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  • Metabolic Syndrome and Diabetes x
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Yuan Huang Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

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Yunyun Hu The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

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Bingshu Bao The Second People’s Hospital, Luqiao, Taizhou, Zhejiang, China

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increase in the obese grade 2 normal visceral fat group ( β : 13.8; 95% CI: 0.10, 27.5, P  = 0.048) showed statistical significance ( Table 3 ). Additionally, the 10-year cardiovascular risk assessment showed the two groups with the highest risk, obese

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Sigrid Bjerge Gribsholt Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark

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Morten Schmidt Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

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Eskild Bendix Kristiansen Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark

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Bjørn Richelsen Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

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Henrik Toft Sørensen Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

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diabetes, hypertension, and dyslipidemia ( 3 , 4 , 5 , 6 ). Additionally, obesity is recognized as a risk factor in the development of CVD morbidity and mortality ( 4 , 7 , 8 , 9 , 10 , 11 ), owing to inflammation, effects on hemodynamics, and

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Ann-Cathrin Koschker Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany

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Bodo Warrings Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany

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Caroline Morbach Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Florian Seyfried Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany

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Nicole Rickert Department of Radiology, University Hospital, University of Würzburg, Würzburg, Germany

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Pius Jung Division of Pneumology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Andreas Geier Division of Hepatology, Department of Internal Medicine II, University Hospital, University of Würzburg, Würzburg, Germany

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Ulrich Dischinger Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Maike Krauthausen Department of General Practice, University Hospital, University of Würzburg, Würzburg, Germany

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Martin J Herrmann Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany

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Christine Stier Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany

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Stefan Frantz Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Uwe Malzahn Center for Clinical Trials, University Hospital, University of Würzburg, Würzburg, Germany

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Stefan Störk Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Martin Fassnacht Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany

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the WAS Study Group
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the WAS Study Group

the risk of new-onset heart failure, particularly heart failure with preserved ejection fraction ( 4 , 5 ). Patients with morbid obesity appear to carry a significantly higher mortality risk ( 6 , 7 ). Currently, bariatric surgery is the only

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Zhiyan Yu Department of Endocrinology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

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Yueyue Wu Department of Endocrinology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

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Rui Zhang Department of Endocrinology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

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Yue Li Department of Endocrinology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

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Shufei Zang Department of Endocrinology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

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diabetes (year) 10.00 (6.00, 20.00) 10.00 (6.00, 18.00) 0.155 10.00 (5.00, 15.00) 10.00 (4.00, 16.00) 0.847 13.00 (8.00, 20.00) 10.00 (7.00, 18.00) 0.054 ALT (U/L) 15.70 (11.00, 22.00) 21.00 (14.00, 29.80) <0.001 16.00 (11

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Yinqiong Huang Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

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Zhaozhao Zhu Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China

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Zhiqin Huang Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

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Jingxiong Zhou Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

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.18 ± 2.83 25.31 ± 3.42 a 23.86 ± 3.99 9.651 0.000 d Diabetes duration (year) NA 5.0 (1.0, 10) 10 (4.25,16.0) b −2.752 0.006 d Hypertension (%) NA 32.9% (24/73) 51.4% (18/35) b 4.210 0.040 b BUN (mmol/L) 4

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Xiaohui Qi Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Ping He Shanghai Hospital Link Center, Shanghai Hospital Development Center, Shanghai, China

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Huayan Yao Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Huanhuan Sun Wonders Information Co. Ltd, Shanghai, China

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Jiying Qi Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Min Cao Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Bin Cui Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Guang Ning Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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than 6 per 100,000 inhabitants per year ( 3 , 4 ). In addition, some studies have shown that the prevalence of BTC among patients with type 2 diabetes (T2D) is greatly increased ( 5 , 6 , 7 , 8 ), but the exact mechanism is not clear. Studies have

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Yanmei Lou Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People’s Republic of China

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Yanyan Zhang Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

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Ping Zhao Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People’s Republic of China

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Pei Qin Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

