Publications
329 results found
Bevan GT, Chew S, Godsland I, et al., 2022, A game for all shapes and sizes? Changes in anthropometric and performance measures of elite professional rugby union players 1999-2018, BMJ Open Sport and Exercise Medicine, Vol: 8, Pages: 1-9, ISSN: 2055-7647
Background: Rugby union player size has increased since the game turned professional in 1995. Changes in physical and performance capability over this period have yet to be fully described.Hypothesis: Increases in player momentum would result from changes in body mass.Methods: Within-player rates of change in anthropometric and kinetic variables with season played were sampled in three successively studied professional rugby union club cohorts playing at the highest level of European competition between 1999-2019. Data comprised 910 seasons of observation for 291 elite male players. Most players had 2, 3 or 4 seasons of observation. Mixed-effects modelling distinguished changes independent of position played, club and international status.Results: With each season played, player body mass, fat-free mass, and maximum speed increased significantly, while percent fat decreased. The mean maximal velocity of a rugby player in 1999 was 8.2 (±0.18) m/s, which in 2019 had risen to 9.1 (±0.10) m/s. Player’s momentum in 2019 was 14% more than those playing in 1999. In the Front Five, momentum increased in this period by more than 25%, mainly driven by greater running speed, disproving our hypothesis.Conclusions: The momentum of players, particularly forwards, increased markedly over 20 seasons of professional rugby. The resulting forces generated in collisions are thus significantly greater, although these may be mitigated by better player conditioning. Proactive regulation to address player safety may be required to address the changing nature of anthropometric measures and physical performance, minimising injury rates and potential long-term sequelae.
Johnson H, Godsland I, Oliver N, et al., 2021, Insight Report: Online public involvement session on the use of the Wynn Database for Metabolic Research, Insight Report: Online public involvement session on the use of the Wynn Database for Metabolic Research
Thomas MG, Avari P, Godsland IF, et al., 2021, Optimizing type 1 diabetes after multiple daily injections and capillary blood monitoring: Pump or sensor first? A meta-analysis using pooled differences in outcome measures, DIABETES OBESITY & METABOLISM, Vol: 23, Pages: 2521-2528, ISSN: 1462-8902
- Author Web Link
- Cite
- Citations: 5
Ngaosuwan K, Johnston DG, Godsland IF, et al., 2021, Mortality risk in patients with adrenal insufficiency using prednisolone or hydrocortisone: a retrospective cohort study, Journal of Clinical Endocrinology and Metabolism, Vol: 106, Pages: 2242-2251, ISSN: 0021-972X
CONTEXT: Prednisolone has been recommended rather than hydrocortisone for glucocorticoid replacement in adrenal insufficiency due its longer duration of action and lower cost. OBJECTIVE: To determine mortality rates with prednisolone versus hydrocortisone. DESIGN: Observational study. SETTING: A UK primary care database (Clinical Practice Research Datalink). PARTICIPANTS: Patients with primary and secondary adrenal insufficiency, treated with either prednisolone or hydrocortisone, and controls individually matched for age, sex, period and place of follow-up. INTERVENTIONS: Nil. OUTCOMES: Mortality relative to individually matched controls. RESULTS: As expected, mortality in adrenal insufficiency irrespective of cause was increased, based on 5478 patients (4228 on hydrocortisone; 1250 on prednisolone) and 54314 controls (41934 and 12380, respectively). Overall, the adjusted hazard ratio (HR) was similar with the two treatments (prednisolone, 1.76 [95% CI, 1.54-2.01] vs. hydrocortisone 1.69 [1.57-1.82]; p=0.65). This was also the case for secondary adrenal insufficiency. In primary disease (1405 on hydrocortisone vs. 137 on prednisolone:13965 and 1347 controls, respectively), prednisolone-users were older, more likely to have another autoimmune disease and malignancy, and less likely to have mineralocorticoid replacement. Nevertheless, after adjustment, the HR for prednisolone-treated patients remained higher than for those taking hydrocortisone (2.92 [2.19-3.91] vs. 1.90 [1.66-2.16]; p=0.0020). CONCLUSIONS: In primary but not in secondary adrenal insufficiency mortality was higher with prednisolone. The study was large, but the number of prednisolone-treated patients was small, and they had greater risk factors. Nonetheless the increased mortality associated with prednisolone persisted despite statistical adjustment. Further evidence is needed regarding the long-term safety of prednisolone as routine replacement.
