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1. Associations of Internet Website Use With Weight Change in a Long-term Weight Loss Maintenance Program

Author

Funk, Kristine L, Stevens, Victor J, Appel, Lawrence J, Bauck, Alan, Brantley, Phillip J, Champagne, Catherine M, Coughlin, Janelle, Dalcin, Arlene T, Harvey-Berino, Jean, Hollis, Jack F, Jerome, Gerald J, Kennedy, Betty M, Lien, Lillian F, Myers, Valerie H, Samuel-Hodge, Carmen, Svetkey, Laura P, and Vollmer, William M

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundThe Weight Loss Maintenance Trial (WLM) compared two long-term weight-maintenance interventions, a personal contact arm and an Internet arm, with a no-treatment control after an initial six-month Phase I weight loss program. The Internet arm focused on use of an interactive website for support of long-term weight maintenance. There is limited information about patterns of website use and specific components of an interactive website that might help promote maintenance of weight loss. ObjectiveThis paper presents a secondary analysis of the subset of participants in the Internet arm and focuses on website use patterns and features associated with long-term weight maintenance. MethodsAdults at risk for cardiovascular disease (CVD) who lost at least 4 kilograms in an initial 20-week group-based, behavioral weight-loss program were trained to use an interactive website for weight loss maintenance. Of the 348 participants, 37% were male and 38% were African American. Mean weight loss was 8.6 kilograms. Participants were encouraged to log in at least weekly and enter a current weight for the 30-month study period. The website contained features that encouraged setting short-term goals, creating action plans, and reinforcing self-management habits. The website also included motivational modules, daily tips, and tailored messages. Based on log-in and weight-entry frequency, we divided participants into three website use categories: consistent, some, and minimal. ResultsParticipants in the consistent user group (n = 212) were more likely to be older (P = .002), other than African American (P = .02), and more educated (P = .01). While there was no significant difference between website use categories in the amount of Phase I change in body weight (P = .45) or income (P = .78), minimal website users (n = 75) were significantly more likely to have attended fewer Phase I sessions (P = .001) and had a higher initial body mass index (BMI) (P < .001). After adjusting for baseline characteristics including initial BMI, variables most associated with less weight regain included: number of log-ins (P = .001), minutes on the website (P < .001), number of weight entries (P = .002), number of exercise entries (P < .001), and sessions with additional use of website features after weight entry (P = .002). ConclusionParticipants defined as consistent website users of an interactive behavioral website designed to promote maintenance of weight loss were more successful at maintaining long-term weight loss. Trial RegistrationNCT00054925; http://clinicaltrials.gov/ct2/show/NCT00054925 (Archived by WebCite at http://www.webcitation.org/5rC7523ue)

Published
2010
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2. Design and Implementation of an Interactive Website to Support Long-Term Maintenance of Weight Loss

Author

Stevens, Victor J, Funk, Kristine L, Brantley, Phillip J, Erlinger, Thomas P, Myers, Valerie H, Champagne, Catherine M, Bauck, Alan, Samuel-Hodge, Carmen D, and Hollis, Jack F

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

Background For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. ObjectiveThis paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. MethodsThe weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. ResultsThe mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. ConclusionsDeveloping interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. Trial Registrationclinicaltrials.gov NCT00054925

Published
2008
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4. The Vegetarian/Flexitarian Diet

Author

Miketinas, Derek C., Champagne, Catherine M., Bendich, Adrianne, Series Editor, Bales, Connie W., Series Editor, Temple, Norman J., editor, Wilson, Ted, editor, Jacobs, Jr., David R., editor, and Bray, George A., editor

Published
2023
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5. Obesity: A Disease of Overnutrition

Author

Bray, George A., Champagne, Catherine M., Bendich, Adrianne, Series Editor, Bales, Connie W., Series Editor, Temple, Norman J., editor, Wilson, Ted, editor, Jacobs, Jr., David R., editor, and Bray, George A., editor

Published
2023
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6. Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Author

