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 a grant on the role of triglycerides on cardiovascular disease in 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

2021-present                EPIDEM 2110: Principles of Epidemiology

2011-present                EPIDEM 2185: Introduction to SAS

2007-2020                    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 HL151328, Triglycerides, Diabetes and Cardiovascular Disease. NIH/NHLBI, 2020-2023
  • R01 DK34818, Epidemiology of Diabetes Complications: Phase II (R01). NIH/NIDDK, 2019-2021


Selected Publications

A complete list of published work can be found in MyBibliography: http://www.ncbi.nlm.nih.gov/sites/myncbi/tina.costacou.1/bibliography/40998574/public/?sort=date&direction=descending

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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
  6. 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.
  7. 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
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. Costacou T, Secrest A, Ferrell RE, Orchard TJ. Haptoglobin Genotype and Cerebrovascular Disease Incidence in Type 1 Diabetes. Diab Vasc Dis Res. 2014;11(5):335-342. PMCID: PMC4134420.
  19. 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.
  20. 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.
  21. 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.
  22. 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 2016 Apr;53(2):243-250. doi: 10.1007/s00592-015-0770-8.
  23. 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.
  24. 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.
  25. Orchard TJ, Backlund JC, Costacou T, Cleary P, Lopes-Virella M, Levy AP, Lachin JM; 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.
  26. Bjornstad P, Costacou T, Miller RG, Maahs DM, Rewers MJ, Orchard TJ, Snell-Bergeon JK. Predictors of Early Renal Function Decline in Adults with Type 1 Diabetes: the Coronary Artery Calcification in Type 1 Diabetes and the Pittsburgh Epidemiology of Diabetes Complications Studies. Diabetic Medicine 2017 Nov; 34(11):1532-1540. doi: 10.1111/dme.13430. PMCID: PMC5647234.
  27. Costacou T, Orchard TJ. Cumulative kidney complication risk by 50 years of type 1 diabetes: The effects of sex, age and calendar year at onset. Diabetes Care 2018 Mar;41(3):426-433. doi: 10.2337/dc17-1118.
  28. Swasey KK, Orchard TJ, Costacou T. Trends in cardiovascular risk factor management in type 1 diabetes by sex. Journal of Diabetes and Its Complications 2018 Apr;32(4):411-417. doi: 10.1016/j.jdiacomp.2018.01.003.
  29. Goldenstein H, Levy NS, Ward J, Costacou T, Levy AP. Haptoglobin genotype is a determinant of hemoglobin adducts and vitamin E content in HDL. J Diabetes Res. 2018 May 20;2018:6125420. doi: 10.1155/2018/6125420. eCollection 2018. PMCID: PMC5985109.
  30. Costacou T, Crandell J, Kahkoska A, Liese AD, Dabelea D, Lawrence JM, Pettitt DJ, Reynolds K, Mayer-Davis EJ, Mottl A. Dietary Patterns and Microalbuminuria in Type 1 Diabetes: The SEARCH Nutrition Ancillary Study. Diabetes Care 2018 Aug;41(8):1615-1622. doi: 10.2337/dc18-0319. PMCID: PMC6054499.
  31. Costacou T, Orchard TJ, Moon CH, Bae KT, Fried L, Evans RW. Is Magnetic Resonance Imaging Detection of Kidney Iron Deposition Increased in Haptoglobin 2-2 Genotype Carriers with Type 1 Diabetes?  Antioxid Redox Signal. 2018 Sep 10;29(8):735-741. doi: 10.1089/ars.2017.7444.
  32. Guo J, Erqou SA, Miller RG, Edmundowicz D, Orchard TJ, Costacou T. The role of coronary artery calcification testing in incident coronary artery disease risk prediction in type 1 diabetes. Diabetologia. 2019 Feb;62(2):259-268.
  33. Costacou T, Orchard TJ. Recent trends over time in Vascular Disease in Type 1 Diabetes: Insights from the Pittsburgh EDC study. Invited, Cardiovascular Endocrinology & Metabolism 2019 March;8(1):3-13. doi: 10.1097/XCE.0000000000000164. NIHMSID: 1517945.
