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  • 1
    Electronic Resource
    Electronic Resource
    Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow-up (1991)
    Springer
    Diabetologia 34 (1991), S. 356-361 
    Details
    ISSN: 1432-0428
    Keywords: Epidemiology ; Paris Prospective Study ; coronary heart disease risk factors ; plasma insulin level ; insulin resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The Paris Prospective Study is a long-term, largescale study of the factors predicting coronary heart disease. The first follow-up examination included, for subjects not known as having diabetes mellitus, a 75 g oral glucose tolerance test with measurement of plasma insulin and glucose levels, fasting and 2 h post-load. Between 1968 and 1973, 6903 men aged 43–54 years were thus examined. Causes of death were ascertained within this group after 15 years of mean follow-up. The baseline variables were tested as predictors of death from coronary heart disease by a Cox regression analysis. Significant independent predictors of coronary heart disease death were: systolic blood pressure, number of cigarettes per day, plasma cholesterol level, and 2 h post-load plasma insulin level when entered as a categorical variable (below or above 452 pmol/l, i.e. the lower limit of the fifth quintile of the distribution). This dichotomization was performed to account for the non-linear univariate distribution of deaths with increasing post-load insulin values. Fasting plasma insulin level was not an independent predictor of death by coronary heart disease over this long-term follow-up. Levels of blood glucose were not significant independent predictors of death by coronary heart disease when plasma insulin levels were included in the model. The same applied to abnormalities of glucose tolerance when the 125 men with known non-insulin-treated diabetes at baseline were added to the group. Under the assumption that hyperinsulinaemia is a marker of insulin resistance, the results are consistent with the hypothesis that insulin resistance is associated with a higher risk of coronary heart disease mortality. However, it is doubtful that circulating insulin per se is a direct cause of arterial complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00405009
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  • 2
    Electronic Resource
    Electronic Resource
    Pre-diabetic blood pressure predicts urinary albumin excretion after the onset of Type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians (1993)
    Springer
    Diabetologia 36 (1993), S. 998-1001 
    Details
    ISSN: 1432-0428
    Keywords: Albuminuria ; risk factors ; blood pressure ; Type 2 (non-insulin-dependent) diabetes mellitus ; Pima Indians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Blood pressure was measured in 490 non-proteinuric Pima Indians from the Gila River Indian Community in Arizona at least 1 year before the diagnosis of Type 2 (non-insulin-dependent) diabetes mellitus. Urine albumin concentration was measured in the same subjects 0–24 years (mean 5 years) after diabetes was diagnosed. Prevalence rates of abnormal albumin excretion (albumin-to-creatinine ratio ≥100 mg/g) after the onset of Type 2 diabetes were 9%, 16%, and 23%, respectively, for the lowest to highest tertiles of pre-diabetic mean blood pressure. When controlled for age, sex, duration of diabetes and pre-diabetic 2-h post-load plasma glucose concentration, higher pre-diabetic mean blood pressure predicted abnormal urinary excretion of albumin after the onset of diabetes. This finding suggests that the higher blood pressure seen in diabetic nephropathy is not entirely a result of the renal disease, but may precede and contribute to it.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02374490
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  • 3
    Electronic Resource
    Electronic Resource
    The association of physical activity with obesity, fat distribution and glucose intolerance in Pima Indians (1993)
    Springer
    Diabetologia 36 (1993), S. 863-869 
    Details
    ISSN: 1432-0428
    Keywords: Physical activity ; obesity ; fat distribution ; glucose intolerance ; Pima Indians ; exercise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relationships between physical activity, obesity, fat distribution and glucose tolerance were examined in the Pima Indians who have the highest documented incidence of non-insulin-dependent diabetes. Fasting and 2-h post-load plasma glucose concentrations, body mass index, and waist-to-thigh circumference ratios were determined in 1054 subjects aged 15–59 years. Current (during the most recent calendar year) and historical (over a lifetime) leisure and occupational physical activity were determined by questionnaire. Current physical activity was inversely correlated with fasting and 2-h plasma glucose concentrations, body mass index and waist-to-thigh ratios for most sex-age groups even when diabetic subjects were excluded. Controlled for age, obesity and fat distribution, activity remained significantly associated with 2-h plasma glucose concentrations in males. In subjects aged 37–59 years, individuals with diabetes compared to those without reported significantly less leisure physical activity during the teenage years (median hours per week of activity, 9.1 vs 13.2 for men; 1.0 vs 2.2 for women). Controlled for body mass index, sex, age and waist-to-thigh ratio, subjects who reported low levels of historical leisure physical activity had a higher rate of diabetes than those who were more active. In conclusion, current physical activity was inversely related to glucose intolerance, obesity and central distribution of fat, particularly in males. Subjects with diabetes were currently less active and reported less historical physical activity than non-diabetic subjects. These findings suggest that activity may protect against the development of non-insulin-dependent diabetes both directly and through an influence on obesity and fat distribution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400363