Uduku C, Pendolino V, Godsland I, et al., 2021, Cross-sectional analysis of emergency hypoglycaemia and outcome predictors among people with diabetes in an urban population, DIABETIC MEDICINE, Vol: 38, ISSN: 0742-3071
Avari P, Unsworth R, Rilstone S, et al., 2021, Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the "Eat Out to Help Out" Government Scheme, in adults with Type 1 diabetes in the United Kingdom, PLOS ONE, Vol: 16, ISSN: 1932-6203
- Author Web Link
- Cite
- Citations: 2
Ngaosuwan K, Johnston DG, Godsland IF, et al., 2021, Increased mortality risk in patients with primary and secondary adrenal insufficiency, Journal of Clinical Endocrinology and Metabolism, Vol: 106, Pages: e2759-e2768, ISSN: 0021-972X
CONTEXT: Mortality data in patients with adrenal insufficiency are inconsistent, possibly due to temporal and geographical differences between patients and their reference populations. OBJECTIVE: To compare mortality risk and causes of death in adrenal insufficiency with an individually-matched reference population. DESIGN: Retrospective cohort study. SETTING: UK general practitioner database (CPRD). PARTICIPANTS: 6821 patients with adrenal insufficiency (primary, 2052; secondary, 3948) and 67564 individually-matched controls (primary, 20366; secondary, 39134). MAIN OUTCOME MEASURES: All-cause and cause-specific mortality; hospital admission from adrenal crisis. RESULTS: With follow-up of 40799 and 406899 person-years for patients and controls respectively, the hazard ratio (HR; [95%CI]) for all-cause mortality was 1.68 [1.58 - 1.77]. HRs were greater in primary (1.83 [1.66 - 2.02]) than in secondary (1.52 [1.40 - 1.64]) disease; (HR; primary versus secondary disease, 1.16 [1.03 - 1.30]). The leading cause of death was cardiovascular disease (HR 1.54 [1.32-1.80]), along with malignant neoplasms and respiratory disease. Deaths from infection were also relatively high (HR 4.00 [2.15 - 7.46]). Adrenal crisis contributed to 10% of all deaths. In the first two years following diagnosis, the patients' mortality rate and hospitalisation from adrenal crisis were higher than in later years. CONCLUSION: Mortality was increased in adrenal insufficiency, especially primary, even with individual matching and was observed early in the disease course. Cardiovascular disease was the major cause but mortality from infection was also high. Adrenal crisis was a common contributor. Early education for prompt treatment of infections and avoidance of adrenal crisis hold potential to reduce mortality.
