Evidence mapPaperPMID 36150365Full record

Trial reportJournal of diabetes and its complications2022

The obesity paradox: Retinopathy, obesity, and circulating risk markers in youth with type 2 diabetes in the TODAY Study.

Lynne L Levitsky, Kimberly L Drews, Morey Haymond, Rose A Glubitosi-Klug, Lorraine E Levitt Katz, Mihai Mititelu, William Tamborlane, Jeanie B Tryggestad, Ruth S Weinstock, TODAY Study Group

Open access · hybridAbstract readRandomized Controlled TrialClinical Trial, Phase III
In one paragraph

Trial report in Journal of diabetes and its complications, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 9 institutions in 1 country.

Lynne L LevitskyMassachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
Kimberly L DrewsGeorge Washington University Biostatistics Center, 6110 Executive Blvd., Rockville, MD 20852, United States of America. Electronic address: kdrews@bsc.gwu.edu.
Morey HaymondBaylor College of Medicine, 6701 Fannin St, Houston, TX 77030, United States of America.
Rose A Glubitosi-KlugRainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, 1100 Euclid Ave, Cleveland, OH 44106, United States of America.
Lorraine E Levitt KatzChildren's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19107, United States of America.
Mihai MititeluUniversity of Wisconsin, Department of Ophthalmology and Visual Sciences, 2870 University Avenue, Suite 206, Madison, WI 53705, United States of America.
William TamborlaneYale University, 1 Long Wharf Drive, New Haven, CT 06511, United States of America.
Jeanie B TryggestadUniveristy of Oklahoma Health Sciences Center, 1200 Children's Ave, Oklahoma, OK 73104, United States of America.
Ruth S WeinstockSUNY Upstate Medical University, 3229 E Genesee St, Syracuse, NY 13214, United States of America.
TODAY Study Group
Baylor College of Medicine · USCase Western Reserve University · USChildren's Hospital of Philadelphia · USGeorge Washington University · USMassachusetts General Hospital · USSUNY Upstate Medical University · USUniversity of Oklahoma Health Sciences Center · USUniversity of Wisconsin–Madison · USYale University · US

Funding

Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) StudyU01DK061230 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI BRAFFETT, BARBARA HALINA, ZEITLER, PHILIP S. · 2001 to 2019
$231.8M
University of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3M
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
ZOPOLRESTAT IN NORMOTENSIVE, TYPE 1 DIA WITH INCIPIENT NEPHROPATHYM01RR000043 · NCRR · UNIVERSITY OF SOUTHERN CALIFORNIA · PI ZAIA, JOHN A · 1985 to 2010
$76.4M
NIH Prior Approval Process ProfessionalUL1TR002535 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2018 to 2022
$51.1M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
ZD6416 Analgesic--Painful Distal Symmetrical PolyneuropaM01RR001066 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI SMITH, MATTHEW RAYMOND · 1985 to 2008
$37.4M
Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
YOGA FOR THE MANAGEMENT OF HIV-METABOLIC SYNDROMESM01RR000036 · NCRR · WASHINGTON UNIVERSITY · PI SHAPIRO, LARRY J · 1985 to 2007
$25.4M
ZIPRASIDONE IN TOURETTES SYNDROME, OBSESSIVE COMPULSIVE &PERVASIVE DEV. DISORDERM01RR000125 · NCRR · YALE UNIVERSITY · PI ALPERN, ROBERT J · 1985 to 2006
$24.1M
NCATS NIH HHS UL1 TR000003NCATS NIH HHS UL1 TR001857NCATS NIH HHS UL1 TR001863NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1 TR002535NCATS NIH HHS UL1 TR002541NCATS NIH HHS UL1 TR002548NCRR NIH HHS M01 RR000036NCRR NIH HHS M01 RR000043NCRR NIH HHS M01 RR000069NCRR NIH HHS M01 RR000084NCRR NIH HHS M01 RR000125NCRR NIH HHS M01 RR001066NCRR NIH HHS M01 RR014467NIDDK NIH HHS U01 DK061212NIDDK NIH HHS U01 DK061230NIDDK NIH HHS U01 DK061239NIDDK NIH HHS U01 DK061242NIDDK NIH HHS U01 DK061254
6 · The paper itself

Abstract

aimTo understand the relationship of obesity and 27 circulating inflammatory biomarkers to the prevalence of non-proliferative diabetic retinopathy (NPDR) in youth with type 2 diabetes.

methodsYouth with type 2 diabetes who participated in the TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) study were followed for 2-6.5 years. Digital fundus photographs were obtained in the last year of the study. Blood samples during the study were processed for inflammatory biomarkers, and these were correlated with obesity tertiles and presence of retinopathy.

resultsHigher BMI was associated with an increase in circulating levels of metabolic biomarkers including high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), fibrinogen, LDL-cholesterol (LDL-C) and Apolipoprotein B (ApoB), tumor necrosis factor receptors 1 and 2 (TNFR-1 and -2), interleukin 6 (IL-6), E-selectin, and homocysteine, as well as a decrease in the metabolic risk markers HDL-cholesterol (HDLC), and insulin-like growth factor binding protein 1 (IGFBP-1). Although NPDR risk decreased with increasing obesity, it was not associated with any of the measured biomarkers.

conclusionsCirculating levels of measured biomarkers did not elucidate the "obesity paradox" of decreased NPDR in the most obese participants in the TODAY study.

trial registrationclinicaltrials.govNCT00081328.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyAdolescentBiomarkersCholesterol, LDLHumansObesityBiomarkersCholesterol, LDLBiomarkersObesityObesity paradoxRetinopathyType 2 diabetesYouth

Identifiers

PMID36150365
PMCPMC12396272
OpenAlexW4286251176

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.