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406 results on '"Ramachandran A."'

1. Clonal Hematopoiesis of Indeterminate Potential (CHIP) and Incident Type 2 Diabetes Risk.

Author

Tobias, Deirdre K, Manning, Alisa K, Wessel, Jennifer, Raghavan, Sridharan, Westerman, Kenneth E, Bick, Alexander G, Dicorpo, Daniel, Whitsel, Eric A, Collins, Jason, Correa, Adolfo, Cupples, L Adrienne, Dupuis, Josée, Goodarzi, Mark O, Guo, Xiuqing, Howard, Barbara, Lange, Leslie A, Liu, Simin, Raffield, Laura M, Reiner, Alex P, Rich, Stephen S, Taylor, Kent D, Tinker, Lesley, Wilson, James G, Wu, Peitao, Carson, April P, Vasan, Ramachandran S, Fornage, Myriam, Psaty, Bruce M, Kooperberg, Charles, Rotter, Jerome I, Meigs, James, and Manson, JoAnn E

Subjects
Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Stem Cell Research, Heart Disease, Precision Medicine, Diabetes, Hematology, Genetics, Aging, Prevention, Cardiovascular, Obesity, 2.1 Biological and endogenous factors, Metabolic and endocrine, Cancer, Good Health and Well Being, Humans, Female, Middle Aged, Male, Clonal Hematopoiesis, Diabetes Mellitus, Type 2, Prospective Studies, Hematopoiesis, Clonal Evolution, Coronary Disease, Mutation, TOPMed Diabetes Working Group and National Heart, Lung, and Blood Institute TOPMed Consortium, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveClonal hematopoiesis of indeterminate potential (CHIP) is an aging-related accumulation of somatic mutations in hematopoietic stem cells, leading to clonal expansion. CHIP presence has been implicated in atherosclerotic coronary heart disease (CHD) and all-cause mortality, but its association with incident type 2 diabetes (T2D) is unknown. We hypothesized that CHIP is associated with elevated risk of T2D.Research design and methodsCHIP was derived from whole-genome sequencing of blood DNA in the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine (TOPMed) prospective cohorts. We performed analysis for 17,637 participants from six cohorts, without prior T2D, cardiovascular disease, or cancer. We evaluated baseline CHIP versus no CHIP prevalence with incident T2D, including associations with DNMT3A, TET2, ASXL1, JAK2, and TP53 variants. We estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs with adjustment for age, sex, BMI, smoking, alcohol, education, self-reported race/ethnicity, and combined cohorts' estimates via fixed-effects meta-analysis.ResultsMean (SD) age was 63.4 (11.5) years, 76% were female, and CHIP prevalence was 6.0% (n = 1,055) at baseline. T2D was diagnosed in n = 2,467 over mean follow-up of 9.8 years. Participants with CHIP had 23% (CI 1.04, 1.45) higher risk of T2D than those with no CHIP. Specifically, higher risk was for TET2 (HR 1.48; CI 1.05, 2.08) and ASXL1 (HR 1.76; CI 1.03, 2.99) mutations; DNMT3A was nonsignificant (HR 1.15; CI 0.93, 1.43). Statistical power was limited for JAK2 and TP53 analyses.ConclusionsCHIP was associated with higher incidence of T2D. CHIP mutations located on genes implicated in CHD and mortality were also related to T2D, suggesting shared aging-related pathology.

Published
2023

2. Trans Fatty Acid Biomarkers and Incident Type 2 Diabetes: Pooled Analysis of 12 Prospective Cohort Studies in the Fatty Acids and Outcomes Research Consortium (FORCE).

Author

Lai, Heidi TM, Imamura, Fumiaki, Korat, Andres V Ardisson, Murphy, Rachel A, Tintle, Nathan, Bassett, Julie K, Chen, Jiaying, Kröger, Janine, Chien, Kuo-Liong, Senn, Mackenzie, Wood, Alexis C, Forouhi, Nita G, Schulze, Matthias B, Harris, William S, Vasan, Ramachandran S, Hu, Frank, Giles, Graham G, Hodge, Allison, Djousse, Luc, Brouwer, Ingeborg A, Qian, Frank, Sun, Qi, Wu, Jason HY, Marklund, Matti, Lemaitre, Rozenn N, Siscovick, David S, Fretts, Amanda M, Shadyab, Aladdin H, Manson, JoAnn E, Howard, Barbara V, Robinson, Jennifer G, Wallace, Robert B, Wareham, Nick J, Chen, Yii-Der Ida, Rotter, Jerome I, Tsai, Michael Y, Micha, Renata, and Mozaffarian, Dariush