Washirasaksiri C, Srivanichakorn W, Godsland IF, et al., 2021, Increasing glycaemia is associated with a significant decline in HDL cholesterol in women with prediabetes in two national populations, Scientific Reports, Vol: 11, ISSN: 2045-2322
Internationally, studies have shown associations between lipids and glycemia; however, whether the link varies by gender and population has been rarely examined. We investigated relationships between glycemia and HDL- and Non-HDL-cholesterol and their modification by gender. We undertook a cross-sectional analysis from the National Health Examination Survey for Thailand (NHES-Thailand) and the Health Survey for England (HS-England) in adults aged 18–75 year. Glycaemia was assessed by FPG in Thailand and by HbA1c in the UK. In population- and gender-stratified analyses, the relationships between glycemia and lipids were explored. A total of 15,145 Thai and 3484 UK adults with blood measurement were included. The prevalences of prediabetes were: in NHES-Thailand, 16% (SE = 0.004), based on FPG (5.6 to < 7.0 mmol/L) and in HS-England, 19% (0.007) based on HbA1c (39 to < 48 mmol/mol). Increasingly abnormal glucose homeostasis was associated with increasing age, adiposity, SBP, proportion of antihypertensive and lipid-lowering agent use and with decreasing HDL-cholesterol. Independent of age, adiposity, smoking, alcohol, physical activity, and lipid and BP lowering drug use, increasing glycemia was associated with decreasing HDL-cholesterol specifically in women with prediabetes (NHES-Thailand, beta-coefficient − 0.07 (95% CI − 0.15, − 0.001) p = 0.04 and HS-England, − 0.03 (− 0.04, − 0.006) p = 0.01). In both populations, among those with prediabetes, increasing glycaemia is associated with an adverse, significant decline in HDL cholesterol, specifically in women. These adverse effects are apparent in widely-differing international populations.
Avari P, Unsworth R, Uduku C, et al., 2021, IMPROVED GLYCAEMIA DURING THE COVID-19 LOCKDOWN IS SUSTAINED IN ADULTS WITH TYPE 1 DIABETES, Publisher: MARY ANN LIEBERT, INC, Pages: A200-A201, ISSN: 1520-9156
Unsworth R, Godsland I, Avari P, et al., 2021, THE EFFECT OF LOCKDOWN AND EASING OF RESTRICTIONS ON GLYCAEMIA IN CHILDREN WITH TYPE 1 DIABETES DURING THE COVID-19 PANDEMIC, Publisher: MARY ANN LIEBERT, INC, Pages: A200-A200, ISSN: 1520-9156
Avari P, Unsworth R, Rilstone S, et al., 2021, HIGHER LEVELS OF SOCIAL DEPRIVATION ASSOCIATED WITH INCREASED PERCENTAGE TIME IN RANGE IN PEOPLE WITH TYPE 1 DIABETES DURING COVID-19 LOCKDOWN, Publisher: MARY ANN LIEBERT, INC, Pages: A197-A197, ISSN: 1520-9156
Ngaosuwan K, Johnston DG, Godsland IF, et al., 2021, Cardiovascular disease in patients with primary and secondary adrenal insufficiency and the role of comorbidities, Journal of Clinical Endocrinology and Metabolism, Vol: 106, Pages: 1284-1293, ISSN: 0021-972X
CONTEXT: Mortality studies have established that cardiovascular disease is the leading cause of death in patients with adrenal insufficiency and the risk is greater than that observed in individually-matched controls. OBJECTIVE: Here we have performed a detailed analysis of cardiovascular morbidity and mortality, taking account of the role of co-morbidities. DESIGN: Retrospective cohort study. SETTING: UK general practitioner database (CPRD). PARTICIPANTS: 6821 patients with adrenal insufficiency (primary, 2052; secondary, 3948) compared with 67564 individually-matched controls, with and without adjustment for comorbidities (diabetes, hypertension, dyslipidaemia, previous cardiovascular disease, and smoking). MAIN OUTCOME MEASURES: Composite cardiovascular events recorded in CPRD and cardiovascular mortality in those participants with linked national mortality data. RESULTS: Hazard ratios (95%CI) for composite cardiovascular events in patients with adrenal insufficiency of any cause were 1.28 (1.20-1.36, unadjusted) and 1.07 (1.01-1.14, adjusted). Increased cerebrovascular events in patients with secondary adrenal insufficiency accounted for most of the increased hazard (1.53 (1.34-1.74, adjusted)) and were associated with cranial irradiation therapy. Cardiovascular mortality data were available for 3547 patients and 34944 controls. The adjusted hazard ratio for ischaemic heart disease mortality was 1.86 (1.25-2.78) for primary adrenal insufficiency and 1.39 (1.02-1.89) for secondary. CONCLUSION: Co-morbidities largely accounted for the increased cardiovascular events but in secondary adrenal insufficiency, cerebrovascular events were independently increased and associated with irradiation treatment. However, the risk of cardiovascular mortality remained increased even following adjustment for co-morbidities in both primary and secondary adrenal insufficiency.
