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Pereira RI, Diaz-Thomas A, Hinton A, Myers AK. A call to action following the US Supreme Court affirmative action ruling. Lancet 2024; 403:332-335. [PMID: 38104576 DOI: 10.1016/s0140-6736(23)02700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Rocio I Pereira
- Denver Health Medicine Service, Denver Health and Hospital Authority, Denver, CO, USA; Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Aurora, CO, USA
| | - Alicia Diaz-Thomas
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt School of Medicine, Nashville, TN, USA
| | - Alyson K Myers
- Division of Endocrinology, Department of Medicine, Montefiore Einstein, Bronx, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
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Finn E, Schlichting L, Grau L, Douglas IS, Pereira RI. Real-world Accuracy of CGM in Inpatient Critical and Noncritical Care Settings at a Safety-Net Hospital. Diabetes Care 2023; 46:1825-1830. [PMID: 37561954 PMCID: PMC10516250 DOI: 10.2337/dc23-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE We sought to determine real-world accuracy of inpatient continuous glucose monitoring (CGM) at multiple levels of acuity in a large safety-net hospital. RESEARCH DESIGN AND METHODS We analyzed records from hospitalized patients on Dexcom G6 CGM, including clinical, point of care (POC), and laboratory (Lab) glucose, and CGM data. POC/Lab values were matched to the closest timed CGM value. Encounters were divided into not critically ill (NCI) versus critically ill (CI). CGM accuracy was evaluated. RESULTS Paired readings (2,744 POC-CGM; 3,705 Lab-CGM) were analyzed for 233 patients with 239 encounters (83 NCI, 156 CI). POC-CGM aggregated and average mean absolute relative differences (MARD) were 15.1% and 17.1%. Lab-CGM aggregated and average MARDs were 11.4% and 12.2%. Accuracy for POC-CGM and Lab-CGM was 96.5% and 99.1% in Clarke Error Grid zones A/B. CONCLUSIONS Real-world accuracy of inpatient CGM is acceptable for NCI and CI patients. Further exploration of conditions associated with lower CGM accuracy in real-world settings is warranted.
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Affiliation(s)
- Erin Finn
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Aurora, CO
| | | | - Laura Grau
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO
| | - Ivor S. Douglas
- Medicine Service, Denver Health and Hospital Authority, Denver, CO
- Department of Medicine, Pulmonary Science, and Critical Care Medicine, University of Colorado, Aurora, CO
| | - Rocio I. Pereira
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Aurora, CO
- Medicine Service, Denver Health and Hospital Authority, Denver, CO
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Thompson DA, Haemer MA, Krebs NF, Pereira RI, Moss A, Furniss AL, Bonczynski J, Nicklas JM. A WIC-Based Behavior Change Intervention for Postpartum Women With Overweight and Obesity: A Pilot Feasibility Randomized Trial. Health Promot Pract 2023:15248399231173704. [PMID: 37226873 PMCID: PMC10674029 DOI: 10.1177/15248399231173704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Background. Postpartum weight retention is a risk factor for obesity and is particularly important among Hispanic women who have an increased rate of obesity. Given its broad reach, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides an ideal setting to implement community-based interventions for low-income postpartum women. Purpose. To examine the feasibility, acceptability, and preliminary efficacy of a multicomponent intervention delivered by staff within the WIC program designed to promote behavior changes in urban, postpartum women with overweight/obesity. Method. This was a 12-week pilot trial randomizing participants to a health behavior change (Intervention) or control (Observation) group. The Intervention included monthly visits with trained WIC staff providing patient-centered behavior change counseling, with multiple touchpoints between visits promoting self-monitoring and offering health behavior change support. Results. Participants (n = 41), who were mainly Hispanic (n = 37, 90%) and Spanish-speaking (n = 33, 81%), were randomized to the Intervention (n = 19) or Observation (n = 22) group. In the Intervention group, 79% (n = 15) of eligible participants were retained for the study duration. All Intervention participants endorsed that they would participate again. Regarding physical activity, participant readiness to change and self-efficacy improved for Intervention participants. About one-quarter of women in the Intervention group (27%, n = 4) had a 5% weight loss compared with one woman (5%) in the Observation group; this difference was not statistically significant (p = .10). Conclusions. This pilot demonstrated the feasibility and acceptability of delivering a low-intensity behavior change intervention within the WIC setting for postpartum women with overweight/obesity. Findings support the role of WIC in addressing postpartum obesity.
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Affiliation(s)
- Darcy A Thompson
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Matthew A Haemer
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Rocio I Pereira
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Angela Moss
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Anna L Furniss
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Jacinda M Nicklas
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
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Ni K, Tampe CA, Sol K, Richardson DB, Pereira RI. Effect of CGM Access Expansion on Uptake Among Patients on Medicaid With Diabetes. Diabetes Care 2023; 46:391-398. [PMID: 36480729 PMCID: PMC9887615 DOI: 10.2337/dc22-1287] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Current studies on continuous glucose monitor (CGM) uptake are revealing for significant barriers and inequities for CGM use among patients from socially underprivileged communities. This study explores the effect of full subsidies regardless of diabetes type on CGM uptake and HbA1c outcomes in a U.S. adult patient population on Medicaid. RESEARCH DESIGN AND METHODS This retrospective cohort study examined 3,036 adults with diabetes enrolled in a U.S. Medicaid program that fully subsidized CGM. CGM uptake and adherence were assessed by CGM prescription and dispense data, including more than one fill and adherence by medication possession ratio (MPR). Multivariate logistic regression evaluated predictors of CGM uptake. Pre- and post-CGM use HbA1c were compared. RESULTS CGM were very well received by both individuals with type 1 diabetes and individuals with type 2 diabetes with similar high fill adherence levels (mean MPR 0.78 vs. 0.72; P = 0.06). No significant difference in CGM uptake outcomes were noted among major racial/ethnic groups. CGM use was associated with improved HbA1c among those with type 2 diabetes (-1.2% [13.1 mmol/mol]; P < 0.001) that was comparable between major racial/ethnic groups and those with higher fill adherence achieved greater HbA1c reduction (-1.4% [15.3 mmol/mol]; P < 0.001) compared with those with lower adherence (-1.0% [10.9 mmol/mol]; P < 0.001). CONCLUSIONS CGM uptake disparities can largely be overcome by eliminating CGM cost barriers. CGM use was associated with improved HbA1c across all major racial/ethnic groups, highlighting broad CGM appeal, utilization, and effectiveness across an underprivileged patient population.
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Affiliation(s)
- Kevin Ni
- Medicine Service–Endocrinology, Denver Health, Denver, CO
- Department of Medicine, University of Colorado, Aurora, CO
| | | | - Kayce Sol
- Medicine Service–Endocrinology, Denver Health, Denver, CO
| | | | - Rocio I. Pereira
- Medicine Service–Endocrinology, Denver Health, Denver, CO
- Department of Medicine, University of Colorado, Aurora, CO
- Corresponding author: Rocio I. Pereira,
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Cervantes L, Hazel CA, Mancini D, Pereira RI, Podewils LJ, Stella SA, Durfee J, Barshney A, Steiner JF. Perspectives of Latinx Individuals Who Were Unvaccinated And Hospitalized for COVID-19: A Qualitative Study. JAMA Netw Open 2022; 5:e2218362. [PMID: 35713898 PMCID: PMC9206184 DOI: 10.1001/jamanetworkopen.2022.18362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Latinx individuals in the United States have lower COVID-19 vaccination rates and higher rates of COVID-19 infections, hospitalizations, and deaths than non-Latinx White individuals. Little is known about the perspectives of Latinx adults who had not received the COVID-19 vaccination and were hospitalized for COVID-19. OBJECTIVE To describe the perspectives of Latinx individuals who were unvaccinated and subsequently hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS This qualitative study was conducted using semistructured phone interviews with 25 Latinx adults who were unvaccinated and survived a COVID-19 hospitalization in a public safety net hospital in Colorado from February to November 2021. Interviews were audio recorded, and transcripts were analyzed using thematic analysis. MAIN OUTCOMES AND MEASURES Themes and subthemes of perspectives on vaccination. RESULTS Among 25 adults (14 [56.0%] women, 11 [44.0%] men; mean [SD] age, 51 [15] years) who participated, all participants self-identified as Latino, Latina, or Latinx or Hispanic. There were 11 individuals who relied on emergency Medicaid (hospital coverage for Denver residents who are undocumented), while 10 individuals (40.0%) were essential workers and 13 individuals (52.0%) were unemployed. In interviews, 3 themes (with subthemes) were identified: factors associated with vaccination after hospitalization (subthemes: fear of death, avoiding hospitalization and reinfection, convinced COVID-19 is real, and responded to pressure from others), concerns about the COVID-19 vaccine (subthemes: experimental status and short timeline for production, contents of vaccine unknown or concerning, vaccine considered ineffective, worrisome immediate and long-term adverse effects, mixed and conflicting information, and government aimed to control or mark population through vaccination), and opportunities to improve vaccine uptake (subthemes; sharing personal experiences through social media, testimonials about minimal vaccine adverse effects, connecting with friends and family about the hospitalization experience, making the vaccine more accessible, and connecting with trusted sources of information). CONCLUSIONS AND RELEVANCE This study found that Latinx individuals who were unvaccinated and subsequently hospitalized for COVID-19 were motivated to engage in advocacy to encourage vaccination in their communities. These findings suggest that supporting patient advocacy after hospital discharge and continued efforts to create low-barrier, patient-informed public health strategies may be associated with increased vaccine uptake in Latinx communities.