Lee, Christine G, Heckman-Stoddard, Brandy, Dabelea, Dana, Gadde, Kishore M, Ehrmann, David, Ford, Leslie, Prorok, Philip, Boyko, Edward J, Pi-Sunyer, Xavier, Wallia, Amisha, Knowler, William C, Crandall, Jill P, Temprosa, Marinella, Group:, Diabetes Prevention Program Research, Bray, George A, Culbert, Iris W, Arceneaux, Jennifer, Chatellier, Annie, Dragg, Amber, Champagne, Catherine M, Duncan, Crystal, Eberhardt, Barbara, Greenway, Frank, Guillory, Fonda G, Herbert, April A, Jeffirs, Michael L, Kennedy, Betty M, Levy, Erma, Lockett, Monica, Lovejoy, Jennifer C, Morris, Laura H, Melancon, Lee E, Ryan, Donna H, Sanford, Deborah A, Smith, Kenneth G, Smith, Lisa L, St. Amant, Julia A, Tulley, Richard T, Vicknair, Paula C, Williamson, Donald, Zachwieja, Jeffery J, Polonsky, Kenneth S, Tobian, Janet, Ehrmann, David A, Matulik, Margaret J, Temple, Karla A, Clark, Bart, Czech, Kirsten, DeSandre, Catherine, Dotson, Brittnie, Hilbrich, Ruthanne, McNabb, Wylie, Semenske, Ann R, Caro, Jose F, Furlong, Kevin, Goldstein, Barry J, Watson, Pamela G, Smith, Kellie A, Mendoza, Jewel, Simmons, Marsha, Wildman, Wendi, Liberoni, Renee, Spandorfer, John, Pepe, Constance, Donahue, Richard P, Goldberg, Ronald B, Prineas, Ronald, Calles, Jeanette, Giannella, Anna, Rowe, Patricia, Sanguily, Juliet, Cassanova-Romero, Paul, Castillo-Florez, Sumaya, Florez, Hermes J, Garg, Rajesh, Kirby, Lascelles, Lara, Olga, Larreal, Carmen, McLymont, Valerie, Mendez, Jadell, Perry, Arlette, Saab, Patrice, Veciana, Bertha, Haffner, Steven M, Hazuda, Helen P, Montez, Maria G, Hattaway, Kathy, Isaac, Juan, Lorenzo, Carlos, Martinez, Arlene, Salazar, Monica, Walker, Tatiana, Hamman, Richard F, Nash, Patricia V, Steinke, Sheila C, Testaverde, Lisa, Truong, Jennifer, and Anderson, Denise R

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Clinical Sciences, Prevention, Clinical Trials and Supportive Activities, Nutrition, Clinical Research, Cancer, Cardiovascular, Diabetes, Aetiology, 2.2 Factors relating to the physical environment, Good Health and Well Being, Adult, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Life Style, Metformin, Diabetes Prevention Program Research Group, Diabetes Prevention Program Research Group:, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveTo determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.Research design and methodsFrom 1996 to 1999, 3,234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin, or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized. Causes of deaths through 31 December 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios (HRs) were estimated from Cox proportional hazards regression models and Fine-Gray models, respectively.ResultsOver a median of 21 years (interquartile range 20-21), 453 participants died. Cancer was the leading cause of death (n = 170), followed by cardiovascular disease (n = 131). Compared with placebo, metformin did not influence mortality from all causes (HR 0.99 [95% CI 0.79, 1.25]), cancer (HR 1.04 [95% CI 0.72, 1.52]), or cardiovascular disease (HR 1.08 [95% CI 0.70, 1.66]). Similarly, lifestyle modification did not impact all-cause (HR 1.02 [95% CI 0.81, 1.28]), cancer (HR 1.07 [95% CI 0.74, 1.55]), or cardiovascular disease (HR 1.18 [95% CI 0.77, 1.81]) mortality. Analyses adjusted for diabetes status and duration, BMI, cumulative glycemic exposure, and cardiovascular risks yielded results similar to those for all-cause mortality.ConclusionsCancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates.

