Alexandra Kautzky-Willer

• Prof. Dr.
• Head of Department at Medical University of Vienna

Recent studies have shown higher levels of CTRP-1 (C1QTNF-related protein) in patients with type 2 diabetes compared to controls. We aimed at investigating CTRP-1 in gestational diabetes mellitus (GDM). CTRP-1 levels were investigated in 167 women (93 with normal glucose tolerance (NGT), 74 GDM) of a high-risk population for GDM. GDM was further di...

Purpose of Review This narrative review makes the case for greater efforts to reduce cardiovascular disease (CVD) risk in women with diabetes. Recent Findings In a recent meta-analysis including five CVOTs of diabetes medications with 46,606 subjects, women (vs men) with type 2 diabetes had a higher relative risk for stroke (RR 1.28; 95% CI 1.09,...

ContextA substantial number of patients undergoing bariatric surgery are prescribed psychopharmacological medication. However, the impact of concomitant psychopharmacological medication on the frequency of relevant vitamin deficiencies in postoperative follow-up is not known.Methods Five hundred twenty-four patients with obesity who underwent baria...

Background In severe obesity, hypogonadism in men and androgen excess in women are frequently observed. Sex hormones play an important role in body composition and glucose and lipid metabolism. However, whether pre-operative gonadal dysfunction impacts weight loss after bariatric surgery is not fully known.MethodsA total of 49 men and 104 women wer...

Objective: Transformation of white into brown fat ("browning") reduces obesity in many preclinical models and holds great promise as therapeutic concept in metabolic disease. Vitamin A metabolites (retinoids) have been linked to thermogenic programming of adipose tissue, however the physiologic importance of systemic retinoid transport for adipose...

Studies conflict concerning the use of enzyme immunoassays (EIA) for plasma free metanephrines (P-MNs) vs. other methods for pheochromocytoma/paraganglioma (PPGL) diagnosis. We compared commercially available EIAs for P-MNs with high-pressure liquid chromatography (HPLC) for 24 h-urinary MNs (U-MNs) and -catecholamines (U-CATs). 943 (565 female, 37...

Context: Thyroid function is clinically evaluated by determination of circulating concentrations of TSH and fT4. However, a tissue-specific effector substrate of thyroid function is lacking. Energy-rich phosphorus-containing metabolites (PM) and phospholipids (PL) might be affected by thyroid hormone action and can be non-invasively measured by 31...

Objectives: Aim of this study was to examine trends over time in smoking status in men and women, and in subgroups, in Austria, a country with poor smoking regulation policies. Design and participants: Two cross-sectional surveys (Austrian Health Interview Surveys for 2007 and 2014), each with more than 15 000 participants from the general popul...

Betatrophin is a liver and adipose tissue-derived protein which has recently been linked to glucose metabolism. So far, no data exist about the role of betatrophin in pregnant women with a history of Roux-En-Y gastric bypass (RYGB) operation with a high risk of postprandial hypoglycaemia. In this prospective clinical study, an oral glucose toleranc...

Objective Acetylcarnitine plays an important role in fat metabolism and can be detected in proton magnetic resonance spectra in skeletal muscle. An inverse relationship of acetylcarnitine to intramyocellular lipids and metabolic markers of chronic hyperglycemia has been suggested. This study aimed to compare the acetylcarnitine concentrations and i...

Aims To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women. Methods Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012–2015). Pregnant women (BMI ≥ 29kg/m²)...

Secretagogin (SCGN) is a calcium binding protein related to insulin release in the pancreas. Although SCGN is not co-released with insulin, plasma concentrations have been found to be increased in type 2 diabetes mellitus patients. Until now, no study on SCGN levels in pregnancy or patients with gestational diabetes mellitus (GDM) has been publishe...

Motivation und Ziele Ziel dieses Projekts ist die Beschreibung der regionalen Variabilität und der zeitlichen Veränderung der Prävalenz und Inzidenz von Diabetes Mellitus Typ 2 (DM2) in Österreich mit Hilfe von Abrechnungsdaten aus den Jahren 2012 bis 2017. Die geographische Auflösung auf der Ebene von politischen Bezirken sowie detaillierte Versc...

The original version of this review article unfortunately contained a mistake.

Background Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, patients suffering from primary adrenal insufficiency (AI) have an increased mortality, mainly due to cardiovascular diseases. Only little knowledge exists on the contribution of MC substitution to the cardiovascular risk. Therefore, this study investiga...