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Affiliation(s)
- Lilia Cervantes
- Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado
- Department of Medicine, University of Colorado, Aurora
| | | | - Diana Mancini
- Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado
| | - Rocio I. Pereira
- Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado
| | - Laura J. Podewils
- Office of Research, Denver Health and Hospital Authority, Denver, Colorado
| | - Sarah A. Stella
- Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado
| | - Joshua Durfee
- Office of Research, Denver Health and Hospital Authority, Denver, Colorado
| | - Alana Barshney
- Office of Research, Denver Health and Hospital Authority, Denver, Colorado
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Dhaliwal R, Pereira RI, Diaz-Thomas AM, Powe CE, Yanes Cardozo LL, Joseph JJ. Eradicating Racism: An Endocrine Society Policy Perspective. J Clin Endocrinol Metab 2022; 107:1205-1215. [PMID: 35026013 DOI: 10.1210/clinem/dgab896] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Indexed: 11/19/2022]
Abstract
The Endocrine Society recognizes racism as a root cause of the health disparities that affect racial/ethnic minority communities in the United States and throughout the world. In this policy perspective, we review the sources and impact of racism on endocrine health disparities and propose interventions aimed at promoting an equitable, diverse, and just healthcare system. Racism in the healthcare system perpetuates health disparities through unequal access and quality of health services, inadequate representation of health professionals from racial/ethnic minority groups, and the propagation of the erroneous belief that socially constructed racial/ethnic groups constitute genetically and biologically distinct populations. Unequal care, particularly for common endocrine diseases such as diabetes, obesity, osteoporosis, and thyroid disease, results in high morbidity and mortality for individuals from racial/ethnic minority groups, leading to a high socioeconomic burden on minority communities and all members of our society. As health professionals, researchers, educators, and leaders, we have a responsibility to take action to eradicate racism from the healthcare system. Achieving this goal would result in high-quality health care services that are accessible to all, diverse workforces that are representative of the communities we serve, inclusive and equitable workplaces and educational settings that foster collaborative teamwork, and research systems that ensure that scientific advancements benefit all members of our society. The Endocrine Society will continue to prioritize and invest resources in a multifaceted approach to eradicate racism, focused on educating and engaging current and future health professionals, teachers, researchers, policy makers, and leaders.
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Affiliation(s)
- Ruban Dhaliwal
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Rocio I Pereira
- Denver Health, Denver, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado 80204, USA
| | - Alicia M Diaz-Thomas
- Division of Pediatric Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee 38103, USA
| | - Camille E Powe
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Licy L Yanes Cardozo
- Departments of Cell and Molecular Biology and Medicine, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA
| | - Joshua J Joseph
- The Ohio State University College of Medicine, Division of Endocrinology, Diabetes and Metabolism, Columbus, Ohio 43210, USA
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Roncoroni J, Pereira RI, Patel MS, García P. A Mixed Method Examination of Sleep Patterns and Barriers to Sleep in Hispanic Women. J Immigr Minor Health 2021; 24:673-681. [PMID: 34529211 DOI: 10.1007/s10903-021-01269-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 12/26/2022]
Abstract
Research on Hispanic sleep (1) remains far behind research on non-Hispanic White sleep, and (2) seldom focuses solely on Hispanic women. A convergent parallel mixed-methods study design was used to examine (1) sleep quantity, quality, and habits; (2) the association of sleep and health; and (3) perceived barriers to healthy sleep in middle-aged Hispanic women living in [a large Midwest city]. A total of 78 Hispanic women were surveyed, and 27 of these Hispanic women participated in focus groups. Participants had: poor sleep quantity, quality, and sleep hygiene. In focus groups, participants identified three barriers to healthy sleep: poor sleep hygiene, responsibilities and related stress, and additional mental health concerns. While poor sleep quantity and quality have serious health consequences for Hispanic women, sleep disorders in Hispanic women have been understudied. This study underscores barriers to healthy sleep and the associations between sleep and health in Hispanic women.
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Affiliation(s)
- Julia Roncoroni
- Department of Counseling Psychology, University of Denver, Denver, CO, USA.
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Affiliation(s)
- Rocio I. Pereira
- Department of Medicine, Denver Health, Denver, Colorado,Department of Medicine, University of Colorado, Aurora, Colorado
| | - Lilia Cervantes
- Department of Medicine, Denver Health, Denver, Colorado,Department of Medicine, University of Colorado, Aurora, Colorado,Office of Research, Denver Health, Denver, Colorado
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Siega-Riz AM, Pace ND, Butera NM, Van Horn L, Daviglus ML, Harnack L, Mossavar-Rahmani Y, Rock CL, Pereira RI, Sotres-Alvarez D. How Well Do U.S. Hispanics Adhere to the Dietary Guidelines for Americans? Results from the Hispanic Community Health Study/Study of Latinos. Health Equity 2019; 3:319-327. [PMID: 31338484 PMCID: PMC6643200 DOI: 10.1089/heq.2018.0105] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Purpose: To examine alignment between 2010 Dietary Guidelines for Americans (DGA) and dietary choices of individuals in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) between 2008 and 2011. Methods: Data are from 15,633 adults 18–74 years from the population-based cohort in HCHS/SOL. The Healthy Eating Index (HEI) 2010 was used to measure diet quality. Means and standard errors (SEs) for the HEI total and each of the 12 component scores were calculated overall and by Hispanic/Latino heritage, sex, age group, and measures of acculturation. Linear regression was used to examine correlates of the HEI 2010 total score. All analyses accounted for complex survey design. Results: The overall HEI mean of 63.8 (SE: 0.4) varied across groups from a high (healthier diet) of 71 (SE: 0.9) among Mexicans to a low of 56 (SE: 0.1) among Puerto Ricans. The proportion with a maximum score for the HEI components varied across heritage groups; >25% of adults adhered to recommendations for total proteins, and seafood and plant proteins, whole fruits, and greens and beans, with the exception of Cubans and Puerto Ricans, who had lower adherence scores for the latter two. The components with the lowest adherence were sodium (<2%) and fatty acids (overall 7.4%) among all heritage groups. Characteristics associated with better adherence included sociodemographic variables, Spanish language preference, weight status, medical conditions, and lifestyle behaviors. Conclusions: Individuals with Mexican, Dominican, and Central American heritage had better overall dietary quality compared to other groups. However, all can improve their eating habits to align more with the DGAs by reducing sodium consumption and improving fatty acid ratios.