Published
2021

9. Circulating sex hormone binding globulin levels are modified with intensive lifestyle intervention, but their changes did not independently predict diabetes risk in the Diabetes Prevention Program

Author

Aroda, Vanita R, Christophi, Costas A, Edelstein, Sharon L, Perreault, Leigh, Kim, Catherine, Golden, Sherita H, Horton, Edward, Mather, Kieren J, Bray, George A, Gadde, Kishore, Culbert, Iris W, Arceneaux, Jennifer, Chatellier, Annie, Dragg, Amber, Champagne, Catherine M, Duncan, Crystal, Eberhardt, Barbara, Greenway, Frank, Guillory, Fonda G, Herbert, April A, Jeffirs, Michael L, Kennedy, Betty M, Levy, Erma, Lockett, Monica, Lovejoy, Jennifer C, Morris, Laura H, Melancon, Lee E, Ryan, Donna H, Sanford, Deborah A, Smith, Kenneth G, Smith, Lisa L, St, Julia A, Amant, Richard T Tulley, Vicknair, Paula C, Williamson, Donald, Zachwieja, Jeffery J, Polonsky, Kenneth S, Tobian, Janet, Ehrmann, David A, Matulik, Margaret J, Clark, Bart, Czech, Kirsten, DeSandre, Catherine, Hilbrich, Ruthanne, McNabb, Wylie, Semenske, Ann R, Caro, Jose F, Furlong, Kevin, Goldstein, Barry J, Watson, Pamela G, Smith, Kellie A, Mendoza, Jewel, Wildman, Wendi, Liberoni, Renee, Spandorfer, John, Pepe, Constance, Donahue, Richard P, Goldberg, Ronald B, Prineas, Ronald, Calles, Jeanette, Ojito, Juliet, Rowe, Patricia, Cassanova-Romero, Paul, Castillo-Florez, Sumaya, Florez, Hermes J, Giannella, Anna, Kirby, Lascelles, Larreal, Carmen, Lara, Olga, McLymont, Valerie, Mendez, Jadell, Perry, Arlette, Saab, Patrice, Veciana, Beth, Haffner, Steven M, Hazuda, Helen P, Montez, Maria G, Hattaway, Kathy, Lorenzo, Carlos, Martinez, Arlene, Walker, Tatiana, Dabelea, Dana, Hamman, Richard F, Nash, Patricia V, Steinke, Sheila C, Testaverde, Lisa, Anderson, Denise R, Ballonoff, Larry B, Bouffard, Alexis, Bucca, Brian, Calonge, B Ned, Delve, Lynne, Farago, Martha, Hill, James O, Hoyer, Shelley R, Jenkins, Tonya, Jortberg, Bonnie T, Lenz, Dione, and Miller, Marsha

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Diabetes, Cardiovascular, Obesity, Estrogen, Clinical Research, Prevention, Nutrition, Aging, Clinical Trials and Supportive Activities, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Prevention of disease and conditions, and promotion of well-being, Metabolic and endocrine, Diabetes Mellitus, Type 2, Female, Glucose Intolerance, Humans, Life Style, Male, Metformin, Sex Hormone-Binding Globulin, DPP Research Group, diabetes mellitus, hormone, life style, primary prevention, type 2, Clinical sciences, Public health
Abstract

Sex hormone binding globulin (SHBG) levels are reported to be inversely associated with diabetes risk. It is unknown whether diabetes prevention interventions increase SHBG and whether resultant changes in SHBG affect diabetes risk. The purpose of this analysis was to determine whether intensive lifestyle intervention (ILS) or metformin changed circulating SHBG and if resultant changes influenced diabetes risk in the Diabetes Prevention Program (DPP). This is a secondary analysis from the DPP (1996-2001), a randomized trial of ILS or metformin versus placebo on diabetes risk over a mean follow-up of 3.2 years. The DPP was conducted across 27 academic study centers in the USA. Men, premenopausal and postmenopausal women without hormone use in the DPP were evaluated. The DPP included overweight/obese persons with elevated fasting glucose and impaired glucose tolerance. Main outcomes measures were changes in SHBG levels at 1 year and risk of diabetes over 3 years. ILS resulted in significantly higher increases (postmenopausal women: p

Published
2020

13. The Vegetarian/Flexitarian Diets

Author

Miketinas, Derek, Champagne, Catherine M., Bendich, Adrianne, Series Editor, Bales, Connie W., Series Editor, Wilson, Ted, editor, Temple, Norman J., editor, and Bray, George A., editor

Published
2022
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18. The Type and Amount of Dietary Fat Affect Plasma Factor VIIc, Fibrinogen, and PAI-1 in Healthy Individuals and Individuals at High Cardiovascular Disease Risk: 2 Randomized Controlled Trials