Subjects
Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Diabetes, Clinical Research, Metabolic and endocrine, Adolescent, Adult, Biomarkers, Cohort Studies, Diabetes Mellitus, Type 2, Fatty Acids, Humans, Outcome Assessment, Health Care, Prospective Studies, Risk Factors, Trans Fatty Acids, Fatty Acids and Outcomes Research Consortium, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveTrans fatty acids (TFAs) have harmful biologic effects that could increase the risk of type 2 diabetes (T2D), but evidence remains uncertain. We aimed to investigate the prospective associations of TFA biomarkers and T2D by conducting an individual participant-level pooled analysis.Research design and methodsWe included data from an international consortium of 12 prospective cohorts and nested case-control studies from six nations. TFA biomarkers were measured in blood collected between 1990 and 2008 from 25,126 participants aged ≥18 years without prevalent diabetes. Each cohort conducted de novo harmonized analyses using a prespecified protocol, and findings were pooled using inverse-variance weighted meta-analysis. Heterogeneity was explored by prespecified between-study and within-study characteristics.ResultsDuring a mean follow-up of 13.5 years, 2,843 cases of incident T2D were identified. In multivariable-adjusted pooled analyses, no significant associations with T2D were identified for trans/trans-18:2, relative risk (RR) 1.09 (95% CI 0.94-1.25); cis/trans-18:2, 0.89 (0.73-1.07); and trans/cis-18:2, 0.87 (0.73-1.03). Trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated with T2D (RR 0.81 [95% CI 0.67-0.99], 0.86 [0.75-0.99], and 0.84 [0.74-0.96], respectively). Findings were not significantly different according to prespecified sources of potential heterogeneity (each P ≥ 0.1).ConclusionsCirculating individual trans-18:2 TFA biomarkers were not associated with risk of T2D, while trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated. Findings may reflect the influence of mixed TFA sources (industrial vs. natural ruminant), a general decline in TFA exposure due to policy changes during this period, or the relatively limited range of TFA levels.

Published
2022

4. Association of metabolic dysregulation with volumetric brain magnetic resonance imaging and cognitive markers of subclinical brain aging in middle-aged adults: the Framingham Offspring Study.

Author

Tan, Zaldy S, Beiser, Alexa S, Fox, Caroline S, Au, Rhoda, Himali, Jayandra J, Debette, Stephanie, Decarli, Charles, Vasan, Ramachandran S, Wolf, Philip A, and Seshadri, Sudha

Subjects
Brain, Humans, C-Reactive Protein, Apolipoproteins E, Interleukin-6, Magnetic Resonance Imaging, Aging, Aged, Middle Aged, Female, Male, Endocrinology & Metabolism, Medical and Health Sciences
Abstract

ObjectiveDiabetic and prediabtic states, including insulin resistance, fasting hyperglycemia, and hyperinsulinemia, are associated with metabolic dysregulation. These components have been individually linked to increased risks of cognitive decline and Alzheimer's disease. We aimed to comprehensively relate all of the components of metabolic dysregulation to cognitive function and brain magnetic resonance imaging (MRI) in middle-aged adults.Research design and methodsFramingham Offspring participants who underwent volumetric MRI and detailed cognitive testing and were free of clinical stroke and dementia during examination 7 (1998-2001) constituted our study sample (n = 2,439; 1,311 women; age 61 ± 9 years). We related diabetes, homeostasis model assessment of insulin resistance (HOMA-IR), fasting insulin, and glycohemoglobin levels to cross-sectional MRI measures of total cerebral brain volume (TCBV) and hippocampal volume and to verbal and visuospatial memory and executive function. We serially adjusted for age, sex, and education alone (model A), additionally for other vascular risk factors (model B), and finally, with the inclusion of apolipoprotein E-ε4, plasma homocysteine, C-reactive protein, and interleukin-6 (model C).ResultsWe observed an inverse association between all indices of metabolic dysfunction and TCBV in all models (P < 0.030). The observed difference in TCBV between participants with and without diabetes was equivalent to approximately 6 years of chronologic aging. Diabetes and elevated glycohemoglobin, HOMA-IR, and fasting insulin were related to poorer executive function scores (P < 0.038), whereas only HOMA-IR and fasting insulin were inversely related to visuospatial memory (P < 0.007).ConclusionsMetabolic dysregulation, especially insulin resistance, was associated with lower brain volumes and executive function in a large, relatively healthy, middle-aged, community-based cohort.