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Affiliation(s)
| | - Nelson D Pace
- Exponent, Inc., Center for Health Sciences, Oakland, California
| | - Nicole M Butera
- Department of Biostatistics, Collaborative Studies Coordinator Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois, Chicago, Illinois
| | - Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Cheryl L Rock
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Rocio I Pereira
- Department of Medicine-Endocrinology, Denver Health, Denver, Colorado.,Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, Colorado
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Collaborative Studies Coordinator Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Rynders CA, Pereira RI, Bergouignan A, Kealey EH, Bessesen DH. Associations Among Dietary Fat Oxidation Responses to Overfeeding and Weight Gain in Obesity-Prone and Resistant Adults. Obesity (Silver Spring) 2018; 26:1758-1766. [PMID: 30358145 PMCID: PMC6214358 DOI: 10.1002/oby.22321] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study tested the hypothesis that 3 days of overfeeding (OF) decreases dietary fat oxidation and predicts longitudinal weight change in adults classified as obesity prone (OP) and obesity resistant (OR) based on self-identification and personal and family weight history. Changes in diurnal profiles of plasma metabolites and hormones were measured to probe mechanisms. METHODS Adults identified as OP (n = 22; BMI: 23.9 ± 2.4 kg/m2 ) and OR (n = 30; BMI: 20.5 ± 2.2 kg/m2 ) completed 3 days of eucaloric (EU) feeding and 3 days of OF. On day 3, the 24-hour total and dietary fat oxidation was measured using room calorimetry and an oral 14 C tracer. Plasma glucose, insulin, triglycerides, and nonesterified fatty acid (NEFA) concentrations were frequently sampled over 24 hours. Body composition was measured annually for 4.0 ± 1.4 years in a subsample (n = 19 OP and 23 OR). RESULTS Dietary fat oxidation over 24 hours was not altered by OF versus EU (P = 0.54). Weight gain in OP correlated with lower nocturnal NEFA concentrations during OF (r = -0.60; P = 0.006) and impaired fuel selection over 24 hours (metabolic inflexibility, wake respiratory quotient-sleep respiratory quotient) (r = -0.48; P = 0.04). CONCLUSIONS Short-term OF did not alter dietary fat oxidation. Lower nocturnal NEFA availability and metabolic inflexibility to overfeeding may be factors contributing to weight gain.
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Affiliation(s)
- Corey A. Rynders
- Division of Geriatric Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rocio I. Pereira
- Denver Health Medical Center, Division of Endocrinology, Denver, Colorado, USA
| | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- IPHC-DEPE, Université de Strasbourg, Strasbourg, France
- UMR 7178 Centre National de la Recherche scientifique (CNRS), Strasbourg, France
| | - Elizabeth H. Kealey
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Daniel H. Bessesen
- Denver Health Medical Center, Division of Endocrinology, Denver, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
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Huescas CGY, Pereira RI, Prichula J, Azevedo PA, Frazzon J, Frazzon APG. Frequency of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPRs) in non-clinical Enterococcus faecalis and Enterococcus faecium strains. BRAZ J BIOL 2018; 79:460-465. [PMID: 30304253 DOI: 10.1590/1519-6984.183375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 01/16/2018] [Indexed: 11/21/2022] Open
Abstract
The fidelity of the genomes is defended by mechanism known as Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) systems. Three Type II CRISPR systems (CRISPR1- cas, CRISPR2 and CRISPR3-cas) have been identified in enterococci isolates from clinical and environmental samples. The aim of this study was to observe the distribution of CRISPR1-cas, CRISPR2 and CRISPR3-cas in non-clinical strains of Enterococcus faecalis and Enterococcus faecium isolates from food and fecal samples, including wild marine animals. The presence of CRISPRs was evaluated by PCR in 120 enterococci strains, 67 E. faecalis and 53 E. faecium. It is the first report of the presence of the CRISPRs system in E. faecalis and E. faecium strains isolated from wild marine animal fecal samples. The results showed that in non-clinical strains, the CRISPRs were more frequently detected in E. faecalis than in E. faecium. And the frequencies of CRISPR1-cas and CRISPR2 were higher (60%) in E. faecalis strains isolated from animal feces, compared to food samples. Both strains showed low frequencies of CRISPR3-cas (8.95% and 1.88%). In conclusion, the differences in the habitats of enterococcal species may be related with the results observe in distribution of CRISPRs systems.
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Affiliation(s)
- C G Y Huescas
- Programa de Pós-graduacao em Microbiologia Agricola e do Ambiente, Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, sala 216, CEP 90050-170, Porto Alegre, RS, Brasil
| | - R I Pereira
- Laboraorio de Gram-positive, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, sala 204, CEP 90050-170, Porto Alegre, RS, Brasil
| | - J Prichula
- Laboraorio de Gram-positive, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, sala 204, CEP 90050-170, Porto Alegre, RS, Brasil
| | - P A Azevedo
- Laboraorio de Gram-positive, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, sala 204, CEP 90050-170, Porto Alegre, RS, Brasil
| | - J Frazzon
- Instituto de Ciencias e Tecnologia de Alimentos, Universidade Federal do Rio Grande do Sul - UFRGS, Av. Bento Gonçalves, 9500, Prédio 443.212, Campus do Vale, CEP 91501-970, Porto Alegre, RS, Brasil
| | - A P G Frazzon
- Programa de Pós-graduacao em Microbiologia Agricola e do Ambiente, Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, sala 216, CEP 90050-170, Porto Alegre, RS, Brasil
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Abstract
Objective: Short-term administration of estradiol (E2) improves insulin-stimulated glucose disposal rate in early postmenopausal (EPM) women compared with a reduction in late postmenopausal (LPM) women. The underlying mechanisms by which E2 action on glucose disposal rate reversed from beneficial early to harmful late in menopause is unknown, but might include adverse changes in estrogen receptors (ERs) or other biomarkers of cellular energy metabolism with age or duration of estrogen deficiency. Methods: We retrospectively analyzed skeletal muscle samples from 27 postmenopausal women who were 6 years or less past menopause (EPM; n = 13) or at least 10 years past menopause (LPM; n = 14). Fasted skeletal muscle (vastus lateralis) samples were collected after 1 week administration of transdermal E2 or placebo, in random cross-over design. Results: Compared with EPM, LPM had reduced skeletal muscle ERα and ERβ nuclear protein. Short-term E2 treatment did not change nuclear ERα or ERβ, but decreased cytosolic ERα, so the proportion of ERα in the nucleus compared with the cytosol tended to increase. There was a group-by-treatment interaction (P < 0.05) for nuclear proliferator-activated receptor γ co-activator 1-α and phosphorylated adenosine monophosphate-activated protein kinase, such that E2 increased these proteins in EPM, but decreased these proteins in LPM. Conclusions: These preliminary studies of skeletal muscle from early and late postmenopausal women treated with E2 suggest there may be declines in skeletal muscle ER and changes in the E2-mediated regulation of cellular energy homeostasis with increasing time since menopause.
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Affiliation(s)
- Young-Min Park
- 1Division of Geriatric Medicine 2Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 3VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center (GRECC), Denver, CO 4Denver Health and Hospital Authority, Denver, CO 5School of Kinesiology, University of Minnesota, Minneapolis, MN
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Ritchie ND, Havranek EP, Moore SL, Pereira RI. Proposed Medicare Coverage for Diabetes Prevention: Strengths, Limitations, and Recommendations for Improvement. Am J Prev Med 2017; 53:260-263. [PMID: 28336351 DOI: 10.1016/j.amepre.2017.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/10/2017] [Accepted: 02/01/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Natalie D Ritchie
- Ambulatory Care Services, Denver Health and Hospital Authority, Denver, Colorado; Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado.
