECTIVE—The purpose of this study was to identify psychosocial issues related to diabetes, approaches to self-care, self-perceptions, and social interactions among insulin pump users with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Adult insulin pump users participated in focus groups loosely formed on the basis of A1C level. Transcripts of focus group meetings were coded into themes by five reviewers using NVivo2 qualitative software.
RESULTS—Thirty adults with long-term diabetes participated in five focus groups: two with low mean ±SD A1C (6.8 ± 0.4%), one with mid A1C (7.80 ± 0.3%), and two with high A1C (9.1 ± 0.5%). Three major themes were identified: impact on diabetes self-care, emotional reactions to the insulin pump, body image, and social acceptance. Participants who described the pump as a tool to meet glycemic goals also described a more active approach to diabetes and had better glycemic control; those who discussed the pump as a panacea described more passive self-care and had poorer glycemic control. Low A1C groups reported that starting the insulin pump reminded them of feelings they experienced at their initial diabetes diagnosis, whereas the high A1C groups did not report these feelings. Women were more concerned than men about body image and social acceptance with pump use.
CONCLUSIONS—Active participation in self-care, realistic expectations of pump use, and emotional recall of diabetes diagnosis were associated with better glycemic control. Interventions to improve diabetes management with pump use should include evaluation and discussion of active versus passive approaches to self-care, recall of diabetes diagnosis, expectations of the pump, and pump-related self-consciousness and body image concerns. The roles of these factors in optimal diabetes management warrant further investigation.
Progressive Loss of β-Cell Function Leads to Worsening Glucose Tolerance in First-Degree Relatives of Subjects With Type 2 Diabetes
Authors: Cnop Miriam , Vidal Josep , Hull Rebecca L. , Utzschneider Kristina M. , Carr Darcy B. , Schraw Todd , Scherer Philipp E. , Boyko Edward J. , Fujimoto Wilfred Y. , Kahn Steven E. 
Published: February 2007

OBJECTIVE—The relative roles of insulin resistance and β-cell dysfunction in the pathogenesis of impaired glucose tolerance (IGT) and type 2 diabetes are debated. First-degree relatives of individuals with type 2 diabetes are at increased risk of developing hyperglycemia.
RESEARCH DESIGN AND METHODS—We evaluated the evolution of insulin sensitivity, β-cell function, glucose effectiveness, and glucose tolerance over 7 years in 33 nondiabetic, first-degree relatives of type 2 diabetic individuals using frequently sampled tolbutamide-modified intravenous and oral glucose tolerance tests.
RESULTS—Subjects gained weight, and their waist circumference increased (P &lt; 0.05). Insulin sensitivity, the acute insulin response to glucose, and glucose effectiveness did not change significantly. However, when we accounted for the modulating effect of insulin sensitivity on insulin release, β-cell function determined as the disposition index decreased by 22% (P &lt; 0.05). This decrease was associated with declines in intravenous and oral glucose tolerance (P &lt; 0.05 and P &lt; 0.001, respectively). Of the subjects with normal glucose tolerance at the first assessment, we compared those who progressed to IGT with those who did not. The disposition index was 50% lower in the progressors than in the nonprogressors at follow-up (P &lt; 0.05).
CONCLUSIONS—The decline in glucose tolerance over time in first-degree relatives of type 2 diabetic individuals is strongly related to the loss of β-cell function. Thus, early interventions to slow the decline in β-cell function should be considered in high-risk individuals.
Two-Year Safety and Efficacy of Inhaled Human Insulin (Exubera) in Adult Patients With Type 1 Diabetes
Authors: Skyler Jay S. , Jovanovic Lois , Klioze Sol , Reis Joann , Duggan William ,   for the Inhaled Human Insulin Type 1 Diabetes Study Group
Published: February 2007