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Changyi Wang Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Jianping Ma Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Xiaolin Peng Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Hongen Chen Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Dan Zhao Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Shan Xu Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Li Wang Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China

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Ming Zhang Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

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Dongsheng Hu Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

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Fulan Hu Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

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hypertension in America have diabetes ( 4 ). Coexistence of hypertension and diabetes can significantly increase the risk of cardiovascular disease and death ( 5 , 6 ). The existence of hypertension may also indicate the likelihood of future diabetes ( 7 , 8

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Ziting Liang Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Mengge Yang Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Changjuan Xu Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Rong Zeng Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Liang Dong Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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trial, respectively. Statistical analysis Review Manager software (version 5.3) was used to estimate the risks of bias of the included studies, analyze data, and create plots. I 2 statistics were also calculated to measure inconsistency across

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Marie Auzanneau Institute of Epidemiology and Medical Biometry, ZIBMT, Medical Faculty of Ulm University, Ulm, Germany
German Center for Diabetes Research (DZD), Neuherberg, Germany

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Alexander J Eckert Institute of Epidemiology and Medical Biometry, ZIBMT, Medical Faculty of Ulm University, Ulm, Germany
German Center for Diabetes Research (DZD), Neuherberg, Germany

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Andreas Fritsche German Center for Diabetes Research (DZD), Neuherberg, Germany
Department of Internal Medicine IV, University Hospital Tübingen, Germany
Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany

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Martin Heni Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
Division of Endocrinology and Diabetology, Department of Internal Medicine 1, University Hospital Ulm, Ulm, Germany
Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany

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Andrea Icks German Center for Diabetes Research (DZD), Neuherberg, Germany
Institute of Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
Institute of Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Centre for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

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Annabel S Mueller-Stierlin Department of General Practice and Primary Care, University Hospital Ulm, Um, Germany
Department of Psychiatry and Psychotherapy II, University Hospital Ulm, Um, Germany

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Ana Dugic Department of Gastroenterology, Klinikum Bayreuth, Medizincampus Oberfranken der Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Bayreuth, Germany

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Alexander Risse Diabetes Center at Sophie-Charlotte-Platz, Diabetes Foot Unit, Berlin, Germany

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Stefanie Lanzinger Institute of Epidemiology and Medical Biometry, ZIBMT, Medical Faculty of Ulm University, Ulm, Germany
German Center for Diabetes Research (DZD), Neuherberg, Germany

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Reinhard W Holl Institute of Epidemiology and Medical Biometry, ZIBMT, Medical Faculty of Ulm University, Ulm, Germany
German Center for Diabetes Research (DZD), Neuherberg, Germany

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, there is a large evidence that hospitalized patients with diabetes, compared to those without diabetes, have a higher risk of complications, longer hospital stays, as well as higher mortality rates ( 4 , 5 , 6 ). To optimize the management of these

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Olli Helminen Department of Pediatrics, PEDEGO Research Group, Medical Research Center, Oulu University, Hospital and University of Oulu, Oulu, Finland
Surgery Research Unit, Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland

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Tytti Pokka Department of Pediatrics, PEDEGO Research Group, Medical Research Center, Oulu University, Hospital and University of Oulu, Oulu, Finland

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Susanna Aspholm Tampere Centre for Child Health Research, Tampere University Hospital, Tampere, Finland

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Jorma Ilonen Immunogenetics Laboratory, University of Turku, Turku, Finland
Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland

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Olli G Simell Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland

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Mikael Knip Tampere Centre for Child Health Research, Tampere University Hospital, Tampere, Finland
Pediatric Research Center, New Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland

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Riitta Veijola Department of Pediatrics, PEDEGO Research Group, Medical Research Center, Oulu University, Hospital and University of Oulu, Oulu, Finland

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in prospective studies ( 3 ). The risk of type 1 diabetes can be estimated based on the HLA genotype ( 4 ) and a series of single nucleotide polymorphisms outside the HLA region ( 5 ). The presence of ≥2 islet autoantibodies is a strong predictive

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