2,721 research outputs found
Insulin Sensitivity and Secretion in Arab Americans with Glucose Intolerance
Background: This study examined the pathophysiological abnormalities in Arab Americans with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). Subjects and Methods: Homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of insulin secretion (HOMA-%?), and the Matsuda Insulin Sensitivity Index composite (ISIcomposite) were calculated from the fasting and stimulated glucose and insulin concentrations measured during the oral glucose tolerance test in a population-based, representative, cross-sectional sample of randomly selected Arab Americans. Results: In total, 497 individuals (42±14 years old; 40% males; body mass index [BMI], 29±6?kg/m2) were studied. Multivariate linear regression models were performed to compare HOMA-IR, HOMA-%?, and ISIcomposite among individuals with normal glucose tolerance (NGT) (n=191) versus isolated IFG (n=136), isolated IGT (n=22), combined IFG/IGT (n=43), and diabetes (n=105). Compared with individuals with NGT (2.9±1.6), HOMA-IR progressively increased in individuals with isolated IFG (4.8±2.7, P<0.001), combined IFG/IGT (6.0±4.3, P<0.001), and diabetes (9.7±8.3, P<0.001) but not in those with isolated IGT (3.0±1.7, P=0.87). After adjustment for sex and BMI, these associations remained unchanged. Whole-body insulin sensitivity as measured by ISIcomposite was significantly lower in individuals with isolated IFG (3.9±2.3, P<0.001), isolated IGT (2.8±1.5, P<0.001), combined IFG/IGT (1.9±1.1, P<0.001), and diabetes (1.6±1.1, P<0.001) compared with those with NGT (6.1±3.5). HOMA-%? was significantly lower in diabetes (113.7±124.9, P<0.001) compared with NGT (161.3±92.0). After adjustment for age, sex, and BMI, isolated IFG (146.6±80.2) was also significantly associated with a decline in HOMA-%? relative to NGT (P=0.005). Conclusions: This study suggests that differences in the underlying metabolic defects leading to diabetes in Arab Americans with IFG and/or IGT exist and may require different strategies for the prevention of diabetes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140352/1/dia.2013.0045.pd
The impact of obesity and timely antiviral administration on severe influenza outcomes among hospitalized adults
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141541/1/jmv24946.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141541/2/jmv24946_am.pd
Clinical and genetic risk factors for biofilm-forming Staphylococcus aureus
The molecular and clinical factors associated with biofilm-forming methicillin-resistant Staphylococcus aureus (MRSA) are incompletely understood. Biofilm production for 182 MRSA isolates obtained from clinical culture sites (2004 to 2013) was quantified. Microbiological toxins, pigmentation, and genotypes were evaluated, and patient demographics were collected. Logistic regression was used to quantify the effect of strong biofilm production (versus weak biofilm production) on clinical outcomes and independent predictors of a strong biofilm. Of the isolates evaluated, 25.8% (47/182) produced strong biofilms and 40.7% (74/182) produced weak biofilms. Strong biofilm-producing isolates were more likely to be from multilocus sequence typing (MLST) clonal complex 8 (CC8) (34.0% versus 14.9%; P = 0.01) but less likely to be from MLST CC5 (48.9% versus 73.0%; P = 0.007). Predictors for strong biofilms were spa type t008 (adjusted odds ratio [aOR], 4.54; 95% confidence interval [CI], 1.21 to 17.1) and receipt of chemotherapy or immunosuppressants in the previous 90 days (aOR, 33.6; 95% CI, 1.68 to 673). Conversely, patients with high serum creatinine concentrations (aOR, 0.33; 95% CI, 0.15 to 0.72) or who previously received vancomycin (aOR, 0.03; 95% CI, 0.002 to 0.39) were less likely to harbor strong biofilm-producing MRSA. Beta-toxin-producing isolates (aOR, 0.31; 95% CI, 0.11 to 0.89) and isolates with spa type t895 (aOR, 0.02 95% CI
Sympathetically-Mediated Cutaneous Vasoconstriction Is Similar Between Non-Hispanic Black and White Individuals
Cardiovascular disease (CVD) prevalence is highest in non-Hispanic Black (BL) individuals compared to any other race. The mechanisms responsible remain incompletely understood and can be impacted by several environmental, psychosocial, and socioeconomic factors. A major contributing factor to elevated CVD risk/prevalence in the BL population is altered vascular function, which could be attributed to an exaggerated vasoconstrictor response to efferent sympathetic activity (i.e., sympathetic vascular transduction). Previous data from our group demonstrates heightened sympathetic vascular transduction in the peripheral vasculature of BL males. However, whether sympathetically-mediated vasoconstriction is exaggerated in