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Tina Costacou, PhD

Associate Professor, Epidemiology

Contact

R-znvy: PbfgnpbhG@rqp.cvgg.rqh
Primary Phone: 967-838-7517


Personal Statement

Dr. Costacou is a nutrition and diabetes epidemiologist, whose research interest has mainly focused on the effects of potentially modifiable environmental (e.g. nutrition, obesity) factors and their genetic interactions on diabetes complication development.  She started her career providing support for the Nutrition Coordinating Center of the DPP clinical trial and has since worked on large multi-center studies in the U.S. (IRAS, EDC) as well as in Europe (EPIC).  She has published extensively on factors leading to the development of diabetes complications and has focused on gender interactions.  Currently, Dr. Costacou is PI of an R01 on the role of HDL in coronary artery disease; a U24 evaluating the biologic mechanisms by which haptoglobin may relate to kidney dysfunction in adults with type 1 diabetes; regional PI of a DP3 assessing the role of ApoC3 and HDL function on cardiovascular complications of type 1 diabetes; and a JDRF funded project to identify biomarkers of cardiorenal complications in two type 1 diabetes cohorts.  She is also Co-Investigator in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study; a randomized clinical trial comparing two screening methods for gestational diabetes (G2DM); and an R21 of retinal imaging markers and cognition in adults with type 1 diabetes.


Education

University of Massachusetts at Amherst – BA, 1993

University of Massachusetts at Amherst – MSc, 1996

University of South Carolina Norman J. Arnold School of Public Health – Ph.D., 2001

University of Pittsburgh – Post Doctoral Fellowship in Diabetes Epidemiology, 2004


Teaching

2011-present                EPIDEM 2185: Introduction to SAS

2007-present                Diabetes Journal Club

 

 


Research Interests

  • Epidemiology of diabetes and its complications
  • Genetic susceptibility (especially Haptoglobin genotype), oxidative stress, inflammation and insulin resistance in relation to diabetes complications
  • Nutrition epidemiology
  • Women’s health


Active Support

Principal Investigator

  • R01 HL130153, Re-evaluating the role of HDL in coronary artery disease (RETRO HDL), NIH/NHLBI, 2016-2019

  • U24 DK076169-09, Kidney IRon by HAptoglobin genotype (KIRHA), DiaComp Pilot & Feasibility Program Subaward: 25732-78, NIH/NIDDK, 2015-2017

  • DP3 DK108209, ApoC3, HDL function and cardiovascular complications of T1DM (DP3), NIH/NIDDK, 2015-2018 (Regional PI; PI: Bornfeldt)

Co-Investigator

  • Retinal Imaging Markers of Cognition in Adults with T1D (R21), NIH/NIDDK, 2015-2017 (PI: Rosano)
  • Comparison of two screening strategies for gestational diabetes (R01), NIH, 2014-2019 (PI: Davis)
  • Epidemiology of Diabetes Complications: Phase II (R01).  NIDDK DK034818, 2008-2019 (PI: Orchard)


Selected Publications

  1. Costacou T. The epidemiology of cardiovascular disease in adults with type 1
    diabetes.  In press, Current Diabetes Reports 2016. DOI: 10.2174/1573399812666160927122643.
  2. Orchard TJ, Costacou T.  Cardiovascular complications of type 1
    diabetes: update on the renal link.  Acta Diabetologica 2017 Apr;54(4):325-334. DOI: 10.1007/s00592-016-0949-7.
  3. Orchard TJ, Backlund JYC, Costacou T, Cleary P, Lopes-Virella M, Levy AP, Lachin JM, and the DCCT/EDIC Research Group.  Haptoglobin 2-2 genotype and the risk of Coronary Artery Disease in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC).  J Diabetes Complications 2016 Nov-Dec;30(8):1577-1584.  DOI: 10.1016/j.jdiacomp.2016.07.014.
  4. Costacou T, Evans RW, Orchard TJ.  Glycaemic control modifies the haptoglobin 2 allele-conferred susceptibility to coronary artery disease in Type 1 diabetes.  Diabet Med. 2016 Nov;33(11):1524-1527. doi: 10.1111/dme.13127.
  5. Miller RG, Anderson SL, Costacou T, Sekikawa A, Orchard TJ.  Risk Stratification for 25-Year Cardiovascular Disease Incidence in Type 1 Diabetes:  Tree-Structured Survival Analysis of the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study.  Diab Vasc Dis Res. 2016 Jul;13(4):250-259. doi: 10.1177/1479164116629353.

  6. Asleh R, Levy N, Doros G, Costacou T, Robinson JG, Blum S, Goldenstein H, Boden WE, Simmons DL, Lacy M, Grunberger G, Anderson TJ, Levy AP.  Haptoglobin genotype as a determinant of benefit or harm from niacin for participants with diabetes in the AIM HIGH study.  J Am Coll Cardiol. 2016 May 31;67(21):2553-2554. doi: 10.1016/j.jacc.2016.03.533.