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  • 4
    Electronic Resource
    Electronic Resource
    Determinants of end-stage renal disease in Pima Indians with Type 2 (non-insulin-dependent) diabetes mellitus and proteinuria (1993)
    Springer
    Diabetologia 36 (1993), S. 1087-1093 
    Details
    ISSN: 1432-0428
    Keywords: Diabetic nephropathy ; proteinuria ; end-stage renal disease ; Type 2 (non-insulin-dependent) diabetes mellitus ; blood pressure ; Pima Indians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To identify factors related to the development of end-stage renal disease after the onset of proteinuria, its incidence was determined in 364 Pima Indians aged 35 years or older with Type 2 (non-insulin-dependent) diabetes mellitus and proteinuria (protein-to-creatinine ratio ≥0.5 g/g). Of these 364 subjects, 95 (36 men, 59 women) developed end-stage renal disease. The cumulative incidence was 40% 10 years after and 61% 15 years after the onset of proteinuria. The incidence of end-stage renal disease was significantly related to the duration of diabetes, the duration of proteinuria, higher 2-h plasma glucose concentration, type of diabetes treatment, and the presence of retinopathy at the time of recognition of the proteinuria, but not to age, sex, or blood pressure. Duration of proteinuria influenced the risk of end-stage renal disease, contingent, however, upon the duration of diabetes at the onset of proteinuria. The higher cumulative incidence of end-stage renal disease 15 years after the onset of proteinuria in Pima Indians (61 %) than in Caucasians from Rochester, Minnesota (17%) may be attributable, in part, to the younger age of onset of Type 2 diabetes in Pima Indians than in Caucasians, to ethnic differences in susceptibility to renal disease, or to lower death rates among the Pima Indians from competing causes of death, such as coronary heart disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02374503
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  • 5
    Electronic Resource
    Electronic Resource
    Quantitative phenotypic and functional analyses of islet immune cells before and after diabetes onset in the BB rat (1993)
    Springer
    Diabetologia 36 (1993), S. 1146-1154 
    Details
    ISSN: 1432-0428
    Keywords: BB rat ; in situ islet immune cells ; inflamed islets ; diabetes mellitus ; islets
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Inflammatory cells invading islets are thought to be mediators of islet destruction in spontaneous autoimmune diabetes mellitus. Thus methods were developed to isolate and characterize in situ islet inflammatory cells from 75–95-day-old prediabetic and diabetic BB rats. Islet inflammatory cells were structurally examined using single- and double-colour flow cytometry. Functional studies consisted of cytolytic assays using normal rat islet target cells and in situ islet or spleen effector cells. Structural data reveal natural killer cells to be the major cell population (70%) of total immune cells present in inflamed islets during prediabetes. At diabetes onset, the natural killer cell population remained at a high level (47%), but an increasing population of T cells (40%) was noted also. Analyses of T-cell subsets before and after diabetes onset revealed CD4+ T cells as predominant (50–55% of total T cells) with double-negative (CD4− CD8−) T cells (25–30%) and CD8+ T cells (15–20%) also present in significant quantities. Activated T cells accounted only for a minority of T cells (〈3%). Functional studies indicate that in situ islet-derived cytolytic effector cells are more potent killers (ten-fold) of normal islet target cells than are splenic effector cells. These data suggest that in situ islet inflammatory cells (a) can be quantitatively studied both structurally and functionally; (b) express structural phenotypes differing substantially from splenic mononuclear cell populations; (c) are considerably more cytolytic than splenic effectors; and (d) should prove informative in determining the most significant autoimmune functional events prior to and during islet beta-cell destruction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401059
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  • 6
    Electronic Resource
    Electronic Resource
    Early and late insulin response as predictors of NIDDM in Pima Indians with impaired glucose tolerance (1995)
    Springer
    Diabetologia 38 (1995), S. 187-192 
    Details
    ISSN: 1432-0428