Agha-Jaffar R, Oliver NS, Kostoula M, et al., 2021, Hyperglycemia Recognized in Early Pregnancy Is Phenotypically Type 2 Diabetes Mellitus Not Gestational Diabetes Mellitus: A Case Control Study, OBSTETRICAL & GYNECOLOGICAL SURVEY, Vol: 76, Pages: 133-135, ISSN: 0029-7828
Agha-Jaffar R, Oliver NS, Kostoula M, et al., 2020, Hyperglycemia recognised in early pregnancy is phenotypically type 2 diabetes mellitus not gestational diabetes mellitus: a case control study, Journal of Maternal-Fetal and Neonatal Medicine, Vol: 33, Pages: 3977-3983, ISSN: 1476-4954
OBJECTIVE: Gestational diabetes mellitus is defined as "diabetes recognized in the second or third trimester that is not clearly overt diabetes". Evidence relating to women with hyperglycemia early in pregnancy is limited. We aimed to evaluate women diagnosed with hyperglycemia early in pregnancy (eGDM) and compared them to those with pregestational established type 2 diabetes mellitus (T2DM) and gestational diabetes diagnosed routinely at 24-28-week gestation (rtGDM) to determine if the length of exposure to hyperglycemia adversely affected outcomes. METHODS: Forty consecutive women with eGDM who attended a multidisciplinary antenatal clinic were reviewed. Two separate BMI-matched control groups were identified, recognized pregestational T2DM (n = 80) and rtGDM (n = 80). Baseline demographics and outcomes were compared. RESULTS: A higher proportion of women in the eGDM and T2DM group required insulin and the incidence of hypertensive disorders was similarly increased compared with the rtGDM group (88.6, 77.0 versus 8.1%, p < .001 and 42.5%, 37.5 versus 12.5% p < .001, respectively). The proportion of infants born small for gestational age varied (eGDM 11.1%, T2DM 13.0%, and rtGDM 2.5%, p=.049). Postpartum, 7.5% of eGDM women were diagnosed with T2DM versus 1.3% in the rtGDM group (p<.001). CONCLUSIONS: These novel data demonstrate that the length of exposure to glucose adversely affects materno-foetal outcomes independent of maternal adiposity.
Petropoulou K, Salt LJ, Edwards CH, et al., 2020, A natural mutation in Pisum sativum L. (pea) alters starch assembly and improves glucose homeostasis in humans, Nature Food
Misra S, Humayra H, Busbridge M, et al., 2020, Type 2 diabetes diagnosed between 18 and 30 years in south Asian (SA) and White individuals is clinically similar but treated differently, Publisher: WILEY, Pages: 62-62, ISSN: 0742-3071
Ji H, Godsland I, Oliver NS, et al., 2020, Loss of association between HbA1c and vascular disease in older adults with type 1 diabetes, PLOS ONE, Vol: 15, ISSN: 1932-6203
- Author Web Link
- Open Access Link
- Cite
- Citations: 1
Misra S, Godsland IF, Bhardwaj N, et al., 2020, Type 2 Diabetes Diagnosed between 16-30 Years in South Asian and White Individuals Is Phenotypically Similar, 80th Scientific Sessions of the American-Diabetes-Association (ADA), Publisher: AMER DIABETES ASSOC, ISSN: 0012-1797
- Author Web Link
- Cite
- Citations: 1
Johnson A, Hill NE, Godsland I, et al., 2020, Glycemic Tracking Before and After Insulin Pump Initiation., J Diabetes Sci Technol, Pages: 1932296820910506-1932296820910506
Kotecha PT, Godsland IF, Crook D, et al., 2020, Effects of tibolone or continuous combined oestradiol and norethisterone acetate on lipids, high-density lipoprotein subfractions and apolipoproteins in postmenopausal women in a two-year, randomized, double-blind, placebo-controlled trial, Clinical Endocrinology, Vol: 92, Pages: 303-311, ISSN: 0300-0664