  7. Costacou T, Levy AP, Miller RG, Snell-Bergeon J, Asleh R, Farbstein D, Fickley CE, Pambianco G, de la Vega R, Evans RW, Orchard TJ.  Effect of vitamin E supplementation on HDL function by Haptoglobin genotype in type 1 diabetes: Results from the HapE randomized crossover pilot trial.  Acta Diabetologica 2015 Apr;53(2):243-250.  doi: 10.1007/s00592-015-0770-8.

  8. Costacou T, Orchard TJ.  The Haptoglobin genotype predicts cardio-renal mortality in type 1 diabetes.  J Diabetes Complications 2016 Mar;30(2):221-226. doi:10.1016/j.jdiacomp.2015.11.011.

  9. Costacou T, Evans RW, Orchard TJ.  Does the concentration of oxidative and inflammatory biomarkers differ by Haptoglobin genotype in type 1 diabetes?  Antioxidants and Redox Signaling 2015 Dec;23(18):1439-1444.  doi: 10.1089/ars.2015.6355.

  10. Eny KM, Orchard TJ, Miller RG, Maynard J, Grant DM, Costacou T, Cleary PA, Braffett BH, Paterson AD, for the DCCT/EDIC Research Group.  Caffeine consumption contributes to skin intrinsic fluorescence in type 1 diabetes.  Diabetes Technology and Therapeutics 2015 Oct;17(10):726-34. doi: 10.1089/dia.2015.0017.

  11. Coffey S, Garth J, Costacou T, Orchard T, Erkan E.  AKT links insulin signaling to albumin endocytosis in proximal tubule epithelial cells.  PLOS ONE 2015 Oct;10(10):e0140417. doi: 10.1371/journal.pone.0140417.

  12. Scifres CM, Abebe KZ, Jones KA, Comer DM, Costacou T, Freiberg MS, Simhan HN, Day NL, Davis EM.  Gestational Diabetes Diagnostic Methods (GD2M) Pilot Randomized Trial.  Matern Child Health J. 2015 Jul;19(7):1472-80. doi: 10.1007/s10995-014-1651-4.

  13. Costacou T, Rosano C, Aizenstein H, Mettenburg JM, Nunley K, Ferrell RE, Orchard TJ.  The Haptoglobin 1 allele correlates with white matter hyperintensities in middle-aged adults with type 1 diabetes.  Diabetes 2015;64(2):654-659.  PMCID: PMC4303969.

  14. Costacou T, Secrest A, Ferrell RE, Orchard TJ. Haptoglobin Genotype and Incident Cerebrovascular Disease in Type 1 Diabetes. Diab Vasc Dis Res. 2014;11(5):335-342. PMCID: PMC4134420.

  15. Koutourousiou M, Vas Guimaraes Filho F, Costacou T, Fernandez-Miranda J, Wang E, Snyderman CH, Rothfus W, Gardner PA. Pontine Encephalocele and Abnormalities of the Posterior Fossa following Transclival Endoscopic Endonasal Surgery. J Neurosurg. 2014;121(2):359-366.

  16. Costacou T, Evans RW, Schaffer GL, Orchard TJ. Oxidative stress and response in relation to coronary artery disease in type 1 diabetes. Diabetes Care. 2013 Nov; 36 (11):3503. PMCID: PMC3816903. PMID: 3509.

  17. Costacou T, Orchard TJ. Differential Effect of Glycemia on the Incidence of Hypertension by Sex: The Epidemiology of Diabetes Complications study. Diabetes care. 2013 Jan; 36 (1):77-83. PMCID: PMC3526198. PMID: 22966097.

  18. Costacou T, Levy AP. Haptoglobin genotype and its role in diabetic cardiovascular disease. Journal of cardiovascular translational research. 2012 Aug; 5 (4):423-35. PMID: 22447230.

  19. Costacou T, Fried L, Ellis D, Orchard TJ. Sex differences in the development of kidney disease in individuals with type 1 diabetes mellitus: a contemporary analysis. American journal of kidney diseases: the official journal of the National Kidney Foundation. 2011 Oct; 58 (4):565-73. PMCID: PMC3183221. PMID: 21840097.

  20. Costacou T, Evans RW, Orchard TJ. High-density lipoprotein cholesterol in diabetes: is higher always better? Journal of clinical lipidology. 2011 Sep; 5 (5):387-94. PMCID: PMC3190122. PMID: 21981840.

