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  • 1
    Online Resource
    Online Resource
    Adipocytokines as features of the metabolic syndrome determined using confirmatory factor analysis
    Elsevier BV ; 2013
    In:  Annals of Epidemiology Vol. 23, No. 7 ( 2013-7), p. 415-421
    Details
    In: Annals of Epidemiology, Elsevier BV, Vol. 23, No. 7 ( 2013-7), p. 415-421
    Type of Medium: Online Resource
    ISSN: 1047-2797
    URL: Article
    DOI: 10.1016/j.annepidem.2013.03.001
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
    detail.hit.zdb_id: 2003468-4
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  • 2
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    Diet-Induced Weight Loss Is Associated with an Improvement in β-Cell Function in Older Men
    The Endocrine Society ; 2004
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 6 ( 2004-06-01), p. 2704-2710
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 89, No. 6 ( 2004-06-01), p. 2704-2710
    Abstract: Although weight loss in older subjects has been shown to improve insulin sensitivity, it is unclear what effect this lifestyle intervention has on β-cell function. To determine whether diet-induced weight loss can improve β-cell function in older subjects, we studied 19 healthy male subjects (age, 65.4 ± 0.9 yr; body mass index, 30.9 ± 0.6 kg/m2; mean ± sem) before and after a 3-month 1200-kcal/d diet. The insulin sensitivity index (SI) was quantified using Bergman’s minimal model. The acute insulin response to glucose (AIRg) and the maximal glucose-potentiated insulin response (AIRmax) were determined and then adjusted for SI (SI × AIRg and SI × AIRmax), thus providing measures of β-cell function. Subjects demonstrated significant weight loss (95.6 ± 2.4 to 86.1 ± 2.5 kg; P & lt; 0.001). Both fasting plasma glucose [97.3 ± 1.6 to 95.1 ± 1.3 mg/dl (5.4 ± 0.09 to 5.3 ± 0.07 mm); P = 0.05] and insulin [18.5 ± 1.3 to 12.2 ± 1.0 μU/ml (110.9 ± 7.7 to 73.5 ± 5.9 pm); P & lt; 0.001] levels decreased. With weight loss, SI increased [1.59 ± 0.24 to 2.49 ± 0.32 × 10−4 min−1/(μU/ml) (2.65 ± 0.4 to 4.15 ± 0.5 × 10−5 min−1/pm); P & lt; 0.001], whereas both AIRg [63.4 ± 13.4 to 51.0 ± 10.7 μU/ml (380 ± 80 to 306 ± 64 pm); P & lt; 0.05] and AIRmax [314 ± 31.4 to 259.9 ± 33.4 μU/ml (1886 ± 188 to 1560 ± 200 pm); P & lt; 0.05] decreased. Overall β-cell function improved (SI × AIRg, 9.63 ± 2.28 to 12.78 ± 2.58 × 10−3 min−1, P & lt; 0.05; and SI × AIRmax, 51.01 ± 9.2 to 72.69 ± 13.4 × 10−3 min−1, P & lt; 0.05). Thus, the weight loss-associated improvements in both insulin sensitivity and β-cell function may explain the beneficial effects of a lifestyle intervention on delaying the development of diabetes in older subjects.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/jc.2003-031827
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2004
    detail.hit.zdb_id: 2026217-6
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  • 3
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    Gestational Diabetes Mellitus Increases the Risk of Cardiovascular Disease in Women With a Family History of Type 2 Diabetes
    American Diabetes Association ; 2006
    In:  Diabetes Care Vol. 29, No. 9 ( 2006-09-01), p. 2078-2083
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 9 ( 2006-09-01), p. 2078-2083
    Abstract: OBJECTIVE— We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with first-degree relatives with type 2 diabetes. RESEARCH DESIGN AND METHODS— Women with (n = 332) and without (n = 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported CVD. RESULTS— Women with prior GDM were younger (48.6 ± 0.7 vs. 52.4 ± 0.6 years [means ± SE];P & lt; 0.001) and less likely to be postmenopausal (48.3 vs. 57.9%; P & lt; 0.005). Although both groups were obese (BMI 34.4 ± 1.2 vs. 33.7 ± 0.6 kg/m2), women with prior GDM were more likely to have metabolic syndrome (86.6 vs. 73.5%; P & lt; 0.001) and type 2 diabetes (93.4 vs. 63.3%; P & lt; 0.001). Moreover, they had a higher prevalence of CVD (15.5 vs. 12.4%; adjusted odds ratio 1.85 [95% CI 1.21–2.82];P = 0.005) that occurred at a younger age (45.5 ± 2.2 vs. 52.5 ± 1.9 years;P = 0.02) and was independent of metabolic syndrome (1.74 [1.10–2.76] ; P = 0.02) and type 2 diabetes (1.56 [1.002–2.43];P & lt; 0.05). CONCLUSIONS— Among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc05-2482