| | - Edward P Havranek
- Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado; Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Susan L Moore
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado; Department of Patient Safety and Quality, Denver Health and Hospital Authority, Denver, Colorado
| | - Rocio I Pereira
- Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado; Department of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado
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Alman AC, Smith SR, Eckel RH, Hokanson JE, Burkhardt BR, Sudini PR, Wu Y, Schauer IE, Pereira RI, Snell-Bergeon JK. The ratio of pericardial to subcutaneous adipose tissues is associated with insulin resistance. Obesity (Silver Spring) 2017; 25:1284-1291. [PMID: 28558132 PMCID: PMC5488713 DOI: 10.1002/oby.21875] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/17/2017] [Accepted: 04/10/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine the association between pericardial adipose tissue (PAT) and the ratio of PAT to subcutaneous adipose tissue (SAT) with insulin resistance in adults with and without type 1 diabetes (T1D). METHODS Data for this report came from a substudy of the Coronary Artery Calcification in Type 1 Diabetes cohort (n = 83; 38 with T1D, 45 without T1D). Insulin resistance was measured by hyperinsulinemic-euglycemic clamp. Abdominal computed tomography (CT) was used to measure visceral adipose tissue (VAT) and SAT. PAT was measured from CT scans of the heart. RESULTS PAT and the ratio of PAT to SAT was higher in males compared to females. After adjustment for demographics, diabetes, blood pressure and lipid factors, BMI, VAT, and log PAT/SAT ratio, log PAT was positively associated with the glucose infusion rate (GIR) in females only (β = 3.36 ± 1.96, P = 0.097, P for sex interaction = 0.055). Conversely, the log PAT/SAT ratio was significantly associated with decreased GIR in both males and females (β = -2.08 ± 1.03, P = 0.047, P for sex interaction = 0.768). CONCLUSIONS A significant association between the PAT/SAT ratio and insulin resistance was found, independent of BMI, VAT, and PAT. These results highlight the importance of considering fat distribution independent of volume.
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Affiliation(s)
- Amy C. Alman
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Steven R. Smith
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL USA
| | - Robert H. Eckel
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO USA
| | - John E. Hokanson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO USA
| | - Brant R. Burkhardt
- Department of Cell Biology, Microbiology and Molecular Biology, College of Liberal Arts and Sciences, University of South Florida, Tampa, FL USA
| | - Preethi R. Sudini
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Yougui Wu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Irene E. Schauer
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Denver VA Medical Center, Denver, CO
| | - Rocio I. Pereira
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Denver Health Medical Center, Denver, CO
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Park YM, Pereira RI, Erickson CB, Swibas TA, Cox-York KA, Van Pelt RE. Estradiol-mediated improvements in adipose tissue insulin sensitivity are related to the balance of adipose tissue estrogen receptor α and β in postmenopausal women. PLoS One 2017; 12:e0176446. [PMID: 28472101 PMCID: PMC5417515 DOI: 10.1371/journal.pone.0176446] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/10/2017] [Indexed: 11/18/2022] Open
Abstract
We recently demonstrated that short-term estradiol (E2) treatment improved insulin-mediated suppression of lipolysis in postmenopausal women, but to a greater extent in those who were late compared to early postmenopausal. In this follow-up study we tested whether subcutaneous adipose tissue (SAT) expression of estrogen receptors (ER) α and β differs between early and late postmenopausal women. We further tested whether the balance of ERα to ERβ in SAT determined the effect of E2 on SAT insulin sensitivity. The present study included 35 women who were ≤6 years past menopause (EPM; n = 16) or ≥10 years past menopause (LPM; n = 19). Fasted SAT samples were taken following 1-week transdermal E2 treatment or placebo (PL) in a random cross-over design. Samples were analyzed for nuclear/cytosolic protein content and mRNA expression using Western blot and qPCR, respectively. While ESR1 increased slightly (~1.4-fold) following E2 treatment in both groups, ERα and ERβ protein expression did not differ between groups at baseline or in response to E2. However, the balance of ERα/ERβ protein in the SAT nuclear fraction increased 10% in EPM compared to a 25% decrease in LPM women (group x treatment interaction, p<0.05). A greater proportion of ERα/ERβ protein in the nuclear fraction of SAT at baseline (placebo day) was associated with greater reduction in SAT insulin resistance (i.e., better suppression of lipolysis, EC50) in response to E2 (r = -0.431, p<0.05). In conclusion, there do not appear to be differences in the proportion of adipose tissue ERα/ERβ protein in late, compared to early, postmenopausal women. However, the balance of ERα/ERβ may be important for E2-mediated improvement in adipose tissue insulin sensitivity. Trial Registration: Clinical Trials#:NCT01605071
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Affiliation(s)
- Young-Min Park
- Department of Medicine, Division of Geriatric Medicine University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Rocio I. Pereira
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
- Denver Health and Hospital Authority, Denver, CO, United States of America
| | - Christopher B. Erickson
- Department of Medicine, Division of Geriatric Medicine University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Tracy A. Swibas
- Department of Medicine, Division of Geriatric Medicine University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Kimberly A. Cox-York
- Department of Nutrition, Colorado State University, Fort Collins, CO, United States of America
| | - Rachael E. Van Pelt
- Department of Medicine, Division of Geriatric Medicine University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
- VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center (GRECC), Denver, CO, United States of America
- * E-mail:
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Ritchie ND, Christoe-Frazier L, McFann KK, Havranek EP, Pereira RI. Effect of the National Diabetes Prevention Program on Weight Loss for English- and Spanish-Speaking Latinos. Am J Health Promot 2017; 32:812-815. [PMID: 28320212 DOI: 10.1177/0890117117698623] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE To study the effect of the National Diabetes Prevention Program (NDPP) on weight loss in Latinos. DESIGN No-control, cohort study comparing Latino and non-Hispanic white (NHW) participants. SETTING A health-care system. PARTICIPANTS Five hundred sixty-seven Latino and 175 NHW patients who enrolled in the NDPP. A total of 45.2% of Latinos selected the Spanish-language NDPP. INTERVENTION The NDPP is a nationwide translation of a clinical trial and seeks to prevent diabetes through weight loss in a yearlong group program. MEASURES Independent variables included ethnicity, class language, and number of sessions attended. Main outcomes were initial attendance, number of sessions attended, and weight loss. ANALYSIS Multivariate logistic regression and analysis of covariance were used to determine differences in NDPP outcomes by ethnicity, language, and number of sessions attended. RESULTS Mean attendance was 8.60 of 22 sessions. Each session was associated with 0.30% (±0.02; P < .001) body weight loss. Latinos were half as likely to attend as NHWs, odds ratio 0.52 ( P < .001). Latino attendees came to 2.67 ± 0.63 ( P < .001) fewer sessions than NHWs. There were no weight loss differences by ethnicity after controlling for attendance. Outcomes did not differ among Latinos in the English- and Spanish-language NDPP. CONCLUSION Latinos appeared to benefit less from the NDPP compared to NHWs, likely due to lower attendance rates. Further efforts are needed to support their participation.
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Affiliation(s)
- Natalie D Ritchie
- 1 Ambulatory Care Services, Denver Health and Hospital Authority, Denver, CO, USA.,2 Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Kim K McFann
- 4 Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Edward P Havranek
- 5 Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA.,6 Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Rocio I Pereira
- 5 Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA.,7 Department of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
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Ohman-Hanson RA, Cree-Green M, Kelsey MM, Bessesen DH, Sharp TA, Pyle L, Pereira RI, Nadeau KJ. Ethnic and Sex Differences in Adiponectin: From Childhood to Adulthood. J Clin Endocrinol Metab 2016; 101:4808-4815. [PMID: 27603898 PMCID: PMC5155686 DOI: 10.1210/jc.2016-1137] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
CONTEXT Insulin resistance (IR) and type 2 diabetes are increasing, particularly in Hispanic (H) vs non-Hispanic White (NHW) populations. Adiponectin has a known role in IR, and therefore, understanding ethnic and sex-specific behavior of adiponectin across the lifespan is of clinical significance. OBJECTIVE To compare ethnic and sex differences in adiponectin, independent of body mass index, across the lifespan and relationship to IR. DESIGN Cross-sectional. SETTING Primary care, referral center. PATIENTS A total of 187 NHW and 117 H participants (8-57 y) without diabetes. Life stage: pre-/early puberty (Tanner 1/2), midpubertal (Tanner 3/4), late pubertal (Tanner 5, <21 years), and adult (Tanner 5, ≥21). INTERVENTIONS None. MAIN OUTCOME MEASURE(S) Fasting adiponectin, insulin, glucose, and revised homeostatic model assessment of insulin resistance. RESULTS Adiponectin was significantly inversely correlated with revised homeostatic model assessment of insulin resistance. Regarding puberty, adiponectin trended downward in late puberty, but only males were significantly lower in adulthood. By sex, adiponectin was lower in adult males vs females of both ethnicities. Regarding ethnicity, H adults of both sexes had lower adiponectin than NHW adults. Of note, in NHW females, adiponectin trended highest in adulthood, whereas in H females, adiponectin fell in late puberty and remained lower in adulthood. CONCLUSIONS Adiponectin inversely correlated with IR, trended down in late puberty, and was lowest in adult males. H adults of both sexes had lower adiponectin than NHW adults, and H females followed a more "male pattern," lacking the rebound in adiponectin seen in NHW females after puberty. These data suggest that adiponectin, independent of body mass index, may relate to the greater cardiometabolic risk seen in H populations and in particular H females.
