bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between alcohol consumption and serum dehydroepiandrosterone sulphate concentration in men with Type 2 diabetes: a link to decreased cardiovascular risk
Authors: Fukui M. , Kitagawa Y. , Nakamura N. , Kadono M. , Hasegawa G. , Yoshikawa T. 
Published: August 2005

AbstractAims  Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with Type 2 diabetes. Both light‐to‐moderate alcohol consumption and higher serum concentrations of dehydroepiandrosterone (DHEA) are associated with reduced CVD mortality, raising the possibility of DHEA as a causal intermediate in CVD and alcohol consumption.Methods  Relationships between alcohol consumption and serum DHEA sulphate (DHEA‐S) concentration, carotid atherosclerosis as evaluated by carotid ultrasonography and major cardiovascular risk factors were investigated in 404 consecutive men with Type 2 diabetes. Patients were divided into three groups according to mean ethanol consumption per week: non‐drinkers, light‐to‐moderate drinkers (< 210 g per week) or heavy drinkers (≥ 210 g per week).Results  Plasma HDL‐cholesterol was positively associated with the degree of alcohol consumption. Intima‐media thickness (0.92 ± 0.21 vs. 1.09 ± 0.35 mm, P < 0.0001) and plaque score (3.0 ± 3.3 vs. 5.2 ± 4.9, P = 0.008) were lower in light‐to‐moderate drinkers than in non‐drinkers. Serum DHEA‐S concentrations were higher in light‐to‐moderate drinkers (1264.2 ± 592.2 ng/ml, P < 0.0001) and heavy drinkers (1176.2 ± 607.6 ng/ml, P = 0.0100) than in non‐drinkers (956.8 ± 538.6 ng/ml). In a subgroup aged 60–75‐year‐old patients (n = 277), serum DHEA‐S concentrations were higher in light‐to‐moderate drinkers (1126.8 ± 502.5 ng/ml, P = 0.0121) than in non‐drinkers (937.9 ± 505.1 ng/ml). Also, in a subgroup without CVD (n = 339), serum DHEA‐S concentrations were higher in light‐to‐moderate drinkers (1328.5 ± 593.7 ng/ml, P < 0.0001) than in non‐drinkers (970.1 ± 540.7 ng/ml).Conclusions  Higher serum DHEA‐S concentrations in light‐to‐moderate drinkers may represent part of the link between light‐to‐moderate alcohol consumption and lower CVD mortality.
Prediction of gestational diabetes mellitus in a high‐risk group by insulin measurement in early pregnancy
Authors: Bitó T. , Földesi I. , Nyári T. , Pál A. 
Published: August 2005

AbstractAims  We hypothesized that an increased serum insulin level in early pregancy reflects an increased demand on the compensatory capacity of the pregnant woman, and can serve as a predictor of gestational diabetes mellitus (GDM).Methods  A 2‐h, 75‐g oral glucose tolerance test (OGTT), with fasting and 2‐h postprandial serum insulin determination, was performed in 71 pregnant women with one or more risk factors for GDM before gestation week 16. In 64 patients, subsequent OGTTs were performed at gestation weeks 24–28, and in the event of a negative result, at gestation weeks 32–34.Results  Insulin determination at fasting and at 120 min had sensitivities of 69.2% and 92.3%, and specificities of 96.4% and 85.7%, respectively, for the prediction of GDM at gestation weeks 24–28. The sensitivities decreased to 33.3% and 75.0%, respectively, for the prediction of GDM at gestation weeks 32–34. Insulin determination at fasting and at 120 min had positive predictive values of 0.90 and 0.75, respectively, for the prediction of GDM at gestation weeks 32–34. The negative predictive values of fasting and 120‐min serum insulin determination at gestation week ≤ 16 were 0.87 and 0.96, respectively, for the prediction of GDM at gestation weeks 24–28. Increased serum insulin levels both at fasting and 120 min before gestation week 16 were very strong predictive factors for GDM by gestation weeks 32–34 with an odds ratio of 16.6 and 13.3, respectively.Conclusions  Serum insulin determination at gestation week ≤ 16 is an easy and reliable method with which to predict GDM in a high‐risk group. Despite a negative OGTT, patients with an elevated fasting and/or 120‐min serum insulin level at gestation week ≤ 16 should be managed in the same way as those with GDM. Considering the very high negative predictive value of the method, patients with a normal fasting and/or 120‐min serum insulin level at gestation week ≤ 16 should undergo an OGTT only at gestation weeks 32–34.
Non‐alcoholic hepatic steatosis and its relation to increased plasma biomarkers of inflammation and endothelial dysfunction in non‐diabetic men. Role of visceral adipose tissue
Authors: Targher G. , Bertolini L. , Scala L. , Zoppini G. , Zenari L. , Falezza G. 
Published: August 2005