Published
2011

5. Secular TRends in DiabEtes in India (STRiDE–I): Change in Prevalence in 10 Years Among Urban and Rural Populations in Tamil Nadu

Author

Priscilla Susairaj, Arun Nanditha, Ramachandran Vinitha, Lakshminarayanan Vijaya, Ambady Ramachandran, Chamukuttan Snehalatha, Mary Simon, Krishnamoorthy Satheesh, and Arun Raghavan

Subjects
Adult, Male, Rural Population, medicine.medical_specialty, Urban Population, Endocrinology, Diabetes and Metabolism, India, 030209 endocrinology & metabolism, Prediabetic State, Young Adult, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Diabetes mellitus, Epidemiology, Diabetes Mellitus, Prevalence, Internal Medicine, medicine, Humans, Obesity, 030212 general & internal medicine, Poisson regression, Prediabetes, Socioeconomic status, Abdominal obesity, Aged, Advanced and Specialized Nursing, business.industry, Public health, Middle Aged, Anthropometry, medicine.disease, symbols, Female, Waist Circumference, medicine.symptom, business, Demography
Abstract

OBJECTIVE The objective of the current study was to assess the secular trends in the prevalence of diabetes, prediabetes, and risk factors from two epidemiological surveys done 10 years apart in three adult populations of different geographic and socioeconomic backgrounds in Tamil Nadu, India. RESEARCH DESIGN AND METHODS This survey was conducted in 2016 using methodology similar to that used in 2006. Persons aged ≥20 years (n = 9,848) were screened for diabetes, prediabetes, and the risk variables. Fasting and 2-h plasma glucose, lipid profile, blood pressure, anthropometry, and socioeconomic and behavioral details were recorded. Comparative analyses of age-standardized prevalence were done. Prevalence ratios (PRs) between 2016 and 2006 of diabetes and also prediabetes were assessed using Poisson regression analyses. RESULTS Prevalence of diabetes increased from 18.6% (95% CI 16.6–20.5) to 21.9 (20.5–23.3) in the city, 16.4 (14.1–18.6) to 20.3 (18.9–21.6) in the town, and 9.2 (8.0–10.5) to 13.4 (11.9–14.8) in the periurban villages (PUVs) (P < 0.0001 in all). The PR showed a nonsignificant 8% rise in diabetes in the city, while significant increases had occurred in the town (39%) and PUVs (34%). Prevalence of prediabetes also increased. Age, family history of diabetes, and waist circumference were common risk determinants among the populations. Though general obesity and abdominal obesity increased, the latter was associated with the increased prevalence. CONCLUSIONS Prevalence of diabetes and prediabetes increased in all locations; the rise was significant only in the town and PUVs. Abdominal obesity is significantly associated with increased trend even among the villagers. Rural populations may be targeted for future public health measures to combat diabetes.

Published
2019
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8. Response to Comment on Nanditha et al. Secular TRends in DiabEtes in India (STRiDE-I): Change in Prevalence in 10 Years Among Urban and Rural Populations in Tamil Nadu. Diabetes Care 2019;42:476-485

Author

Lakshminarayanan Vijaya, Arun Raghavan, Jonathan E. Shaw, Priscilla Susairaj, Chamukuttan Snehalatha, Arun Nanditha, Ramachandran Vinitha, Mary Simon, Krishnamoorthy Satheesh, and Ambady Ramachandran

Subjects
Rural Population, Index (economics), Urban Population, Endocrinology, Diabetes and Metabolism, STRIDE, India, 030209 endocrinology & metabolism, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal Medicine, medicine, Diabetes Mellitus, Prevalence, Humans, 030212 general & internal medicine, Advanced and Specialized Nursing, business.industry, Incidence (epidemiology), Mortality rate, medicine.disease, language.human_language, Secular variation, Tamil, language, Population Risk, business, Demography
Abstract

We appreciate the interest shown by Tonnies et al. (1) in their comment on the prevalence data published by us and for having calculated the incidence based on the data provided in our article (2). In order to properly understand the causes of changes in the prevalence of diabetes, it is essential to assess incidence, as this, not prevalence, is the key index of population risk. Tonnies et al. (1) calculated the mean incidence across the 2006–2016 time period based on mathematical assumptions using the prevalence, temporal changes, mortality rate, etc. This calculation included a number of assumptions, since not all the actual data were available (1). Taking a different analytical approach to the same problem, we have now used the data from …

Published
2019

10. Erratum. Relations Between Subclinical Disease Markers and Type 2 Diabetes, Metabolic Syndrome, and Incident Cardiovascular Disease: The Jackson Heart Study. Diabetes Care 2015;38:1082–1088

