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Biomedical subjects

S E Moss

Publications and source records attributed to S E Moss.

At least 145 records · Page 8Linked to original sources
PubMed1991

Cause-specific mortality in a population-based study of diabetes.

BACKGROUND: Mortality from vascular diseases has been reported to be high in diabetic persons. METHODS: To evaluate mortality from these and other specific causes, we examined cause-specific age-sex standardized mortality ratios in a geographically defined population of younger onset (diagnosed before age 30 and taking insulin, n = 1200) and older onset (diagnosed after age 30, n = 1772) diabetic persons followed for 8.5 years. Cause of death was determined from death certificates. RESULTS: In younger onset persons, age-sex standardized mortality ratios were significantly high (P less than .05) for all causes of death (7.5) as well as for diabetes (191), all heart disease (9.1), ischemic heart disease (10.1), other heart disease (6.3), nephritis and nephrosis (41.2), accidents (2.9), and all other causes (3.2). In older onset persons, age-sex standardized mortality ratios were significantly high for all causes of death (2.0) as well as for diabetes (16.8), all heart disease (2.3), ischemic heart disease (2.3), other heart disease (2.1), stroke (2.0), and pneumonia and influenza (1.7). CONCLUSIONS: Diabetic persons experience very high mortality, especially from vascular diseases, compared to the general population.

Adult↗
PubMed1991

Association of elevated IGF-I levels with increased retinopathy in late-onset diabetes.

Insulinlike growth factor I (IGF-I) has been suggested to play a role in the pathogenesis of proliferative diabetic retinopathy (PDR). We determined IGF-I levels in subjects in a large population-based study of 928 people with diabetes diagnosed at 30 yr of age or older. PDR was found in 15.7% of the insulin-using group (n = 517) and in 2.8% of those not using insulin (n = 397). The mean serum level of IGF-I was 208 micrograms/L in individuals using insulin and 222 micrograms/L in those not using insulin, both significantly lower than in a nondiabetic comparison group (278 micrograms/L, P less than 0.0001). Logistic regression analysis was used to examine the relationship between IGF-I and PDR while controlling for other factors associated with the presence of PDR. After controlling for duration of diabetes, glycosylated hemoglobin, systolic blood pressure, presence of proteinuria, and age at diagnosis, higher levels of IGF-I were significantly associated with an increased frequency of PDR (P = 0.025) in the group using insulin. In individuals not using insulin, higher levels of IGF-I were associated with an increased frequency of PDR or moderate non-PDR (P = 0.08). These data suggest that higher IGF-I levels may be a risk factor for the development of severe retinopathy in people with diabetes diagnosed at 30 yr of age or older.

Adult↗
PubMed1991

Association of cigarette smoking with diabetic retinopathy.

OBJECTIVE: To determine whether cigarette smoking is associated with the incidence and progression of diabetic retinopathy. RESEARCH DESIGN AND METHODS: Younger-onset diabetic subjects who had been diagnosed at less than 30 yr of age and taking insulin (n = 1210) and a random sample of older-onset diabetic subjects diagnosed at greater than or equal to 30 yr of age (n = 1780) were selected. Baseline examinations were conducted on 996 younger- and 1370 older-onset subjects. Incidence of retinopathy was based on 138 younger-onset and 154 older-onset insulin-taking subjects and 321 older-onset non-insulin-taking subjects who were free of retinopathy at baseline. Progression of retinopathy was based on 530 younger-onset and 418 older-onset insulin-taking subjects and 486 older-onset non-insulin-taking subjects with less than proliferative diabetic retinopathy at baseline. RESULTS: Baseline smoking history was categorized by status (nonsmoker, ex-smoker, current smoker) and pack-years smoked while diabetic. Retinopathy was documented by stereoscopic fundus photography. In univariate analyses, the only significant association was between pack-years and progression to proliferative diabetic retinopathy in older-onset insulin-taking subjects (P less than 0.01). After controlling for known risk factors for the incidence and progression of retinopathy, pack-years smoked was borderline significant (P = 0.052) in predicting incidence of retinopathy in younger-onset subjects. Smoking was not associated with incidence in older-onset subjects or with progression or progression to proliferative diabetic retinopathy in any of the groups. CONCLUSIONS: Smoking is not likely to be an important risk factor for diabetic retinopathy.