AbstractAims  To compare plasma biomarkers of inflammation and endothelial dysfunction in individuals with and without non‐alcoholic hepatic steatosis (HS), and to evaluate whether such differences were mediated by the adverse metabolic pattern, typically found in these subjects.Methods  HS (by ultrasound and computed tomography), visceral fat (by computed tomography), insulin resistance (by homeostasis model assessment—HOMA), plasma biomarkers of inflammation and endothelial dysfunction (hs‐C reactive protein, fibrinogen, von Willebrand factor, plasminogen activator inhibitor‐1 activity) were measured in 100 non‐smoking, healthy, male volunteers.Results  Plasma hs‐CRP, fibrinogen, v‐WF and plasminogen activator inhibitor‐1 (PAI‐1) activity levels were markedly higher (P < 0.01 or less) in subjects with non‐alcoholic HS (n = 35) than in those without HS (n = 65). The former also had significantly higher values for body mass index (BMI), visceral fat, diastolic blood pressure, HOMA insulin resistance score, plasma insulin (both fasting and after glucose load), triglycerides, liver enzymes, and lower high‐density lipoprotein (HDL)‐cholesterol concentration. While the marked differences in these pro‐inflammatory biomarkers observed between the groups were little affected by adjustment for age, BMI, blood pressure values, HOMA insulin resistance score, plasma triglyceride and liver enzyme concentrations, they were completely abolished after controlling for visceral fat. Similarly, in multivariate regression analyses, increased visceral fat significantly predicted the pro‐inflammatory biomarkers, independently of HS and other potential confounders.Conclusions  These results indicate that, in non‐smoking, non‐diabetic men, the significant increase of plasma biomarkers of inflammation and endothelial dysfunction in the presence of non‐alcoholic HS is largely mediated by abdominal visceral fat accumulation.
Decreased isometric muscle strength after acute hyperglycaemia in Type 1 diabetic patients
Authors: Andersen H. , Schmitz O. , Nielsen S. 
Published: August 2005

AbstractAims  Fatigue is a common complaint in diabetic patients during periods of hyperglycaemia. To test whether muscle performance is reduced during acute hyperglycaemia, diabetic patients were studied whilst performing maximal isokinetic and isometric contractions.Methods  In this double‐blind placebo controlled study, maximal isometric and isokinetic muscle strength was determined in seven Type 1 diabetic patients during normo‐ and hyperglycaemia using a hyperglycaemic clamp technique. On two separate days, maximal muscle strength of the knee extensors was determined quantitatively using a dynamometer. On both days, muscle strength was determined before a constant blood glucose level was obtained and after the blood glucose level had been kept constant at either 5 or 16 mmol/l for 3 h. Percentage of change from baseline at the two glycaemic levels were calculated and compared. In addition, the changes from baseline at these glycaemic levels were related to glucose turnover.Results  Following hyperglycaemia, a significant decrease in maximal isometric muscle strength was found as compared with normoglycaemia (86 vs. 104% of the initial level) (P = 0.018). In contrast, no alteration of maximal isokinetic muscle strength was found comparing normo‐ and hyperglycaemia (96 and 95%) (P = 0.74). Changes in muscle strength were not significantly related to either basal or hyperglycaemic glucose turnover.Conclusions  A few hours of hyperglycaemia in Type 1 diabetic patients leads to a reduction of isometric muscle performance, whereas isokinetic muscle strength is unchanged. The reduction in muscle strength could play a role in the development of fatigue and is related more closely to ambient glucose concentrations than to systemic glucose availability.
Excess mortality in Black compared with White patients with Type 1 diabetes: an examination of underlying causes
Authors: Bosnyak Z. , Nishimura R. , Hagan Hughes M. , Tajima N. , Becker D. , Tuomilehto J. , Orchard T. J. 
Published: August 2005