OBJECTIVE—The purpose of this study was to evaluate the long-term (2-year) safety and efficacy of inhaled human insulin (Exubera [insulin human (rDNA origin)] inhalation powder) (EXU) in adult patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Patients were randomly assigned to receive EXU (n = 290) or subcutaneous (SC) insulin (n = 290), plus basal (intermediate- or long-acting) insulin. The primary end point was the annual rate of decline in pulmonary function (forced expiratory volume in 1 s [FEV1] and carbon monoxide diffusing capacity [DLCO]).
RESULTS—The mean ± SEM annual rates of change between months 0 and 24 were −0.051 ± 0.005 l/year with EXU and −0.034 ± 0.005 l/year with SC insulin (significant mean difference −0.017 ± 0.007 l/year [90% CI −0.028 to −0.005]) for FEV1 and −0.437 ± 0.073 ml · min−1 · mmHg−1 · year−1 with EXU and −0.287 ± 0.065 ml · min−1 · mmHg−1 · year−1with SC insulin (nonsignificant mean difference −0.150 ml · min−1 · mmHg−1 · year−1 [−0.310 to 0.011]) for DLCO. The mean annual rates of change in FEV1 between months 3 and 24 were −0.041 ± 0.005 and −0.031 ± 0.006 l/year in the EXU and SC insulin groups, respectively (nonsignificant mean difference −0.011 l/year [−0.023 to 0.002]), indicating that the significant difference between the treatment groups in FEV1 developed during the first 3 months and was not progressive thereafter. Adverse event profiles were similar except for a higher incidence of cough (usually mild and unproductive) in patients receiving EXU (37.6 vs. 13.1%) that decreased to 1.3% by month 24. Glycemic control was sustained in both groups (adjusted mean treatment difference in change from baseline A1C at month 24 0.25 ± 0.07% [0.13–0.37]). Although the overall hypoglycemic events were comparable between groups (4.0 vs. 3.8 events/subject-month), the incidence of severe hypoglycemic events was lower with EXU than with SC insulin (2.8 vs. 4.1 events/100 subject-months, risk ratio 0.67 [0.57–0.79]). Body weight increased to a significantly lesser extent with EXU (adjusted mean treatment difference −1.25 ± 0.36 kg [−1.85 to −0.66]).
CONCLUSIONS—Treatment group differences in lung function between EXU and SC insulin in adult patients with type 1 diabetes are small, develop early, and are nonprogressive for up to 2 years of therapy.
Prevalence and Treatment of Low HDL Cholesterol Among Primary Care Patients With Type 2 Diabetes
Authors: Grant Richard W. , Meigs James B. 
Published: February 2007

OBJECTIVE—Patients with diabetes remain at high risk for cardiovascular events despite aggressive blood pressure, LDL cholesterol, and blood glucose control. We identified prevalence and predictors of low HDL cholesterol, characterized current lipid therapy, and estimated the theoretical benefit of more effective HDL cholesterol–raising methods among patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—We analyzed a primary care–based population of patients with type 2 diabetes (n = 7,692) in 12 eastern Massachusetts outpatient practices. We grouped fibrates, niacins, and n-3 fatty acid preparations as nonstatin HDL cholesterol–raising medicines, and we used published studies to estimate the potential benefit of raising HDL cholesterol levels in this population.
RESULTS—Nearly half (49.5%) of patients had low HDL cholesterol (&lt;40 mg/dl for men, &lt;50 mg/dl for women). Low HDL cholesterol was independently associated with prevalent cardiovascular disease (CVD), younger age, and higher A1C levels. Nearly two-thirds of patients (63.0%) were prescribed a statin (67.6% of patients below the HDL cholesterol goal, 80.5% of patients with CVD). In contrast, only 7.9% of patients were prescribed a nonstatin HDL cholesterol–raising medication, including 16.4% of patients below the HDL cholesterol goal with CVD. Based on published studies, normalizing low HDL cholesterol in this primary care cohort would correspond to an estimated CVD mortality reduction of 42% in women and 23% in men.
CONCLUSIONS—Nearly half of the patients in this large primary care cohort had low HDL cholesterol levels. In contrast to frequent statin use, few patients were prescribed currently available medicines to raise HDL cholesterol. Low HDL cholesterol represents a highly prevalent and potentially modifiable risk factor for CVD prevention in type 2 diabetes.