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Affiliation(s)
- Rebecca A Ohman-Hanson
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Melanie Cree-Green
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Megan M Kelsey
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Daniel H Bessesen
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Teresa A Sharp
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Laura Pyle
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Rocio I Pereira
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
| | - Kristen J Nadeau
- Pediatric Endocrinology (R.O.-H., M.C.-G., M.M.K., K.J.N.), University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado 80045; Endocrinology (D.H.B., R.I.P.), University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado 80045; Colorado School of Public Health at the University of Northern Colorado (T.A.S.), Greeley, Colorado 80639; Department of Pediatrics (L.P.), University of Colorado School of Medicine, Aurora, Colorado 80045; and Department of Biostatistics and Informatics (L.P.), Colorado School of Public Health, Aurora, Colorado 80045
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18
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Cox-York KA, Erickson CB, Pereira RI, Bessesen DH, Van Pelt RE. Region-specific effects of oestradiol on adipose-derived stem cell differentiation in post-menopausal women. J Cell Mol Med 2016; 21:677-684. [PMID: 27862950 PMCID: PMC5345675 DOI: 10.1111/jcmm.13011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 09/18/2016] [Indexed: 12/25/2022] Open
Abstract
The goal of this study was to determine the effect of acute transdermal 17β‐oestradiol (E2) on the adipogenic potential of subcutaneous adipose‐derived stem cells (ASC) in post‐menopausal women. Post‐menopausal women (n = 11; mean age 57 ± 4.5 years) were treated for 2 weeks, in a randomized, cross‐over design, with transdermal E2 (0.15 mg) or placebo patches. Biopsies of abdominal (AB) and femoral (FEM) subcutaneous adipose tissue (SAT) were obtained after each treatment and mature adipocytes were analysed for cell size and ASC for their capacity for proliferation (growth rate), differentiation (triglyceride accumulation) and susceptibility to tumour necrosis factor alpha‐induced apoptosis. Gene expression of oestrogen receptors α and β (ESR1 and ESR2), perilipin 1 and hormone‐sensitive lipase (HSL), was also assessed. In FEM SAT, but not AB SAT, 2 weeks of E2 significantly (P = 0.03) increased ASC differentiation and whole SAT HSL mRNA expression (P = 0.03) compared to placebo. These changes were not associated with mRNA expression of oestrogen receptors α and β, but HSL expression was significantly increased in FEM SAT with transdermal E2 treatment. Adipose‐derived stem cells proliferation and apoptosis did not change in either SAT depot after E2 compared with placebo. Short‐term E2 appeared to increase the adipogenic potential of FEM, but not AB, SAT in post‐menopausal women with possible implications for metabolic disease. Future studies are needed to determine longer term impact of E2 on regional SAT accumulation in the context of positive energy imbalance.
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Affiliation(s)
| | - Christopher B Erickson
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rocio I Pereira
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Denver Health and Hospital Authority, Denver, CO, USA
| | - Daniel H Bessesen
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Denver Health and Hospital Authority, Denver, CO, USA
| | - Rachael E Van Pelt
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Fischer HH, Pereira RI, Moore SL, Durfee MJ, Rozwadowski JM, Havranek EP. Response to Comment on Fischer et al. Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016;39:1364-1370. Diabetes Care 2016; 39:e207-e208. [PMID: 27926904 DOI: 10.2337/dci16-0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | - Rocio I Pereira
- Denver Health and Hospital Authority, Denver, CO.,University of Colorado School of Medicine, Aurora, CO
| | | | | | | | - Edward P Havranek
- Denver Health and Hospital Authority, Denver, CO.,University of Colorado School of Medicine, Aurora, CO
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20
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Fischer HH, Fischer IP, Pereira RI, Furniss AL, Rozwadowski JM, Moore SL, Durfee MJ, Raghunath SG, Tsai AG, Havranek EP. Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care 2016; 39:1364-70. [PMID: 26861922 DOI: 10.2337/dc15-2137] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/07/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although the benefits of in-person Diabetes Prevention Program (DPP) classes for diabetes prevention have been demonstrated in trials, effectiveness in clinical practice is limited by low participation rates. This study explores whether text message support enhances weight loss in patients offered DPP classes. RESEARCH DESIGN AND METHODS English- and Spanish-speaking patients with prediabetes (n = 163) were randomized to the control group, which only received an invitation to DPP classes as defined by the Centers for Disease Control and Prevention, or to the text message-augmented intervention group, which also received text messages adapted from the DPP curriculum for 12 months. RESULTS Mean weight decreased 0.6 pounds (95% CI -2.7 to 1.6) in the control group and 2.6 pounds (95% CI -5.5 to 0.2) in the intervention group (P value 0.05). Three percent weight loss was achieved by 21.5% of participants in the control group (95% CI 12.5-30.6), compared with 38.5% in the intervention group (95% CI 27.7-49.3) (absolute difference 17.0%; P value 0.02). Mean glycated hemoglobin (HbA1c) increased by 0.19% or 2.1 mmol/mol (95% CI -0.1 to 0.5%) and decreased by 0.09% or 1.0 mmol/mol (95% CI -0.2 to 0.0%) in the control group and intervention participants, respectively (absolute difference 0.28%; P value 0.07). Stratification by language demonstrated a significant treatment effect in Spanish speakers but not in English speakers. CONCLUSIONS Text message support can lead to clinically significant weight loss in patients with prediabetes. Further study assessing effect by primary language and in an operational setting is warranted.
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Affiliation(s)
| | | | - Rocio I Pereira
- Denver Health and Hospital Authority, Denver, CO University of Colorado School of Medicine, Aurora, CO
| | | | | | | | | | | | - Adam G Tsai
- University of Colorado School of Medicine, Aurora, CO Kaiser Permanente, Denver, CO
| | - Edward P Havranek
- Denver Health and Hospital Authority, Denver, CO University of Colorado School of Medicine, Aurora, CO
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21
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Pereira RI, Low Wang CC, Wolfe P, Havranek EP, Long CS, Bessesen DH. Associations of Adiponectin with Adiposity, Insulin Sensitivity, and Diet in Young, Healthy, Mexican Americans and Non-Latino White Adults. Int J Environ Res Public Health 2015; 13:ijerph13010054. [PMID: 26703682 PMCID: PMC4730445 DOI: 10.3390/ijerph13010054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 10/22/2015] [Accepted: 12/01/2015] [Indexed: 12/24/2022]
Abstract
Low circulating adiponectin levels may contribute to higher diabetes risk among Mexican Americans (MA) compared to non-Latino whites (NLW). Our objective was to determine if among young healthy adult MAs have lower adiponectin than NLWs, independent of differences in adiposity. In addition, we explored associations between adiponectin and diet. This was an observational, cross-sectional study of healthy MA and NLW adults living in Colorado (U.S.A.). We measured plasma total adiponectin, adiposity (BMI, and visceral adipose tissue), insulin sensitivity (IVGTT), and self-reported dietary intake in 43 MA and NLW adults. Mean adiponectin levels were 40% lower among MA than NLW (5.8 ± 3.3 vs. 10.7 ± 4.2 µg/mL, p = 0.0003), and this difference persisted after controlling for age, sex, BMI, and visceral adiposity. Lower adiponectin in MA was associated with lower insulin sensitivity (R2 = 0.42, p < 0.01). Lower adiponectin was also associated with higher dietary glycemic index, lower intake of vegetables, higher intake of trans fat, and higher intake of grains. Our findings confirm that ethnic differences in adiponectin reflect differences in insulin sensitivity, but suggest that these are not due to differences in adiposity. Observed associations between adiponectin and diet support the need for future studies exploring the regulation of adiponectin by diet and other environmental factors.