AbstractAims  Excess mortality in Type 1 diabetes has previously been found among Black individuals. The aim of the present study was therefore to determine underlying causes.Methods  A longitudinal study of 1261 [1184 White (93.9%) and 76 Black (6.0%)] individuals diagnosed with Type 1 diabetes between 1965 and 1979, at age < 17 years from the Allegheny County, Pennsylvania and Children's Hospital of Pittsburgh registries. Subjects were contacted in 1999 to determine living status and, where appropriate, cause of death. Living status was determined in 1183 participants (93.8%).Results  Of the 200 deaths overall, cause of death was determined in 157 subjects (79%); 31 dying from acute and 101 from chronic complications, and 25 from non‐diabetes related causes. Seven deaths were investigated but no cause determined. Black participants had a significantly higher mortality rate compared with White participants for acute complications (hazard ratio = 4.9, 95% confidence interval: 2.0, 11.6), but not for any other cause. There was a temporal decline in the 20‐year mortality rates in both racial groups across the three cohorts diagnosed in 1965–69, 1970–74 and 1975–79.Conclusions  These results show that the excess mortality in Black people was attributed to acute complications which therefore should be a focus for prevention.
Synergism between mutant HNF1A and the metabolic syndrome in Oji‐Cree Type 2 diabetes
Authors: Pollex R. L. , Hanley A. J. G. , Zinman B. , Harris S. B. , Khan H. M. R. , Hegele R. A. 
Published: August 2005

AbstractAims  To determine the prevalence of the metabolic syndrome in the Sandy Lake Oji‐Cree and to examine its interaction with HNF1A in association with impaired glucose tolerance and Type 2 diabetes.Methods  Using data collected from the Sandy Lake Health and Diabetes Project (1993–1995), the presence or absence of the metabolic syndrome was determined in 515 Oji‐Cree subjects, ≥ 18 years of age. In the original study, fasting plasma analytes were measured, a 75‐g oral glucose tolerance test was administered, and subjects were genotyped for HNF1A G319S.Results  The unadjusted prevalence of the metabolic syndrome in the Oji‐Cree adults was 29.9%. The adjusted odds ratio (OR) and 95% confidence interval for Type 2 diabetes among subjects who carried the HNF1A G319S mutation and had the modified metabolic syndrome (excluding hyperglycaemia) was 20.3 (6.94, 59.6). Adjusted ORs for Type 2 diabetes for subjects with either the HNF1A G319S mutation alone or the modified metabolic syndrome alone were 5.56 (2.85, 10.9) and 4.84 (2.53, 9.27), respectively. The risk of having impaired glucose tolerance was not influenced by the presence of either factor.Conclusions  The risk of Type 2 diabetes was similar (approximately five‐fold increased) for subjects with either the presence of the modified metabolic syndrome or the private HNF1A G319S mutation. Interestingly, when present in combination, the two independent risk factors appeared to act synergistically to confer an even greater increased risk of Type 2 diabetes.
The G1888A variant in the mitochondrial 16S rRNA gene may be associated with Type 2 diabetes in Caucasian–Brazilian patients from southern Brazil
Authors: Crispim D. , Canani L. H. , Gross J. L. , Carlessi R. M. , Tschiedel B. , Souto K. E. P. , Roisenberg I. 
Published: August 2005

AbstractAim  To compare the frequencies of the G1888A variant in the mitochondrial 16S rRNA gene between patients with Type 2 diabetes and non‐diabetic control subjects from southern Brazil.Methods  We analysed 520 Type 2 diabetic patients (389 Caucasian– and 131 African–Brazilians) and 530 control subjects (400 Caucasian– and 130 African–Brazilians). DNA samples were amplified by polymerase chain reaction and digested with the RsaI enzyme. Variant frequency in patients and control subjects was compared using χ2 test, Fisher's exact test or odds ratio test. We also investigated the frequency of the G1888A variant in a subgroup of the patients with a maternal history of Type 2 diabetes plus two or more features of maternally inherited diabetes and deafness.Results  The 1888A allele does not seem to be associated with Type 2 diabetes in African–Brazilians (frequency of 3.8% in patients and 0.8% in control subjects; PFisher = 0.213). However, in Caucasian–Brazilians, the 1888A allele was significantly associated with diabetes (12.3% in patients vs. 3.5% in control subjects; OR = 3.881; 95% CI 2.106–7.164; P < 0.001) and also with higher levels of insulin resistance. The majority of the patients carrying the 1888A allele did not have clinical features of maternally inherited diabetes and deafness.Conclusion  The present study indicates the association of the mitochondrial G1888A variant with Type 2 diabetes and insulin resistance in Caucasian–Brazilian patients from southern Brazil. However, further studies are required to confirm its effects on mitochondrial function and the role of these effects on the pathogenesis of Type 2 diabetes.
Gestational diabetes: dilemma caused by multiple international diagnostic criteria
Authors: Agarwal M. M. , Dhatt G. S. , Punnose J. , Koster G. 
Published: August 2005