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
    detail.hit.zdb_id: 1490520-6
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  • 4
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    Modestly Elevated Glucose Levels During Pregnancy Are Associated With a Higher Risk of Future Diabetes Among Women Without Gestational Diabetes Mellitus
    American Diabetes Association ; 2008
    In:  Diabetes Care Vol. 31, No. 5 ( 2008-05-01), p. 1037-1039
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 31, No. 5 ( 2008-05-01), p. 1037-1039
    Abstract: OBJECTIVE—To determine whether 1-h oral glucose challenge test (OGCT) or 3-h oral glucose tolerance test (OGTT) results below gestational diabetes mellitus (GDM) criteria are associated with developing diabetes. RESEARCH DESIGN AND METHODS—A retrospective cohort study was performed among women without GDM who had a pregnancy OGCT (n = 24,780) or OGTT (n = 6,222). Subsequent diabetes was ascertained by ICD-9 codes or pharmacy or laboratory data over a median follow-up of 8.8 years. RESULTS—Diabetes risk increased across OGCT quartiles: adjusted hazard ratio (HR) 1.67 (95% CI 1.07–2.61) for 5.4–6.2 mmol/l, 2.13 (1.39–3.25) for 6.3–7.3 mmol/l, and 3.60 (2.41–5.39) for ≥7.4 mmol/l compared with ≤5.3 mmol/l. Women with one abnormal OGTT result had a higher risk compared with those with normal values (HR 2.08 [95% CI 1.35–3.20]). CONCLUSIONS—Women with modestly elevated glucose levels below the threshold for GDM had a higher risk for diabetes.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc07-1957
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2008
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  • 5
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    Relationship of Liver Enzymes to Insulin Sensitivity and Intra-Abdominal Fat
    American Diabetes Association ; 2007
    In:  Diabetes Care Vol. 30, No. 10 ( 2007-10-01), p. 2673-2678
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 30, No. 10 ( 2007-10-01), p. 2673-2678
    Abstract: OBJECTIVE— The purpose of this study was to determine the relationship between plasma liver enzyme concentrations, insulin sensitivity, and intra-abdominal fat (IAF) distribution. RESEARCH DESIGN AND METHODS— Plasma γ-glutamyl transferase (GGT), aspartate transaminase (AST), alanine transaminase (ALT) levels, insulin sensitivity (insulin sensitivity index [SI]), IAF area, and subcutaneous fat (SCF) area were measured in 177 no ndiabetic subjects (75 men and 102 women, aged 31–75 years) with no history of liver disease. On the basis of BMI ( & lt; or ≥27.5 kg/m2) and SI ( & lt; or ≥7.0 × 10−5 min/pmol) subjects were divided into lean insulin sensitive (LIS, n = 53), lean insulin resistant (LIR, n = 60), and obese insulin resistant (OIR, n = 56) groups. RESULTS— Levels of all three liver enzymes were higher in men than in women (P & lt; 0.0001 for each). In men, GGT levels were higher in insulin-resistant than in insulin-sensitive subjects (P & lt; 0.01). In women, GGT levels were higher in the OIR than in the LIS group (P & lt; 0.01) but no different in the LIR group. There was no difference in ALT and AST levels among the LIS, LIR, and OIR groups. GGT was associated with SI (r = −0.26, P & lt; 0.0001), IAF area (r = 0.22, P & lt; 0.01), waist-to-hip ratio (WHR) (r = 0.25, P = 0.001), BMI (r = 0.17, P & lt; 0.05), and SCF area (r = 0.16, P & lt; 0.05) after adjustments for age and sex. In men, only SI (r = −0.29, P & lt; 0.05) remained independently correlated with GGT in multiple regression analysis. In women, IAF area (r = 0.29, P & lt; 0.01) and WHR (r = 0.29, P & lt; 0.01) were independently associated with GGT, but SI was not. CONCLUSIONS— In nondiabetic men GGT but not AST or ALT levels, are inversely related to insulin sensitivity independent of IAF area. However in women, GGT is related to measures of central body fat rather than to insulin sensitivity.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc06-1758
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2007
    detail.hit.zdb_id: 1490520-6
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  • 6
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    Gestational Diabetes or Lesser Degrees of Glucose Intolerance and Risk of Preeclampsia
    Informa UK Limited ; 2011