  21. Secrest AM, Costacou T, Gutelius B, Miller RG, Songer TJ, Orchard TJ. Association of socioeconomic status with mortality in type 1 diabetes: the Pittsburgh epidemiology of diabetes complications study. Annals of epidemiology. 2011 May; 21 (5):367-73. PMCID: PMC3070912. PMID: 21458730.

  22. Secrest AM, Costacou T, Gutelius B, Miller RG, Songer TJ, Orchard TJ. Associations between socioeconomic status and major complications in type 1 diabetes: the Pittsburgh epidemiology of diabetes complication (EDC) Study. Annals of epidemiology. 2011 May; 21 (5):374-81. PMCID: PMC3079455. PMID: 21458731.

  23. Pambianco G, Costacou T, Strotmeyer E, Orchard TJ. Risk factor associations with clinical distal symmetrical polyneuropathy and various neuropathy screening instruments and protocols in type 1 diabetes. Diabetes research and clinical practice. 2011 Jan; 91 (1):e15-20. PMCID: PMC3093294. PMID: 21035227.

  24. Orchard TJ, Secrest AM, Miller RG, Costacou T. In the absence of renal disease, 20 year mortality risk in type 1 diabetes is comparable to that of the general population: a report from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetologia. 2010 Nov; 53 (11):2312-9. PMCID: PMC3057031. PMID: 20665208.

  25. Orchard TJ, Costacou T. When are type 1 diabetic patients at risk for cardiovascular disease? Current diabetes reports. 2010 Feb; 10 (1):48-54. PMID: 20425067 (invited).

  26. Miller RG, Costacou T, Orchard TJ. Lipoprotein-associated phospholipase A2, C-reactive protein, and coronary artery disease in individuals with type 1 diabetes and macroalbuminuria. Diabetes & vascular disease research : official journal of the International Society of Diabetes and Vascular Disease. 2010 Jan; 7 (1):47-55. PMCID: PMC2858394. PMID: 20368232.

  27. Costacou T, Ferrell RE, Ellis D, Orchard TJ. Haptoglobin genotype and renal function decline in type 1 diabetes. Diabetes. 2009 Dec; 58 (12):2904-9. PMCID: PMC2780877. PMID: 19720796.

  28. Conway B, Costacou T, Orchard T. Is glycaemia or insulin dose the stronger risk factor for coronary artery disease in type 1 diabetes? Diabetes & vascular disease research : official journal of the International Society of Diabetes and Vascular Disease. 2009 Oct; 6 (4):223-30. PMCID: PMC2865431. PMID: 20368215.

  29. Costacou T, Orchard TJ. Adiponectin: Good, bad or just plain ugly? Kidney International 2008;74(5):549-551. (invited).

  30. Costacou T, Ferrell RE, Orchard TJ. Haptoglobin genotype: a determinant of cardiovascular complication risk in type 1 diabetes. Diabetes. 2008 Jun; 57 (6):1702-6. PMID: 18332093.

  31. Costacou T, Ma B, King IB, Mayer-Davis EJ. Plasma and dietary vitamin E in relation to insulin secretion and sensitivity. Diabetes, obesity & metabolism. 2008 Mar; 10 (3):223-228. PMID: 18269637.

  32. Costacou T, Bosnyak Z, Harger GF, Markovic N, Silvers N, Orchard TJ. Postpartum adiponectin concentration, insulin resistance and metabolic abnormalities among women with pregnancy-induced disturbances. Preventive cardiology. 2008; 11 (2):106-115. PMID: 18401239.

  33. Costacou T, Edmundowicz D, Prince C, Conway B, Orchard TJ. Progression of coronary artery calcium in type 1 diabetes mellitus. The American journal of cardiology. 2007 Nov 15; 100 (10):1543-1547. PMCID: PMC2206537. PMID: 17996516.

  34. Costacou T, Ellis D, Fried L, Orchard TJ. Sequence of progression of albuminuria and decreased GFR in persons with type 1 diabetes: a cohort study. American journal of kidney diseases: the official journal of the National Kidney Foundation. 2007 Nov; 50 (5):721-732. PMID: 17954285.

  35. Keenan HA, Costacou T, Sun JK, Doria A, Cavellerano J, Coney J, Orchard TJ, Aiello LP, King GL. Clinical factors associated with resistance to microvascular complications in diabetic patients of extreme disease duration: the 50-year medalist study. Diabetes care. 2007 Aug; 30 (8):1995-1997. PMID: 17507696.

  36. Pambianco G, Costacou T, Orchard TJ. The prediction of major outcomes of type 1 diabetes: a 12-year prospective evaluation of three separate definitions of the metabolic syndrome and their components and estimated glucose disposal rate: the Pittsburgh Epidemiology of Diabetes Complicat. Diabetes care. 2007 May; 30 (5):1248-1254. PMID: 17303788.