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Affiliation(s)
- Rocio I Pereira
- Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
- Denver Health Medical Center, Denver, CO 80204, USA.
| | | | - Pamela Wolfe
- Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
| | | | - Carlin S Long
- Denver Health Medical Center, Denver, CO 80204, USA.
| | - Daniel H Bessesen
- Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
- Denver Health Medical Center, Denver, CO 80204, USA.
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22
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Krantz MJ, Havranek EP, Pereira RI, Beaty B, Mehler PS, Long CS. Effects of omega-3 fatty acids on arterial stiffness in patients with hypertension: a randomized pilot study. J Negat Results Biomed 2015; 14:21. [PMID: 26631058 PMCID: PMC4668614 DOI: 10.1186/s12952-015-0040-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/24/2015] [Indexed: 11/18/2022] Open
Abstract
Background Omega–3 fatty acids prevent cardiovascular disease (CVD) events in patients with myocardial infarction or heart failure. Benefits in patients without overt CVD have not been demonstrated, though most studies did not use treatment doses (3.36 g) of omega-3 fatty acids. Arterial stiffness measured by pulse wave velocity (PWV) predicts CVD events independent of standard risk factors. However, no therapy has been shown to reduce PWV in a blood pressure-independent manner. We assessed the effects of esterified omega–3 fatty acids on PWV and serum markers of inflammation among patients with hypertension. Design and methods We performed a prospective, randomized; double-blinded pilot study of omega-3 fatty acids among 62 patients in an urban, safety net hospital. Patients received 3.36 g of omega–3 fatty acids vs. matched placebo daily for 3-months. The principal outcome measure was change in brachial-ankle PWV. Serum inflammatory markers associated with CVD risk were also assessed. Results The majority (71 %) were of Latino ethnicity. After 3-months, mean change in arterial PWV among omega-3 and placebo groups was −97 cm/s vs. −33 cm/s respectively (p = 0.36 for difference, after multivariate adjustment for baseline age, systolic blood pressure, and serum adiponectin). Non-significant reductions in lipoprotein-associated phospholipase A2 (LpPLA2) mass and high sensitivity C-reactive protein (hsCRP) relative to placebo were also observed (p = 0.08, and 0.21, respectively). Conclusion High-dose omega-3 fatty acids did not reduce arterial PWV or markers of inflammation among patients within a Latino-predominant population with hypertension. Clinical trial registration NCT00935766, registered July 8 2009.
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Affiliation(s)
- Mori J Krantz
- Cardiology Division, Denver Health Medical Center, 777 Bannock St., MC0960, Denver, CO, 80204, USA. .,Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA.
| | - Edward P Havranek
- Cardiology Division, Denver Health Medical Center, 777 Bannock St., MC0960, Denver, CO, 80204, USA. .,Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA.
| | - Rocio I Pereira
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA.
| | - Brenda Beaty
- Colorado Health Outcomes Program, University of Colorado School of Medicine, 13199 E. Montview Blvd. Suite 300, Aurora, CO, 80045, USA.
| | - Philip S Mehler
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA.
| | - Carlin S Long
- Cardiology Division, Denver Health Medical Center, 777 Bannock St., MC0960, Denver, CO, 80204, USA. .,Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA.
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Pereira RI, Casey BA, Swibas TA, Erickson CB, Wolfe P, Van Pelt RE. Timing of Estradiol Treatment After Menopause May Determine Benefit or Harm to Insulin Action. J Clin Endocrinol Metab 2015; 100:4456-62. [PMID: 26425886 PMCID: PMC4667161 DOI: 10.1210/jc.2015-3084] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/28/2015] [Indexed: 12/24/2022]
Abstract
CONTEXT Type 2 diabetes (T2D) is reduced in postmenopausal women randomized to estrogen-based hormone therapy (HT) compared with placebo. Insulin sensitivity is a key determinant of T2D risk and overall cardiometabolic health, and studies indicate that estradiol (E2) directly impacts insulin action. OBJECTIVE We hypothesized that the timing of E2 administration after menopause is an important determinant of its effect on insulin action. DESIGN We performed a randomized, crossover, placebo-controlled study. PARTICIPANTS Study participants were early postmenopausal (EPM; ≤ 6 years of final menses; n = 22) and late postmenopausal (LPM; ≥ 10 years since last menses; n = 24) women naive to HT. INTERVENTION Study interventions included short-term (1 week) transdermal E2 and placebo. MAIN OUTCOMES AND MEASURES The study's main outcome was insulin-mediated glucose disposal (glucose disposal rate [GDR]) via hyperinsulinemic-euglycemic clamp. RESULTS Compared to EPM women, LPM women were older (mean ± SD; 63 ± 3 vs 56 ± 4 years, P < .05) and more years past menopause (12 ± 2 vs 3 ± 2 years, P < .05). Body mass index (24 ± 3 vs 25 ± 7 kg/m(2)) and fat mass (25 ± 7 vs 23 ± 6 kg) did not differ between groups, but fat-free mass (FFM) was lower in LPM women compared to EPM women (40 ± 4 vs 43 ± 5 kg, P < .05). Baseline GDR did not differ between groups (11.7 ± 2.8 vs 11.5 ± 2.9 mg/kg FFM/min). In support of our hypothesis, 1 week of E2 decreased GDR in LPM women compared to an increase in EPM women (+0.44 ± 1.7 vs - 0.76 ± 2.1 mg/kg FFM/min, P < .05). CONCLUSIONS There was not an apparent decline in GDR with age or time since menopause per se. However, E2 action on GDR was dependent on time since menopause, such that there was an apparent benefit early (≤ 6 years) compared to harm later (≥ 10 years) in menopause. E2-mediated effects on insulin action may be one mechanism by which HT reduces the incidence of T2D in early postmenopausal women.
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Affiliation(s)
- R I Pereira
- Department of Medicine (T.A.S., C.B.E., R.E.V.P.), Division of Geriatric Medicine; Department of Medicine (R.I.P., B.A.C.), Division of Endocrinology, Metabolism and Diabetes; Colorado School of Public Health, Biostatistics and Informatics (P.W.), University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - B A Casey
- Department of Medicine (T.A.S., C.B.E., R.E.V.P.), Division of Geriatric Medicine; Department of Medicine (R.I.P., B.A.C.), Division of Endocrinology, Metabolism and Diabetes; Colorado School of Public Health, Biostatistics and Informatics (P.W.), University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - T A Swibas
- Department of Medicine (T.A.S., C.B.E., R.E.V.P.), Division of Geriatric Medicine; Department of Medicine (R.I.P., B.A.C.), Division of Endocrinology, Metabolism and Diabetes; Colorado School of Public Health, Biostatistics and Informatics (P.W.), University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - C B Erickson
- Department of Medicine (T.A.S., C.B.E., R.E.V.P.), Division of Geriatric Medicine; Department of Medicine (R.I.P., B.A.C.), Division of Endocrinology, Metabolism and Diabetes; Colorado School of Public Health, Biostatistics and Informatics (P.W.), University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - P Wolfe
- Department of Medicine (T.A.S., C.B.E., R.E.V.P.), Division of Geriatric Medicine; Department of Medicine (R.I.P., B.A.C.), Division of Endocrinology, Metabolism and Diabetes; Colorado School of Public Health, Biostatistics and Informatics (P.W.), University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - R E Van Pelt
- Department of Medicine (T.A.S., C.B.E., R.E.V.P.), Division of Geriatric Medicine; Department of Medicine (R.I.P., B.A.C.), Division of Endocrinology, Metabolism and Diabetes; Colorado School of Public Health, Biostatistics and Informatics (P.W.), University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
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Medeiros AW, Pereira RI, Oliveira DV, Martins PD, d'Azevedo PA, Van der Sand S, Frazzon J, Frazzon APG. Molecular detection of virulence factors among food and clinical Enterococcus faecalis strains in South Brazil. Braz J Microbiol 2014; 45:327-32. [PMID: 24948952 PMCID: PMC4059318 DOI: 10.1590/s1517-83822014005000031] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 04/01/2013] [Indexed: 12/14/2022] Open
Abstract
The present report aimed to perform a molecular epidemiological survey by investigating the presence of virulence factors in E. faecalis isolated from different human clinical (n = 57) and food samples (n = 55) in Porto Alegre, Brazil, collected from 2006 to 2009. In addition, the ability to form biofilm in vitro on polystyrene and the β-haemolytic and gelatinase activities were determined. Clinical strains presented a higher prevalence of aggregation substance (agg), enterococcal surface protein (esp) and cytolysin (cylA) genes when compared with food isolates. The esp gene was found only in clinical strains. On the other hand, the gelatinase (gelE) and adherence factor (ace) genes had similar prevalence among the strains, showing the widespread occurrence of these virulence factors among food and clinical E. faecalis strains in South Brazil. More than three virulence factor genes were detected in 77.2% and 18.2% of clinical and food strains, respectively. Gelatinase and β-haemolysin activities were not associated with the presence of gelE and cylA genes. The ability to produce biofilm was detected in 100% of clinical and 94.6% of food isolates, and clinical strains were more able to form biofilm than the food isolates (Student’s t-test, p < 0.01). Results from the statistical analysis showed significant associations between strong biofilm formation and ace (p = 0.015) and gelE (p = 0.007) genes in clinical strains. In conclusion, our data indicate that E. faecalis strains isolated from clinical and food samples possess distinctive patterns of virulence factors, with a larger number of genes that encode virulence factors detected in clinical strains.