ObjectiveTo compare the effects of (a) tibolone, (b) continuous combined oestrogen plus progestogen and (c) placebo on plasma lipid and lipoprotein markers of cardiovascular risk in healthy postmenopausal women.Study designRandomized, single‐centre, placebo‐controlled, double‐blind study.PatientsOne hundred and one postmenopausal women were randomized (1:1:1) into one of three groups taking daily 2.5 mg tibolone, continuous oral oestradiol‐17β 2 mg plus norethisterone acetate 1 mg daily (E2/NETA) or placebo.Main outcome measuresFasting serum lipid, lipoprotein and apolipoprotein concentrations measured at baseline and after 6, 12 and 24 months of treatment.ResultsBoth tibolone and E2/NETA lowered plasma total cholesterol concentrations relative to placebo. With tibolone, high‐density lipoprotein cholesterol (HDL‐C) was reduced (−27% at 24 months, P < .001), the greatest effect being in the cholesterol‐enriched HDL2 subfraction (−40%, P < .001). Tibolone's effect on HDL concentrations was also apparent in the principal HDL protein component, apolipoprotein AI (−29% at 24 months, P < .001). However, there was no significant effect of tibolone on low‐density or very low‐density lipoprotein cholesterol (LDL‐C and VLDL‐C, respectively). By contrast, the greatest reduction in cholesterol with E2/NETA was in LDL‐C (−22% at 24 months, P = .008). E2/NETA reduced HDL‐C to a lesser extent than tibolone (−12% at 24 months, P < .001). Effects on HDL apolipoproteins were similarly diminished relative to tibolone. E2/NETA had no effect on VLDL‐C or on the protein component of LDL, apolipoprotein B.ConclusionTibolone reduces serum HDL. E2/NETA reduces LDL cholesterol but not apolipoprotein B, suggesting decreased cholesterol loading of LDL. Any impact these changes may have on CVD risk needs further investigation.
Oliver N, Johnston D, Godsland I, et al., 2020, A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent Type 2 diabetes in India and the UK – a randomised controlled trial, Diabetologia, Vol: 63, Pages: 486-496, ISSN: 0012-186X
Aims/hypothesis This randomised controlled trial was performed in India and UK in people with prediabetes to study whether mobile phone short message services can be used to motivate and educate people to follow lifestyle modification, to prevent type 2 diabetes.Methods The study was performed in people with prediabetes (n=2062, control: n=1031; intervention: n=1031) identified by glycosylated haemoglobin A1c42 and 47mmol/mol (6.0% and 6.4%). Participants were recruited from public and private sector organisations in India and by the NHS Health Checks programme in the UK. Allocation to the study groups was performed using a computer generated sequence (1:1) in India and by stratified randomisation in permuted blocks in the UK. Investigators in both countries remained blinded throughout the study period. All participants received advice on healthy lifestyle at baseline. The intervention group in addition received supportive text messages using mobile phone short messaging services2-3 times per week. Participants were assessed at intervals for 2years. The primary outcome was conversion to diabetes and secondary outcomes included anthropometry, biochemistry, dietary and physical activity change, blood pressure and quality of life. Results At 2years follow-up, in the intention-to-treat population the hazard ratio for development of diabetes calculated using a discrete-time proportional hazards model was 0.89,95%CI(0.74-1.07) p=0.22. There were no significant differences in the secondary outcomes.Conclusions/Interpretation This trial in 2 countries with varied ethnic and cultural backgrounds showed no significant reduction in the progression in diabetes in 2 years by lifestyle modification using short messaging services (Hazard Ratio 0.89, 95% CI 0.74 – 1.07, p=0.22)
Bhattarai S, Godsland IF, Misra S, et al., 2019, Metabolic health and vascular complications in type 1 diabetes, Journal of Diabetes and its Complications, Vol: 33, Pages: 634-640, ISSN: 1056-8727