    In:  Hypertension in Pregnancy Vol. 30, No. 2 ( 2011-05), p. 153-163
    Details
    In: Hypertension in Pregnancy, Informa UK Limited, Vol. 30, No. 2 ( 2011-05), p. 153-163
    Type of Medium: Online Resource
    ISSN: 1064-1955 , 1525-6065
    URL: Article
    DOI: 10.3109/10641950903115012
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2011
    detail.hit.zdb_id: 2028086-5
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  • 7
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    Impact of Differences in Fasting Glucose and Glucose Tolerance on the Hyperbolic Relationship Between Insulin Sensitivity and Insulin Responses
    American Diabetes Association ; 2006
    In:  Diabetes Care Vol. 29, No. 2 ( 2006-02-01), p. 356-362
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 2 ( 2006-02-01), p. 356-362
    Abstract: OBJECTIVE—To determine whether the hyperbolic relationship between insulin sensitivity and the acute insulin response to glucose (AIRg) exists in subjects with impaired fasting glucose (IFG) or decreased glucose tolerance. RESEARCH DESIGN AND METHODS—We studied 219 healthy subjects (88 male and 131 female subjects, aged 26–75 years) with fasting plasma glucose (FPG) & lt;6.11 mmol/l. Subjects underwent an intravenous glucose tolerance test to determine the insulin sensitivity index (Si), AIRg, and the glucose disappearance constant (Kg), the latter a measure of intravenous glucose tolerance. RESULTS—Si and AIRg were inversely related for the entire cohort, and this relationship was not significantly different from hyperbolic. The inverse relationship between Si and AIRg was not significantly different when compared between groups based on fasting glucose (normal fasting glucose [NFG], FPG & lt;5.56 mmol/l vs. IFG, FPG 5.56–6.11 mmol/l) or by the Kg quartile. However, the curve relating Si and AIRg was left shifted in the IFG compared with NFG group (P & lt; 0.001) and was progressively more left shifted with decreasing Kg (P & lt; 0.001), consistent with decreasing β-cell function. These changes were not observed for the curves relating Si and fasting insulin, suggesting that in the fasting state β-cell function is maintained even in patients with mild IFG. Finally, the disposition index (DI) (Si × AIRg) was calculated as a measure of β-cell function. The DI progressively decreased with increasing FPG, even in the group of subjects classified as NFG. CONCLUSIONS—The inverse relationship between insulin sensitivity and AIRg is consistent with a hyperbola not only in subjects with normal glucose tolerance but also with mild IFG or decreased Kg. Based on a hyperbolic relationship, a decrease in β-cell function can be detected as FPG increases, even in patients who are normal glucose tolerant.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.29.02.06.dc05-1963
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
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  • 8
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    Impact of Intra-Abdominal Fat and Age on Insulin Sensitivity and β-Cell Function
    American Diabetes Association ; 2004
    In:  Diabetes Vol. 53, No. 11 ( 2004-11-01), p. 2867-2872
    Details
    In: Diabetes, American Diabetes Association, Vol. 53, No. 11 ( 2004-11-01), p. 2867-2872
    Abstract: The prevalence of glucose intolerance and type 2 diabetes increases with age. To determine whether the hyperbolic relationship between insulin sensitivity and the insulin response is affected by age and whether the decline in β-cell function with age is related to increases in intra-abdominal fat or age per se, we studied 220 healthy subjects with fasting glucose & lt;6.1 mmol/l (89 men and 131 women, aged 26–75 years, BMI 18.7–40.4 kg/m2). The insulin sensitivity index (Si) and the acute insulin response to glucose (AIRg) were determined, and from these β-cell function was estimated as the disposition index (Si × AIRg). Intra-abdominal fat and subcutaneous fat areas were quantified by computed tomography. Si (5.40 ± 0.5 vs. 7.86 ± 0.7 ×10−5 min−1/[pmol/l]), P & lt; 0.01) was decreased and intra-abdominal fat (117 ± 10 vs. 81 ± 9 cm2, P & lt; 0.05) was increased in the oldest (age 60–75 years) versus the youngest (age 26–44 years) quartile. The hyperbolic relationship between Si and AIRg was present independent of age; thus, β-cell function measured as the disposition index (1,412 ± 120 vs. 2,125 ± 150 ×10−5 min−1, P & lt; 0.01) was lower in the oldest versus the youngest quartile. In multiple regression, intra-abdominal fat (r = −0.470, P & lt; 0.001) but not age was associated with Si, but both intra-abdominal fat (r = −0.198, P = 0.003) and age (r = −0.131, P = 0.05) were correlated with the disposition index. These data suggest that although intra-abdominal fat is a strong determinant of insulin sensitivity and β-cell function, age has an independent effect on β-cell function that may contribute to the increased prevalence of type 2 diabetes in older populations.