bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin Sensitivity and β-Cell Function in Women With Polycystic Ovary Syndrome
Authors: Vrbíková Jana , Bendlová Bela , Hill Martin , Vanková Markéta , Vondra Karel , Stárka Luboslav 
Published: March 2007

OBJECTIVE—To evaluate insulin sensitivity (IS) and β-cell function (βF) in lean and obese women with polycystic ovary syndrome (PCOS), either separately or by using a disposition index (DI).
RESEARCH DESIGN AND METHODS—A total of 64 women with PCOS and 20 healthy women were examined by anthropometry, oral glucose tolerance tests (OGTTs), and insulin tolerance tests. Statistical analysis used one-way ANOVA, Kruskal-Wallis, and Mann-Whitney U tests, as appropriate.
RESULTS—A significantly higher waist-to-hip ratio (P &lt; 0.0001) was found in both lean and obese women with PCOS. Higher basal blood glucose (P &lt; 0.004) and blood glucose values at 3 h of OGTT (P &lt; 0.008) were found in lean and obese PCOS subjects in comparison with control subjects. Insulin resistance by homeostasis model assessment (P &lt; 0.007) was significantly higher in obese PCOS than in control or lean PCOS subjects. Early-phase insulin secretion (insulinogenic index [ΔI/ΔG30–0, where I is insulin and G is glucose]; P &lt; 0.0007) was significantly higher in both lean and obese PCOS subjects than in healthy women. All tested combinations of parameters of IS and βF (DIs) followed a physiological hyperbolic relationship. Significantly lower values of the fasting state–derived DIs were found (all P &lt; 0.05) in obese PCOS subjects. Significantly higher values of all of these indexes derived from nonfasting values were found in lean PCOS as compared with control and obese PCOS subjects (all P &lt; 10–3).
CONCLUSIONS—Increased βF was found even in lean individuals with PCOS. Insulin hypersecretion is thus probably connected to the pathogenesis of PCOS.
Effects of Diets Enriched in Saturated (Palmitic), Monounsaturated (Oleic), or trans (Elaidic) Fatty Acids on Insulin Sensitivity and Substrate Oxidation in Healthy Adults
Authors: Lovejoy Jennifer C. , Smith Steven R. , Champagne Catherine M. , Most Marlene M. , Lefevre Michael , DeLany James P. , Denkins Yvonne M. , Rood Jennifer C. , Veldhuis Johannes , Bray George A. 
Published: March 2007

OBJECTIVE—Diets high in total and saturated fat are associated with insulin resistance. This study examined the effects of feeding monounsaturated, saturated, and trans fatty acids on insulin action in healthy adults.
RESEARCH DESIGN AND METHODS—A randomized, double-blind, crossover study was conducted comparing three controlled 4-week diets (57% carbohydrate, 28% fat, and 15% protein) enriched with different fatty acids in 25 healthy men and women. The monounsaturated fat diet (M) had 9% of energy as C18:1cis (oleic acid). The saturated fat diet (S) had 9% of energy as palmitic acid, and the trans fatty acid diet (T) had 9% as C18:1trans. Body weight was kept constant throughout the study. After each diet period, insulin pulsatile secretion, insulin sensitivity index (SI) by the minimal model method, serum lipids, and fat oxidation by indirect calorimetry were measured.
RESULTS—Mean SI for the M, S, and T diets was 3.44 ± 0.26, 3.20 ± 0.26, and 3.40 ± 0.26 × 10−4 min−1 · μU−1 · ml−1, respectively (NS). SI decreased by 24% on the S versus M diet in overweight subjects but was unchanged in lean subjects (NS). Insulin secretion was unaffected by diet, whereas total and HDL cholesterol increased significantly on the S diet. Subjects oxidized the least fat on the M diet (26.0 ± 1.5 g/day) and the most fat on the T diet (31.4 ± 1.5 g/day) (P = 0.02).
CONCLUSIONS—Dietary fatty acid composition significantly influenced fat oxidation but did not impact insulin sensitivity or secretion in lean individuals. Overweight individuals were more susceptible to developing insulin resistance on high-saturated fat diets.
The Economic Cost of Diabetes in Canada, 1998
Authors: Dawson Keith G. , Gomes Daniel , Gerstein Hertzel , Blanchard James F. , Kahler Kristijan H. 
Published: March 2007