Adult↗
PubMed1991

Treating a case of surface dyslexia after closed head injury.

We describe an original treatment program for surface dyslexia in a patient with a closed head injury. Addressing the question of whether the deficient lexical reading routes could be improved in this type of case. we designed three tasks and administered them over ten consecutive treatment sessions. Results indicate improved accuracy of responses as a function of presentation times or response times, or both, on all treatment tasks. Comparisons of standardized reading comprehension and oral reading tests before and after therapy disclosed increases in reading rate, with the patient's originally high level of accuracy remaining constant. This suggests that the patient incorporated the more rapid lexical reading strategy without compromising her level of accuracy.

Journal Article↗
PubMed1991

The incidence of gross proteinuria in people with insulin-dependent diabetes mellitus.

Epidemiologic data on the incidence of gross proteinuria in people with diabetes are important in medical counseling, in projecting estimates of needs and costs of health care, and for developing approaches to prevent renal complications. We performed a population-based incidence study in southern Wisconsin of insulin-taking diabetic persons diagnosed before 30 years of age. The presence of gross proteinuria (greater than or equal to 0.30 g/L) was determined by means of a reagent strip. The incidence of proteinuria in a 4-year interval was 14.4% (95% confidence interval, 11.7% to 17.0%). The relative risk of developing proteinuria after 4 years for those with glycosylated hemoglobin levels in the highest quartile compared with those in the lowest quartile was 3.0 (95% confidence interval, 1.6 to 5.3). The incidence of proteinuria was also associated with higher diastolic blood pressure, being male, taking more insulin, and having more severe retinopathy at the baseline examination. The relationship between glycosylated hemoglobin level and the incidence of proteinuria was significant even after controlling for these other risk variables. These data suggest that hyperglycemia, as measured by glycosylated hemoglobin level, is a significant risk factor for the development of gross proteinuria.

Adolescent↗
PubMed1990

Alternative splicing gives rise to two forms of the p68 Ca2(+)-binding protein.

The p68 Ca2+ and phospholipid binding protein of the lipocortin/calpactin family appears to exist as two forms. These may be resolved into a closely-spaced polypeptide doublet by SDS-PAGE. The cloning and sequencing of p68 revealed an apparent 18 nucleotide alternative splice sequence, which could account for this observation. We show here that an antiserum directed against a synthetic peptide corresponding to the region containing the splice sequence, recognises only the upper band of the p68 doublet by both immunoprecipitation and Western blotting. These results are consistent with alternative splicing being responsible for the generation of the two forms of p68.

Amino Acid Sequence↗
PubMed1990

Increased testosterone in type I diabetic subjects with severe retinopathy.

Diabetic retinopathy rarely occurs before puberty, suggesting that changes in sex hormones may influence the development of this condition. The authors measured serum testosterone, estradiol, DHEA-S, and sex hormone binding globulin levels in 26 men and 22 women with type I diabetes from the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), a population-based study of diabetic complications. The mean age was 23 years and the mean duration of diabetes was 14 years. Subjects with proliferative or preproliferative retinopathy (greater than or equal to retinopathy level 51-80) were matched by duration of diabetes (+/- 2 years) and sex to subjects with minimal or no retinopathy (less than or equal to retinopathy level 21). Seven stereoscopic retinal photographs of each eye were obtained and photographs were read by the University of Wisconsin Reading Center. Serum testosterone concentrations were significantly higher in male diabetic subjects with proliferative retinopathy (648 +/- 36 ng/dl) than in male diabetic subjects with minimal or no retinopathy (512 +/- 43 ng/dl) (P = 0.017). No other statistically significant differences in sex hormones between subjects with and without proliferative retinopathy were observed. Although these results should be regarded as preliminary because of the small number of subjects, they support the hypothesis that testosterone concentrations may be associated with the development of retinopathy in type I diabetic patients.