Author

Xanthakis, Vanessa, primary, Sung, Jung Hye, additional, Samdarshi, Tandaw E., additional, Hill, Alethea N., additional, Musani, Solomon K., additional, Sims, Mario, additional, Gharaibeh, Kamel A., additional, Liebson, Philip R., additional, Taylor, Herman A., additional, Vasan, Ramachandran S., additional, and Fox, Ervin R., additional

Published
2021
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13. Effect of Insulin Glargine and n-3FA on Carotid Intima-Media Thickness in People With Dysglycemia at High Risk for Cardiovascular Events: The Glucose Reduction and Atherosclerosis Continuing Evaluation Study (ORIGIN-GRACE)

Author

Lonn, Eva M., Bosch, Jackie, Diaz, Rafael, Lopez-Jaramillo, Patricio, Ramachandran, Ambady, Hâncu, Nicolae, Hanefeld, Markolf, Krum, Henry, Ryden, Lars, Smith, Sandra, McQueen, Matthew J., Dyal, Leanne, Yusuf, Salim, and Gerstein, Hertzel C.

Published
2013
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19. High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study

Author

Aschner, Pablo, primary, Gagliardino, Juan José, additional, Ilkova, Hasan, additional, Lavalle, Fernando, additional, Ramachandran, Ambady, additional, Mbanya, Jean Claude, additional, Shestakova, Marina, additional, Bourhis, Yann, additional, Chantelot, Jean-Marc, additional, and Chan, Juliana C.N., additional

Published
2020
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20. Response to Comment on Nanditha et al. Secular TRends in DiabEtes in India (STRiDE–I): Change in Prevalence in 10 Years Among Urban and Rural Populations in Tamil Nadu. Diabetes Care 2019;42:476–485

Author

Ramachandran, Ambady, primary, Snehalatha, Chamukuttan, additional, Shaw, Jonathan E., additional, Susairaj, Priscilla, additional, Simon, Mary, additional, Vijaya, Lakshminarayanan, additional, Satheesh, Krishnamoorthy, additional, Vinitha, Ramachandran, additional, Raghavan, Arun, additional, and Nanditha, Arun, additional

Published
2019
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21. Erratum. Secular TRends in DiabEtes in India (STRiDE–I): Change in Prevalence in Ten Years Among Urban and Rural Populations in Tamil Nadu. Diabetes Care 2019;42:476–485

Author

Nanditha, Arun, primary, Snehalatha, Chamukuttan, additional, Satheesh, Krishnamoorthy, additional, Susairaj, Priscilla, additional, Simon, Mary, additional, Vijaya, Lakshminarayanan, additional, Raghavan, Arun, additional, Vinitha, Ramachandran, additional, and Ramachandran, Ambady, additional

Published
2019
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33. Cross-sectional associations between abdominal and thoracic adipose tissue compartments and adiponectin and resistin in the Framingham Heart Study

Author

Jain, Shilpa H., Massaro, Joseph M., Hoffmann, Udo, Rosito, Guido A., Vasan, Ramachandran S., Raji, Annaswamy, O'Donnell, Christopher J., Meigs, James B., and Fox, Caroline S.

Subjects
Complications and side effects, Research, Risk factors, Health aspects, Obesity -- Complications and side effects -- Research -- Risk factors, Metabolic syndrome X -- Risk factors -- Research -- Complications and side effects, Adipose tissue -- Health aspects -- Research, Cardiovascular diseases -- Risk factors -- Research -- Complications and side effects, Adipose tissues -- Health aspects -- Research
Abstract

OBJECTIVE--To test the association of regional fat depots with circulating adiponectin and resistin concentrations and to assess the potential mediating effect of adipokines on associations between abdominal fat depots and [...]

Published
2009

35. An Early-Onset Subgroup of Type 2 Diabetes: A Multigenerational, Prospective Analysis in the Framingham Heart Study

Author

Mohit Jain, Justin B. Echouffo-Tcheugui, Susan Cheng, Martin G. Larson, Mir Henglin, Elizabeth L. McCabe, Teemu J. Niiranen, and Ramachandran S. Vasan

Subjects
Research design, Adult, Male, medicine.medical_specialty, Cardiovascular and Metabolic Risk, Offspring, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Type 2 diabetes, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Framingham Heart Study, Risk Factors, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Age of Onset, Prospective cohort study, Glycemic, Cause of death, Aged, Advanced and Specialized Nursing, Aged, 80 and over, Family Characteristics, business.industry, Middle Aged, medicine.disease, United States, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Adult Children, Female, business, Diabetic Angiopathies
Abstract