AbstractAims  To highlight the variation in the diagnosis of gestational diabetes (GDM) as defined by six well‐accepted international expert panels.Methods  Two thousand, five hundred and fifty‐four pregnant women underwent a 75‐g oral glucose tolerance test for routine, antenatal GDM screening. They were classified using the criteria of the American Diabetes Association, Australasian Diabetes in Pregnancy Society, the Canadian Diabetes Association, the European Association for the Study of Diabetes, the New Zealand Society for the study of Diabetes and the World Health Organization (WHO).Results  Between any two criteria, both the GDM prevalence (range; 7.9–24.9%) and the women classified differently [range; 70 (2.7%)−454 (17.8%) women], was significant (P < 0.001). The most inclusive criteria, i.e. Australasian, despite generating the highest prevalence of GDM, did not pick up all the women identified by the most restrictive criteria, i.e. Canadian. The Australasian and the WHO criteria were associated with an increase in the number of Caesarean sections [odds ratio (OR); 1.64, 1.45, respectively] while the American, Canadian and New Zealand criteria identified an increase in macrosomia (birthweight ≥ 4000 g) incidence (OR; 2.09, 2.01, 1.92, respectively).Conclusions  The guidelines of the various professional committees, being based on consensus and expert opinion, show major discrepancies in their ability to identify women with GDM and their capacity to predict adverse pregnancy outcome. Only evidence‐based criteria derived from reliable and consistent scientific data will eliminate the confusion caused in clinical practice.
Peroxisome proliferator‐activated receptor‐γ co‐activator‐1α (PGC‐1α) gene polymorphisms and their relationship to Type 2 diabetes in Asian Indians
Authors: Vimaleswaran K. S. , Radha V. , Ghosh S. , Majumder P. P. , Deepa R. , Babu H. N. S. , Rao M. R. S. , Mohan V. 
Published: August 2005

AbstractAims  The objective of the present investigation was to examine the relationship of three polymorphisms, Thr394Thr, Gly482Ser and +A2962G, of the peroxisome proliferator activated receptor‐γ co‐activator‐1 alpha (PGC‐1α) gene with Type 2 diabetes in Asian Indians.Methods  The study group comprised 515 Type 2 diabetic and 882 normal glucose tolerant subjects chosen from the Chennai Urban Rural Epidemiology Study, an ongoing population‐based study in southern India. The three polymorphisms were genotyped using polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). Haplotype frequencies were estimated using an expectation–maximization (EM) algorithm. Linkage disequilibrium was estimated from the estimates of haplotypic frequencies.Results  The three polymorphisms studied were not in linkage disequilibrium. With respect to the Thr394Thr polymorphism, 20% of the Type 2 diabetic patients (103/515) had the GA genotype compared with 12% of the normal glucose tolerance (NGT) subjects (108/882) (P = 0.0004). The frequency of the A allele was also higher in Type 2 diabetic subjects (0.11) compared with NGT subjects (0.07) (P = 0.002). Regression analysis revealed the odds ratio for Type 2 diabetes for the susceptible genotype (XA) to be 1.683 (95% confidence intervals: 1.264–2.241, P = 0.0004). Age adjusted glycated haemoglobin (P = 0.003), serum cholesterol (P = 0.001) and low‐density lipoprotein (LDL) cholesterol (P = 0.001) levels and systolic blood pressure (P = 0.001) were higher in the NGT subjects with the XA genotype compared with GG genotype. There were no differences in genotype or allelic distribution between the Type 2 diabetic and NGT subjects with respect to the Gly482Ser and +A2962G polymorphisms.Conclusions  The A allele of Thr394Thr (G → A) polymorphism of the PGC‐1 gene is associated with Type 2 diabetes in Asian Indian subjects and the XA genotype confers 1.6 times higher risk for Type 2 diabetes compared with the GG genotype in this population.
Long‐term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa
Authors: Gill G. V. , Huddle K. R. L. , Monkoe G. 
Published: August 2005

