The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n ‫؍‬ 89) and women (n ‫؍‬ 129) with a broad range of age (

No abstract

The C-Leg ® (Otto Bock, Duderstadt, Germany) is a microprocessor-controlled prosthetic knee that may enhance amputee gait. This intrasubject randomized study compared the gait biomechanics of transfemoral amputees wearing the C-Leg ® with those wearing a common noncomputerized prosthesis, the Mauch SNS ® (Ossur, Reykjavik, Iceland). After subjects had a 3-month acclimation period with each prosthetic knee, typical gait biomechanical data were collected in a gait laboratory. At a controlled walking speed (CWS), peak swing phase knee-flexion angle decreased for the C-Leg ® group compared with the Mauch SNS ® group (55.2° ± 6.5° vs 64.41° ± 5.8°, respectively; p = 0.005); the C-Leg ® group was similar to control subjects' peak swing knee-flexion angle (56.0° ± 3.4°). Stance knee-flexion moment increased for the C-Leg ® group compared with the Mauch SNS ® group (0.142 ± 0.05 vs 0.067 ± 0.07 N•m, respectively; p = 0.01), but remained significantly reduced compared with control subjects (0.477 ± 0.1 N•m). Prosthetic limb step length at CWS was less for the C-Leg ® group compared with the Mauch SNS ® group (0.66 ± 0.04 vs 0.70 ± 0.06 m, respectively; p = 0.005), which resulted in increased symmetry between limbs for the C-Leg ® group. Subjects also walked faster with the C-Leg ® versus the Mauch SNS ® (1.30 ± 0.1 vs 1.21 ± 0.1 m/s, respectively; p = 0.004). The C-Leg ® prosthetic limb vertical ground reaction force decreased compared with the Mauch SNS ® (96.3 ± 4.7 vs 100.3 ± 7.5 % body weight, respectively; p = 0.0092).

THE AMERICAN DIABETES ASSOCIATIONGENNID STUDY GROUP* OBJECTIVE -We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with firstdegree relatives with type 2 diabetes.RESEARCH DESIGN AND METHODS -Women with (n ϭ 332) and without (n ϭ 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported CVD.RESULTS -Women with prior GDM were younger (48.6 Ϯ 0.7 vs. 52.4 Ϯ 0.6 years [means Ϯ SE]; P Ͻ 0.001) and less likely to be postmenopausal (48.3 vs. 57.9%; P Ͻ 0.005). Although both groups were obese (BMI 34.4 Ϯ 1.2 vs. 33.7 Ϯ 0.6 kg/m 2 ), women with prior GDM were more likely to have metabolic syndrome (86.6 vs. 73.5%; P Ͻ 0.001) and type 2 diabetes (93.4 vs. 63.3%; P Ͻ 0.001). Moreover, they had a higher prevalence of CVD (15.5 vs. 12.4%; adjusted odds ratio 1.85 [95% CI 1.21-2.82]; P ϭ 0.005) that occurred at a younger age (45.5 Ϯ 2.2 vs. 52.5 Ϯ 1.9 years; P ϭ 0.02) and was independent of metabolic syndrome (1.74 [1.10 -2.76]; P ϭ 0.02) and type 2 diabetes (1.56 [1.002-2.43]; P Ͻ 0.05).CONCLUSIONS -Among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes.

Background: Specific gravity (SG) may perform as well as creatinine (CR) correction for adjusting urinary hormone concentrations, as well as offer some advantages. We compared the two methods and applied them to US and Bangladeshi specimens to evaluate their use in different populations. Methods: Pearson correlations between serum concentrations and SG, CR, and uncorrected urinary concentrations were compared using paired daily urine and serum specimens from one menstrual cycle from 30 US women. Corrected urinary estrone conjugate and pregnanediol glucuronide concentrations were compared with serum estradiol and progesterone. Urine specimens across one menstrual cycle from 13 Bangladeshi women were used to evaluate the applicability of both methods to a nonindustrialized population. Linear mixed-effects models were used to compare CR and SG values in the Bangladeshi vs US specimens. Results: There was no significant difference between SG-corrected vs serum and CR-corrected vs serum correlations for either assay. Usable CR results were obtained for all US specimens, but 37% of the Bangladeshi specimens were below the CR assay limit of detection. The Bangladeshi sample had significantly lower CR and higher inter-and intrasubject CR variability than the US sample. Conclusions: SG is a potentially useful alternative to CR correction for normalizing urinary steroid hormone