About

Adin-Cristian Andrei is a professor in the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine. His academic appointment is within the fields of Biostatistics and Informatics. He is affiliated with several institutes, including the Center for Diabetes and Metabolism, the Institute for Augmented Intelligence in Medicine, the Northwestern University Clinical and Translational Sciences Institute (NUCATS), and the Potocsnak Longevity Institute. His work focuses on preventive medicine, with an emphasis on biostatistics and informatics, contributing to research and education in these areas.

Research topics

• Cardiology
• Medicine
• Internal medicine
• Computer Science
• Surgery
• Nursing

Selected publications

• Glycemia Range and Offspring Weight and adiposity in response To Human milk (GROWTH) study: protocol for an observational cohort designed to study lactational programming

  BMJ Open · 2026-04-01

  articleOpen access

  INTRODUCTION: Maternal human milk feedings continue an offspring's exposure to the programming stimuli of maternal metabolism during the postnatal period. While considerable research focuses on associations between in utero environments and offspring metabolic disease, few studies have been able to specifically measure how human milk composition modifies programming of children's growth in conjunction with comprehensive measures of maternal glycaemia during pregnancy. METHODS AND ANALYSIS: The Glycemia Range and Offspring Weight and adiposity in response To Human milk (GROWTH) Study is a longitudinal cohort enrolling women with a singleton pregnancy who (1) undergo serial testing of glycaemia during pregnancy and (2) are intending to provide their breast milk through direct breastfeeding or pumped milk as the primary nutrition for their infant. Enrolment started in October 2023 and is expected to be completed in December 2026. Key procedures include virtual lactation support visits, serial human milk sampling at three time points, maternal and infant blood sampling, serial maternal and child anthropometric measurements and diet assessment. After delivery, mother-child dyads are followed until children turn 2 years of age. The primary exposure variable is maternal glycaemia obtained from a fasting, 3 hour 100 g oral glucose tolerance test performed at 24-28 weeks of gestation, and the primary outcome measure is the composite of human milk linoleic and docosahexaenoic acid concentrations in milk samples collected at 1 month postpartum. ETHICS AND DISSEMINATION: Lurie Children's Hospital Institutional Review Board (IRB) provides central oversight of the GROWTH Study in conjunction with each participating centre's IRB. The GROWTH Study data has the potential to inform perinatal health and future research in lactation and human milk science by providing comprehensive measures of human milk composition and early childhood growth and body composition parameters impacted by maternal metabolism in pregnancy.

  PublisherDOI

• 1426-P: Investigating the Prevalence of Elevated Fibrosis-4 Index in Individuals with Type 1 Diabetes

  Diabetes · 2025-06-13

  article

  Introduction and Objective: While the relationship between Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) and Type 2 Diabetes Mellitus (T2DM) is well-established, less is known about the prevalence of MASLD in individuals with Type 1 Diabetes Mellitus (T1DM). Fibrosis-4 index (FIB-4) is a noninvasive scoring system to estimate risk of liver fibrosis. The objective of this study was to evaluate the prevalence of elevated FIB-4 in individuals with T1DM and determine associated risk factors. Methods: A retrospective review was conducted on individuals with T1DM age 35-65 seen at our academic Endocrinology clinic who had relevant FIB-4 labs (liver function tests and platelet count) obtained within the last three years. FIB-4 was calculated to stratify patients into low-risk and intermediate/high-risk categories. Demographics and glycemic status-related variables (HbA1c, device use, glucometric data from continuous glucose monitoring (CGM), and total daily insulin) were obtained and compared between FIB-4 risk categories using two-sample t and Fisher’s exact tests. Results: A total of 354 individuals were included in the study. Of them, 61 (17.2%) were deemed intermediate/high-risk for fibrosis by FIB-4. The intermediate/high-risk group had a significantly lower BMI (mean±SD 26.5±5.3 vs 28.8±6.1 kg/m2) and higher likelihood of being on public insurance (25% vs 12%) compared to the low-risk group. No significant differences by FIB-4 risk category were observed in the other variables assessed including HbA1c and CGM metrics. Conclusion: Individuals with T1DM with lower BMI or on public insurance may be at higher risk for an abnormal FIB-4, and therefore, at higher risk for the presence of liver fibrosis. It may be worthwhile to screen for liver fibrosis in individuals with T1DM using FIB-4 irrespective of BMI or glycemic status. Future research should investigate the potential pathophysiologic link between low BMI and the presence of liver fibrosis in this population. Disclosure J. Friedman: None. E.E. Fronczyk: None. J. Brown: None. Y. Cheung: None. A.C. Andrei: None. G. Aleppo: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation, Fractyl Health, Inc., MannKind Corporation, Tandem Diabetes Care, Inc, WellDoc, EMMES, AbbVie Inc, Bayer Pharmaceuticals, Inc.