AbstractAims  To assess the long‐term (20 years) mortality, with causes of death, in a cohort of Type 1 diabetic patients resident in Soweto, South Africa.Methods  A cohort of Type 1 diabetic patients attending the Diabetic Clinic of Baragwanath Hospital, Soweto were studied in 1982. They were followed over the subsequent 20 years, the final investigation being in 2002. Numbers dying during the period were recorded, as well as year of death and cause. The complication status of survivors was also assessed.Results  Of the original cohort of 88 Type 1 patients, 21 died during the follow‐up period. There were 39 lost to follow‐up, giving a crude 20 years’ mortality of 43%. Kaplan–Meier analysis showed mortality hazard of 33%. Of those dying, most (9/21) were as a result of renal failure. Other causes were hypoglycaemia (6), ketoacidosis (2), infection (2) and undetermined (2). Of the survivors, comparing data at 0 and 20 years’ follow‐up, there was a significant increase in rates of retinopathy (P < 0.02) and hypertension (P < 0.005), but not of other complications.Conclusions  This is the first long‐term outcome study of Type 1 diabetes in sub‐Saharan Africa. Although the mortality was substantial, it is similar to equivalent studies of United States (US) Afro‐Americans with Type 1 diabetes. The major cause of death was renal failure related to diabetic nephropathy, and reflects lack of adequate facilities for renal replacement therapy. Despite the deprivation, poverty, political upheaval and recent AIDS epidemic in Soweto, Type 1 diabetes carries a reasonable long‐term prognosis, and survivors are generally free of debilitating complications.
Microvascular endothelial function in subjects with Type 2 diabetes and the effect of lipid‐lowering therapy
Authors: Fegan P. G. , Shore A. C. , Mawson D. , Tooke J. E. , MacLeod K. M. 
Published: August 2005

AbstractAims  Abnormalities of microvascular and endothelial function are present in subjects with Type 2 diabetes. Although statin therapy improves cardiovascular risk in diabetes, dyslipidaemia in diabetes may be more responsive to combined statin and fibrate therapy. We examined the effect of cerivastatin and fenofibrate on microvascular function in subjects with Type 2 diabetes with no clinical evidence of cardiovascular disease and near normal lipid levels.Methods  Age‐, sex‐, lipid‐ and blood pressure‐matched subjects with Type 2 diabetes were randomized in double‐blind fashion to one of four treatment groups: group 1 placebo/placebo (n = 12), group 2 fenofibrate/placebo (n = 10), group 3 cerivastatin/placebo (n = 20) and group 4 cerivastatin/fenofibrate (n = 11). The subjects were recruited from the Lipid in Diabetes Study. Microvascular function was assessed by skin blood flow response to iontophoresis of acetylcholine and sodium nitroprusside and by skin maximum hyperaemia to local heating. Measurements were carried out at baseline and 3 months later.Results  Although all lipid parameters improved in groups 2–4 after 3 months’ therapy, no difference was detected in skin blood flow to iontophoresis or maximum hyperaemia in any of the groups. Highly sensitive c‐reactive protein (Hs‐CRP) did not change with therapy.Conclusions  In conclusion, we were unable to demonstrate any improvement in microvascular endothelial function in non‐hyperlipidaemic Type 2 diabetic subjects treated with single or combination lipid‐lowering therapy.Diabet. Med. (2005)
Effect of a pocket‐size tablet‐dispensing device on glycaemic control in Type 2 diabetic patients
Authors: Maier C. , Mustapic D. , Schuster E. , Luger A. , Eher R. 
Published: August 2005

AbstractAim  To evaluate whether a pocket‐size tablet‐dispensing device would improve adherence to therapy as judged by reduction of HbA1c levels in a large population of Type 2 diabetic patients.Methods  The study design was prospective, randomized, open label with two parallel groups. Patients (2296) were recruited from general practitioners and internists and randomized to either receive a tablet dispenser (TD) or no intervention (control group, CO). Patients’ characteristics and current oral therapy (including dosage) were recorded at baseline. HbA1c was compared between groups at baseline and after 6 months’ intervention.Results  Data were available in 2081 patients. Baseline characterisitcs, including age, body mass index (BMI), blood pressure and gender distribution were comparable between the two groups, as was HbA1c[7.9 (7.9–8.0), TD vs. 8.0 (7.9–8.0)%, CO, means (95% CI)]. After 6 months, HbA1c improved in both groups, but improvement was significantly greater in TD than in controls [−0.74 (0.67–0.80) vs. −0.53 (0.47–0.59)%, P < 0.0001]. Possession of a dispenser remained an independent predictor of improved control in a multiple regression model. In the subgroup analysis, the effect was significantly more pronounced (i) in patients receiving more medications and (ii) more diabetes medications per day (iii) in younger patients.Conclusion  In this large study population in a ‘realistic’ setting, a simple tablet‐dispensing device led to a significant and clinically relevant improvement in HbA1c levels. Because patients with a more complex therapy regimen benefited more, we suggest that TD might have improved adherence to therapy.