OBJECTIVE—In Canada, diabetes poses a significant health problem, and current estimates of its economic burden have not incorporated the total cost of the disease. The objective of this study was to quantify the direct medical- and mortality-related productivity cost of diabetes in Canada for 1998.
RESEARCH DESIGN AND METHODS—Direct medical costs included hospital services, physician services, and medicines consumed by people with diabetes. These costs were based on a top-down costing methodology that allocated 1998 total medical expenditures to diabetes. The prevalence of diagnosed and undiagnosed diabetes and the relative risk of complications in people with diabetes were used to estimate the proportion of medical services that were consumed by people with diabetes. Mortality-related productivity losses were calculated using the human capital approach.
RESULTS—After varying the assumptions in a sensitivity analysis, the total economic burden (in U.S. dollars) of diabetes and its chronic complications in Canada for 1998 was likely to be between $4.76 and $5.23 billion. In those people just with diagnosed diabetes, the direct medical costs associated with diabetes care, before considering any complications, were $573 million. Of the costs associated with the complications of diabetes, cardiovascular disease was by far the greatest, at $637 million.
CONCLUSIONS—Cardiovascular disease was the major contributor to the direct costs of diabetes. The preventive management of diabetes should receive priority attention, and the prevention of cardiovascular disease in the patient with diabetes should become an imperative.
Distribution of HbA1c Levels For Children and Young Adults in the U.S.
Authors: Saaddine Jinan B. , Fagot-Campagna Anne , Rolka Deborah , Narayan K.M. Venkat , Geiss Linda , Eberhardt Mark , Flegal Katherine M. 
Published: March 2007

OBJECTIVE—To describe the distribution of HbA1c levels among children and young adults in the U.S. and to evaluate the effects of age, sex, race/ethnicity, socioeconomic status, parental history of diabetes, overweight, and serum glucose on HbA1c levels.
RESEARCH DESIGN AND METHODS—We analyzed HbA1c data from the Third National Health and Nutrition Examination Survey, 1988–1994, for 7,968 participants aged 5–24 years who had not been treated for diabetes. After adjusting for the complex sample design, we compared the distributions of HbA1c in subgroups and developed multiple linear regression models to examine factors associated with HbA1c.
RESULTS—Mean HbA1c level was 4.99% (SD 0.50%) and varied from 4.93% (95% CI ±0.04) in non-Hispanic whites to 5.05% (±0.02) in Mexican-Americans to 5.17% (±0.02) in non-Hispanic blacks. There were very small differences among subgroups. Within each age- group, among men and women, among overweight and nonoverweight subjects, and at any level of education, mean HbA1c levels were higher in non-Hispanic blacks than in non-Hispanic whites. After adjusting for confounders, HbA1c levels for non-Hispanic blacks (5.15%, 95% CI ±0.04) and Mexican-Americans (5.01%, ±0.04) were higher than those for non-Hispanic whites (4.93%, ±0.04).
CONCLUSIONS—These data provide national reference levels for HbA1c distributions among Americans aged 5–24 years and show statistically significant racial/ethnic differences in HbA1c levels that are not completely explained by demographic and health-related variables.
Prevalence of Insulin Resistance Syndrome in Southwestern France and Its Relationship With Inflammatory and Hemostatic Markers
Authors: Marques-Vidal Pedro , Mazoyer Elizabeth , Bongard Vanina , Gourdy Pierre , Ruidavets Jean-Bernard , Drouet Ludovic , Ferrières Jean 
Published: March 2007