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Affiliation(s)
- A W Medeiros
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
| | - R I Pereira
- Instituto de Ciências Básicas da Saúde Departamento de Microbiologia Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
| | - D V Oliveira
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
| | - P D Martins
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
| | - P A d'Azevedo
- Departamento de Ciências Básicas da Saúde Universidade Federal de Ciências da Saúde de Porto Alegre Porto AlegreRS Brazil
| | - S Van der Sand
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
| | - J Frazzon
- Instituto de Ciência e Tecnologia de Alimentos Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
| | - A P G Frazzon
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil
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Miller MR, Pereira RI, Langefeld CD, Lorenzo C, Rotter JI, Chen YDI, Bergman RN, Wagenknecht LE, Norris JM, Fingerlin TE. Levels of free fatty acids (FFA) are associated with insulin resistance but do not explain the relationship between adiposity and insulin resistance in Hispanic Americans: the IRAS Family Study. J Clin Endocrinol Metab 2012; 97:3285-91. [PMID: 22761463 PMCID: PMC3431582 DOI: 10.1210/jc.2012-1318] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
CONTEXT AND OBJECTIVE We investigated whether free fatty acids (FFA) mediate the association between adiposity and insulin resistance in the Hispanic-American families of the Insulin Resistance Atherosclerosis Family Study. DESIGN In 815 Hispanic individuals in the Insulin Resistance Atherosclerosis Family Study, we tested for association between the following: 1) levels of adiposity [body mass index (BMI), visceral and sc adipose tissue area (VAT and SAT)] and circulating levels of FFA; 2) levels of circulating FFA and insulin sensitivity (S(I)); and 3) levels of adiposity and S(I), additionally testing to see whether levels of FFA mediated or modified the relationship between adiposity and S(I.) RESULTS After adjusting for age, sex, clinic site, and admixture, increasing levels of BMI, VAT, and SAT were weakly associated with increasing levels of circulating FFA (BMI: P = 0.024; VAT: P = 2.33 × 10(-3); SAT: P = 0.018; percent variation explained: ∼1.00%). Increasing levels of circulating FFA were associated with decreasing S(I) (P = 8.10 × 10(-11)). Increasing BMI, VAT, and SAT were also associated with decreasing S(I) (BMI: P = 4.98 × 10(-71); VAT: P = 1.48 × 10(-64); SAT: P = 4.21 × 10(-62)), but this relationship was not significantly mediated by FFA. VAT, but not BMI or SAT, interacts with levels of FFA to influence S(I) (P = 0.021). CONCLUSIONS Although levels of circulating FFA are associated both with increasing adiposity and decreasing S(I), they do not appear to mediate the association between levels of adiposity and S(I) in this large cohort of Hispanic-Americans. These results may indicate that FFA contribute to insulin resistance independent of adiposity.
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Affiliation(s)
- Melissa R Miller
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado 80045, USA
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Pereira RI, Snell-Bergeon JK, Erickson C, Schauer IE, Bergman BC, Rewers M, Maahs DM. Adiponectin dysregulation and insulin resistance in type 1 diabetes. J Clin Endocrinol Metab 2012; 97:E642-7. [PMID: 22278421 PMCID: PMC3319187 DOI: 10.1210/jc.2011-2542] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 12/29/2011] [Indexed: 12/21/2022]
Abstract
CONTEXT Type 1 diabetes (T1D) is associated with insulin resistance despite elevated levels of the insulin-sensitizing protein adiponectin. Whether the expected positive correlation between adiponectin and insulin sensitivity is preserved in a T1D population is unknown. OBJECTIVE We measured the correlation between total and high-molecular-weight (HMW) adiponectin and insulin sensitivity in T1D patients and nondiabetic controls and identified determinants of adiponectin levels in patients with T1D. DESIGN AND PARTICIPANTS Fasting total and HMW adiponectin were measured in 86 subjects from the Coronary Artery Calcification in T1D (CACTI) cohort (39 T1D, 47 nondiabetic; age 45 ± 8 yr; 55% female). The association of adiponectin levels with insulin sensitivity was analyzed. SETTING The study was conducted at an academic research institute. METHODS Fasting total and HMW adiponectin were measured by RIA and ELISA, respectively. Insulin sensitivity was measured by a hyperinsulinemic-euglycemic clamp. Multivariate linear regression was used to identify determinants of adiponectin levels. RESULTS Adiponectin levels positively correlated with insulin sensitivity in both subject groups (total adiponectin, r = 0.33 P < 0.05 for T1D, r = 0.29 P < 0.05 controls), but insulin sensitivity was lower in T1D subjects at any given level of total or HMW adiponectin. Adiponectin levels were independently associated with age, gender, and trunk fat, but these variables did not account for increased adiponectin in patients with T1D. CONCLUSION Adiponectin levels are positively correlated with insulin sensitivity in T1D patients. However, T1D patients have decreased insulin sensitivity compared with controls at every level of adiponectin, suggesting an important adaptive change of adiponectin set point.
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Affiliation(s)
- Rocio I Pereira
- University of Colorado, Anschutz Medical Campus, Division of Endocrinology, MS 8106, Aurora, Colorado 80045-0511,USA.