    Keywords: Key words Impaired glucose tolerance ; insulin response ; cholesterol.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Risk factors predicting deterioration to diabetes mellitus were examined in 181 subjects with impaired glucose tolerance. Fifty-seven subjects had impaired glucose tolerance on one occasion followed by normal glucose tolerance at a repeat oral glucose tolerance test, and 124 subjects had impaired glucose tolerance on two successive oral glucose tolerance tests. Subjects were followed for a median period of 5.0 years (range 1.0–17.2). The age- and sex-adjusted cumulative incidence of diabetes at 10 years of follow-up was higher in subjects who had impaired glucose tolerance on both tests (70 %) than in those whose glucose tolerance was normal at the repeat test (53 %), [rate ratio (RR) = 1.6, 95 % confidence intervals (CI) = 1.0–2.5]. Proportional hazards analyses were used to identify baseline risk factors (measured at the repeat oral glucose tolerance test) for subsequent diabetes, and incidence rate ratios were calculated for the 90th percentile compared with the 10th percentile of each continuous variable for the whole group. In all subjects, in separate models, higher body mass index [RR = 2.0, 95 % CI = 2.2–9.9], high fasting serum insulin concentrations [RR = 2.4, 95 % CI = 1.4–4.2], and low early insulin response [RR = 0.5, 95 % CI = 0.3–0.8] 30 min after a glucose load were significant predictors for deterioration to diabetes. In a multivariate analysis which controlled for age and sex, 120-min post-load glucose, fasting insulin and late insulin response predicted diabetes. In subgroup analyses the predictors of diabetes were generally similar in subjects who had impaired glucose tolerance at only one test and those who had impaired glucose tolerance on both tests. These findings suggest that in those subjects with impaired glucose tolerance whose glucose tolerance has returned to normal, the risk of subsequent diabetes is high. Insulin resistance, impaired early insulin response, or both, are predictive of subsequent development of diabetes in Pima Indians with impaired glucose tolerance. [Diabetologia (1995) 38: 187–192]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400093
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  • 7
    Electronic Resource
    Electronic Resource
    Early and late insulin response as predictors of NIDDM in Pima Indians with impaired glucose tolerance (1995)
    Springer
    Diabetologia 38 (1995), S. 187-192 
    Details
    ISSN: 1432-0428
    Keywords: Impaired glucose tolerance ; insulin response ; cholesterol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Risk factors predicting deterioration to diabetes mellitus were examined in 181 subjects with impaired glucose tolerance. Fifty-seven subjects had impaired glucose tolerance on one occasion followed by normal glucose tolerance at a repeat oral glucose tolerance test, and 124 subjects had impaired glucose tolerance on two successive oral glucose tolerance tests. Subjects were followed for a median period of 5.0 years (range 1.0–17.2). The age- and sex-adjusted cumulative incidence of diabetes at 10 years of follow-up was higher in subjects who had impaired glucose tolerance on both tests (70%) than in those whose glucose tolerance was normal at the repeat test (53%), [rate ratio (RR)=1.6, 95% confidence intervals (CI)=1.0–2.5]. Proportional hazards analyses were used to identify baseline risk factors (measured at the repeat oral glucose tolerance test) for subsequent diabetes, and incidence rate ratios were calculated for the 90th percentile compared with the 10th percentile of each continuous variable for the whole group. In all subjects, in separate models, higher body mass index [RR=2.0, 95% CI=2.2–9.9], high fasting serum insulin concentrations [RR=2.4, 95% CI=1.4–4.2], and low early insulin response [RR=0.5, 95% CI=0.3–0.8] 30 min after a glucose load were significant predictors for deterioration to diabetes. In a multivariate analysis which controlled for age and sex, 120-min post-load glucose, fasting insulin and late insulin response predicted diabetes. In subgroup analyses the predictors of diabetes were generally similar in subjects who had impaired glucose tolerance at only one test and those who had impaired glucose tolerance on both tests. These findings suggest that in those subjects with impaired glucose tolerance whose glucose tolerance has returned to normal, the risk of subsequent diabetes is high. Insulin resistance, impaired early insulin response, or both, are predictive of subsequent development of diabetes in Pima Indians with impaired glucose tolerance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400093
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  • 8
    Electronic Resource
    Electronic Resource
    The role of non-esterified fatty acids in the deterioration of glucose tolerance in Caucasian subjects: results of the Paris Prospective Study (1997)
    Springer
    Diabetologia 40 (1997), S. 1101-1106 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Non-insulin-dependent diabetes mellitus ; impaired glucose tolerance ; non-esterified fatty acids ; insulin resistance ; insulin secretion ; epidemiology.