AIMS: Optimal glycaemic control benefits risk of microvascular and macrovascular complications in type 1 diabetes (T1DM) but the importance of other components of metabolic health is less certain, particularly in the context of routine clinical practice. METHODS: Data for this cross-sectional analysis derived from a database covering inner North West London adult diabetes clinics. People with T1DM and with complete information for height, weight, blood pressure and serum high and low-density lipoprotein cholesterol (HDL-c and LDL-c) and triglyceride concentration measurements were included. RESULTS: Among the 920 participants, those with complications were older and had longer duration of diabetes but had similar HbA1c to people without complications. Systolic hypertension and low HDL-c were independently associated with complications. From having 0 risk factors, the prevalence of micro and macrovascular disease increased with increasing number of risk factors. Relative to those with ≥1 risk factor, those with 0 risk factors (n = 179) were at lower risk of retinopathy (OR 0.6 (0.4-0.9), p = 0.01) and nephropathy [OR 0.1 (0.04-0.3), p = 0.002], independent of individual characteristics. CONCLUSIONS: In routine clinical management of T1DM, associations between lipid and blood pressure risk factors and prevalent micro and macrovascular disease remain, implying that more intensive risk factor management may be beneficial.
Groom O, McLaughlin K, Johns J, et al., 2019, Utility of anti-tetraspanin 7 auto-antibodies in adults and children with type 1 diabetes: insights from the ADDRESS-2 study, 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S204-S205, ISSN: 0012-186X
- Author Web Link
- Cite
- Citations: 1
Sivapatham S, Walkey HC, Kaur A, et al., 2019, Changes in beta cell function 6 and 12 months after a diagnosis of type 1 diabetes: insights from the ADDRESS-2 study, 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S155-S155, ISSN: 0012-186X
Humphreys A, Bravis V, Kaur A, et al., 2019, Individual and diabetes presentation characteristics associated with partial remission status in children and adults evaluated up to 12 months following diagnosis of type 1 diabetes: An ADDRESS-2 (After Diagnosis Diabetes Research Support System-2) study analysis, Diabetes Research and Clinical Practice, Vol: 155, ISSN: 0168-8227
AIMS: People with recently-diagnosed type 1 diabetes mellitus (T1D) may undergo a transient period of glycaemic control with less exogenous insulin. Identification of predictors of this 'remission' could inform a better understanding of glycaemic control. METHODS: Participants in the ADDRESS-2 study were included who had 1 or 2 assessments of remission status (coincident insulin dose and HbA1c measurement, with remission defined by ≤0.4 units insulin/kg-body-weight/day with HbA1c < 53 mmol/mol). Demographic and clinical presentation characteristics were compared according to remission status and predictors of remission were explored by logistic regression analysis. RESULTS: 1470 first and 469 second assessments of remission status were recorded within 12 months of diagnosis of T1D. Step increases in the probability of remission were identified at age-at-diagnosis 20 years and 3 months after diagnosis (both p < 0.001). Among those aged < 20 years, remission was associated with male gender (p = 0.02), no ketoacidosis (p = 0.02) and fewer than 2 symptoms at presentation (p = 0.004). None of these characteristics predicted remission in those aged ≥ 20 years. In the subgroup with two assessments, transition to remission was independently associated with first remission assessment in months 1-2 post-diagnosis (p = 0.01), with age-at-diagnosis ≥ 20 years (p = 0.01) and, in those aged < 20 years, with an early HbA1c of <57 mmol/mol. Adiposity, ethnicity, autoantibody status and other autoimmune disease were unrelated to remission. CONCLUSIONS: For those diagnosed before 20 years of age, males, ketoacidosis-free, with fewer symptoms and low early HbA1c were more likely to experience remission, but remission was most likely in anyone aged ≥ 20 at diagnosis.