Adolescent↗
PubMed1990

The validity of estimating the incidence of diabetic retinopathy from prevalence.

A method for estimating incidence rates of a disease from prevalence proportions with differential mortality was validated for diabetic retinopathy in a large population of diabetic persons followed for 4 years, 1980-1982 to 1984-1986, in southern Wisconsin. Four-year age- or duration-specific incidence rates of retinopathy were calculated from prevalence and mortality in persons with and those without retinopathy. These rates were lower than the actual rates obtained at the 4-year follow-up examination by 50% or more in most age intervals in both younger and older onset persons. Estimated duration-specific rates were up to 29 and 57% lower than the actual rates in younger and older onset persons, respectively. These discrepancies could not be accounted for by violations of the assumptions underlying the method. In applying the method to diabetic retinopathy, age- and duration-specific incidence may be more appropriate. Such estimated rates agree well with actual rates except in older onset persons with diabetes of short duration.

Adolescent↗
PubMed1990

The Wisconsin epidemiologic study of diabetic retinopathy: an update.

Population-based epidemiologic data on the incidence and progression of diabetic retinopathy are important in developing approaches to preventing diabetic retinopathy, in medical counselling and rehabilitative services. The objectives of the Wisconsin Epidemiological Study of Diabetic Retinopathy were as follows: (1) to describe the prevalence, incidence, and progression of diabetic retinopathy and its component lesions, and to determine the incidence of visual impairment in a large population-based cohort; and (2) to determine the relationships between incidence and progression of diabetic retinopathy and risk factors in this cohort. Grading of stereoscopic fundus photographs was performed at the University of Wisconsin Fundus Photograph Reading Centre for photographs from both the baseline examination in 1980-1982 and follow-up examination four years later. Insulin-taking persons diagnosed to have diabetes before 30 years of age had the highest prevalence (71%), four-year incidence (59%) and progression to proliferative diabetic retinopathy (11%) while older-onset persons diagnosed to have diabetes at or after 30 years of age and not using insulin had the lowest prevalence (39%), incidence (34%) and progression to proliferative diabetic retinopathy (3%). These incidence data indicate that a substantial proportion of older onset diabetic people, a group previously thought to be protected from retinopathy, developed it during the four-year interval and underscores the need for careful ophthalmologic examination.

Adult↗
PubMed1990

Wisconsin Epidemiologic Study of Diabetic Retinopathy. XII. Relationship of C-peptide and diabetic retinopathy.

The relationship between plasma C-peptide and the frequency and severity of diabetic retinopathy was examined in a population-based study in Wisconsin in 1984-1986. Individuals with younger- (n = 835) and older- (n = 940) onset diabetes were included. C-peptide was measured by radioimmunoassay with Heding's M1230 antiserum. Retinopathy was determined from stereoscopic fundus photographs. The highest frequencies and most severe retinopathy were found in insulin-using individuals with undetectable or low plasma C-peptide (less than 0.3 nM), whereas the lowest frequencies of retinopathy were found in older-onset overweight individuals not using insulin. In older-onset individuals using insulin, having no detectable C-peptide was significantly associated with the presence of proliferative retinopathy. Otherwise, within each group (younger onset using insulin, older onset using insulin, and older onset not using insulin), after controlling for other characteristics associated with retinopathy, there was no relationship between higher levels of C-peptide and lower frequency of or less severe retinopathy.

C-Peptide↗
PubMed1990

Is insulinlike growth factor I associated with diabetic retinopathy?

Insulinlike growth factor I (IGF-I) is the mediator of the growth-promoting effects of growth hormone and has been suspected of playing a role in the pathogenesis of proliferative diabetic retinopathy (PDR). However, previous attempts to correlate IGF-I levels with PDR have yielded conflicting results. We determined IGF-I levels in a large population-based study of 682 early-onset (diagnosed before 30 yr of age) adult (greater than or equal to 18 yr old) insulin-taking diabetic subjects. PDR was found in 25% of the population. IGF-I levels were measured by radioimmunoassay. The mean serum level of IGF-I was 277 +/- 108 micrograms/L (mean +/- SD). Spearman rank correlations showed statistically significant negative correlations between IGF-I levels and age (r = -0.51, P less than 0.0001), duration of disease (r = -0.36, P less than 0.0001), and glycosylated hemoglobin (r = -0.09, P less than 0.05). There was a significant trend (P less than 0.001) toward decreasing risk of PDR with increasing IGF-I. However, after controlling for duration of diabetes, glycosylated hemoglobin, diastolic blood pressure, and the presence of proteinuria and/or creatinine greater than or equal to 265 microM in a multiple logistic regression model, IGF-I was not significantly associated with PDR. These data suggest that IGF-I may not be a risk factor for the development of PDR.