This position paper provides a comprehensive orientation for dealing with and the care of children and adolescents with diabetes in schools, in order to compensate the existing deficits in information and to increase awareness for this problematic topic. The increasing number of schoolchildren with diabetes and the longer duration of time spent in...

Introduction Secretagogin (SCGN) is a calcium binding protein related to insulin release in the pancreas. Although SCGN is not co-released with insulin, plasma concentrations have been found to be increased in type 2 diabetes mellitus patients.1,2,3 Up to this day, no study on SCGN levels in patients with gestational diabetes mellitus (GDM) has bee...

Background: Sex hormones are believed to play an important role in development and progression of cardiovascular disease. However, the gender gap in onset and mortality is not yet completely understood. Transsexuals undergoing hormone therapy are a promising collective for analysing the effects of sex hormones on cardiometabolic disease. Methods: A...

Introduction Cushing’s syndrome is associated with significant chronic and acute comorbidities including acute thromboembolic and cardiovascular events. To date, there are no data on the prevalence and predictors of acute and perioperative complications in patients with active Cushing’s syndrome. Methods In a single-center cohort analysis we evalua...

Background Patients with active acromegaly exhibit low hepatocellular lipid content (HCL) despite pronounced insulin resistance. This contrasts the strong association of insulin resistance with non-alcoholic fatty liver disease in the general population. Acromegaly may therefore help to elucidate antisteatotic pathways. Since low HCL in acromegaly...

Background Accumulating evidence links brown adipose tissue (BAT) to increased cold-induced energy expenditure (CIEE) and regulation of lipid metabolism in humans. BAT has also been proposed as a novel source for biologically active lipid mediators including polyunsaturated fatty acids (PUFAs) and oxylipins. However, little is known about cold-medi...

Introduction: Both diabetes mellitus and being female significantly increase the risk of being diagnosed with major depressive disorder (MDD). The diagnosis of MDD, combined with diabetes mellitus, can be detrimental in terms of mortality and morbidity. We aimed at investigating the impact of diabetes mellitus on the gender gap in MDD over the cou...

Background and Aims Insulin clearance is a relevant process in glucose homeostasis. In this observational study, we aimed to assess insulin clearance (ClINS) in women with former gestational diabetes (fGDM) both early after delivery and after a follow-up. Methods and Results We analysed 59 fGDM women, and 16 women not developing GDM (CNT). All wom...

Background Although previous studies evaluated the association of maternal health parameters with neonatal adiposity, little is known regarding the complexity of the relationships among different maternal health parameters throughout pregnancy and its impact on neonatal adiposity. Objectives To evaluate the direct and indirect associations between...

Patients with active acromegaly (ACRO) exhibit low hepatocellular lipids (HCL), despite pronounced insulin resistance (IR). This contrasts the strong association of IR with nonalcoholic fatty liver disease in the general population. Since low HCL levels in ACRO might be caused by changes in oxidative substrate metabolism, we investigated mitochondr...

Background: Multimorbidity, the co-occurrence of two or more diseases in one patient, is a frequent phenomenon. Understanding how different diseases condition each other over the lifetime of a patient could significantly contribute to personalised prevention efforts. However, most of our current knowledge on the long-term development of the health...

Objectives To investigate the importance of time in pregnancy and neonatal sex on the association between maternal metabolic parameters and neonatal sum of skinfolds. Methods This was a longitudinal, secondary analysis of the vitamin D and lifestyle intervention for gestational diabetes mellitus study, conducted in nine European countries during 2...

Introduction Inhibitors of sodium-glucose linked transporter-2 (SGLT2i) are enhancing glucose excretion in the proximal renal tubules, and thus are increasingly used to lower blood glucose levels in patients with type 2 diabetes mellitus (T2DM). The glucose analog 2-deoxy-2-(¹⁸F) fluoro-D-glucose (FDG) can be used to quantify renal function in vivo...

Transformation of white into brown fat ("browning") reduces obesity in many preclinical models and holds great promise as therapeutic concept in metabolic disease. Vitamin A metabolites (retinoids) have been linked to thermogenic programming of adipose tissue (AT), however the physiologic importance of systemic retinoid metabolism for AT browning a...

BACKGROUND The health state of elderly patients is typically characterized by multiple cooccurring diseases requiring the involvement of several types of healthcare provider. OBJECTIVE We aim to quantify how multimorbid patients benefit from seeking specialist care in terms of long-term readmission risks. METHODS From an administrative database w...

Background: The health state of elderly patients is typically characterized by multiple co-occurring diseases requiring the involvement of several types of health care providers. Objective: We aimed to quantify the benefit for multimorbid patients from seeking specialist care in terms of long-term readmission risks. Methods: From an administra...