Author

Kris-Etherton, Penny M, Stewart, Paul W, Ginsberg, Henry N, Tracy, Russell P, Lefevre, Michael, Elmer, Patricia J, Berglund, Lars, Ershow, Abby G, Pearson, Thomas A, Ramakrishnan, Rajasekhar, Holleran, Stephen F, Dennis, Barbara H, Champagne, Catherine M, Karmally, Wahida, Ginsberg, Henry, Siddiqui, Maliha, Chen, Niem-Tzu, Holleran, Steve, Johnson, Colleen, Holeman, Roberta, Chirgwin, Karen, Stennett, Kellye, Ganga, Lencey, Towolawai, Tajsudeen, Myers, Minnie, Ngai, Colleen, Fontenez, Nelson, Jones, Jeff, Rodriguez, Carmen, Useche, Norma, Roheim, Paul S, Ryan, Donna, Most, Marlene, Champagne, Catherine, Williamson, Donald, Tulley, Richard, Brock, Ricky, Bodin, Deonne, Kennedy, Betty, Barkate, Michelle, Foust, Elizabeth, York, Deshoin, Kris-Etherton, Penny, Jonnalagadda, Satya, Derr, Janice, Farhat-Wood, Abir, Mustad, Vikkie, Meaker, Kate, Mills, Edward, Tilley, Mary-Ann, Smiciklas-Wright, Helen, Sigman-Grant, Madeleine, Yu, Shaomei, Guinard, Jean-Xavier, Sechevich, Pamela, Reddy, C Channa, Mastro, Andrea M, Cooper, Allen D, Elmer, Patricia, Folsom, Aaron, Van Heel, Nancy, Wold, Christine, Fritz, Kay, Slavin, Joanne, Jacobs, David, Dennis, Barbara, Stewart, Paul, Davis, C, Hosking, James, Anderson, Nancy, Blackwell, Susan, Martin, Lynn, Bryan, Hope, Stewart, W Brian, Abolafia, Jeffrey, Foley, Malachy, Zien, Conroy, Leu, Szu-Yun, Youngblood, Marston, Goodwin, Thomas, Miles, Monica, Wehbie, Jennifer, Pearson, Thomas, Reed, Roberta, Tracy, Russell, Cornell, Elaine, Stewart, Kent, Phillips, Katherine, McGee, Bernestine, Williams, Brenda, Beecher, Gary, Holden, Joanne, Davis, Carol, Ershow, Abby, Gordon, David, Proschan, Michael, and Rifkind, Basil

Published
2020
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20. Isocaloric replacement of ultraprocessed foods was associated with greater weight loss in the POUNDS Lost trial.

Author

Yao, Qisi, de Araujo, Carolina D., Juul, Filippa, Champagne, Catherine M., Bray, George A., Sacks, Frank M., and Vadiveloo, Maya K.

Subjects
WEIGHT loss, REGULATION of body weight, WAIST circumference, FAT, ENERGY dissipation
Abstract

Objective: Higher intake of ultraprocessed foods (UPFs) is associated with obesity. We examined whether replacing UPFs (NOVA 4) with minimally processed foods and culinary ingredients (NOVA 1 + 2) was associated with differential weight change in this secondary prospective analysis of the Preventing Overweight Using Novel Dietary Strategies (POUNDS) Lost trial. Methods: We estimated percent energy intake (%kcal) from the four NOVA groups using 24‐h dietary recalls in a subset of 356 participants. Multivariable‐adjusted substitution models examined whether replacing %kcal from UPFs with NOVA 1 + 2 was associated with greater weight, body fat percentage, trunk fat, and waist circumference reduction at 6 months; changes in parameters were compared among NOVA 1 + 2 tertiles (T). Results: Participants were on average 52.3 years of age, 85% White, 55% female, and 58.2% nonsmoking, with a mean BMI of 32.7 kg/m2. Replacing 10%kcal of UPFs with NOVA 1 + 2 was associated with greater 6‐month weight (ß = 0.51, 95% CI: −0.93 to −0.09, p = 0.02), body fat percentage (ß = 2.7, 95% CI: −5.10 to −0.43, p = 0.02), and trunk fat reduction (ß = 3.9, 95% CI: −7.01 to −0.70, p = 0.02), but not waist circumference reduction. Participants in T3 (−8.33 kg) versus T1 (−5.32 kg) of NOVA 1 + 2 had greater weight loss (p < 0.001). Conclusions: Isocaloric substitution of UPFs with NOVA 1 + 2 was associated with marginally greater weight loss under energy restriction. These modest findings support more research exploring the mechanisms linking UPFs with body weight regulation beyond energy intake. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Driving Restrictions and Early Arrhythmias in Patients Receiving a Secondary Prevention Implantable Cardioverter-Defibrillator (DREAM-ICD- II study)