Adolescent↗
PubMed1990

Effect of pregnancy on progression of diabetic retinopathy.

A prospective study was undertaken to determine the effect of pregnancy on diabetic retinopathy. Insulin-taking diabetic women were enrolled; one group was comprised of pregnant women, the other group was comprised of women who were not pregnant. Women were evaluated on referral and again in the postpartum period. The severity of diabetic retinopathy was based on grading of fundus photographs of seven standard photographic fields. The glycosylated hemoglobin, duration of diabetes, current age, diastolic blood pressure, number of past pregnancies, and current pregnancy status were evaluated as risk factors for progression of diabetic retinopathy. After adjusting for glycosylated hemoglobin, current pregnancy was significantly associated with progression (P less than 0.005, adjusted odds ratio 2.3). Diastolic blood pressure had a lesser effect on the probability of progression. The findings from this study indicate that pregnancy and level of glycemia are associated with progression of diabetic retinopathy.

Adult↗
PubMed1990

Is menarche associated with diabetic retinopathy?

The goal of this study was to evaluate the association between menarchal status and diabetic retinopathy. Diabetic retinopathy was present in 51 of 129 females; 7 were premenarchal, and 44 were postmenarchal. The range of severity of retinopathy was greater in the postmenarchal group. In multivariate analyses, duration of diabetes, menarchal status, and diastolic blood pressure were associated with the prevalence of diabetic retinopathy. After partitioning the duration of diabetes into years before and years after menarche, both were significant, but the number of years of diabetes after menarche was more strongly associated. At a 4-yr follow-up examination, more postmenarchal than premenarchal females had progression of their retinopathy (P = 0.06). These data suggest that stage of sexual development, as reflected by menarchal status, is associated with the presence and possibly the risk of progression of diabetic retinopathy.

Adolescent↗
PubMed1990

Weight gain associated with improved glycemic control in population-based sample of subjects with type I diabetes.

Previous studies have suggested that weight gain is an identifiable risk of efforts to lower blood glucose with intensive insulin therapy in type I (insulin-dependent) diabetic subjects. This study examined this relationship in a population-based sample of type I diabetic subjects participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Four hundred five adults (aged greater than or equal to 21 yr) with type I diabetes, who were diagnosed before age 30 yr, were studied from 1980 to 1982 and in a follow-up examination from 1984 to 1986. Weight gain over the 4-yr interval averaged 1.8 +/- 5.9 kg. Weight gain was significantly associated (r = -0.26, P less than 0.001) with improvements in glycosylated hemoglobin levels; the quartile of subjects with the greatest improvements in glycemic control gained 3.4 kg, whereas the quartile of subjects with the smallest improvements in glycemic control lost 0.6 kg. Weight gain was also correlated with increases in the number of shots of insulin per day and change in the treatment regimen from one type of insulin to a combination of short- and long-acting insulins. These results suggest that weight gain may be an adverse consequence of improved glycemic control. Efforts to better understand the mechanism explaining weight gain and to prevent weight gain are needed.

Adult↗
PubMed1990

Oral contraceptives in women with diabetes.

We evaluated the association of oral contraceptive use with the presence and severity of diabetic retinopathy, hypertension, and glycosylated hemoglobin in women of childbearing age who have diabetes. Neither current or past use nor number of years of use of oral contraceptives was associated with severity of retinopathy, hypertension, or current glycosylated hemoglobin. In conclusion, further study of various birth control methods in young women of childbearing age should be considered.

Adolescent↗