We have read with great interest the accepted manuscript of the meta-analysis performed by Huang, et al. titled “A functional polymorphism rs10830963 in melatonin receptor 1B associated with the risk of gestational diabetes mellitus” published online in the 2019 December 6 issue of Bioscience Reports (https://doi.org/10.1042/BSR20190744). We do agr...

Background: Based on biological and behavioural diversity sex and gender may affect co-morbidities associated with prediabetes and diabetes. Besides evaluating the prevalence of prediabetes and diabetes (using fasting plasma glucose and HbA1c levels), the primary aim of the study is to investigate sex and gender differences in the prevalence of co...

Introduction: Bariatric surgery confers a high risk for nutritional deficiencies that could affect physiologic adaptation of lipids during pregnancy. We aimed to evaluate differences in serum lipids in pregnant women after bariatric surgery compared to obese and lean mothers. Methods: 25 women with a history of Roux-en-Y gastric bypass (RYGB), 1...

Background: This study aimed to design a simple surrogate marker (i.e., predictor) of the minimal model glucose effectiveness (SG), namely calculated SG (CSG), from a short insulin-modified intravenous glucose tolerance test (IM-IVGTT), and then to apply it to study women with previous gestational diabetes mellitus (pGDM). Methods: CSG was desig...

Circulating concentrations of insulin are determined by a balance between the secretion rate of insulin from pancreatic beta-cells and insulin degradation (“clearance”). However, limited attention has been devoted to the study of insulin clearance in women with former gestational diabetes mellitus (GDM), which are known to be at increased type 2 di...

Women with a previous history of gestational diabetes mellitus (GDM) have increased risk of developing GDM in future pregnancies (i.e. recurrent GDM) and also Type 2 Diabetes (T2D). Insulin clearance represents one of the processes regulating glucose tolerance but has been scarcely investigated for its possible impairment in high-risk subjects. The...

While there is considerable evidence about sex-related differences between men and women in drug metabolism, efficacy and safety of frequently prescribed drugs such as analgesics, tranquillizers, statins and beta-blockers, clinicians’ awareness of the implications on dosing and adverse event monitoring in routine practice is inadequate. Some drugs...

Purpose of Review The DALI (vitamin D and lifestyle intervention in the prevention of gestational diabetes mellitus (GDM)) study aimed to prevent GDM with lifestyle interventions or Vitamin D supplementation (1600 IU/day). This review summarizes the learnings from the DALI studies among pregnant women with a BMI ≥ 29 kg/m². Recent Findings Women d...

Background: Increased fructose intake has been associated with metabolic consequences such as impaired hepatic lipid metabolism and development of nonalcoholic fatty liver disease (NAFLD). Objectives: The aim of this study was to investigate the role of fructose in glucose and lipid metabolism in the liver, heart, skeletal muscle, and adipose ti...

Zusammenfassung Dieses Positionspapier gibt eine umfassende Orientierung im Umgang und in der Betreuung von Kindern und Jugendlichen mit Diabetes in Schulen, um bestehende Informationsdefizite zu kompensieren und das Problembewusstsein für die Thematik zu erhöhen. Die steigende Zahl an Schulkindern mit Diabetes sowie die längere Aufenthaltsdauer in...

Background: Quality of life is becoming an important health outcome and among the main goals of every healthcare intervention. This study aims to assess the reliability of the German version of the World Health Organization Quality of Life-BREF instrument (WHOQOL-BREF) among Austrian patients with diabetes and examine the correlation to glycated h...

Background Assessing the quality of life (QOL) for patients with type 2 diabetes is an essential part of diabetes management, especially for the evaluation of new antidiabetic treatments and glucose monitoring technologies. Accordingly, the aim of this study was to assess QOL according to treatment types. Methods This cross-sectional study include...

Zusammenfassung Erhöhter Blutdruck bleibt eine Hauptursache von kardiovaskulären Erkrankungen, Behinderung und frühzeitiger Sterblichkeit in Österreich, wobei die Raten an Diagnose, Behandlung und Kontrolle auch in rezenten Studien suboptimal sind. Das Management von Bluthochdruck ist eine häufige Herausforderung für Ärztinnen und Ärzte vieler Fach...

Objective Whether HMG-CoA-reductase inhibition, the main mechanism of statins, plays a role in the pathogenesis of osteoporosis, is not entirely known so far. Consequently, this study was set out to investigate the relationship of different kinds and dosages of statins with osteoporosis, hypothesising that the inhibition of the synthesis of cholest...

