Evidence map›Paper›PMID 38402400›Full record

ArticleCardiovascular diabetology2024

Intensive lifestyle intervention in type 2 diabetes and risk of incident coronary artery disease for the common haptoglobin phenotypes: the Look AHEAD study.

Rachel A Warren, Michael P Bancks, Allie S Carew, Andrew P Levy, John Sapp, Judy Bahnson, Cora E Lewis, Eric B Rimm, Mark A Espeland, Leah E Cahill

Open access · goldAbstract read
In one paragraph

Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 18% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Trial
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 6 institutions in 3 countries.

Rachel A WarrenDepartment of Medicine, Dalhousie University, Halifax, Canada.
Michael P BancksDepartment of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, USA.
Allie S CarewDepartment of Medicine, Dalhousie University, Halifax, Canada.
Andrew P LevyRappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
John SappDepartment of Medicine, Dalhousie University, Halifax, Canada.
Judy BahnsonDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA.
Cora E LewisDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
Eric B RimmDepartment of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA.
Mark A EspelandDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA.
Leah E CahillDepartment of Medicine, Dalhousie University, Halifax, Canada. leah.cahill@dal.ca.
Nova Scotia Health Authority · CAWake Forest University · USDalhousie University · CAHarvard University · USTechnion – Israel Institute of Technology · ILUniversity of Alabama at Birmingham · US

Funding

Look AHEAD: Action for Health in DiabetesU01DK057136 · NIDDK · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ESPELAND, MARK ANDREW, WAGENKNECHT, LYNNE E · 1999 to 2020
$54.9M
Wake Forest University School of Medicine Alzheimer's Disease Research CenterP30AG072947 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SUZANNE CRAFT · 2021 to 2026
$24.3M
NIA NIH HHS P30 AG072947NIDDK NIH HHS DK057136NIDDK NIH HHS U01 DK057136
6 · The paper itself

Abstract

backgroundIntensive glycemic control reduced coronary artery disease (CAD) events among the Action to Control Cardiovascular Disease Risk in Diabetes (ACCORD) participants with the haptoglobin (Hp) 2-2 phenotype only. It remains unknown whether Hp phenotype modifies the effect of an intensive lifestyle intervention (ILI) on CAD in type 2 diabetes.

methodsHaptoglobin phenotype was measured in 4542 samples from the Action for Health in Diabetes (Look AHEAD) study. Cox regression models assessed the effect of ILI (focused on weight loss from caloric restriction and physical activity) versus diabetes support and education (DSE) on CAD events in each phenotype group, and within pre-specified subgroups including race/ethnicity, sex, history of cardiovascular disease, diabetes medication use, and diabetes duration.

results1590 (35%) participants had the Hp2-2 phenotype. The ILI did not lower glycated hemoglobin (%HbA1c) to < 6.5% in either phenotype, with a peak significant difference between treatment arms of 0.5% [non-Hp2-2] and 0.6% [Hp2-2]. The cumulative CAD incidence was 13.4% and 13.8% in the DSE arm and 12.2% and 13.6% in the ILI arm for non-Hp2-2 and Hp2-2 groups, respectively. Compared to DSE, the ILI was not associated with CAD among participants without (HR = 0.95, 95% CI 0.78-1.17) or with (0.89, 0.68-1.19) the Hp2-2 phenotype (p-interaction between Hp phenotype and ILI = 0.58). After Bonferroni correction, there were no significant results among any subgroups.

conclusionsHp phenotype did not modify the effect of the weight loss ILI on risk of CAD in Look AHEAD, potentially because it did not substantially impact glycemic control among participants with or without the Hp2-2 phenotype. Further research is needed to determine if these results are conclusive.

Indexed as

Cardiovascular DiseasesCoronary Artery DiseaseDiabetes Mellitus, Type 2HaptoglobinsHumansLife StylePhenotypeWeight LossHaptoglobinsCoronary artery diseaseEpidemiologyGenetic associationGlycated hemoglobinHaptoglobin phenotypeType 2 diabetes mellitus

Identifiers

PMID38402400
PMCPMC10894470
OpenAlexW4392138636

What OpenQuestion holds

Textmetadata
LicenceCC BY
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 OpenQuestion graph.