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Pereira RI, Wang CCL, Hosokawa P, Dickinson LM, Chonchol M, Krantz MJ, Steiner JF, Bessesen DH, Havranek EP, Long CS. Circulating adiponectin levels are lower in Latino versus non-Latino white patients at risk for cardiovascular disease, independent of adiposity measures. BMC Endocr Disord 2011; 11:13. [PMID: 21736747 PMCID: PMC3141565 DOI: 10.1186/1472-6823-11-13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 07/07/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Latinos in the United States have a higher prevalence of type 2 diabetes than non-Latino whites, even after controlling for adiposity. Decreased adiponectin is associated with insulin resistance and predicts T2DM, and therefore may mediate this ethnic difference. We compared total and high-molecular-weight (HMW) adiponectin in Latino versus white individuals, identified factors associated with adiponectin in each ethnic group, and measured the contribution of adiponectin to ethnic differences in insulin resistance. METHODS We utilized cross-sectional data from subjects in the Latinos Using Cardio Health Actions to reduce Risk study. Participants were Latino (n = 119) and non-Latino white (n = 60) men and women with hypertension and at least one other risk factor for CVD (age 61 ± 10 yrs, 49% with T2DM), seen at an integrated community health and hospital system in Denver, Colorado. Total and HMW adiponectin was measured by RIA and ELISA respectively. Fasting glucose and insulin were used to calculate the homeostasis model insulin resistance index (HOMA-IR). Variables independently associated with adiponectin levels were identified by linear regression analyses. Adiponectin's contribution to ethnic differences in insulin resistance was assessed in multivariate linear regression models of Latino ethnicity, with logHOMA-IR as a dependent variable, adjusting for possible confounders including age, gender, adiposity, and renal function. RESULTS Mean adiponectin levels were lower in Latino than white patients (beta estimates: -4.5 (-6.4, -2.5), p < 0.001 and -1.6 (-2.7, -0.5), p < 0.005 for total and HMW adiponectin), independent of age, gender, BMI/waist circumference, thiazolidinedione use, diabetes status, and renal function. An expected negative association between adiponectin and waist circumference was seen among women and non-Latino white men, but no relationship between these two variables was observed among Latino men. Ethnic differences in logHOMA-IR were no longer observed after controlling for adiponectin levels. CONCLUSIONS Among patients with CVD risk, total and HMW adiponectin is lower in Latinos, independent of adiposity and other known regulators of adiponectin. Ethnic differences in adiponectin regulation may exist and future research in this area is warranted. Adiponectin levels accounted for the observed variability in insulin resistance, suggesting a contribution of decreased adiponectin to insulin resistance in Latino populations.
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Affiliation(s)
- Rocio I Pereira
- Denver Health Medical Center, 660 Bannock Street, Denver, CO 80204, USA
- University of Colorado Denver, Anschutz Medical Campus, P.O. Box 6511, MS8106, Aurora, CO 80045, USA
| | - Cecilia CL Wang
- University of Colorado Denver, Anschutz Medical Campus, P.O. Box 6511, MS8106, Aurora, CO 80045, USA
- Denver Veterans Affairs Medical Center, 1055 Clermont Street, Denver, CO 80220, USA
| | - Patrick Hosokawa
- University of Colorado Denver, Anschutz Medical Campus, P.O. Box 6511, MS8106, Aurora, CO 80045, USA
| | - L Miriam Dickinson
- University of Colorado Denver, Anschutz Medical Campus, P.O. Box 6511, MS8106, Aurora, CO 80045, USA
| | - Michel Chonchol
- University of Colorado Denver, Anschutz Medical Campus, P.O. Box 6511, MS8106, Aurora, CO 80045, USA
| | - Mori J Krantz
- Denver Health Medical Center, 660 Bannock Street, Denver, CO 80204, USA
| | - John F Steiner
- Institute for Health Research, Kaiser Permanente, P.O. Box 378066, Denver, CO 80237, USA
| | - Daniel H Bessesen
- Denver Health Medical Center, 660 Bannock Street, Denver, CO 80204, USA
- University of Colorado Denver, Anschutz Medical Campus, P.O. Box 6511, MS8106, Aurora, CO 80045, USA
| | - Edward P Havranek
- Denver Health Medical Center, 660 Bannock Street, Denver, CO 80204, USA
| | - Carlin S Long
- Denver Health Medical Center, 660 Bannock Street, Denver, CO 80204, USA
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Pereira RI, Leitner JW, Erickson C, Draznin B. Pioglitazone acutely stimulates adiponectin secretion from mouse and human adipocytes via activation of the phosphatidylinositol 3′-kinase. Life Sci 2008; 83:638-43. [DOI: 10.1016/j.lfs.2008.09.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 08/07/2008] [Accepted: 09/02/2008] [Indexed: 11/15/2022]
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Pereira RI, Draznin B. Inhibition of the phosphatidylinositol 3'-kinase signaling pathway leads to decreased insulin-stimulated adiponectin secretion from 3T3-L1 adipocytes. Metabolism 2005; 54:1636-43. [PMID: 16311098 DOI: 10.1016/j.metabol.2005.07.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adiponectin is a protein secreted by adipocytes, which modulates insulin resistance and is thought to confer protection from atherosclerosis. Decreased circulating adiponectin is seen in states of insulin resistance, yet the cause of this decrease remains unclear. We investigated the role of insulin in adiponectin secretion and the effect of selective insulin resistance on insulin-stimulated adiponectin secretion by 3T3-L1 adipocytes. Inhibition of the phosphatidylinositol 3'-kinase (PI3K) insulin-signaling pathway was induced with wortmannin (WT) or with a kinase-inactive Akt adenoviral construct (Akt-KD), and inhibition of the mitogen-activated protein kinase pathway was induced with PD98059 or with a dominant-negative ras adenoviral construct (DNras). The PI3K pathway was activated with a constitutively active Akt adenoviral construct (Akt-myr). Adiponectin was measured by Western blot, and adiponectin messenger RNA (mRNA) levels were determined by real-time reverse transcription-polymerase chain reaction. Insulin treatment increased adiponectin secretion and decreased intracellular adiponectin. Treatment with 100 nmol/L insulin for 24 hours resulted in a 78% increase in secreted adiponectin (P < .05). Insulin had no effect on adiponectin mRNA. WT or Akt-KD, but not PD98059 or DNras, inhibited insulin-stimulated adiponectin secretion (P < .05). Activation of the PI3K pathway resulted in increased insulin-independent adiponectin secretion. Inhibition of the PI3K- or mitogen-activated protein kinase-dependent pathway decreased adiponectin mRNA by 50% (P < .01). We demonstrate a decrease in insulin-stimulated adiponectin secretion with selective inhibition of the PI3K pathway. These results suggest a mechanism for the observed decreased adiponectin levels associated with insulin resistance, when defects in the PI3K-dependent insulin-signaling pathway lead to decreased adiponectin production, inadequate adiponectin secretion, and therefore low circulating adiponectin levels.
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Affiliation(s)
- Rocio I Pereira
- Research Service, Denver Veterans Affairs Medical Center, Denver, CO 80220, USA
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Abstract
BACKGROUND Our objective was to explore the relationship between baseline characteristics of hospitalized smokers and 6-month to 2-year self-reported quit rates. METHODS We surveyed adult smokers (n = 154) admitted to the Medicine service of an urban public hospital. We used the pharmacy database, a follow-up telephone survey, and medical records to characterize nicotine patch use and post-discharge smoking abstinence. RESULTS Among the 102 patients for whom smoking status at least 6 months after discharge was known, 18 (18%) were not smoking at last contact (mean follow-up 20 months). Individual factors associated with quitting include confidence to quit within 1 week, stage of change other than precontemplation, filling a nicotine patch prescription after discharge, number of previous quit attempts, and increasing age. With multivariate modeling, only confidence to quit [OR 9.8, confidence interval (CI), 2.8-35.0] and the number of previous quit attempts (OR 1.3 per attempt, 95% CI, 1.0-1.5) remained significantly associated with future abstinence. CONCLUSIONS A high level of confidence to quit and multiple prior quit attempts are strongly associated with future abstinence among hospitalized patients who smoke. Using a simple confidence-to-quit scale to target interventions to patients with high confidence may improve the effectiveness of smoking cessation programs.
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Affiliation(s)
- Thomas D MacKenzie
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80203, USA.
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Cecatti JG, Pereira RI, Vial JS, Barini R. [Myasthenia gravis and pregnancy: review of the literature and report of 2 cases]. Rev Paul Med 1991; 109:41-6. [PMID: 1882173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Two cases of women with myasthenia gravis are presented. These women had three pregnancies followed by the authors, and description is made of clinical follow-up, therapeutic complications, termination of pregnancy, puerperal and perinatal outcome. A review of the literature is made due to the rarity of this condition and emphasis is given to the specialized knowledge required to adequately manage these cases. Myasthenia gravis, when associated to pregnancy, presents aspects that make it a high risk disease, decompensations of myasthenia being more common. Aspects relative to diagnosis and therapy of myasthenia in pregnancy and in the newly-born are reviewed, and considerations about anesthesia in the myasthenic pregnant woman.
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Affiliation(s)
- J G Cecatti
- Departamento de Tocoginecologia, Campinas, SP
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