OBJECTIVE—To assess the prevalence and relationships of insulin resistance syndrome (IRS) with inflammatory and hemostatic markers in a representative sample of the population of Southwestern France aged 35–64 years.
RESEARCH DESIGN AND METHODS—In this cross-sectional study, data were collected from 597 men and 556 women and were assessed regarding BMI, blood pressure, total and HDL cholesterol levels, triglyceride level, glucose level, plasma insulin level, white blood cell count, fibrinogen level, factor VII level, von Willebrand factor, C-reactive protein level, soluble intercellular adhesion molecule, soluble vascular cell adhesion molecule-1, and soluble CD14. Insulin resistance was defined by homeostasis model assessment ≥3.8.
RESULTS—Prevalence of IRS was higher in men than in women (23 vs. 12%, respectively; P &lt; 0.001) and increased with age in both sexes (9, 24, and 34% for age groups 35–44, 45–54, and 55–64 years, respectively, for men and 4, 10, and 21% for women). After adjusting for age, alcohol consumption, tobacco smoking, and also for menopause in women, subjects (men and women) with IRS had significantly higher white blood cell count, factor VII levels, coagulating factor VII levels, and C-reactive protein levels than the other subjects. In men, further increases in soluble intercellular adhesion molecule and soluble vascular cell adhesion molecule-1 were noted, whereas in women, the differences were borderline significant. Conversely, no differences were found in fibrinogen, von Willebrand factor, and soluble CD14 in both sexes.
CONCLUSIONS—IRS is relatively common in residents of Southwestern France and is related to a deleterious increase in hemostatic and inflammatory parameters.
The Prevalence of Diabetes in the Kingdom of Tonga
Authors: Colagiuri Stephen , Colagiuri Ruth , Na’ati Siva , Muimuiheata Soana , Hussain Zafirul , Palu Taniela 
Published: March 2007

OBJECTIVE—To determine the prevalence of diabetes, impaired glucose metabolism, and related risk factors in Tonga.
RESEARCH DESIGN AND METHODS—A randomly selected representative national sample of 1,024 people aged &gt;15 years was surveyed. Each participant had fasting blood glucose and HbA1c measured. Subjects with a fasting blood glucose &gt;5.0 mmol/l (90 mg/dl) and &lt;11.1 mmol/l (200 mg/dl) or a fasting blood glucose ≤5.0 mmol/l and an HbA1c &gt;6.0% and every fifth subject with a fasting blood glucose ≤5.0 mmol/l and a normal HbA1c had a 75-g oral glucose tolerance test (OGTT). A total of 472 individuals had an OGTT based on these criteria. Subjects with a fasting blood glucose ≥11.1 mmol/l and an elevated HbA1c were diagnosed as having diabetes.
RESULTS—The mean age was 41.3 years, and the mean BMI was 32.3 kg/m2. The age-standardized prevalence of diabetes was 15.1% (CI 12.5–17.6), 12.2% (8.7–15.8) in men and 17.6% (14.0–21.1) in women (NS), of which only 2.1% was previously diagnosed. A total of 75% of people with newly diagnosed diabetes had a fasting plasma glucose ≥7.0 mmol/l (126 mg/dl). The prevalence of impaired glucose tolerance was 9.4% (7.3–11.5) and of impaired fasting glycemia 1.6% (0.7–2.6). Undiagnosed diabetes was significantly associated with increasing age, obesity, hypertension, and a family history of diabetes.
CONCLUSIONS—The current prevalence of diabetes in Tonga is 15.1%, of which 80% is undiagnosed. A similar survey in 1973 reported a 7.5% diabetes prevalence, indicating a doubling of diabetes over the past 25 years. In addition, lesser degrees of glucose intolerance are common, and much of the community is overweight
Role of Hyperglycemia in Nitrotyrosine Postprandial Generation
Authors: Ceriello Antonio , Quagliaro Lisa , Catone Barbara , Pascon Roberta , Piazzola Marta , Bais Bruno , Marra Giampiero , Tonutti Laura , Taboga Claudio , Motz Enrico 
Published: March 2007