  PublisherDOI

• EP.05.08 Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) for Staging cN0-N1 Non-Small Cell Lung Cancer

  Journal of Thoracic Oncology · 2025-10-01

  article
  PublisherDOI

• Spasms and not Myoclonus in Subacute Sclerosing Panencephalitis. A Case Report and Review of the Literature

  Neuropediatrics · 2025-07-22 · 1 citations

  article

  Subacute sclerosing panencephalitis (SSPE) is a neurodegenerative disease caused by the measles virus. An affected child typically presents with cognitive decline and abnormal movements, described as myoclonia. Early diagnosis is crucial for prognosis, but can be challenging because early symptoms may be subtle, and EEG findings are not always typical. We propose that better description and documentation of motor symptoms may facilitate earlier recognition of SSPE.A 4-year-old boy presented with cognitive decline and motor symptoms evolving over 6 months. The patient had a history of measles at 2 months of age. Initial investigations, conducted when he developed clinical regression and abnormal movements, were inconclusive. After a partial recovery, he relapsed with further regression, worsening of abnormal movements, and seizures. At our hospital, we diagnosed SSPE based on Dyken's criteria. EEG and EMG recordings showed movements beginning after a diffuse slow wave, followed by a flattening of the EEG line, with a typical diamond pattern on the EMG lasting 0.5 to 1 second. Movements were classified as epileptic spasms.We propose that patients with SSPE may present epileptic spasms as the abnormal motor phenomena, and not only myoclonus. Raising awareness about epileptic spasms as a clinical manifestation may aid early diagnosis of SSPE.

  PublisherDOI

• Does race influence health-related quality of life outcomes in older patients who undergo advanced cardiac surgical therapies?

  JHLT Open · 2025-05-13 · 1 citations

  articleOpen access

  Background: Racial minorities are disproportionately affected by heart failure (HF). We aimed to determine whether (1) older patients (60-80 years) with HF who underwent long-term mechanical circulatory support (MCS, i.e., destination therapy), compared to patients who underwent heart transplantation (HT), with (HT MCS) or without (HT non-MCS) pretransplant MCS, experienced noninferior change in overall health-related quality of life (HRQOL) by race (White vs racial minorities) from baseline to 1-year postoperatively and (2) race was a risk factor associated with overall HRQOL at 1-year postoperatively. Methods: = 305). Of the 305 patients who underwent surgery, 107 long-term MCS, 56 HT MCS, and 87 HT non-MCS had data through 1-year follow-up. Analyses included noninferiority (NI) testing using the Kansas City Cardiomyopathy-12 Questionnaire overall summary score (KCCQ-12 OSS, score range = 1[worst]-100[best] HRQOL) at baseline and 3-, 6-, and 12-months follow-up and multivariable linear regression. Results: The cohort's average age was 66 years, 78% were male, and 84% were White. The long-term MCS racial minority group did not demonstrate NI compared to the HT MCS and HT non-MCS racial minority groups, and the White long-term MCS group did not demonstrate NI compared to the White HT MCS and HT non-MCS groups. Sex (male) and surgical strategies (HT MCS and HT non-MCS) were positively associated with the KCCQ-12 OSS, whereas the number of postoperative adverse events was negatively associated. Conclusions: Patients experienced improved HRQOL after surgery, regardless of race; demographic and clinical factors were associated with HRQOL.

