2005

Unexplained Elevations in Alanine Aminotransferase in Individuals with the Metabolic Syndrome: Results from the Third National Health & NHANES III

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Liangpunsakul S, Chalasani N. Unexplained Elevations in Alanine Aminotransferase in Individuals with the Metabolic Syndrome: Results from the Third National Health and Nutrition Survey (NHANES III). Am J Med Sci. 2005;329:111-116. Unexplained elevations in alanine aminotransferase (ALT) level have been suggested to signify the presence of nonalcoholic fatty liver disease (NAFLD) in adult NHANES III participants.

Underuse of ACE inhibitors and angiotensin II receptor blockers in elderly patients with diabetes

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Winkelmayer WC, Fischer MA, Schneeweiss S, Wang PS, Levin R, Avorn J. Underuse of ACE inhibitors and angiotensin II receptor blockers in elderly patients with diabetes. Am J Kidney Dis. 2005;46:1080-1087. National guidelines recommend angiotensin-converting enzyme (ACE)-inhibitor or angiotensin receptor blocker (ARB) therapy in patients with diabetes who also have hypertension and/or proteinuria to retard the progression of renal damage. However, little is known about the adequacy of adherence to these guidelines in elderly patients with diabetes and predictors of such appropriate ACE-inhibitor or ARB use.

Thiazolidinediones, metformin, and outcomes in older patients with diabetes and heart failure: an observational study

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Masoudi FA, Inzucchi SE, Wang Y, Havranek EP, Foody JM, Krumholz HM. Thiazolidinediones, metformin, and outcomes in older patients with diabetes and heart failure: an observational study. Circulation. 2005;111:583-590. Insulin-sensitizing drugs of the thiazolidinedione class and metformin are commonly prescribed to treat diabetes in patients with heart failure despite strong warnings from the Food and Drug Administration against this practice. Whether this results in adverse outcomes is unknown.

Thiazolidinediones upregulate fatty acid uptake and oxidation in adipose tissue of diabetic patients

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Boden G, Homko C, Mozzoli M, Showe LC, Nichols C, Cheung P. Thiazolidinediones upregulate fatty acid uptake and oxidation in adipose tissue of diabetic patients. Diabetes. 2005;54:880-885. Thiazolidinediones (TZDs) are a new class of insulin-sensitizing drugs. To explore how and in which tissues they improve insulin action, we obtained fat and muscle biopsies from eight patients with type 2 diabetes before and 2 months after treatment with rosiglitazone (n = 5) or troglitazone (n = 3).

Thiazolidinedione (Pioglitazone) blocks P. gingivalis- and F. nucleatum but not E. coli lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) production

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Yamaguchi M, Nishimura F, Naruishi H, Soga Y, Kokeguchi S, Takashiba S. Thiazolidinedione (Pioglitazone) blocks P. gingivalis- and F. nucleatum, but not E. coli, lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) production in adipocytes. J Dent Res. 2005;84:240-244. An elevated level of C-reactive protein (CRP) predicts the future development of coronary heart disease. Periodontitis appears to up-regulate CRP. CRP is produced by hepatocytes in response to interleukin-6 (IL-6). A major source of IL-6 in obese subjects is adipocytes.

The role of non-invasive imaging in the risk stratification of asymptomatic diabetic subjects

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Anand DV, Lim E, Lahiri A, Bax JJ. The role of non-invasive imaging in the risk stratification of asymptomatic diabetic subjects. Eur Heart J. Eur Heart J. 2005. Coronary artery disease (CAD) is the leading cause of death in patients with diabetes. Patients often present with advanced and asymptomatic disease. Proposed strategies that may favourably affect CAD risk and outcomes in this patient population include identifying diabetic patients with subclinical disease at high risk of future cardiac events.

The metabolic syndrome: requiescat in pace

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Reaven GM. The metabolic syndrome: requiescat in pace. Clin Chem. 2005;51:931-938. Values for insulin-mediated glucose disposal vary continuously throughout a population of apparently healthy individuals, with at least a sixfold variation between the most insulin sensitive and most insulin resistant of these individuals.

The metabolic syndrome, insulin resistance, and cardiovascular risk in diabetic and nondiabetic patients

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Saely CH, Aczel S, Marte T, Langer P, Hoefle G, Drexel H. The metabolic syndrome, insulin resistance, and cardiovascular risk in diabetic and nondiabetic patients. J Clin Endocrinol Metab. 2005;90:5698-5703. The contribution of insulin resistance per se to the vascular risk conferred by the metabolic syndrome (MetS) is not known; conversely, it is uncertain whether insulin resistance confers vascular risk beyond the entity of the MetS.

The metabolic syndrome is a stronger risk factor for early carotid atherosclerosis in women than in men

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Iglseder B, Cip P, Malaimare L, Ladurner G, Paulweber B. The metabolic syndrome is a stronger risk factor for early carotid atherosclerosis in women than in men. Stroke. 2005;36:1212-1217. The metabolic syndrome (MetS) is associated with an increased risk for subsequent development of type 2 diabetes mellitus, cardiovascular disease, and stroke. Type 2 diabetes increases the risk of stroke and coronary heart disease in women to a greater extent than in men, and thus the question arises whether there are sex differences in the association of early atherosclerosis and MetS.

The metabolic syndrome in older individuals: prevalence and prediction of cardiovascular events: the Cardiovascular Health Study

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Scuteri A, Najjar SS, Morrell CH, Lakatta EG. The metabolic syndrome in older individuals: prevalence and prediction of cardiovascular events: the Cardiovascular Health Study. Diabetes Care. 2005;28:882-887. The prevalence of the metabolic syndrome, a potent risk factor for cardiovascular diseases (CVDs), has not been adequately explored in older individuals. Moreover, two sets of criteria have been proposed for the definition of metabolic syndrome, one by the World Health Organization (WHO) and one by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII).

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