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Sökning: db:Swepub > (2010-2011) > Groop Leif > Lunds universitet

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61.
  • Thanabalasingham, G., et al. (författare)
  • A large multi-centre European study validates high-sensitivity C-reactive protein (hsCRP) as a clinical biomarker for the diagnosis of diabetes subtypes
  • 2011
  • Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 54:11, s. 2801-2810
  • Tidskriftsartikel (refereegranskat)abstract
    • An accurate molecular diagnosis of diabetes subtype confers clinical benefits; however, many individuals with monogenic diabetes remain undiagnosed. Biomarkers could help to prioritise patients for genetic investigation. We recently demonstrated that high-sensitivity C-reactive protein (hsCRP) levels are lower in UK patients with hepatocyte nuclear factor 1 alpha (HNF1A)-MODY than in other diabetes subtypes. In this large multi-centre study we aimed to assess the clinical validity of hsCRP as a diagnostic biomarker, examine the genotype-phenotype relationship and compare different hsCRP assays. High-sensitivity CRP levels were analysed in individuals with HNF1A-MODY (n = 457), glucokinase (GCK)-MODY (n = 404), hepatocyte nuclear factor 4 alpha (HNF4A)-MODY (n = 54) and type 2 diabetes (n = 582) from seven European centres. Three common assays for hsCRP analysis were evaluated. We excluded 121 participants (8.1%) with hsCRP values > 10 mg/l. The discriminative power of hsCRP with respect to diabetes aetiology was assessed by receiver operating characteristic curve-derived C-statistic. In all centres and irrespective of the assay method, meta-analysis confirmed significantly lower hsCRP levels in those with HNF1A-MODY than in those with other aetiologies (z score -21.8, p < 5 x 10(-105)). HNF1A-MODY cases with missense mutations had lower hsCRP levels than those with truncating mutations (0.03 vs 0.08 mg/l, p < 5 x 10(-5)). High-sensitivity CRP values between assays were strongly correlated (r (2) a parts per thousand yenaEuro parts per thousand 0.91, p a parts per thousand currency signaEuro parts per thousand 1 x 10(-5)). Across the seven centres, the C-statistic for distinguishing HNF1A-MODY from young adult-onset type 2 diabetes ranged from 0.79 to 0.97, indicating high discriminative accuracy. In the largest study to date, we have established that hsCRP is a clinically valid biomarker for HNF1A-MODY in European populations. Given the modest costs and wide availability, hsCRP could translate rapidly into clinical practice, considerably improving diagnosis rates in monogenic diabetes.
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62.
  • Tornberg, Åsa, et al. (författare)
  • Exercise capacity in relation to body fat distribution and muscle fibre distribution in elderly male subjects with impaired glucose tolerance, type 2 diabetes and matched controls.
  • 2011
  • Ingår i: Diabetes Research and Clinical Practice. - : Elsevier BV. - 1872-8227 .- 0168-8227. ; 94, s. 57-63
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The aim of this study was to examine the impact of insulin sensitivity and muscle fibre composition to exercise capacity in individuals with type 2 diabetes (T2D), impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: Thirty-nine male patients with T2D, 44 male subjects with IGT and 58 subjects with NGT matched for age, weight and body mass index (BMI) participated in the study. Insulin sensitivity was obtained with hyperinsulinemic-euglycemic clamps, muscle fibre distribution with a biopsy and exercise capacity from an incremental exercise test. Anthropometric measurements as height, weight, waist and hip circumference were performed. RESULTS: There were small differences between groups in waist hip ratio (WHR) with significance attained between NGT and T2D. There was a progressive reduction in exercise capacity, both expressed as VO(2peak) and work rate from subjects with NGT to IGT to T2D. Multiple regression analysis with VO(2peak) as dependent variable showed insulin sensitivity to be the most important factor followed by Type I fibres. WHR and capillary density also influenced the variance of VO(2peak). CONCLUSION: Exercise capacity is independently related to insulin sensitivity, muscle fibre composition and WHR in subjects with NGT, IGT and T2D who are matched for age and BMI.
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63.
  • Tornberg, Åsa, et al. (författare)
  • Impact of exercise intensity and duration on insulin sensitivity in women with T2D.