  PublisherOA PDFDOI

• Comparing Outcomes Amongst Mechanically Ventilated Patients Who Are Transferred vs Retained in a Large Health System

  CHEST Critical Care · 2025-07-30 · 1 citations

  articleOpen access

  <h3>Background</h3> Mechanically ventilated (MV) patients undergoing a transfer to a higher-resourced hospital have variable outcomes. We aimed to evaluate patient outcomes by transfer status and timing. <h3>Research Question</h3> What are the characteristics and outcomes of mechanically ventilated patients who are transferred from 1 ICU to another? Does timing of transfer affect these outcomes? <h3>Study Design and Methods</h3> In a retrospective observational study, we identified patients admitted on a ventilator to a Midwestern health system (7 local hospitals, 1 tertiary hospital) from March 2018 to December 2021. Exposures were transfer status (being transferred to a tertiary hospital or retained at a local hospital) and transfer timing (early transfers if transferred ≤ 2 days after admission or late transfers). Propensity score weighting was used to balance patient characteristics (age, sex, race/ethnicity, insurance, comorbidity, and primary diagnosis) and baseline clinical factors (admission Sequential Organ Failure Assessment score, COVID-19 test, days on mechanical ventilation, major surgery, and ICU use of dialysis, tracheostomy, and vasopressors). Associations with exposures were estimated through multinomial logistic regression for discharge destination or negative binomial regression for total length of stay (LOS). <h3>Results</h3> Of a total of 5,883 adult MV patients, 5,719 were retained and 164 were transfers (80 early transfers and 84 later transfers). Transfers were associated with longer LOS (33.4 days vs 10.2 days; incident rate ratio [IRR] = 3.11; 95% CI, 2.53-3.82; <i>P</i> < .001) and had an increased likelihood of discharge to other facilities (rehabilitation and nursing facilities) (OR = 2.62; 95% CI, 1.51-4.56; <i>P</i> < .01) than retained patients at the local hospitals. Additionally, early transfer was found to be associated with a shorter LOS than late transfers (19.6 days vs 47.7 days; IRR=0.41; 95% CI, 0.33-0.51; <i>P</i> < .01). <h3>Interpretation</h3> Our results show that MV patient transfers within our health system have lower likelihood of discharge to home and longer LOS when compared with MV patients retained at local hospitals. However, the time to transfer may be an important contributor to better outcomes.

  PublisherOA PDFDOI

• Hospital variation in adoption of balanced transfusion practices among injured patients requiring blood transfusions

  Surgery · 2024-07-27 · 6 citations

  articleOpen access
  PublisherOA PDFDOI

• Association of Patient Reported Outcomes With Caregiver Burden in Older Patients With Advanced Heart Failure: Insights From the SUSTAIN-IT Study

  Circulation Heart Failure · 2024-06-24 · 2 citations

  article

  BACKGROUND: Caregivers of patients with advanced heart failure may experience burden in providing care, but whether changes in patient health status are associated with caregiver burden is unknown. METHODS: This observational study included older patients (60–80 years old) receiving advanced surgical heart failure therapies and their caregivers at 13 US sites. Patient health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (range, 0–100; higher scores are better). Caregiver burden was assessed using the Oberst Caregiving Burden Scale, which measures time on task (OCBS-time) and task difficulty (OCBS-difficulty; range, 1–5; lower scores are better). Measurements occurred before surgery and 12 months after in 3 advanced heart failure cohorts: patients receiving long-term left ventricular assist device support; heart transplantation with pretransplant left ventricular assist device support; and heart transplantation without pretransplant left ventricular assist device support. Multivariable linear regression was used to identify predictors of change in OCBS-time and OCBS-difficulty at 12 months. RESULTS: Of 162 caregivers, the mean age was 61.0±9.4 years, 139 (86%) were female, and 140 (86%) were the patient’s spouse. At 12 months, 99 (61.1%) caregivers experienced improved OCBS-time, and 61 (37.7%) experienced improved OCBS-difficulty (versus no change or worse OCBS). A 10-point higher baseline 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=−0.09 [95% CI, −0.14 to −0.03]; P &lt;0.001) and OCBS-difficulty (β=−0.08 [95% CI, −0.12 to −0.05]; P &lt;0.001). Each 10-point improvement in the 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=−0.07 [95% CI, −0.12 to −0.03]; P =0.002) and OCBS-difficulty (β=−0.09 [95% CI, −0.12 to −0.06]; P &lt;0.001). CONCLUSIONS: Among survivors at 12 months, baseline and change in patient health status were associated with subsequent caregiver time on task and task difficulty in dyads receiving advanced heart failure surgical therapies, highlighting the potential for serial 12-item Kansas City Cardiomyopathy Questionnaire assessments to identify caregivers at risk of increased burden. REGISTRATION: URL: https://www.clinicaltrials.gov ; unique identifier: NCT02568930.