Author

Steinberg, Christian, Dognin, Nicolas, Sodhi, Amit, Champagne, Catherine, Staples, John A., Champagne, Jean, Laksman, Zachary, Sarrazin, Jean-François, Bennett, Matthew, Plourde, Benoit, Deyell, Marc W., Andrade, Jason G., Roy, Karine, Yeung-Lai-Wah, John A., Hawkins, Nathaniel M., Mondésert, Blandine, Blier, Louis, Nault, Isabelle, O’Hara, Gilles, Krahn, Andrew D., Philippon, François, and Chakrabarti, Santabhanu

Published
2022
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26. Sleep characteristics and health-related quality of life in 9- to 11-year-old children from 12 countries

Author

Katzmarzyk, Peter T., Church, Timothy S., Lambert, Denise G., Barreira, Tiago, Broyles, Stephanie, Butitta, Ben, Champagne, Catherine, Cocreham, Shannon, Denstel, Kara D., Drazba, Katy, Harrington, Deirdre, Johnson, William, Milauskas, Dione, Mire, Emily, Tohme, Allison, Rodarte, Ruben, Amoroso, Bobby, Luopa, John, Neiberg, Rebecca, Rushing, Scott, Timothy Olds, Maher, Carol, Lewis, Lucy, Ferrar, Katia, Georgiadis, Effie, Stanley, Rebecca, Rodrigues Matsudo, Victor Keihan, Matsudo, Sandra, Araujo, Timoteo, Carlos de Oliveira, Luis, Fabiano, Luis, Bezerra, Diogo, Ferrari, Gerson, Tremblay, Mark S., Chaput, Jean-Philippe, Bélanger, Priscilla, Borghese, Mike, Boyer, Charles, LeBlanc, Allana, Francis, Claire, Leduc, Geneviève, Zhao, Pei, Hu, Gang, Diao, Chengming, Li, Wei, Li, Weiqin, Liu, Enqing, Liu, Gongshu, Liu, Hongyan, Ma, Jian, Qiao, Yijuan, Tian, Huiguang, Wang, Yue, Zhang, Tao, Zhang, Fuxia, Sarmiento, Olga, Acosta, Julio, Alvira, Yalta, Diaz, Maria Paula, Gamez, Rocio, Garcia, Maria Paula, Gómez, Luis Guillermo, Gonzalez, Lisseth, Gonzalez, Silvia, Grijalba, Carlos, Gutierrez, Leidys, Leal, David, Lemus, Nicolas, Mahecha, Etelvina, Mahecha, Maria Paula, Mahecha, Rosalba, Ramirez, Andrea, Rios, Paola, Suarez, Andres, Triana, Camilo, Fogelholm, Mikael, Jalo, Elli, Kivelä, Jemina, Räsänen, Sari, Roito, Sanna, Saloheimo, Taru, Arjanne, Leena, Kurpad, Anura, Kuriyan, Rebecca, Lokesh, Deepa P., D'Almeida, Michelle Stephanie, R, Annie Mattilda, Correa, Lygia, Murthy, Vijay Dakshina, Onywera, Vincent, Wachira, Lucy-Joy, Muthuri, Stella, Maia, Jose, da Silva Borges, Alessandra, Sá Cachada, Sofia Oliveira, Nichele de Chaves, Raquel, Queiroz Ferreira Gomes, Thayse Natacha, Sampaio Pereira, Sara Isabel, Monteiro de Vilhena e Santos, Daniel, Karina dos Santos, Fernanda, Rodrigues da Silva, Pedro Gil, Caroline de Souza, Michele, Lambert, Vicki, April, Matthew, Uys, Monika, Naidoo, Nirmala, Synyanya, Nandi, Carstens, Madelaine, Standage, Martyn, Cumming, Sean, Drenowatz, Clemens, Emm, Lydia, Gillison, Fiona, Zakrzewski, Julia, Tudor-Locke, Catrine, Braud, Ashley, Donatto, Sheletta, Lemon, Corbin, Jackson, Ana, Pearson, Ashunti, Pennington, Gina, Ragus, Daniel, Roubion, Ryan, Schuna, John, Jr., Wiltz, Derek, Xiao, Qian, Olds, Timothy, Lambert, Estelle V., and Sarmiento, Olga L.