  34. Syreeni A, Sandholm N, Cao J, Toppila I, Maahs DM, Rewers MJ, Snell-Bergeon JK, Costacou T, Orchard TJ, Caramori ML, Mauer M, Klein BEK, Klein R, Valo E, Parkkonen M, Forsblom C, Harjutsalo V, Paterson AD; DCCT/EDIC Research Group, Groop PH; FinnDiane Study Group. Genetic Determinants of Glycated Hemoglobin in Type 1 Diabetes. Diabetes 2019 Apr;68(4):858-867. doi: 10.2337/db18-0573.
  35. Williams KV, Becker DJ, Orchard TJ, Costacou T. Persistent C-Peptide Levels and Microvascular Complications in Childhood Onset Type 1 Diabetes of Long Duration. J Diabetes Complications. 2019 Sep;33(9):657-661. doi: 10.1016/j.jdiacomp.2019.05.019.
  36. Khouja T, Miller RG, Moore PA, Orchard TJ, Costacou T. Periodontal disease, smoking, cardiovascular complications and mortality in type 1 diabetes. J Diabetes Complications. 2019 Sep;33(9):603-609. doi: 10.1016/j.jdiacomp.2019.05.025.
  37. Guo J, Brooks MM, Muldoon MF, Naimi AI, Orchard TJ, Costacou T. Optimal Blood Pressure Thresholds for Minimal Coronary Artery Diabetes Risk in Type 1 Diabetes. Diabetes Care 2019 Sep;42(9):1692-1699. doi: 10.2337/dc19-0480.
  38. Guo J, Muldoon MF, Brooks MM, Orchard TJ, Costacou T. Prognostic Significance of Pulse Pressure and Other Blood Pressure Components for Coronary Artery Disease in Type 1 Diabetes. Am J Hypertens. 2019 Oct 16;32(11):1075-1081. doi: 10.1093/ajh/hpz099. PubMed PMID: 31214692; PMCID: PMC6794945.
  39. Yi Y, Denic H, Rubinstein D, Orchard TJ, Costacou T. Effect of age at menarche on microvascular complications among women with Type 1 diabetes. Diabet. Med. 2019 Oct;36:1287-1293. doi: 10.1111/dme.13936. PMCID: PMC6699942.
  40. Guo J, Naimi AI, Brooks MM, Muldoon MF, Orchard TJ, Costacou T. Mediation analysis for estimating cardioprotection of longitudinal RAS inhibition beyond lowering blood pressure and albuminuria in type 1 diabetes. Ann Epidemiol. 2020 Jan;41:7‐13.e1. doi:10.1016/j.annepidem.2019.12.004.
  41. Ju J, Tomaszewski EL, Orchard TJ, Evans RW, Feingold E, Costacou T. The haptoglobin 2-2 genotype is associated with cardiac autonomic neuropathy in type 1 diabetes: the RETRO HDLc study. Acta Diabetol. 2020 Mar;57(3):271–278. doi:10.1007/s00592-019-01422-6.
  42. Miller RG, Orchard TJ, Costacou T. Risk factors differ by first manifestation of cardiovascular disease in type 1 diabetes. Diabetes Res Clin Pract. 2020 Apr 8;163:108141. doi: 10.1016/j.diabres.2020.108141.
  43. Costacou T, Saenger AK, Orchard TJ. High-sensitivity cardiac Troponin-T and N-terminal pro B-Type Natriuretic Peptide in relation to cardiovascular outcomes in type 1 diabetes. Diabetes Care 2020 Jul;43(9):2199-2207. doi:10.2337/dc20-0359.
  44. Miller RG, Yu L, Becker DJ, Orchard TJ, Costacou T. Older age of childhood type 1 diabetes onset is associated with islet autoantibody positivity >30 years later: the Pittsburgh Epidemiology of Diabetes Complications Study. Diabet Med. 2020 Aug;37(8):1386-1394. doi:10.1111/dme.14261.
  45. Limonte CP, Valo E, Montemayor D, Afshinnia F, Ahluwalia TS, Costacou T, Darshi M, Forsblom C, Hoofnagle AN, Groop PH, Miller RG, Orchard TJ, Pennathur S, Rossing P, Sandholm N, Snell-Bergeon JK, Ye H, Zhang J, Natarajan L, de Boer IH, Sharma K. A Targeted Multiomics Approach to Identify Biomarkers Associated with Rapid eGFR Decline in Type 1 Diabetes. Am J Nephrol. 2020 Oct;51(10):839-848. doi: 10.1159/000510830. PMCID: PMC7606554.
  46. Tomaszewski EL, Orchard TJ, Hawkins M, Conway BN, Buchanich JM, Maynard J, Songer T, Costacou T. Skin intrinsic fluorescence scores are a predictor of all-cause mortality risk in type 1 diabetes: The Epidemiology of Diabetes Complications study. J Diabetes Complications. 2021 Feb;35(2):107770. doi: 10.1016/j.jdiacomp.2020.107770. PMCID: PMC7855847.