the cutaneous circulation of BL individuals remains unknown. PURPOSE: This study tested the hypothesis that BL individuals exhibit exaggerated vasoconstriction to intra-dermal infusions of the α-adrenoreceptor agonist norepinephrine (NE) relative to White (WH) individuals. METHODS: In this study, young, healthy college-aged BL (n=13; 6 females) and WH (n=10; 4 females) individuals participated. Participants were instrumented with an intradermal microdialysis membrane in the dorsal forearm. Red blood cell flux was continuously assessed via laser Doppler flowmetry before (baseline) and during incrementally stronger infusions of NE (10-8 M â 10-2 M; 6 min/dose). Data were analyzed as a relative (i.e., percent) reduction in cutaneous vascular conductance (CVC: flux/MAP) compared to the pre-infusion baseline. RESULTS: NE caused a dose-dependent reduction in CVC in both groups (P\u3c0.001). There was no difference between the BL and WH individuals (P=0.37) nor was there a race x dose interaction (P=0.84). Similarly, when the data were separated by sex there was no difference between BL and WH males (P=0.56) or females (P=0.26). CONCLUSION: Vasoconstrictor responsiveness to α-adrenoreceptor activation was similar between BL and WH individuals. These data suggest that the cutaneous circulation may exhibit divergent sympathically-mediated vasoconstrictor responsiveness relative to other peripheral vascular beds in BL individuals
Human coronaviruses and other respiratory infections in young adults on a university campus: Prevalence, symptoms, and shedding
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145532/1/irv12563.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145532/2/irv12563_am.pd
Influenza vaccine effectiveness among outpatients in the US Influenza Vaccine Effectiveness Network by study site 2011â2016
BackgroundInfluenza vaccination is recommended for all US residents aged â„6 months. Vaccine effectiveness (VE) varies by age, circulating influenza strains, and the presence of highârisk medical conditions. We examined siteâspecific VE in the US Influenza VE Network, which evaluates annual influenza VE at ambulatory clinics in geographically diverse sites.MethodsAnalyses were conducted on 27 180 outpatients â„6 months old presenting with an acute respiratory infection (ARI) with cough of â€7âday duration during the 2011â2016 influenza seasons. A testânegative design was used with vaccination status defined as receipt of â„1 dose of any influenza vaccine according to medical records, registries, and/or selfâreport. Influenza infection was determined by reverseâtranscription polymerase chain reaction. VE estimates were calculated using odds ratios from multivariable logistic regression models adjusted for age, sex, race/ethnicity, time from illness onset to enrollment, highârisk conditions, calendar time, and vaccination statusâsite interaction.ResultsFor all sites combined, VE was statistically significant every season against all influenza and against the predominant circulating strains (VE = 19%â50%) Few differences among four sites in the US Flu VE Network were evident in five seasons. However, in 2015â16, overall VE in one site was 24% (95% CI = â4%â44%), while VE in two other sites was significantly higher (61%, 95% CI = 49%â71%; P = .002, and 53%, 95% CI = 33,67; P = .034).ConclusionWith few exceptions, siteâspecific VE estimates aligned with each other and overall VE estimates. Observed VE may reflect inherent differences in community characteristics of the sites and highlights the importance of diverse settings for studying influenza vaccine effectiveness.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155981/1/irv12741_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155981/2/irv12741.pd
Coronavirus Occurrence and Transmission Over 8 Years in the HIVE Cohort of Households in Michigan
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156082/1/jiaa161.pdfSEL
Multiple-University Extension Program Addresses Postdisaster Oil Spill Needs Through Private Funding Partnership
In response to the Deepwater Horizon Oil Spill, the Gulf of Mexico Research Initiative (GoMRI) was formed to answer oil spillârelated scientific questions. However, peer-reviewed scientific discoveries were not reaching people whose livelihoods depended on a healthy Gulf of Mexico. GoMRI and the four Gulf of Mexico Sea Grant programs partnered to develop a regional Extension program with a team of multidisciplinary specialists and a regional manager embedded within the Sea Grant programs. The team answered oil spill science questions from target audiences. The program leaders also identified the value of adding a regional Extension communicator to enhance their Extension products
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