Published
2020
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31. Prevalence of Distal Symmetrical Polyneuropathy by Diabetes Prevention Program Treatment Group, Diabetes Status, Duration of Diabetes, and Cumulative Glycemic Exposure.

Author

Lee, Christine G., Ciarleglio, Adam, Edelstein, Sharon L., Crandall, Jill P., Dabelea, Dana, Goldberg, Ronald B., Kahn, Steven E., Knowler, William C., Ma, Maxwell T., White, Neil H., Herman, William H., Bray, George A., Gadde, Kishore M., Culbert, Iris W., Arceneaux, Jennifer, Chatellier, Annie, Dragg, Amber, Champagne, Catherine M., Duncan, Crystal, and Eberhardt, Barbara

Subjects
POLYNEUROPATHIES, DIABETES, SYMPTOMS, OLDER people, LOGISTIC regression analysis
Abstract

OBJECTIVE: To assess associations between distal symmetric polyneuropathy (DSPN) and Diabetes Prevention Program (DPP) treatment groups, diabetes status or duration, and cumulative glycemic exposure approximately 21 years after DPP randomization. RESEARCH DESIGN AND METHODS: In the DPP, 3,234 adults ≥25 years old at high risk for diabetes were randomized to an intensive lifestyle (ILS), metformin, or placebo intervention to prevent diabetes. After the DPP ended, 2,779 joined the Diabetes Prevention Program Outcomes Study (DPPOS). Open-label metformin was continued, placebo was discontinued, ILS was provided in the form of semiannual group-based classes, and all participants were offered quarterly lifestyle classes. Symptoms and signs of DSPN were assessed in 1,792 participants at DPPOS year 17. Multivariable logistic regression models were used to evaluate DSPN associations with treatment group, diabetes status/duration, and cumulative glycemic exposure. RESULTS: At 21 years after DPP randomization, 66% of subjects had diabetes. DSPN prevalence did not differ by initial DPP treatment assignment (ILS 21.5%, metformin 21.5%, and placebo 21.9%). There was a significant interaction between treatment assignment to ILS and age (P < 0.05) on DSPN. At DPPOS year 17, the odds ratio for DSPN in comparison with ILS with placebo was 17.4% (95% CI 3.0, 29.3) lower with increasing 5-year age intervals. DSPN prevalence was slightly lower for those at risk for diabetes (19.6%) versus those with diabetes (22.7%) and was associated with longer diabetes duration and time-weighted HbA1c (P values <0.001). CONCLUSIONS: The likelihood of DSPN was similar across DPP treatment groups but higher for those with diabetes, longer diabetes duration, and higher cumulative glycemic exposure. ILS may have long-term benefits on DSPN for older adults. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Genetic Modulation of Lipid Profiles following Lifestyle Modification or Metformin Treatment: The Diabetes Prevention Program

