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Objective: To examine the associations between change in plant-centered diet quality and type 2 diabetes risk and change in body size.Research Design and Methods: A prospective study conducted in the U.S. enrolled adults ages 18-30 years in 1985-1986 (examination year [Y0]) and followed them through 2015-2016. We analyzed the associations between change in plant-centered diet quality over 20 years (Y0-Y20) and diabetes (Y20-30; n = 2,534) and change (Y0-Y20 and Y20-30) in BMI, waist circumference (WC), and weight (n > 2,434). Plant-centered diet quality was measured using the A Priori Diet Quality Score (APDQS); a higher score favors nutritionally rich plant foods. Cox regression models were used to assess diabetes risk, and linear regression models were used to examine change in body size.Results: During a mean follow-up of 9.3 (± 1.7) years, 206 case subjects with incident diabetes were observed. In multivariable analysis, participants with the largest increase in APDQS over 20 years had a 48% (95% CI 0.31-0.85; Ptrend < 0.001) lower risk of diabetes over the subsequent 10 years compared with participants whose score remained stable. Each 1-SD increment in APDQS over 20 years was associated with lower gains in BMI (-0.39 kg/m2; SE 0.14; P = 0.004), WC (-0.90 cm; SE 0.27; P < 0.001) and weight (-1.14 kg; SE 0.33; P < 0.001) during the same period, but not with subsequent changes.Conclusions: Young adults who increased plant-centered diet quality had a lower diabetes risk and gained less weight by middle adulthood. [ABSTRACT FROM AUTHOR]

OBJECTIVE -- Inflammation plays a key role in chronic obstructive pulmonary disease (COPD) and asthma. Increasing evidence paints toward a role of inflammation in the pathogenesis of type 2 diabetes. We wanted to determine the relation of COPD and asthma with the development of type 2 diabetes. RESEARCH DESIGN AND METHODS -- The Nurses' Health Study is a prospective cohort study. From 1988-1996, 103,614 female nurses were asked biennially about a physician diagnosis of emphysema, chronic bronchitis, asthma, and diabetes. RESULTS -- During 18 years of follow-up, we documented a total of 2,959 new cases of type 2 diabetes. The risk of type 2 diabetes was significantly higher for patients with COPD than those without (multivariate relative risk 1.8, 95% CI 1.1-2.8). By contrast, the risk of type 2 diabetes among asthmatic patients was not increased (1.0, 0.8-1.2). The asthma results remained nonsignificant even when ye evaluated diabetes risk by duration of asthma exposure. CONCLUSIONS -- Our findings suggest that COPD may be a risk factor for developing type 2 diabetes. Difference, in the inflammation and cytokine profile between COPD and asthma might explain why CC PD, but not asthma, is associated with increased risk of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Erectile dysfunction appears to be one of the earliest signs of systemic vascular disease and might be considered as an early marker for subclinical cardiovascular disease. There is paucity of data regarding erectile dysfunction (ED) among men with type 2 diabetes and established coronary artery disease (CAD). We examined the association of age, duration of diabetes and HbA1c levels and ED among men at baseline randomized in the BARI 2D trial. This trial enrolled patients with type 2 diabetes and angiographically documented CAD. ED was assessed at study entry by patient interview with clinical staff that were familiar with the definition of ED. Of the 1528 men enrolled in BARI 2D, there was a high prevalence, 56.5%, of ED. Higher levels of HbA1c were associated with higher rates of ED, with 52.4% for HbA1c ≤ 7%, 59.7% for HbA1c 7.1-8% and 59,9% for HbA1c > 8% (p=0.01 for trend). ED prevalence was also higher with longer duration of diabetes, with 46.4% of males suffering from ED among those who had diabetes for <5 years, 60.7 for 5-<15 yrs and 64.2% for > 15 yrs (p< 0.0001 for trend). In multivariable regression analyses adjusting for age, HbA1c level, duration of diabetes, regular exercise, smoking, hypercholesterolemia, hypertension, use of medication including, beta blocker, statin, insulin, oral hypoglycemic drugs, men with longer duration of diabetes had significantly higher odds of ED compared to those with diabetes < 5 years (5-< 15 yrs OR 1.41,95% CI 1.09-1.83; > 15 yrs OR 1.37, 95% CI 1.0-1.9). Age was also independently associated with ED; using age 50-59 yrs as a reference group, men < 50 yrs had a lower risk (OR 0.5, 95% CI 0.32-0.74) and older men had a higher risk of ED (60-69 yrs OR 1.23, CI 0.95-1.6; ≥ 70yrs OR 1.37, 95% CI 1.0-1.9). The association between ED and higher HbA1c, however, was not statistically significant after multivariable adjustment (compared to ≤ 7%, HbA1c 7.1-8% OR 1.25, 95% CI 0.95-1.63; HbA1c > 8% OR 1.24, 95% CI 0.94- 1.62). More emphasis on treating and screening for ED is warranted among men with type 2 diabetes and established coronary artery disease. [ABSTRACT FROM AUTHOR]

The article highlights a study which examines the association of concentrations of PAI-1 antigen with obesity and physical inactivity in Type 2 diabetes patients and established coronary disease in the BARI2D. According to the study, obesity and physical inactivity are associated with an increased risk of coronary artery disease (CAD). To assess the relationship between body mass index (BMI) category, a linear regression model was used.

High body mass index (BMI) and waist circumference (WC) have both been associated with high atherogenic risk. We evaluated whether WC, reflecting central obesity, is a better measure of atherogenic risk than BMI among subjects randomized into the BARI2D trial. This international trial is designed to simultaneously test 2 hypotheses: one is the timing of revascularization and the other compares an insulin-sensitizing vs. an insulin-providing approach to diabetes management. 2273 subjects had measurements of BMI and WC as well as atherogenic risk factors at their baseline visit. Multiple linear regression models were constructed after adjusting for gender, age, race/ethnicity, region of the world, duration of diabetes, regular exercise and current smoking. Partial correlations of BMI with risk factors after controlling for WC and of WC with risk factors after controlling for BMI were also evaluated. The patients were 66% non-Hispanic white, 71% men, mean age was 62 years, 90% had BMI over 25 and 56% over 30; 68% of men had WC ≥102 cm, 89% of women had WC ≥ 89 cm and 74% reported no regular exercise. In separate linear models, coefficients estimates and 95% confidence intervals for associations with several risk factors were similar for BMI vs. WC; each 5 units of BMI or 10 cm of WC were significantly associated with higher triglyceride (TG) and lower HDL-cholesterol levels and higher albumin/creatinine (AC) ratio (P<0.01 for all). Associations with high blood pressure (BP) were also significant (BMI P<0.01 and WC P=0.04 for systolic BP and BMI P=0.01 and WC P=0.05 for diastolic BP) while associations with HbA1C (%) were non-significant. After controlling for BMI, WC was still significantly associated with TG (P<0.01), HDL-cholesterol (P<0.01) and AC ratio (P=0.04); after adjusting for WC, BMI was only still significantly associated with systolic BP (P=0.02). In separate models both BMI and WC had significant linear relationships with multiple atherogenic risk factors; however, WC had stronger associations with lipids and AC ratio while BMI had stronger association with systolic BP. Measurement of both WC and BMI compared to BMI alone may better reflect the burden of atherogenic risk in the BAR2D patients with type 2 diabetes mellitus and significant coronary artery disease. [ABSTRACT FROM AUTHOR]