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  • 1
    ISSN: 1432-0428
    Keywords: Key words Diabetes mellitus ; glucose intolerance ; insulin ; cognition ; aged ; epidemiology.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension. We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95 % confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04–1.46), newly-diagnosed diabetic patients of 1.16 (0.91–1.48) and subjects with impaired glucose tolerance of 1.18 (0.98–1.41), after adjustment for confounding due to age, occupation and cigarette smoking (p-trend = 0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03–1.50), after adjustment for confounding (p-trend = 0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment. [Diabetologia (1995) 38: 1096–1102]
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Key words Non-insulin-dependent diabetes mellitus ; hypertension ; insulin ; longitudinal ; overweight.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To elucidate the role of hypertension as part of the insulin resistance syndrome, the longitudinal relationships of hypertension and overweight with hyperinsulinaemia and glucose tolerance were examined in the Dutch and Finnish cohorts of the Seven Countries Study (Zutphen, and east and west Finland). Three cohorts of men, born between 1900 and 1919, were first examined in 1959/1960. At the 30-year follow-up survey a 2-h glucose tolerance test was carried out on 619 of the surviving men, and fasting insulin was also measured. Blood pressure and body mass index (BMI) were measured several times during the entire 30-year follow-up period. In cross-sectional analyses, men with diabetes and impaired glucose tolerance at the 30-year follow-up examination had a significantly higher systolic blood pressure and a higher prevalence of hypertension than men with normal glucose tolerance, independent of age, cohort and BMI (p 〈 0.01). These differences had already been seen 5, 20 and 30 years earlier. Subjects with hyperinsulinaemia (fasting insulin ≥ 9.2 mU/l) had a higher BMI and a higher prevalence of hypertension. This cross-sectional association with hypertension was independent of age, cohort and BMI. BMI levels of men with hyperinsulinaemia had been shown to be higher 5, 20 and 30 years earlier, but blood pressure levels had not. These results indicate that hypertension is independently associated with glucose tolerance and insulin resistance in three Caucasian cohorts. Changes in blood pressure precede abnormal glucose tolerance but not hyperinsulinaemia; therefore, glucose tolerance appears to be a stronger correlate of hypertension than hyperinsulinaemia. [Diabetologia (1995) 38: 839–847]
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 40 (1997), S. 344-347 
    ISSN: 1432-0428
    Keywords: Keywords Insulin ; glucose tolerance ; vitamin D ; elderly.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Vitamin D status was assessed in 142 elderly Dutchmen participating in a prospective population-based study of environmental factors in the aetiology of non-insulin-dependent diabetes mellitus. Of the men aged 70–88 years examined between March and May 1990, 39 % were vitamin D depleted. After adjustment for confounding by age, BMI, physical activity, month of sampling, cigarette smoking and alcohol intake the 1-h glucose and area under the glucose curve during a standard 75-g oral glucose tolerance test (OGTT) were inversely associated with the serum concentration of 25-OH vitamin D (r = −0.23, p 〈 0.01; r = −0.26, p 〈 0.01, respectively). After excluding newly diagnosed diabetic patients total insulin concentrations during OGTT were also inversely associated with the concentration of 25-OH vitamin D (r = −0.18 to −0.23, p 〈 0.05). Hypovitaminosis D may be a significant risk factor for glucose intolerance. [Diabetologia (1997) 40: 344–347]
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; glucose intolerance ; insulin ; cognition ; aged ; epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension. We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95% confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04–1.46), newly-diagnosed diabetic patients of 1.16 (0.91–1.48) and subjects with impaired glucose tolerance of 1.18 (0.98–1.41), after adjustment for confounding due to age, occupation and cigarette smoking (p-trend=0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03–1.50), after adjustment for confounding (p-trend=0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7284
    Keywords: Coronary heart disease ; Mortality ; Prediction ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cohorts of men aged 40–59 in geographically defined areas of Croatia, former Yugoslavia, were enrolled in 1958 and cardiovascular risk factors were measured. The cohort of Dalmatia, on the Adriatic coast, was made up of 671 men (participation rate 98%), that of Slavonia, in the inland plain, of 696 men (participation rate 91%). Similar examinations were repeated 5 and 10 years after the entry one. A complete follow-up for vital status and causes of death was run for 25 years. Death rates in 25 year from coronary heart disease (CHD) were 90 per 1000 in Dalmatia and 148 per 1000 in Slavonia where also all other major causes of death and all-cause mortality rates were higher (642 vs 465 per 1000 in 25 years). Univariate and multivariate analysis relating ten risk factors to CHD mortality, showed that age and systolic blood pressure were significant predictors in Dalmatia; age, subscapular skinfold and body mass index (inverse) in Slavonia; and age, systolic blood pressure and subscapular skinfold in a multivariate model with lumped cohorts, where dummy variables identifying cohorts indicated a large unexplained extra-risk in Slavonia. In the pooled analysis cigarette smoking and serum cholesterol carried non significant coefficients. Blood pressure change in the first 10 years of follow-up added predictivity to a model exploring the delayed CHD morality occurring between year 10 and 25 of follow-up. Among the base-line mea surements only serum cholesterol was significantly different between the two groups (188 mg/dl in Dalmatia and 199 mg/dl in Slavonia). The method for covariance adjustment of rates based on the logistic regression was able to explain only 9% of the difference in CHD mortality between the two cohorts using the available risk factors. Dietary habits, measured only on subsamples, add some explanation in CHD mortality difference between the two cohorts.
    Type of Medium: Electronic Resource
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