OBJECTIVE—Recently, much attention has been paid to the possibility that postprandial hyperglycemia may be a cardiovascular risk factor in diabetes. Oxidative stress has been involved in the pathogenesis of diabetic complications, and increased plasma levels of nitrotyrosine, a product of peroxynitrite action, have been found in the plasma of diabetic subjects. The aim of the present study was to evaluate whether postprandial hyperglycemia is accompanied by nitrotyrosine generation and, if so, to explore a possible direct role of hyperglycemia in such a phenomenon.
RESEARCH DESIGN AND METHODS—A total of 23 type 2 diabetic patients and 15 matched normal healthy subjects were recruited for this study. Two different tests were performed in diabetic patients: a standard meal preceded by regular insulin (0.15 units/kg body wt) or insulin aspart (0.15 units/kg body wt) to achieve different levels of postprandial hyperglycemia. The meal test was also performed in healthy control subjects. At 0 min and 1, 2, 4, and 6 h after each meal, blood glucose, triglyceride, and nitrotyrosine levels were measured.
RESULTS—Fasting nitrotyrosine was significantly increased in diabetic patients and was further increased during both meal tests in diabetic subjects but not normal subjects. As compared with regular insulin, aspart administration significantly reduced the area under the curve of both glycemia (P &lt; 0.04) and nitrotyrosine (P &lt; 0.03), whereas that of triglycerides was not significantly affected by the treatment.
CONCLUSIONS—This study shows a direct correlation between postprandial hyperglycemia and the production of nitrotyrosine, a marker of oxidative stress, in patients with type 2 diabetes.
Walking Strategy in Diabetic Patients With Peripheral Neuropathy
Authors: Giacomozzi Claudia , Caselli Antonella , Macellari Velio , Giurato Laura , Lardieri Lina , Uccioli Luigi 
Published: March 2007

OBJECTIVE—Diabetic neuropathic patients show a peculiar loading pattern of the foot, which led us to hypothesize that a substantial modification exists in their deambulatory strategy. The aim of the present study was to support this hypothesis by quantifying the changes of the loading patterns and by monitoring the excursion of center of pressure (COP) during gait.RESEARCH DESIGN AND METHODS—A total of 21 healthy volunteers (C) and 61 diabetic patients were evaluated: 27 diabetic subjects without neuropathy (D), 19 with neuropathy (DN), and 15 with previous neuropathic ulcer (DPU). A piezo-dynamometric platform was used to record the foot-to-floor interaction by measuring loading time and the instantaneous COP position during the stance phase of gait.RESULTS—Loading time was significantly longer in neuropathic patients than in control subjects (DPU: 816.8 ± 150 ms; DN: 828.6 ± 152 ms; D: 766.5 ± 89.9 ms; C: 723.7 ± 65.7 ms; P &lt; 0.05). COP excursion along the medio-lateral axis of the foot clearly decreased from C to DPU groups (C: 6.41 ± 0.1 cm; D: 4.88 ± 0.2 cm; DN: 4.57 ± 0.1 cm; DPU: 3.36 ± 0.1 cm; P &lt; 0.05) as well as COP excursion along the longitudinal axis for the DPU group only (C: 26.6 ± 1 cm; D: 26.9 ± 1 cm; DN: 27.2 ± 1 cm; DPU: 24.2 ± 1 cm; P &lt; 0.05). COP integrals were significantly reduced for all pathological classes (DPU: 14.2 ± 8 cm2; DN: 25.8 ± 6 cm2; D: 27.7 ± 3 cm2; C: 38.6 ± 6 cm2; P &lt; 0.05).CONCLUSIONS—The accurate quantification of loading patterns and of COP excursions and integrals highlights changes of foot-to-floor interaction in diabetic neuropathic patients. The decreased medio-lateral and longitudinal COP excursions and corresponding changes of loading times and patterns support our hypothesis that a change in the walking strategy of diabetic patients with peripheral neuropathy does occur.
Treatment With Dietary trans10cis12 Conjugated Linoleic Acid Causes Isomer-Specific Insulin Resistance in Obese Men With the Metabolic Syndrome
Authors: Risérus Ulf , Arner Peter , Brismar Kerstin , Vessby Bengt 
Published: March 2007

