Individuals with type 2 diabetes who are normal weight (body mass index <25) might be considered “metabolically obese.” The association of the metabolically obese normal-weight phenotype with mortality is unclear. In an analysis of data from 5 longitudinal cohort studies, Carnethon and colleagues identified 2625 patients with incident diabetes. During 27 125 person-years of follow-up, the authors found that compared with patients who were overweight or obese at the time of diabetes diagnosis, those who were normal weight had higher rates of total, cardiovascular, and noncardiovascular mortality. In an editorial, Florez and Castillo-Florez discuss the associations of cardiorespiratory fitness and fatness with mortality.
Kit and colleagues examined trends in lipid concentrations among 16 116 youths aged 6 to 19 years who participated in the cross-sectional and nationally representative National Health and Nutrition Examination Survey during 3 periods: 1988-1994, 1999-2000, and 2007-2010. Among the authors' findings were that mean total cholesterol and prevalence of elevated total cholesterol decreased between 1988-1994 and 2007-2010; however, almost 1 in 10 youths had elevated total cholesterol in 2007-2010. In an editorial, de Ferranti discusses factors that may be contributing to improved lipid levels among youths.
In an analysis of data from the National HIV Surveillance System—representing 46 US states and 5 US territories—Prosser and colleagues found that among those who were diagnosed as having HIV from 2007 through 2010, 16.2% were born outside the United States. Compared with US-born persons diagnosed as having HIV, persons born outside the United States were more likely to be Hispanic or Asian and to have acquired HIV through heterosexual transmission. In an editorial, Katz discusses HIV infection among persons born outside the United States.
Optimal management of nonalcoholic fatty liver disease (NAFLD)—a common cause of chronic liver disease in the United States—is uncertain. Afdhal uses the case of Mr T, a 60-year-old man with obesity, diabetes mellitus, and chronically increased serum transaminase levels, to discuss an evidence-based approach to diagnosis and treatment of NAFLD. The roles of liver biopsy, lifestyle modification, and pharmacological therapy are considered.
A term newborn—whose parents are of Hispanic descent and have dark skin and black hair—has abnormally light skin and silvery gray hair. Their first child had similar hair and died at age 3 months. What would you do next?
Arguing that few stem cell therapies are ready for clinical use, some researchers are skeptical about a plan to offer accreditation to clinics that offer stem cell–based treatments for a range of conditions.
Supreme Court ruling on the Affordable Care Act
Transcatheter aortic valve replacement
Potential studies and observational data registration
Payment reform for primary care
“Despite their stark differences, the VIP and UIP are both integral to medical education. They disrupt our sense of a just health care system.” From “VIP and UIP.”
Dr Bauchner summarizes and comments on this week's issue. Go to http://jama.jamanetwork.com/multimedia.aspx#Weekly
Join Melanie A. Thompson, MD, and Paul A. Volberding, MD, Wednesday, August 15, from 2 to 3 PM eastern time to discuss updated recommendations for treatment of HIV infection. To register, go to http://www.ihi.org/AuthorintheRoom.
For your patients: Information about dry eye.
Theme Issue on Violence/Human Rights
This Week in JAMA. JAMA. 2012;308(6):541. doi:10.1001/jama.2012.3138