  37. Costacou T, Huskey ND, Edmundowicz D, Stolk R, Orchard TJ. Lower-extremity arterial calcification as a correlate of coronary artery calcification. Metabolism: clinical and experimental. 2006 Dec; 55 (12):1689-1696. PMID: 17142145.

  38. Costacou T, Chang Y, Ferrell RE, Orchard TJ. Identifying genetic susceptibilities to diabetes-related complications among individuals at low risk of complications: An application of tree-structured survival analysis. American journal of epidemiology. 2006 Nov 1; 164 (9):862-872. PMID: 16928730.

  39. Orchard TJ, Costacou T, Kretowski A, Nesto RW. Type 1 diabetes and coronary artery disease. Diabetes care. 2006 Nov; 29 (11):2528-2538. PMID: 17065698 (invited).

  40. Pambianco G, Costacou T, Ellis D, Becker DJ, Klein R, Orchard TJ. The 30-year natural history of type 1 diabetes complications: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes. 2006 May; 55 (5):1463-1469. PMID: 16644706.

  41. Yishak AA, Costacou T, Virella G, Zgibor J, Fried L, Walsh M, Evans RW, Lopes-Virella M, Kagan VE, Otvos J, Orchard TJ. Novel predictors of overt nephropathy in subjects with type 1 diabetes. A nested case control study from the Pittsburgh Epidemiology of Diabetes Complications cohort. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2006 Jan; 21 (1):93-100. PMID: 16144851.

  42. Costacou T, Zgibor JC, Evans RW, Tyurina YY, Kagan VE, Orchard TJ. Antioxidants and coronary artery disease among individuals with type 1 diabetes: Findings from the Pittsburgh Epidemiology of Diabetes Complications Study. Journal of diabetes and its complications. 2006; 20 (6):387-394. PMID: 17070445.

  43. Costacou T. Evaluation of epidemiologic evidence on the role of nutrition in the development of diabetes and its complications. Current diabetes reports. 2005 Oct; 5 (5):366-373. PMID: 16188172 (invited).

  44. Costacou T, Zgibor JC, Evans RW, Otvos J, Lopes-Virella MF, Tracy RP, Orchard TJ. The prospective association between adiponectin and coronary artery disease among individuals with type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications Study. Diabetologia. 2005 Jan; 48 (1):41-48. PMID: 15616802.

  45. Costacou T, Lopes-Virella MF, Zgibor JC, Virella G, Otvos J, Walsh M, Orchard TJ. Markers of endothelial dysfunction in the prediction of coronary artery disease in type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications Study. Journal of diabetes and its complications. 2005; 19 (4):183-193. PMID: 15993351.

  46. Mayer-Davis EJ, Sparks KC, Hirst K, Costacou T, Lovejoy JC, Regensteiner JG, Hoskin MA, Kriska AM, Bray GA, Diabetes Prevention Program Research Group. Dietary intake in the diabetes prevention program cohort: baseline and 1-year post randomization. Annals of epidemiology. 2004 Nov; 14 (10):763-772. PMID: 15573453.

  47. Costacou T, Bamia C, Ferrari P, Riboli E, Trichopoulos D, Trichopoulou A. Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population. European journal of clinical nutrition. 2003 Nov; 57 (11):1378-1385. PMID: 14576750.

  48. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. The New England journal of medicine. 2003 Jun 26; 348 (26):2599-2608. PMID: 12826634.

  49. Costacou T, Mayer-Davis EJ. Nutrition and prevention of type 2 diabetes. Annual review of nutrition. 2003; 23:147-70. PMID: 12626686 (invited).

  50. Mayer-Davis EJ, Costacou T, King I, Zaccaro DJ, Bell RA, Insulin Resistance and Atherosclerosis Study (IRAS). Plasma and dietary vitamin E in relation to incidence of type 2 diabetes: The Insulin Resistance and Atherosclerosis Study (IRAS). Diabetes care. 2002 Dec; 25 (12):2172-2177. PMID: 12453956.

  51. Trichopoulou A, Naska A, Costacou T, DAFNE III Group. Disparities in food habits across Europe. The Proceedings of the Nutrition Society. 2002 Nov; 61 (4):553-558. PMID: 12691185.

  52. Mayer-Davis EJ, Costacou T. Obesity and sedentary lifestyle: modifiable risk factors for prevention of type 2 diabetes. Current diabetes reports. 2001 Oct; 1 (2):170-176. PMID: 12643113 (invited).

  53. Costacou T, Levin S, Mayer-Davis EJ. Dietary patterns among members of the Catawba Indian nation. Journal of the American Dietetic Association. 2000 Jul; 100 (7):833-835. PMID: 10916525.

 

 

Tina  Costacou
© 2017 by University of Pittsburgh Graduate School of Public Health

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