OBJECTIVE—Conjugated linoleic acid (CLA) is a group of dietary fatty acids with antiobesity and antidiabetic effects in some animals. The trans10cis12 (t10c12) CLA isomer seems to cause these effects, including improved insulin sensitivity. Whether such isomer-specific effects occur in humans is unknown. The aim of this study was to investigate whether t10c12 CLA or a commercial CLA mixture could improve insulin sensitivity, lipid metabolism, or body composition in obese men with signs of the metabolic syndrome.
RESEARCH DESIGN AND METHODS—In a randomized, double-blind controlled trial, abdominally obese men (n = 60) were treated with 3.4 g/day CLA (isomer mixture), purified t10c12 CLA, or placebo. Euglycemic-hyperinsulinemic clamp, serum hormones, lipids, and anthropometry were assessed before and after 12 weeks of treatment.
RESULTS—Baseline metabolic status was similar between groups. Unexpectedly, t10c12 CLA increased insulin resistance (19%; P &lt; 0.01) and glycemia (4%; P &lt; 0.001) and reduced HDL cholesterol (−4%; P &lt; 0.01) compared with placebo, whereas body fat, sagittal abdominal diameter, and weight decreased versus baseline, but the difference was not significantly different from placebo. The CLA mixture did not change glucose metabolism, body composition, or weight compared with placebo but lowered HDL cholesterol (−2%; P &lt; 0.05).
CONCLUSIONS—These results reveal important isomer-specific metabolic actions of CLA in abdominally obese humans. A CLA-induced insulin resistance has previously been described only in lipodystrophic mice. Considering the use of CLA-supplements among obese individuals, it is important to clarify the clinical consequences of these results, but they also provide physiological insights into the role of specific dietary fatty acids as modulators of insulin resistance in humans.
Combination Therapy With Nateglinide and a Thiazolidinedione Improves Glycemic Control in Type 2 Diabetes
Authors: Rosenstock Julio , Shen Sharen G. , Gatlin Marjorie R. , Foley James E. 
Published: March 2007

OBJECTIVE—To compare the effects of monotherapy using nateglinide and the thiazolidinedione troglitazone with initial combination of the two agents on glycated hemoglobin (HbA1c) in patients with type 2 diabetes inadequately controlled by diet alone.
RESEARCH DESIGN AND METHODS—This study consisted of a 28-week, double-blind, randomized, multicenter study that included a 4-week, single-blind, placebo, run-in period and a 24-week (shortened to 16 weeks), double-blind, active treatment period.
RESULTS—At the 16-week end point, nateglinide 120 mg, troglitazone 600 mg, and the combination of the agents achieved statistically significant decreases in HbA1c in comparison with placebo and a baseline HbA1c of 8.1–8.4% (P &lt; 0.001). The reductions in HbA1c were similar in the nateglinide (0.6%) and troglitazone (0.8%) monotherapy groups. The reduction in HbA1c (1.7%) was greatest in the combination group; 79% of patients in the combination group achieved HbA1c levels of &lt;7%. The combination group had a higher number of adverse events, primarily due to an increased incidence of mild hypoglycemia in this treatment group.
CONCLUSIONS—Nateglinide and troglitazone are equally effective in decreasing HbA1c levels. However, these reductions from baseline HbA1c values of &gt;8% are not adequate to achieve HbA1c levels of &lt;7%. In contrast, the combination of nateglinide and of a thiazolidinedione shows an additive effect that is highly effective in reducing HbA1c levels to the target of &lt;7% in 66% of patients, from a baseline HbA1c that is just above 8%.
All-Cause and Cardiovascular Mortality Among Diabetic Participants in the San Antonio Heart Study
Authors: Hunt Kelly J. , Williams Ken , Resendez Roy G. , Hazuda Helen P. , Haffner Steve M. , Stern Michael P. 
Published: March 2007