OBJECTIVE To assess the relation of type 2 diabetes occurring earlier (age RESEARCH DESIGN AND METHODS In the Framingham Heart Study, a community-based prospective cohort study, glycemic status was ascertained at serial examinations over six decades among 5,571 first- and second-generation participants with mortality data and 2,123 second-generation participants who initially did not have diabetes with data on parental diabetes status. We assessed cause of death in a case (cardiovascular death)–control (noncardiovascular death) design and incident diabetes in offspring in relation to parental early-onset diabetes. RESULTS Among the participants in two generations (N = 5,571), there were 1,822 cardiovascular deaths (including 961 coronary deaths). The odds of cardiovascular versus noncardiovascular death increased with decreasing age of diabetes onset (P < 0.001 trend). Compared with never developing diabetes, early-onset diabetes conferred a 1.81-fold odds (95% CI 1.10–2.97, P = 0.02) of cardiovascular death and 1.75-fold odds (0.96–3.21, P = 0.07) of coronary death, whereas later-onset diabetes was not associated with greater risk for either (P = 0.09 for cardiovascular death; P = 0.51 for coronary death). In second-generation participants, having a parent with early-onset diabetes increased diabetes risk by 3.24-fold (1.73–6.07), whereas having one or both parents with late-onset diabetes increased diabetes risk by 2.19-fold (1.50–3.19). CONCLUSIONS Our findings provide evidence for a diabetes subgroup with an early onset, a stronger association with cardiovascular death, and higher transgenerational transmission.

Published
2019

40. Cost-effectiveness of the interventions the primary prevention of diabetes among Asian Indians: within-trial results of the Indian Diabetes Prevention Programme (IDPP)

Author

Ramachandran, Ambady, Snehalatha, Chamukuttan, Yamuna, Annasami, Mary, Simon, and Ping, Zhang

Subjects
Finance, Prevention, Evaluation, Dosage and administration, Methods, Health aspects, Company financing, Diabetes mellitus -- Prevention, Metformin -- Dosage and administration -- Evaluation, Lifestyles -- Health aspects -- Methods, Health promotion -- Methods -- Evaluation -- Finance -- Health aspects, Diabetes -- Prevention, Life style -- Health aspects -- Methods
Abstract

OBJECTIVE--In the Indian Diabetes Prevention Programme (IDPP), a 3-year randomized, controlled trial, lifestyle modification (LSM) and metformin helped to prevent type 2 diabetes in subjects with impaired glucose tolerance (IGT). [...]

Published
2007

50. Update and Next Steps for Real-World Translation of Interventions for Type 2 Diabetes Prevention: Reflections From a Diabetes Care Editors’ Expert Forum

Author

Ambady Ramachandran, Hertzel C. Gerstein, Ele Ferrannini, Julio Rosenstock, William T. Cefalu, John B. Buse, Jaakko Tuomilehto, G. Alexander Fleming, Itamar Raz, Peter H. Bennett, and Steven E. Kahn

Subjects
Advanced and Specialized Nursing, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, MEDLINE, Psychological intervention, Alternative medicine, 030209 endocrinology & metabolism, Type 2 diabetes, medicine.disease, 3. Good health, Impaired glucose tolerance, 03 medical and health sciences, 0302 clinical medicine, Family medicine, Intervention (counseling), Pandemic, Internal Medicine, medicine, Diabetes Care Expert Forum, 030212 general & internal medicine, Prediabetes, business
Abstract

The International Diabetes Federation estimates that 415 million adults worldwide now have diabetes and 318 million have impaired glucose tolerance. These numbers are expected to increase to 642 million and 482 million, respectively, by 2040. This burgeoning pandemic places an enormous burden on countries worldwide, particularly resource-poor regions. Numerous landmark trials evaluating both intensive lifestyle modification and pharmacological interventions have persuasively demonstrated that type 2 diabetes can be prevented or its onset can be delayed in high-risk individuals with impaired glucose tolerance. However, key challenges remain, including how to scale up such approaches for widespread translation and implementation, how to select appropriately from various interventions and tailor them for different populations and settings, and how to ensure that preventive interventions yield clinically meaningful, cost-effective outcomes. In June 2015, a Diabetes Care Editors’ Expert Forum convened to discuss these issues. This article, an outgrowth of the forum, begins with a summary of seminal prevention trials, followed by a discussion of considerations for selecting appropriate populations for intervention and the clinical implications of the various diagnostic criteria for prediabetes. The authors outline knowledge gaps in need of elucidation and explore a possible new avenue for securing regulatory approval of a prevention-related indication for metformin, as well as specific considerations for future pharmacological interventions to delay the onset of type 2 diabetes. They conclude with descriptions of some innovative, pragmatic translational initiatives already under way around the world.

Published
2016
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