  PublisherDOI

• Peak insulin drip rate associated with decreased infections post‐solid organ transplant

  Clinical Transplantation · 2024-01-01

  articleOpen access

  Infection and rejection outcomes were retrospectively analyzed in patients following liver transplant and separately following heart transplant with patients being stratified by their severity of immediate postoperative insulin resistance as measured by the peak insulin drip rate that was required to reduce glucose levels. For each group, these peak insulin drip rates were divided into quartiles (Q). In liver transplant patients (n = 207), those in Q4 (highest infusion rate) had significantly fewer infections up to 6 months post-transplant (42.3% vs. 60.0%, p = .036) and borderline fewer rejection episodes (25.0% vs. 40.0%, p = .066) compared to Q1-Q3 patients. To confirm these unexpected results, a subsequent similar analysis in heart transplant (n = 188) patients again showed that Q4 patients had significantly fewer infections up to 6 months (19.1% vs. 53.9%, p < .0001) compared to Q1-Q3 patients. Logistic regression in a subset of 103 cardiac transplant patients showed that the maximum glucose during surgery, prior MI, and hypertension were associated with severe insulin resistance (SIR) status, while the presence of pre-existing diabetes and BMI were not. We hypothesize that patients are who are able to mount a more robust counter-regulatory response that causes the insulin resistance may be healthier and thus able to mount a better response to infections.

  PublisherOA PDFDOI

• Abstract 4128187: Does Health-related Quality of Life Differ by Race over time in Older Patients with Heart Failure from Before to After Heart Transplantation or Long-term Mechanical Circulatory Support?

  Circulation · 2024-11-12

  article

  Background: Minority patients are disproportionately affected by heart failure. Therefore, we aimed to determine the impact of race on health-related quality of life in three groups of older patients (60-80 years) with heart failure who underwent advanced surgical therapies (within race and by surgery group): (1) heart transplantation (HT, with pre-transplant mechanical circulatory support [HT MCS]), (2) HT without pre-transplant MCS (HT Non-MCS), or (3) long-term MCS, if ineligible for HT. Methods: Secondary analyses were conducted using data from the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support study. From 10/1/15 to 12/31/18, 396 patients with heart failure were recruited at 13 U.S. medical centers, of which 305 patients underwent HT (n=161 [68 HT MCS and 93 HT Non-MCS]) or long-term MCS (n=144) and had data through 1 year follow-up. Analysis included non-inferiority testing (Long-term MCS vs HT MCS; Long-term MCS vs HT Non-MCS). To demonstrate non-inferiority, the surgical strategies by race needed to show a difference of at least 5 percentage points, with a 95% lower confidence boundary and a two-tailed p-value&lt;0.05 in health-related quality of life, using the Kansas City Cardiomyopathy-12 Questionnaire Overall Summary Score at baseline and 3-, 6-, and 12 months. Results: The entire cohort was on average 66.2±4.7 years, 78% male, and 84% White. All three surgical groups experienced improved health-related quality of life from before to 1 year follow-up; with the largest gain through 3-months. Using non-inferiority testing, the long-term MCS minority group did not demonstrate non-inferiority when compared to both the HT MCS minority group and HT Non-MCS minority group confidence limits above the non-inferiority margin of -5 (Figure). Also, the White long-term MCS group did not demonstrate non-inferiority when compared to the White HT MCS and White HT Non-MCS groups. Conclusion: Differences in health-related quality of life among groups based on race were not statistically significant. Per non-inferiority testing, HT is superior to long-term MCS for health-related quality of life, regardless of race.

  PublisherDOI

Frequent coauthors

• Patrick M. McCarthy

  122 shared

• Philip G. Jones

  Janssen (United States)

  117 shared

• Kathleen L. Grady

  110 shared

• John A. Spertus

  University of Missouri–Kansas City

  100 shared

• James K. Kirklin

  Kirklin Clinic

  89 shared

• Jane Kruse

  89 shared

• Mary Amanda Dew

  University of Pittsburgh

  86 shared

• Gerdi Weidner

  San Francisco State University

  65 shared