Sex differences may assume a key role in condition of impaired glucose metabolism and progression to type 2 diabetes, affecting insulin-dependent processes. However, the presence of sex differences in non-insulin-dependent processes (i.e. glucose effectiveness) has been scarcely investigated. The aim of this study was to detect the presence of sex...

Multimorbidity, the co-occurrence of two or more chronic diseases such as diabetes, obesity or cardiovascular diseases in one patient, is a frequent phenomenon. To make care more efficient, it is of relevance to understand how different diseases condition each other over the life time of a patient. However, most of our current knowledge on such pat...

Background: Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore, we assessed whether renin concentrations during routine GC and MC substitution thera...

Background: Depending on CYP21A2 genotype, congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency leads to biochemical alterations (including hyperandrogenism, hypocortisolism, and hypoaldosteronism) and a wide spectrum of phenotypic disease manifestation. The latter include life-threatening salt-wasting crises, prenatal virilizatio...

OBJECTIVE: In our randomized controlled trial, we investigated the impact of healthy eating (HE) aiming for restricted gestational weight gain (GWG) and physical activity (PA) interventions on maternal and neonatal lipid metabolism. RESEARCH DESIGN AND METHODS: Obese pregnant women (n = 436) were included before 20 weeks' gestation and underwent gl...

Aims/hypothesis Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity. Methods In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DAL...

Background: In patients suffering from primary adrenal insufficiency (AI) mortality is increased despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, mainly due to an increased cardiovascular risk. Since activation of the renin-angiotensin-aldosterone system (RAAS) plays an important role in the modulation of cardiov...

Gestationsdiabetes (GDM) wird als Glukosetoleranzstörung definiert, die erstmals in der Schwangerschaft entdeckt wird. GDM ist mit einer erhöhten fetomaternalen Morbidität sowie Langzeitkomplikationen bei Mutter und Kind assoziiert. Frauen, die die Kriterien eines manifesten Diabetes bereits in der Frühschwangerschaft erfüllen (Nüchternplasmaglukos...

Die Hyperglykämie ist wesentlich an der Entstehung der Spätkomplikationen bei an Diabetes mellitus Typ 2 erkrankten Patienten/Patientinnen beteiligt. Während Lebensstilmaßnahmen die Eckpfeiler jeder Diabetestherapie bleiben, benötigen im Verlauf die meisten Patienten/Patientinnen mit Typ 2 Diabetes eine medikamentöse Therapie. Bei der Definition in...

Metabolische Erkrankungen beeinflussen das Leben von Männern und Frauen in den verschiedenen Lebensabschnitten in unterschiedlicher und vielfältiger Weise und stellen eine große Herausforderung für das Gesundheitssystem dar. Die behandelnden Ärztinnen und Ärzte sind mit den unterschiedlichen Bedürfnissen von Männern und Frauen im klinischen Alltag...

Dieses Positionspapier zur Anwendung der subkutanen Insulinpumpentherapie (CSII) bei Diabetes mellitus basiert auf aktueller Evidenz zu Sicherheit und Vor-und Nachteile der CSII, insbesondere im Hinblick auf glykämische Kontrolle, Hypoglykämie, ketoazidotische Entgleisung, Lebensqualität und Anwendung in der Schwangerschaft. Dieser Artikel beinhalt...

Die Leitlinie nimmt Bezug auf die Diagnostik, einschließlich begleitender Autoimmunerkrankungen, bei Typ 1 Diabetes mellitus, die Insulintherapie und die glykämischen Zielwerte.

Diabetes mellitus ist häufig mit psychischen Erkrankungen assoziiert. Depressive Störungen kommen bei diabetischen PatientInnen doppelt so häufig vor wie in der nicht-diabetischen Population. Andere psychische Erkrankungen, die gehäuft mit Prädiabetes und Diabetes mellitus vorkommen, sind kognitive Dysfunktionen bis zur Demenz, auffälliges Essverha...

Die vorliegende Leitlinie nimmt Bezug auf die Indikation und praktische Umsetzung der Insulintherapie bei Typ 2 Diabetes, insbesondere auch im Hinblick auf die unterschiedlichen Formen der Insulintherapie.

Rezente epidemiologische Untersuchungen zeigen, dass etwa 2–3 % aller Österreicher Diabetes mit Nierenbeteiligung aufweisen. Diese betrifft somit in Österreich etwa 250.000 Menschen. Das Risiko des Auftretens und Fortschreitens der Erkrankung kann durch Lebensstilinterventionen und Optimierung der Einstellung des Blutdrucks, Blutzuckers und speziel...