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/diabetes.53.11.2867
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2004
    detail.hit.zdb_id: 1501252-9
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  • 9
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    Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome
    American Diabetes Association ; 2004
    In:  Diabetes Vol. 53, No. 8 ( 2004-08-01), p. 2087-2094
    Details
    In: Diabetes, American Diabetes Association, Vol. 53, No. 8 ( 2004-08-01), p. 2087-2094
    Abstract: The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26–75 years) and BMI (18.4–46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 × 10−5 min−1/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P & lt; 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P & lt; 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose & lt;6.4 mmol/l.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/diabetes.53.8.2087
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2004
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  • 10
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    Reduced Adipogenic Gene Expression in Thigh Adipose Tissue Precedes Human Immunodeficiency Virus-Associated Lipoatrophy
    The Endocrine Society ; 2008
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 93, No. 3 ( 2008-03-01), p. 959-966
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 93, No. 3 ( 2008-03-01), p. 959-966
    Abstract: Context: The expression of adipogenic genes in sc adipose tissue has been reported to be lower among patients with HIV-associated lipoatrophy than HIV-uninfected controls. It is unclear whether this is a result or cause of lipoatrophy. Objective: The objective of the study was to investigate the temporal relationships among changes in adipogenic gene expression in sc adipose tissue and changes in body fat distribution and metabolic complications in HIV-infected subjects on antiretroviral therapy. Design: This was a prospective longitudinal study. Setting: The study was conducted at HIV clinics in Seattle, Washington. Participants: The study population included 31 HIV-infected and 12 control subjects. Interventions: Subjects were followed up for 12 months after they initiated or modified their existing antiretroviral regimen. Main Outcome Measures: Changes in body composition, plasma lipids, insulin sensitivity, and gene expression in sc abdominal and thigh adipose tissue. Results: Subjects who developed lipoatrophy (n = 10) had elevated fasting triglycerides [3.16 (sd 2.79) mmol/liter] and reduced insulin sensitivity as measured by frequently sampled iv glucose tolerance test [1.89 (sd 1.27) × 10−4 min−1/μU·ml] after 12 months, whereas those without lipoatrophy (n = 21) did not show any metabolic complications [triglycerides 1.32 (sd 0.58) mmol/liter, P = 0.01 vs. lipoatrophy; insulin sensitivity 3.52 (sd 1.91) × 10−4 min−1/μU·ml, P = 0.01 vs. lipoatrophy] . In subjects developing lipoatrophy, the expression of genes involved in adipocyte differentiation, lipid uptake, and local cortisol production in thigh adipose tissue was significantly reduced already at the 2-month visit, several months before any loss of extremity fat mass was evident. Conclusions: In HIV-infected subjects, lipoatrophy is associated with elevated fasting triglycerides and insulin resistance and might be caused by a direct or indirect effect of antiretroviral drugs on sc adipocyte differentiation.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/jc.2007-0197
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2008
    detail.hit.zdb_id: 2026217-6
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