ContextThe association of obesity with development of type 2 diabetes may be partly mediated by altered secretion of adipokines by adipose tissue. Greater adiposity downregulates secretion of adiponectin, an adipokine with anti-inflammatory and insulinsensitizing properties. The strength and consistency of the relation between plasma adiponectin and risk of type 2 diabetes is unclear.Objective To systematically review prospective studies of the association of plasma adiponectin levels and risk of type 2 diabetes. Data Sources A systematic search of the MEDLINE, EMBASE, and Science CitationIndex Expanded databases using adiponectin and diabetes and various synonyms and reference lists of retrieved articles up to April 10, 2009. Study SelectionWe included prospective studies with plasma adiponectin levels as the exposure and incidence of type 2 diabetes as the outcome variable.Data Extraction Two reviewers independently extracted data and assessed study quality. Generalized least-squares trend estimation was used to assess dose-response relationships. Pooled relative risks and 95% confidence intervals were calculated using random-effects models to incorporate between-study variation. ResultsThirteen prospective studies with a total of 14 598 participants and 2623 incident cases of type 2 diabetes were included in the meta-analysis. Higher adiponectin levels were monotonically associated with a lower risk of type 2 diabetes. The relative risk of type 2 diabetes was 0.72 (95% confidence interval, 0.67-0.78) per 1-log µg/mL increment in adiponectin levels. This inverse association was consistently observed in whites, East Asians, Asian Indians, African Americans, and Native Americans and did not differ by adiponectin assay, method of diabetes ascertainment, duration of follow-up, or proportion of women. The estimated absolute risk difference (cases per 1000 person-years) per 1-log µg/mL increment in adiponectin levels was 3.9 for elderly Americans and 30.8 for Americans with impaired glucose tolerance.Conclusion Higher adiponectin levels are associated with a lower risk of type 2 diabetes across diverse populations, consistent with a dose-response relationship.

Longitudinal designs, with careful control for prior exposures, outcomes, and confounders, and suitable methodology, will strengthen research on mental health, religion and health, and in the biomedical and social sciences generally.

In this cohort of US women, frequent religious service attendance was associated with a significantly lower rate of suicide.

OBJECTIVELow-carbohydrate diets (LCDs) may improve short-term glycemic control in patients with gestational diabetes mellitus (GDM), but the long-term effect on progression from GDM to type 2 diabetes mellitus (T2DM) is unknown. We aimed to examine the long-term risk of T2DM in association with a low-carbohydrate dietary pattern among women with a history of GDM.RESEARCH DESIGN AND METHODSOverall, 4,502 women with a history of GDM from the Nurses' Health Study II (NHSII) cohort, as part of the Diabetes & Women’s Health (DWH) study, were followed up from 1991 to 2011. Overall, animal, or vegetable LCD scores, which represent adherence to different low-carbohydrate dietary patterns, were calculated using diet intake information assessed every 4 years since 1991 by validated food-frequency questionnaires. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs.RESULTSWe documented 722 incident cases of T2DM during 68,897 person-years of observation. The multivariable-adjusted HRs (95% CIs) of T2DM, comparing the highest with lowest quintiles, were 1.36 (1.04–1.78) for overall LCD score (P = 0.003 for trend), 1.40 (1.06–1.84) for animal LCD score (P = 0.004 for trend), and 1.19 (0.91–1.55) for vegetable LCD score (P = 0.50 for trend).CONCLUSIONSAmong women with a history of GDM, a low-carbohydrate dietary pattern, particularly with high protein and fat intake mainly from animal-source foods, is associated with higher T2DM risk, whereas a low-carbohydrate dietary pattern with high protein and fat intake from plant-source foods is not significantly associated with risk of T2DM.