Loh WJ, Stevenson JC, Godsland IF, 2019, Independent relationships between bone mineral density, regional body fat and insulin sensitivity in white males, Clinical Endocrinology, Vol: 91, Pages: 63-71, ISSN: 1365-2265
BACKGROUND: Adiposity and insulin sensitivity may affect bone mineral density (BMD) but the confounding effect of weight hinders discrimination of independent associations. We explored whether regional fat masses and insulin sensitivity are independently related to BMD. MATERIALS AND METHODS: Relationships between total and regional body fat, insulin sensitivity and measures of BMD in 8 different regions were evaluated in a cross-section of 590 generally healthy, white males, 274 of whom received measurement of insulin sensitivity (Si) using the intravenous glucose tolerance test. Measurements included total, android and gynoid fat and lean body mass and regional BMDs by dual-energy X-ray absorptiometry. Linear regression analyses were combined in a mediation analysis to explore associations with each regional BMD. RESULTS: Weight correlated positively with total fat mass (R2 =0.67, p<0.001) and negatively with Si (R2 =0.14, p<0.001). Body composition measures were consistently positively related to BMD in all regions except lumbar and thoracic spine. Accounting for body weight rendered negative the majority of associations between total and regional fat masses and BMDs. An independent association between android fat and spine BMD was particularly apparent. Si was positively associated with total and limb BMD (p<0.01) specifically among exercisers. Accounting for Si diminished the associations of total fat (negative) and lean body mass (positive) with total and limb BMD. CONCLUSION: Android fat is independently negatively associated with spine BMD. Among those taking exercise, increased insulin sensitivity is associated with higher limb BMD and may underlie positive associations between lean body mass and BMD.
Walkey HC, Kaur A, Godsland IF, et al., 2019, The impact of ethnicity on clinical characteristics and autoantibody status at clinical onset of Type 1 diabetes-from the ADDRESS-2 study, 79th Scientific Sessions of the American-Diabetes-Association (ADA), Publisher: AMER DIABETES ASSOC, Pages: 1-2, ISSN: 0012-1797
Introduction: The phenotype of type 1 diabetes (T1D) has been explored mainly in white populations. People of non-white ethnicity are reportedly less likely to be antibody positive, but phenotypic differences are not well characterised. We investigated ethnic group differences in the clinical characteristics and antibody (Ab) status at clinical onset of T1D.Methods: We studied people of white European (WE), Asian (A) and black African/Caribbean (AC) ethnicity with clinically-assigned T1D, age ≥5 years, recruited ≤ 6 months after diagnosis, and with Abs (GADA, IA-2A and ZnT8A) measured by radioimmunoassay.Results: Ethnic breakdown: WE n=1,997, A n=50, AC n=41. Median (IQR) ages were: WE 23(14-24), A 18(12-29), AC 26 (15-41) years p=0.007. Presentation with DKA was more common in AC (65%) than WE (42%) or A (53%) p=0.006; otherwise clinical presentation (polyuria/dipsia, weight loss, fatigue, symptom duration) was similar. Proportions with 0, 1 and ≥2 Abs differed by ethnicity: WE (15%, 24%, 61%); A (28%, 26%, 46%); AC (36%, 32%, 32%) p<0.001. For Ab negative (0 Abs), ethnic groups differed in BMI (p=0.001) and presentation with DKA (<0.001), but other characteristics, including daily insulin dose, were similar. For Ab positive (≥1 Ab), there were differences in parental history of diabetes p=0.02; otherwise ethnicity had no impact. Also, differences were seen in the frequency of IA-2A: WE (67%), A (53%), AC (50%) p=0.03 and ZnT8A: WE (60%), A (39%), AC (42%) p=0.01, but not GADA: WE (83%), A (94%) AC (92%) p=0.09.Conclusion: Although clinical presentation of T1D was remarkably similar across ethnic groups, variations were found in the proportions with Ab positivity and frequencies of individual Abs. Antibody negativity was more common in non-white ethnic groups and the presence of >1 Ab most common in white ethnicity. Practitioners should be alert to differences in phenotype according to antibody status that may impact classification in some ethn
