One-step vs 2-step gestational diabetes mellitus screening and pregnancy outcomes: an updated systematic review and meta-analysis.

Objective: This was a systematic review and meta-analysis comparing maternal and neonatal outcomes of patients screened with the 1-step or 2-step screening method for gestational diabetes mellitus.

Data Sources: PubMed, Scopus, Cochrane, ClinicalTrials.gov, and LILACS were searched from inception up to September 2022.

Constricting Life Space and Likelihood of Neurodegenerative Disease in Community-Dwelling Older Men.

Importance: Life space is a measure of the frequency, range, and independence of movement through the environment. There is increasing interest in life space as a holistic measure of function in older adults, but the association between change in life space and incident neurodegenerative disease is unknown.

Objective: To evaluate the association between change in life space and cognitive decline or incident neurodegenerative disease over 7 years among community-dwelling older men.

The Association between Changes in Built Environment and Changes in Walking among Older Women in Portland, Oregon.

Some cross-sectional evidence suggests that the objectively measured built environment can encourage walking among older adults. We examined the associations between objectively measured built environment with change in self-reported walking among older women by using data from the Study of Osteoporotic Fractures (SOF). We evaluated the longitudinal associations between built environment characteristics and walking among 1253 older women (median age = 71 years) in Portland, Oregon using generalized estimating equation models.

First year infant weight trajectories predict overweight/obesity at age 2 in a diverse population.

Background: Obesity is emerging as early as two years of age and risk may be elucidated by differences in infant growth trajectories. We examined infant weight gain in the first year of life and association with overweight/obesity at age two.

Methods: In a diverse, population-based cohort study we conducted growth curve analysis using Health Maintenance Organization electronic medical record data from January 1, 2012 through December 31, 2013.

Impact of earlier gestational diabetes screening for pregnant people with obesity on maternal and perinatal outcomes.

Objectives: Gestational diabetes (GDM) screening at 24-28 weeks' gestation reduces risk of adverse maternal and perinatal outcomes. While experts recommend first-trimester screening for high-risk patients, including those with obesity, data supporting this recommendation is limited.

Methods: We implemented a systematic population intervention to encourage first-trimester GDM screening by oral glucose tolerance testing in a cohort of pregnant people with obesity in two integrated health systems from 2009 to 2013, and compared outcomes to the same population pre-intervention (2006-2009).

Further implications from a pragmatic randomized clinical trial of gestational diabetes screening: per-protocol and as-treated estimates.

Objective:: In a recently published pragmatic clinical trial we found significantly higher incidence of diagnosed GDM but no significant differences in primary perinatal outcomes with 1-step versus 2-step gestational diabetes (GDM) screening. The published inverse probability weighted intent-to-treat (IPW-ITT) analyses provide the most robust and unbiased test of potential differences between the two methods, as they adjust for lower adherence to the 1-step method. Our objective here is to newly report the results of per-protocol (PP) and as-treated (AT) analyses to further inform future study designs, meta-analyses, and clinical practice and address questions raised by our recently published trial.

Vitamin D deficiency and insufficiency in Hawaii: Levels and sources of serum vitamin D in older adults.

Objective: To examine the major sources of vitamin D [25-hydroxyvitamin D (25(OH)D)] and evaluate their collective role on rates of vitamin D deficiency/insufficiency among older adults.

Methods: Cross-sectional analysis of the relationship between serum 25(OH)D levels and sources of vitamin D (self-reported and objectively validated sun exposure, supplementation, food including fortified sources). Study subjects were part of the Hawaii Longitudinal Study of Personality and Health who completed a clinic visit between 55 and 65 years (M = 59.

A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening.

Background: Gestational diabetes mellitus is common and is associated with an increased risk of adverse maternal and perinatal outcomes. Although experts recommend universal screening for gestational diabetes, consensus is lacking about which of two recommended screening approaches should be used.

Methods: We performed a pragmatic, randomized trial comparing one-step screening (i.

Timing of Gestational Diabetes Diagnosis by Maternal Obesity Status: Impact on Gestational Weight Gain in a Diverse Population.

We hypothesized that earlier gestational diabetes mellitus (GDM) diagnosis and treatment of high-risk women would reduce gestational weight gain (GWG) in the first trimester and overall. We evaluated timing of GDM diagnosis among 5,391 pregnant women who delivered singleton births 2010-2013 in a large diverse health maintenance organization (HMO). All GDM screening was by the same oral glucose tolerance testing protocol; GDM treatment protocols were also consistent irrespective of timing of diagnosis.

A randomized pragmatic clinical trial of gestational diabetes screening (ScreenR2GDM): Study design, baseline characteristics, and protocol adherence.

Background: ScreenR2GDM is a pragmatic randomized clinical trial designed to investigate if one of two gestational diabetes (GDM) screening and treatment protocols results in improved outcomes in the context of standard clinical care.

Methods: Pregnant women are randomized to one of two GDM screening strategies: 1-step: 2-h, 75 g, oral glucose tolerance test (OGTT) or 2-step: 1-h, 50 g glucose challenge test (GCT) followed by 3-h, 100 g OGTT if GCT-positive. Providers are prompted within the electronic medical record to order the assigned test but were given the option to order the alternate test.