  • 2010
  • Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 21:5, s. 404-408
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Clinical guidelines seldom provide in depth information about the most suitable type and intensity of exercise to obtain optimal benefit in different subgroups of T2D individuals. The aim of this study was to examine the effect of group exercise training on exercise capacity, insulin sensitivity and HbA1c in women with diabetes. METHODS: Twenty-two women with T2D participated in a supervised group exercise program for six months. The program combined endurance and resistance exercise. The duration and intensity of exercise for each subject was recorded. The volume of exercise was calculated as the product of exercise duration and intensity. Exercise capacity, insulin sensitivity and HbA1c were measured at baseline and after six months of training. The subjects were dichotomized with respect to training volume in a high training volume group and a low training volume group. RESULTS: Exercise capacity did not change significantly during the training period. Insulin sensitivity increased significantly and HbA1c decreased significantly from baseline in the high volume group but not in the low volume group. The increase in insulin sensitivity was explained with the intensity of exercise by 30%. The reduction in HbA1c was explained with exercise by 25%. CONCLUSION: Improvement in insulin sensitivity after six months combined supervised group training in female diabetic subjects is related to exercise intensity, whereas the reduction in HbA1c is related mainly to training volume. Metabolic effects of training may be seen in the absence of improved exercise capacity.
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64.
  • Tornberg, Åsa, et al. (författare)
  • Relation between cycling exercise capacity, fiber-type composition, and lower extremity muscle strength and muscle endurance.
  • 2011
  • Ingår i: Journal of Strength and Conditioning Research. - 1533-4287. ; 25:1, s. 16-22
  • Tidskriftsartikel (refereegranskat)abstract
    • Segerström, ÅB, Holmbäck, AM, Hansson, O, Elgzyri, T, Eriksson, K-F, Ringsberg, K, Groop, L, Wollmer, P, and Thorsson, O. Relation between cycling exercise capacity, fiber-type composition, and lower extremity muscle strength and muscle endurance. J Strength Cond Res 25(1): 16-22, 2011-The aim of the study was to determine the relation between peak oxygen uptake (&OV0312;o2peak), peak work rate (WRpeak), fiber-type composition, and lower extremity strength and endurance during a maximal incremental cycle test. Thirty-nine healthy sedentary men, aged 30-46, participated in the study. Subjects performed a maximal incremental cycle test and isokinetic knee extension (KE) and flexion (KF) strength and endurance tests at velocities of 60 and 180°·s. Muscle biopsies were taken from m. vastus lateralis and analyzed for fiber-type composition. A significant correlation existed between KE strength and &OV0312;o2peak and WRpeak. Also, KF endurance correlated significantly to &OV0312;o2peak and WRpeak. The KE endurance correlated significantly to WRpeak (rp = 0.32, p < 0.05) and almost significantly to &OV0312;o2peak (rp = 0.28, p = 0.06). Stepwise multiple regression analyses showed that KE strength, KF endurance, and the percentage of type I fibers could explain up to 40% of the variation in &OV0312;o2peak and WRpeak. The performance of sedentary subjects in a maximal incremental cycle test is highly affected by knee muscle strength and endurance. Fiber-type composition also contributes but to a smaller extent.
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65.
  • Tornberg, Åsa, et al. (författare)
  • Upper Body Muscle Strength and Endurance in Relation to Peak Exercise Capacity During Cycling in Healthy Sedentary Male Subjects.
  • 2011
  • Ingår i: Journal of Strength and Conditioning Research. - 1533-4287. ; 25, s. 1413-1417
  • Tidskriftsartikel (refereegranskat)abstract
    • Segerström, AB, Holmbäck, AM, Elzyri, T, Eriksson, KF, Ringsberg, K, Groop, L, Thorsson, O, and Wollmer, P. Upper body muscle strength and endurance in relation to peak exercise capacity during cycling in healthy sedentary male subjects. J Strength Cond Res 24(x): 000-000, 2010-The aim of this study was to investigate the relation between upper body muscle strength and endurance, and exercise capacity during an incremental cycle exercise test in sedentary healthy male subjects before and after 6 months of combined supervised group training. Exercise capacity was measured as maximal oxygen consumption (&OV0312;O2peak) and maximum work rate (WRpeak). Muscle strength and endurance of the upper body were assessed by bench press and isometric measurement of trunk extensor and flexor maximum voluntary contraction (MVC) and trunk extensor and flexor endurance. Thirty-one subjects were studied before and after the training period. Bench press and trunk extensor MVC correlated to exercise capacity at baseline and after training. Training improved &OV0312;O2peak and WRpeak. The correlation between trunk extensor MVC and exercise capacity improved after training. Upper body strength may affect exercise capacity by increasing the rider's ability to generate force on the handlebar that can be transmitted to the pedals. Resistance training of the arms, chest, and trunk may help improve cycling performance.