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although an increased plasma non-esterified fatty acid (NEFA) concentration has been shown to increase insulin resistance (Randle cycle), decrease insulin secretion and increase hepatic gluconeogenesis, the effect of NEFA on the deterioration of glucose tolerance has not been studied prospectively in Caucasian subjects. Therefore, we investigated whether plasma NEFA may be regarded as predictors of deterioration of glucose tolerance in subjects with normal (NGT, n = 3671) or impaired (IGT, n = 418) glucose tolerance who were participants in the Paris Prospective study. The subjects were first examined between 1967 and 1972 and underwent two 75-g oral glucose tolerance tests 2 years apart with measurements of plasma glucose, insulin and NEFA concentrations. Glucose tolerance deteriorated from NGT to IGT or non-insulin-dependent diabetes (NIDDM) in 177 subjects and from IGT to NIDDM in 32 subjects. In multivariate analysis, high fasting plasma NEFA in NGT subjects and high 2-h plasma NEFA and low 2-h plasma insulin concentrations in IGT subjects were significant independent predictors of deterioration along with older age, high fasting and 2-h plasma glucose concentrations and high iliac to thigh ratio. When subjects were divided by tertiles of plasma NEFA concentration at baseline, there was an increase in 2-h glucose concentration with increasing NEFA in the subjects who did not deteriorate, but no effect of plasma NEFA in those who deteriorated. In subjects with IGT who deteriorated compared with those who did not 2-h plasma insulin concentration was lower but there was no evidence that this resulted from an effect of plasma NEFA. Our data suggest that a high plasma NEFA concentration is a risk marker for deterioration of glucose tolerance independent of the insulin resistance or the insulin secretion defect that characterize subjects at risk for NIDDM. [Diabetologia (1997) 40: 1101–1106]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050793
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  • 9
    Electronic Resource
    Electronic Resource
    Glycated haemoglobin, plasma glucose and diabetic retinopathy: cross-sectional and prospective analyses (1993)
    Springer
    Diabetologia 36 (1993), S. 428-432 
    Details
    ISSN: 1432-0428
    Keywords: Glycated haemoglobin A1 ; plasma glucose ; diabetic retinopathy ; risk factor ; receiver operating characteristic (ROC) analysis ; Pima Indians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among Pima Indians with Type 2 (non-insulin-dependent) diabetes mellitus the relationships between glycated haemoglobin (HbA1), fasting or 2-h post-load plasma glucose and diabetic retinopathy were examined by cross-sectional and prospective analyses, and the strengths of the associations were directly compared by receiver operating characteristic analysis. In the cross-sectional analysis, HbA1, fasting and 2-h plasma glucose were each significantly related to retinopathy among 789 diabetic subjects by separate logistic models. In a stepwise multiple logistic model in which HbA1, fasting and 2-h plasma glucose were included, HbA1 was selected as having the strongest association with retinopathy and neither fasting nor 2-h plasma glucose contributed significantly to the model once HbA1 was entered. Similarly, in the prospective analysis, HbA1, fasting and 2-h plasma glucose all predicted retinopathy in 227 diabetic subjects by separate proportional-hazards models. In a stepwise proportional-hazards model with HbA1, fasting and 2-h plasma glucose available to the model, HbA1 was again selected as having the strongest association with the incidence of retinopathy, and neither fasting nor 2-h plasma glucose significantly added to the prediction of retinopathy. A receiver operating characteristic analysis was used to determine if HbA1 was statistically significantly better than fasting or 2-h plasma glucose in assessing the risk for retinopathy. In neither the cross-sectional nor the prospective data did the area under the receiver operating characteristic curve for HbA1 differ significantly from that for fasting or 2-h plasma glucose (p〉0.05 for each). In conclusion, HbA1, an integrated measure of blood glucose concentration over a period of 2–3 months, is slightly more closely associated with the prevalence and incidence of diabetic retinopathy than a single blood glucose determination. However, the differences between HbA1 and fasting or 2-h plasma glucose in assessing the association with or the risk for retinopathy are not significant.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00402279
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  • 10
    Electronic Resource
    Electronic Resource
    Differential synthesis of an alkaline endonuclease in Physarum polycephalum (1979)
    Springer
    Archives of microbiology 122 (1979), S. 195-200 
    Details
    ISSN: 1432-072X
    Keywords: Physarum polycephalum ; PolyA-specific endonuclease ; RNA turnover ; Sclerotization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract During the sclerotization of microplasmodia of Physarum polycephalum in non-nutrient salt medium or in salt medium supplemented by glucose, RNA or nucleotides a 6-fold increase in the specific activity of an alkaline endonuclease was found within 6 h after the induction. The increase was based on de novo synthesis of the enzyme and it was strongly correlated to the sharp drop in the level of cellular RNA in the first hours of the process of scerotization. The induction in exhausted growth medium or in salt medium supplemented by protein or mannitol showed a gradual 2-3-fold increase of the endonuclease in 30 h, parallel to the gradual decrease of the RNA. No changes in the specific activity of the endonuclease were found during logarithmic growth or under conditions of starvation without the induction to sclerotization. The alkaline, polyA-specific endonuclease could possibly regulate the turnover of RNA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00411360
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