Long-Term Weight Trajectory and Risk of Hip Fracture, Falls, Impaired Physical Function, and Death.

Objectives: To determine the association between weight trajectory, health status, and mortality in older women.

Design: Cohort study.

Setting: Study of Osteoporotic Fractures.

Glycated Peptide Levels Are Associated With Cognitive Decline Among Nondiabetic Older Women.

Background: The association between diabetes and dementia may be explained in part by elevated levels of glycated peptides; we sought to determine whether serum-glycated peptides predicted cognitive decline in nondiabetic older adults.

Methods: We prospectively studied 525 community-dwelling nondiabetic women, mean age of 82 years, and analyzed baseline glycated peptides (serum level of fructosamine and glycated albumin). Cognitive outcomes included 5-year decline on the short Mini-Mental State Examination (sMMSE), Trails B, and performance on a battery of five other cognitive tests at the follow-up visit.

Frailty Phenotype and Healthcare Costs and Utilization in Older Women.

Objectives: To determine the association of the frailty phenotype with subsequent healthcare costs and utilization.

Design: Prospective cohort study (Study of Osteoporotic Fractures (SOF)).

Setting: Four U.

Associations of Smoking, Moderate Alcohol Use, and Function: A 20-Year Cohort Study of Older Women.

The objective of this study is to determine whether the health effects of smoking and moderate alcohol use persist with aging. Smoking status, alcohol use, and measures of function and health were obtained from 9,704 women aged ≥65 years at baseline and over 10- and 20-year follow-up periods. Adjusted multiple linear and logistic regression and Cox proportional hazard models estimated associations.

The Ability of a Single BMD and Fracture History Assessment to Predict Fracture Over 25 Years in Postmenopausal Women: The Study of Osteoporotic Fractures.

The ability of bone mineral density (BMD) and other risk factors to predict fracture risk is well-established for as long as 5 to 10 years. However, their value to predict risk over a longer term has not been directly studied. We investigated whether a single assessment of femoral neck BMD and fracture history can predict fracture risk over 20 to 25 years.

Sleep Disturbances and Risk of Hospitalization and Inpatient Days Among Older Women.

Study Objectives: Determine the associations of sleep disturbances with hospitalization risk among older women.

Methods: One thousand eight hundred and twenty-seven women (mean age 83.6 years) participating in Study of Osteoporotic Fractures Year 16 (Y16) examination (2002-2004) linked with Medicare and/or HMO claims.

Weight Trajectory over 20 Years and Likelihood of Mild Cognitive Impairment or Dementia Among Older Women.

Objectives: The association between weight change and cognition is controversial. We examined the association between 20-year weight change and cognitive function in late life.

Design: Cohort study.

Impact of Maternal Glucose and Gestational Weight Gain on Child Obesity over the First Decade of Life in Normal Birth Weight Infants.

Objective To determine, among children with normal birth weight, if maternal hyperglycemia and weight gain independently increase childhood obesity risk in a very large diverse population. Methods Study population was 24,141 individuals (mothers and their normal birth weight offspring, born 1995-2003) among a diverse population with universal GDM screening [50-g glucose-challenge test (GCT); 3 h. 100 g oral glucose tolerance test (OGTT) if GCT+].

Impact of radiographic vertebral fractures on inpatient healthcare utilization in older women.

Background: Vertebral fractures (VFx) are the most common osteoporotic fracture and are associated with higher risk of impaired function, additional fractures and death. The purpose of this analysis was to test the hypotheses that VFx are also associated with greater inpatient healthcare utilization.

Methods: We studied 4709 Caucasian women enrolled in the Study of Osteoporotic Fractures (SOF) and merged SOF cohort data with Medicare claims or Kaiser encounter data.

Lifetime trauma, personality traits, and health: A pathway to midlife health status.

Objective: This study investigated whether lifetime experience of trauma is related to personality through instrumental and reactive trait processes, and whether lifetime trauma is a mechanism underlying the association between childhood conscientiousness and objectively assessed adult physical health.

Method: Participants (N = 831) were 442 women and 389 men from the Hawaii longitudinal study of personality and health. Teacher assessments of personality were obtained when the participants were in elementary school.

Measures of Sleep-Wake Patterns and Risk of Mild Cognitive Impairment or Dementia in Older Women.

Objective: Sleep disturbances are common in older adults. Little is known about the sleep of cognitively intact older adults and its relationship to subsequent cognitive impairment. The objective of this study was to examine the association between objective sleep-wake measures and risk of incident cognitive impairment.

Effects of Mobility and Cognition on Hospitalization and Inpatient Days in Women in Late Life.

Background: This study examines effects of mobility and cognition on hospitalization and inpatient days among women late in life.

Methods: Prospective study of 663 women (mean age 87.7 years) participating in the Study of Osteoporotic Fractures Year 20 examination (2006-2008) linked with their inpatient claims data.

Cystatin C and Objectively Measured Mobility 10 Years Later in Older Women.

Background: Serum biomarkers predicting physical performance in late life are uncertain. We tested the hypotheses that lower serum cystatin C (cysC) in older women is associated with good mobility 10 years later.

Methods: We conducted a longitudinal analysis of a prospective cohort of 1,384 women attending Year 10 and Year 20 examinations of the Study of Osteoporotic Fractures.