Author

Pollin, Toni I, Isakova, Tamara, Jablonski, Kathleen A, de Bakker, Paul IW, Taylor, Andrew, McAteer, Jarred, Pan, Qing, Horton, Edward S, Delahanty, Linda M, Altshuler, David, Shuldiner, Alan R, Goldberg, Ronald B, Florez, Jose C, Franks, Paul W, Bray, George A, Culbert, Iris W, Champagne, Catherine M, Eberhardt, Barbara, Greenway, Frank, Guillory, Fonda G, Herbert, April A, Jeffirs, Michael L, Kennedy, Betty M, Lovejoy, Jennifer C, Morris, Laura H, Melancon, Lee E, Ryan, Donna, Sanford, Deborah A, Smith, Kenneth G, Smith, Lisa L, St. Amant, Julia A, Tulley, Richard T, Vicknair, Paula C, Williamson, Donald, Zachwieja, Jeffery J, Polonsky, Kenneth S, Tobian, Janet, Ehrmann, David, Matulik, Margaret J, Clark, Bart, Czech, Kirsten, DeSandre, Catherine, Hilbrich, Ruthanne, McNabb, Wylie, Semenske, Ann R, Caro, Jose F, Watson, Pamela G, Goldstein, Barry J, Smith, Kellie A, Mendoza, Jewel, Liberoni, Renee, Pepe, Constance, Spandorfer, John, Donahue, Richard P, Prineas, Ronald, Rowe, Patricia, Calles, Jeanette, Cassanova-Romero, Paul, Florez, Hermes J, Giannella, Anna, Kirby, Lascelles, Larreal, Carmen, McLymont, Valerie, Mendez, Jadell, Ojito, Juliet, Perry, Arlette, Saab, Patrice, Haffner, Steven M, Montez, Maria G, Lorenzo, Carlos, Martinez, Arlene, Hamman, Richard F, Nash, Patricia V, Testaverde, Lisa, Anderson, Denise R, Ballonoff, Larry B, Bouffard, Alexis, Calonge, B Ned, Delve, Lynne, Farago, Martha, Hill, James O, Hoyer, Shelley R, Jortberg, Bonnie T, Lenz, Dione, Miller, Marsha, Price, David W, Regensteiner, Judith G, Seagle, Helen, Smith, Carissa M, Steinke, Sheila C, VanDorsten, Brent, Lawton, Kathleen E, Arky, Ronald A, Bryant, Marybeth, Burke, Jacqueline P, Caballero, Enrique, Callaphan, Karen M, and Ganda, Om P

Subjects
Diabetes, Nutrition, Clinical Research, Prevention, Genetics, Cardiovascular, Metabolic and endocrine, Adult, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Diabetes Mellitus, Type 2, Dyslipidemias, Female, Genetic Association Studies, Humans, Hypoglycemic Agents, Life Style, Lipid Metabolism, Lipoproteins, Magnetic Resonance Spectroscopy, Male, Metformin, Middle Aged, Polymorphism, Single Nucleotide, Risk Factors, Triglycerides, Weight Loss, Diabetes Prevention Program Research Group, Developmental Biology
Abstract

Weight-loss interventions generally improve lipid profiles and reduce cardiovascular disease risk, but effects are variable and may depend on genetic factors. We performed a genetic association analysis of data from 2,993 participants in the Diabetes Prevention Program to test the hypotheses that a genetic risk score (GRS) based on deleterious alleles at 32 lipid-associated single-nucleotide polymorphisms modifies the effects of lifestyle and/or metformin interventions on lipid levels and nuclear magnetic resonance (NMR) lipoprotein subfraction size and number. Twenty-three loci previously associated with fasting LDL-C, HDL-C, or triglycerides replicated (P = 0.04-1 × 10(-17)). Except for total HDL particles (r = -0.03, P = 0.26), all components of the lipid profile correlated with the GRS (partial |r| = 0.07-0.17, P = 5 × 10(-5)-1 10(-19)). The GRS was associated with higher baseline-adjusted 1-year LDL cholesterol levels (β = +0.87, SEE ± 0.22 mg/dl/allele, P = 8 × 10(-5), P(interaction) = 0.02) in the lifestyle intervention group, but not in the placebo (β = +0.20, SEE ± 0.22 mg/dl/allele, P = 0.35) or metformin (β = -0.03, SEE ± 0.22 mg/dl/allele, P = 0.90; P(interaction) = 0.64) groups. Similarly, a higher GRS predicted a greater number of baseline-adjusted small LDL particles at 1 year in the lifestyle intervention arm (β = +0.30, SEE ± 0.012 ln nmol/L/allele, P = 0.01, P(interaction) = 0.01) but not in the placebo (β = -0.002, SEE ± 0.008 ln nmol/L/allele, P = 0.74) or metformin (β = +0.013, SEE ± 0.008 nmol/L/allele, P = 0.12; P(interaction) = 0.24) groups. Our findings suggest that a high genetic burden confers an adverse lipid profile and predicts attenuated response in LDL-C levels and small LDL particle number to dietary and physical activity interventions aimed at weight loss.

Published
2012

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