1,721,987 research outputs found
Do different dimensions of the metabolic syndrome change together over time?. Evidence supporting obesity as the central feature
No full textOBJECTIVE—The metabolic syndrome is a loosely defined cluster of cardiovascular risk factors including low HDL cholesterol, hypertriglyceridemia, glucose intolerance, and hypertension. Evidence for inclusion of these features in the syndrome has mostly come from cross-sectional studies, and a few studies have examined how the various factors change together over time. RESEARCH DESIGN AND METHODS—We conducted a prospective population-based cohort study of 937 individuals aged 40–65 years who underwent oral glucose tolerance testing on two occasions at 4.5-year intervals. Changes in the components of the metabolic syndrome were analyzed by principal component analysis in the entire population and in a subgroup of 471 individuals who did not receive pharmaceutical therapy for hypertension and dyslipidemia. RESULTS—Principal component analysis identified three independent factors in men: a blood pressure factor (systolic and diastolic blood pressure and BMI), a glucose factor (fasting and 120-min postload glucose, BMI, waist-to-hip ratio [WHR], and fasting insulin level), and a lipid factor (triglycerides and HDL cholesterol, BMI, WHR, and fasting insulin level). In women, an additional factor was identified, which included BMI, WHR, fasting insulin, and triglycerides. Analysis of the contribution of these variables to the different subdimensions indicated that BMI was the central feature of the syndrome in both sexes. CONCLUSIONS—This analysis of change in the features of the metabolic syndrome over time provides evidence of the fundamental importance of obesity in the origin of this disorder. <br/
Variation in the promoter of the human hormone sensitive lipase gene shows gender specific effects on insulin and lipid levels: results from the Ely study
No full textWe previously identified a hormone sensitive lipase (HSL) promoter variant, ?60C>G, which in vitro exhibits 40% reduced promoter activity. In this study we examined the effect of the ?60C>G on glycemic and lipid measures in the population based Ely study of metabolic function and insulin resistance in 218 middle-aged men and 276 middle-aged women. Adipose tissue HSL is the rate-limiting step in triglyceride lipolysis, generating free fatty acids for energy utilization. HSL is also expressed in pancreatic ?-cells where its activity therefore may affect insulin secretion. In the women, carriers of the HSL ?60G allele had significantly lower fasting insulin levels (P=0.0005) and a lower total area under the curve for insulin during the oral glucose tolerance test (P=0.005). There was no demonstrable association in men with these measures of insulin sensitivity but carriers of the ?60G allele had significantly lower fasting non-esterified fatty acid (NEFA) levels (P=0.025) and higher low density lipoprotein cholesterol levels (P=0.02) than men who were non-carriers. This study provides additional evidence for a role for HSL in the development of insulin resistance, from which carriers of the ?60G allele, associated here with markers of insulin sensitivity in women, and with lower NEFA levels in men, might be protected
Concurrent changes in diet quality and physical activity and association with adiposity in adults
No full textIMPORTANCE: Diet and physical activity (PA) are both associated with body weight, but less is understood about how long-term changes in these behaviors may be associated with changes in adiposity in the general population.OBJECTIVE: To evaluate associations of concurrent changes in diet quality and PA with different body composition indices.DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted among participants in the UK population-based Fenland study, with repeated measurements of health behaviors and adiposity. Data collection occurred in 2005 to 2015 and 2014 to 2020, with a mean (SD) follow-up of 7.2 (2.0) years. Data were analyzed from January 2024 through April 2025.EXPOSURES: Mediterranean diet score (MDS), a measure of adherence to the Mediterranean diet (range, 0-15 points), was assessed with a food frequency questionnaire. PA energy expenditure (PAEE), measured in kilojoules per kilogram per day, was assessed and calibrated with heart rate and movement sensing. Change variables were derived.MAIN OUTCOMES AND MEASURES: Indices of total adiposity (weight, body mass index and body fat) and regional adiposity (waist circumference, visceral adipose tissue [VAT], and subcutaneous adipose tissue) were assessed with anthropometry and dual-energy x-ray absorptiometry. Hepatic steatosis was ascertained by abdominal ultrasonography.RESULTS: The analysis included 7256 participants (mean [SD; range] age at recruitment, 48.8 [7.4; 29-65] years; 3748 female [51.7%]). In multivariable linear regression models after adjustment for potential confounders and baseline values, changes in both exposures were negatively associated with changes in all adiposity indices. For example, each 1-SD (1.27 points) increase in the change in MDS was negatively associated with changes in adiposity measures (change in body fat: β = -0.47 kg; 95% CI, -0.58 to -0.36 kg; change in VAT: β = -45 g; 95% CI, -55 to -35 g), and each 1-SD (19.0 kJ/kg/d) in the change in PAEE was similarly negatively associated with changes in adiposity measures (change in body fat: β = -1.40 kg; 95% CI, -1.51 to -1.26 kg; change in VAT: β = -108 g; 95% CI, -118 to -98 g) . Despite no evidence for a diet-PA interaction, simultaneous increases in MDS and PAEE were associated with a greater magnitude of decrease in adiposity, with a β of -149 g (95% CI, -187 to -111 g) for change in VAT among participants in higher joint change in MDS and change in PAEE tertiles. Associations had higher β values among individuals with overweight or obesity or who were physically inactive at baseline; for example, for each 1-SD increase in the change in PAEE, the β for change in body fat was -0.96 kg (95% CI, -1.10 to -0.81 kg) when baseline BMI was less than 25 and -1.74 kg (95% CI, -1.91 to -1.57 kg) when baseline BMI was 25 or greater (P for interaction < .001).CONCLUSIONS AND RELEVANCE: In this study, improved diet quality and increased PA were independently associated with weight loss or less weight gain and a healthier adiposity profile. Combining these health behaviors was associated with the greatest adiposity-related benefits.</p
Supported Telemonitoring and Glycemic Control in People with Type 2 Diabetes: the Telescot Diabetes Pragmatic Multicenter Randomized Controlled Trial
Full text linkBackgroundSelf-monitoring of blood glucose among people with type 2 diabetes not treated with insulin does not appear to be effective in improving glycemic control. We investigated whether health professional review of telemetrically transmitted self-monitored glucose results in improved glycemic control in people with poorly controlled type 2 diabetes.Methods and Findings We performed a randomized, parallel, investigator-blind controlled trial with centralised randomization in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated haemoglobin (HbA1c) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice weekly morning and evening glucose for review by family practice clinicians who were not blinded to allocation group. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycemic or blood pressure control.. HbA1c assessed at nine months was the primary outcome. Intention-to-treat analyses were performed. 160 people were randomized to the intervention group and 161 to the usual care group between June 6, 2011 and July 19, 2013. HbA1c data at follow-up were available for 146 people in the intervention group and 139 people in the control group. The mean (SD) HbA1c at follow-up was 63.0 (15.5) mmol/mol in the intervention group and 67.8 (14.7) mmol/mol in the usual care group. For primary analysis, adjusted mean HbA1c was 5.60 mmol/mol / 0.51% lower (95% CI 2.38 to 8.81 mmol/mol/ 95% CI 0.22% to 0.81%, p=0·0007). For secondary analyses, adjusted mean ambulatory systolic blood pressure was 3.06mm Hg lower (95% CI 0.56-5.56 mmHg, p=0.017 ) and mean ambulatory diastolic blood pressure was 2.17mm Hg lower (95% CI 0.62 to 3.72, p=0.006) among people in the intervention group when compared with usual care after adjustment for baseline differences and minimisation strata . No significant differences were identified between groups in weight, treatment pattern, in adherence to medication or3quality of life in secondary analyses. There were few adverse events and these were equally distributed between the intervention and control groups. In secondary analysis, there was a greater number of telephone calls between practice nurses and patients in the intervention compared with control group (rate ratio 7.50 (95% CI 4.45 to 12.65, p<0.0001) but no other significant differences between groups in use of health services were identified between groups. Key limitations include potential lack of representativeness of trial participants, inability to blind participants and health professionals and uncertainty about the mechanism, the duration of the effect and the optimal length of the intervention.Conclusions Supported telemonitoring resulted in clinically important improvements in control of glycaemia in patients with type 2 diabetes in family practice. Current Controlled Trials, registration number ISRCTN71674628</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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