  47. Devaraj SM, Kriska AM, Orchard TJ, Miller RG, Costacou T. Cardiovascular health in early adulthood predicts the development of coronary heart disease in individuals with type 1 diabetes: 25 year follow-up from the Pittsburgh Epidemiology of Diabetes Complications study. Diabetologia. 2021 Mar;64(3):571-580. doi: 10.1007/s00125-020-05328-9. Epub 2020 Nov 14. PMID: 33190165; PMCID: PMC7867591.
  48. Yi Y, El Khoudary SR, Buchanich JM, Miller RG, Rubinstein D, Orchard TJ, Costacou T. Association of Age at Diabetes Complication Diagnosis with Age at Natural Menopause in Women with Type 1 Diabetes: The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study. J Diabetes Complications. 2021 Mar;35(3):107832. doi: 10.1016/j.jdiacomp.2020.107832. PMCID: PMC7870550.
  49. Yi Y, El Khoudary SR, Buchanich JM, Miller RG, Rubinstein D, Matthews K, Orchard TJ, Costacou T. Women with Type 1 diabetes (T1D) experience a shorter reproductive period compared with nondiabetic women: the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study and the Study of Women’s Health Across the Nation (SWAN). Menopause. 2021 Mar 1;28(6):634-641. doi: 10.1097/GME.0000000000001758. PMID: 33651743.
  50. Miller RG, McGurnaghan SJ, Onengut-Gumuscu S, Chen WM, Colhoun HM, Rich SS, Orchard TJ, Costacou T. Insulin resistance-associated genetic variants in type 1 diabetes. J Diabetes Complications 2021 Apr;35(4):107842. doi: 10.1016/j.jdiacomp.2020.107842.
  51. Yi Y, El Khoudary SR, Buchanich JM, Miller RG, Rubinstein D, Orchard TJ, Costacou T. Predictors of the age at which natural menopause occurs in women with type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications (EDC) study. Menopause. 2021 Apr 5;28(7):735-740. doi: 10.1097/GME.0000000000001772. PMID: 33828035; PMCID: PMC8225549.
  52. Miller RG, Orchard TJ, Onengut-Gumuscu S, Chen WM, Rich SS, Costacou T. Heterogeneous long-term trajectories of glycaemic control in type 1 diabetes. Diabet Med. 2021 Aug;38(8):e14545. doi: 10.1111/dme.14545. PMCID: PMC8295176.
  53. Afshinnia F, Rajendiran TM, He C, Byun J, Montemayor D, Darshi M, Tumova J, Kim J, Limonte CP, Miller RG, Costacou T, Orchard TJ, Ahluwalia TS, Rossing P, Snell-Bergeon JK, de Boer IH, Natarajan L, Michailidis G, Sharma K, Pennathur S. Circulating Free Fatty Acid and Phospholipid Signature Predicts Early Rapid Kidney Function Decline in Patients With Type 1 Diabetes. Diabetes Care. 2021 Sep;44(9):2098-2106. doi: 10.2337/dc21-0737.
  54. Devaraj SM, Miller RG, Orchard TJ, Kriska AM, Gary-Webb T, Costacou T. Data driven patterns of nutrient intake and coronary artery disease risk in adults with type 1 diabetes. J Diabetes Complications. 2021 Oct;35(10):108016. doi: 10.1016/j.jdiacomp.2021.108016. PMCID: PMC8434996.
  55. Mychaleckyj JC, Valo E, Ichimura T, Ahluwalia TS, Dina C, Miller RG, Shabalin IG, Gyorgy B, Cao J, Onengut-Gumuscu S, Satake E, Smiles AM, Haukka JK, Tregouet DA, Costacou T, O'Neil K, Paterson AD, Forsblom C, Keenan HA, Pezzolesi MG, Pragnell M, Galecki A, Rich SS, Sandholm N, Klein R, Klein BE, Susztak K, Orchard TJ, Korstanje R, King GL, Hadjadj S, Rossing P, Bonventre JV, Groop PH, Warram JH, Krolewski AS. Association of Coding Variants in Hydroxysteroid 17-beta Dehydrogenase 14 (HSD17B14) with Reduced Progression to End Stage Kidney Disease in Type 1 Diabetes. J Am Soc Nephrol. 2021 Oct;32(10):2634-2651. doi: 10.1681/ASN.2020101457.
  56. Tomaszewski EL, Orchard TJ, Hawkins MS, Conway RBN, Buchanich JM, Maynard J, Songer T, Costacou T. Predictors of Change in Skin Intrinsic Fluorescence in Type 1 Diabetes: The Epidemiology of Diabetes Complications Study. J Diabetes Sci Technol. 2021 Nov;15(6):1368-1376. doi: 10.1177/19322968211014337. PMCID: PMC8655295.
  57. Miller RG, Orchard TJ, Costacou T. 30-Year Cardiovascular Disease in Type 1 Diabetes: Risk and Risk Factors Differ by Long-Term Patterns of Glycemic Control. Diabetes Care. 2022 Jan 1;45(1):142-150. doi: 10.2337/dc21-1381. PMCID: PMC8753768.

 

Tina  Costacou