Godsland IF, 2019, Stats: abuse by researchers' lust for certainty, Nature, Vol: 569, Pages: 192-192, ISSN: 0028-0836
Srivanichakorn W, Godsland IF, Washirasaksiri C, et al., 2019, Cardiometabolic risk factors in Thai individuals with prediabetes treated in a high-risk, prevention clinic - unexpected relationship between HDL cholesterol and glycaemia in men, Journal of Diabetes Investigation, Vol: 10, Pages: 771-779, ISSN: 2040-1124
BACKGROUND: Relationships between cardiometabolic risk and glycaemia have been rarely studied in people under clinical evaluation and treatment for cardiometabolic risk and with prediabetes. We investigated relationships between glycaemia and cardiometabolic risk factors in clinic participants with prediabetes. METHODS: This was a cross-sectional analysis of data collected at a centre in Thailand. Clinic attendees were at high-risk of diabetes or cardiovascular disease, with HbA1c 39-<48 mmol/mol or fasting plasma glucose (FPG) 5.6-<7.0 mmol/L. The relationships between glycaemia and cardiometabolic risk factors were explored. RESULTS: Of 357 participants, two or more insulin resistance-related metabolic disturbances were present in 84%; 61% took a statin and 75% an antihypertensive agent. Independently of age, gender, adiposity, medication use, possible NAFLD and gender-glycaemia interaction, neither FPG nor HbA1c were associated with variation in any other cardiometabolic risk factors. HDL cholesterol decreased with HbA1c in women (female*HbA1c interaction, p=0.03) but, unexpectedly, increased with FPG in men (male*FPG interaction, p=0.02). CONCLUSION: Overall, in Thai people treated for high-cardiometabolic risk and with prediabetes defined by FPG and/or HbA1c, neither FPG nor HbA1c were associated with other cardiometabolic risk factors. However, according to gender, HDL cholesterol showed the expected relationship with glycaemia in women but the reverse in men.
Izzi-Engbeaya CN, Comninos AN, Clarke S, et al., 2018, The effects of kisspeptin on β-cell function, serum metabolites and appetite in humans, Diabetes, Obesity and Metabolism, Vol: 20, Pages: 2800-2810, ISSN: 1462-8902
AimsTo investigate the effect of kisspeptin on glucose‐stimulated insulin secretion and appetite in humans.Materials and methodsIn 15 healthy men (age: 25.2 ± 1.1 years; BMI: 22.3 ± 0.5 kg m−2), we compared the effects of 1 nmol kg−1 h−1 kisspeptin versus vehicle administration on glucose‐stimulated insulin secretion, metabolites, gut hormones, appetite and food intake. In addition, we assessed the effect of kisspeptin on glucose‐stimulated insulin secretion in vitro in human pancreatic islets and a human β‐cell line (EndoC‐βH1 cells).ResultsKisspeptin administration to healthy men enhanced insulin secretion following an intravenous glucose load, and modulated serum metabolites. In keeping with this, kisspeptin increased glucose‐stimulated insulin secretion from human islets and a human pancreatic cell line in vitro. In addition, kisspeptin administration did not alter gut hormones, appetite or food intake in healthy men.ConclusionsCollectively, these data demonstrate for the first time a beneficial role for kisspeptin in insulin secretion in humans in vivo. This has important implications for our understanding of the links between reproduction and metabolism in humans, as well as for the ongoing translational development of kisspeptin‐based therapies for reproductive and potentially metabolic conditions.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.