OBJECTIVE—The observation that Hispanics have lower all-cause and cardiovascular mortality, despite increased diabetes and obesity, lower socioeconomic status (SES), and barriers to health care, has been termed the “Hispanic Paradox.” We examined the relationship between ethnicity and all-cause and cardiovascular mortality in Mexican Americans (MAs) and non-Hispanic whites (NHWs) with diabetes.
RESEARCH DESIGN AND METHODS—In the San Antonio Heart Study, a prospective cohort, we compared the mortality in 554 U.S.-born MAs, 95 Mexico-born MAs, and 178 NHW participants with diabetes aged 25–72 years. Over an average of 10.4 years, 188 deaths occurred: 115 from cardiovascular disease (CVD) [death certificate ICD-9 codes 401–414 or 420–447 (excluding 427.5)]. Because of potential differences between migrants and nonmigrants, hazard ratios (HRs) were calculated comparing U.S.-born MAs and Mexico-born MAs with NHWs.
RESULTS—The age- and sex-adjusted HR for all-cause mortality comparing U.S.-born MAs with NHWs was 1.66 (95% CI 1.15–2.40), while comparing Mexico-born MAs with NHWs was 1.14 (95% CI 0.63–2.06). Cardiovascular mortality HRs were 1.66 (95% CI 1.04–2.65) and 0.89 (95% CI 0.40–2.01), respectively. After adjusting for possible confounders, such as fasting glucose and diabetes duration, the hazard of all-cause and cardiovascular mortality (although not statistically significant) appeared higher in U.S.-born MAs than in the other two groups.
CONCLUSIONS—We found it important to differentiate MAs by birthplace. Among diabetic participants, contrary to the prediction of the “Hispanic Paradox,” compared with NHWs, U.S.-born MAs were at greater risk of all-cause and cardiovascular mortality, while Mexico-born MAs appeared to be at similar risk.
Depression and Anxiety Among Partners of European-American and Latino Patients With Type 2 Diabetes
Authors: Fisher Lawrence , Chesla Catherine A. , Skaff Marilyn M. , Mullan Joseph T. , Kanter Richard A. 
Published: March 2007

OBJECTIVE—To assess the levels of and the independent contributors to depressive affect and anxiety among partners of patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—The partners of 75 Latino and 113 European-American patients with type 2 diabetes were assessed for level of depressive affect and anxiety and for three groups of potential stressors: demographics (age, gender, and education), patient disease status (time since diagnosis, HbA1c, comorbidities, and BMI), and family stress (disease impact, spouse conflict, and family closeness). Dependent variables were partner depressive affect (Center for Epidemiological Studies-Depression scale) and anxiety (Symptom Checklist [SCL-90] anxiety). Predictors of partner depressive affect and anxiety and partner-patient concordance rates were computed.
RESULTS—Levels of depressive affect and anxiety and rates of likely depression (21.4%) were as high for partners as they were for patients. No differences were found on depressive affect or anxiety by ethnicity, but female partners scored higher than male partners on both measures. Partner-patient concordance rates were low. The family level variables accounted for the most variance in both depressive affect and anxiety, with demographics and disease status variables contributing modest or nonsignificant independent variance.
CONCLUSIONS—Partners of patients with type 2 diabetes experience levels of psychological distress as high or even higher than patients, especially if the partner is female. Low levels of concordance suggest that partners can be distressed even if patients are not. Many life stresses contribute to psychological distress among partners, not just disease-related indicators. The findings suggest the utility of evaluating both partners and patients using a life-centered rather than a disease-focused perspective.