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66.
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67.
  • Tura, A., et al. (författare)
  • An empirical index of insulin sensitivity from short IVGTT: validation against the minimal model and glucose clamp indices in patients with different clinical characteristics
  • 2010
  • Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 53:1, s. 144-152
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims/hypothesis Minimal model analysis for insulin sensitivity has been validated against the glucose clamp and is an accepted method for estimating insulin sensitivity from IVGTT. However minimal model analysis requires a 3 h test and relevant expertise to run the mathematical model. The aim of this study was to suggest a simple predictor of minimal model analysis index using only 1 h IVGTT. Methods We studied participants with different clinical characteristics who underwent 3 h regular (n=336) or insulin-modified (n=160) IVGTT, or 1 h IVGTT and euglycaemic-hyperinsulinaemic clamp (n=247). Measures of insulin sensitivity were insulin sensitivity index estimated by minimal model analysis ( SI) and the mean glucose infusion rate (clamp) (M). A calculated S-I (CSI) predictor, CSI alpha x K-G/(Delta AUC(INS)/T), was suggested, based on the calculation of the rate of glucose disappearance K-G and the suprabasal AUC of insulin concentration Delta AUC(INS) over T=40 min. For all the participants, a was assumed equal to the regression line slope between K-G/(Delta AUC(INS)/T) and S-I in control participants. Results CSI and S-I showed high correlation (R-2=0.68-0.96) and regression line slopes of approximately one in the majority of groups. CSI tended to overestimate S-I in type 2 diabetic participants, but results were more reliable when CSI was computed with insulin-modified rather than regular IVGTT. CSI showed behaviours similar to S-I as regards relationships with BMI, acute insulin response and sex. CSI showed good correlation with M (R-2=0.82). Conclusions/interpretation A short test can achieve a good approximation of minimal model analysis and clamp insulin sensitivity. The importance of a method such as CSI is that it allows analysis of IVGTT datasets with samples limited to 1 h.
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68.
  • Vassy, Jason L., et al. (författare)
  • Association between parental history of diabetes and type 2 diabetes genetic risk scores in the PPP-Botnia and Framingham Offspring Studies
  • 2011
  • Ingår i: Diabetes Research and Clinical Practice. - : Elsevier BV. - 1872-8227 .- 0168-8227. ; 93:2, s. 76-79
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Parental history of diabetes and specific gene variants are risk factors for type 2 diabetes, but the extent to which these factors are associated is unknown. Methods: We examined the association between parental history of diabetes and a type 2 diabetes genetic risk score (GRS) in two cohort studies from Finland (population-based PPP-Botnia study) and the US (family-based Framingham Offspring Study). Results: Mean (95% CI) GRS increased from 16.8 (16.8-16.9) to 16.9 (16.8-17.1) to 17.1 (16.8-17.4) among PPP-Botnia participants with 0, 1, and 2 parents with diabetes, respectively (p(trend) = 0.03). The trend was similar among Framingham Offspring but was not statistically significant (p = 0.07). The meta-analyzed p value for trend from the two studies was 0.005. Conclusions: The very modest associations reported above suggest that the increased risk of diabetes in offspring of parents with diabetes is largely the result of shared environmental/lifestyle factors and/or hitherto unknown genetic factors. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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69.
  • Voight, Benjamin F., et al. (författare)
  • Twelve type 2 diabetes susceptibility loci identified through large-scale association analysis
  • 2010
  • Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 42:7, s. 579-589
  • Tidskriftsartikel (refereegranskat)abstract
    • By combining genome-wide association data from 8,130 individuals with type 2 diabetes (T2D) and 38,987 controls of European descent and following up previously unidentified meta-analysis signals in a further 34,412 cases and 59,925 controls, we identified 12 new T2D association signals with combined P < 5 x 10(-8). These include a second independent signal at the KCNQ1 locus; the first report, to our knowledge, of an X-chromosomal association (near DUSP9); and a further instance of overlap between loci implicated in monogenic and multifactorial forms of diabetes (at HNF1A). The identified loci affect both beta-cell function and insulin action, and, overall, T2D association signals show evidence of enrichment for genes involved in cell cycle regulation. We also show that a high proportion of T2D susceptibility loci harbor independent association signals influencing apparently unrelated complex traits.
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70.
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