Es besteht breiter Konsens, dass eine effiziente Diabetes-Therapie in den meisten Fällen auch von einer Modifikation des Lebensstils begleitet sein muss. Das bedeutet für die Patienten in der Regel eine Normalisierung des Körpergewichts (Gewichtsreduktion und/oder Halten des Gewichts) in Kombination mit einer Veränderung des Bewegungs- und Ernährun...

Fragility fractures are increasingly recognized as a complication of both type 1 and type 2 diabetes, with fracture risk that increases with disease duration and poor glycemic control. The identification and management of fracture risk in these patients remains challenging. This manuscript explores the clinical characteristics of bone fragility in...

In 1989 the St. Vincent Declaration aimed to achieve comparable pregnancy outcomes in diabetic and non-diabetic women. However, currently women with pre-gestational diabetes still feature a higher risk of perinatal morbidity and even increased mortality. This fact is mostly ascribed to a persistently low rate of pregnancy planning and pre-pregnancy...

Background & aims: As vitamin D deficiency is associated with an increased risk of gestational diabetes mellitus (GDM), we aimed to test vitamin D supplementation as a strategy to reduce GDM risk (evaluated after fasting plasma glucose (FPG), insulin resistance and weight gain) in pregnant overweight/obese women. Methods: The DALI vitamin D mult...

Background Obesity is known to induce a deterioration of insulin sensitivity (SI), one of the insulin‐dependent components of glucose tolerance. However, few studies investigated whether obesity affects also the insulin‐independent component, i.e. glucose effectiveness (SG). This cross‐sectional study aimed to analyse SG and its components in diffe...

Background: Elevated levels of troponin are associated with future major adverse cardiac events (MACE). Data on the prognostic value of high sensitive troponin T (hs-TnT) compared to high sensitive troponin I (hs-TnI) in diabetic and non-diabetic patients are sparse. Methods: We analyzed patients of a single-center registry undergoing coronary sten...

Objective: Cystic fibrosis–related diabetes (CFRD) is associated with adverse clinical outcomes and should be screened for by an annual oral glucose tolerance test (OGTT). Since pathophysiologic studies have mainly been performed in a pediatric/adolescent, nontransplanted collective, we aimed to assess parameters of insulin secretion and sensitivit...

A better understanding of what drives behaviour change in obese pregnant overweight women is needed to improve the effectiveness of lifestyle interventions in this group at risk for gestational diabetes (GDM). Therefore, we assessed which factors mediated behaviour change in the Vitamin D and Lifestyle Intervention for GDM Prevention (DALI) Lifesty...

Background & aims: Obesity is associated with lower breastfeeding rates. The underlying pathophysiological mechanisms are not well-understood, but there is increasing evidence on an association between parameters of maternal glucose metabolism and prolactin concentrations. In this cross-sectional observational study we investigate the relationship...

A team of experts from the fields of gynaecology and obstetrics, diabetology, internal medicine, paediatrics and midwifery from Germany, Austria and Switzerland produced a new version of the existing S3 guideline on gestational diabetes. It replaces the recommendations of the German Association for Gynaecology and Obstetrics and the German Diabetes...

The rs10830963 variant of the Melatonin Receptor 1B (MTNR1B) gene is associated with the development of gestational diabetes mellitus (GDM). We hypothesized that carrying the rs10830963/G risk allele had effect on antenatal insulin therapy (AIT) initiation in GDM in a body mass index (BMI)-dependent manner. Design: In this post hoc analysis the MTN...

Background: Despite a higher prevalence of chronic kidney disease among women, more men than women start renal replacement therapy (RRT). We hypothesized that gender differences in health care access exist and therefore aimed at determining whether characteristics and outcomes of haemodialysis patients over time differ by sex. Methods: We studie...

Background The influential role of incretin hormones on glucose metabolism in patients with a history of Roux-en-Y gastric bypass (RYGB) has been investigated thoroughly, but there has been little examination of the effect of incretins and ectopic lipids on altered glucose profiles, especially severe hypoglycemia in pregnant women with RYGB. Metho...

Evidence for the predictive value of IADPSG/WHO2013 diagnostic gestational diabetes mellitus criteria for long-term maternal and offspring outcomes is missing. Recently, William L Lowe Jr and colleagues report a high risk of maternal glycaemic disorders and childhood adiposity 10 to 14 years after untreated gestational diabetes mellitus in the HAPO...