| 1. |
- Agewall, S, et al.
(författare)
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Insulin sensitivity and hemostatic factors in clinically healthy 58-year-old men.
- 2000
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Ingår i: Thrombosis and haemostasis. - 0340-6245. ; 84:4, s. 571-5
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this cross-sectional study was to investigate the relationship between factors of the coagulation- and fibrinolysis systems and insulin sensitivity in 104 clinically healthy, 58-years-old men. Insulin sensitivity (hyperinsulinemic euglycemic clamp) adjusted for lean body mass, the metabolic syndrome according to a suggested definition, and different factors in the coagulation- and fibrinolysis system were determined. Subjects with the metabolic syndrome were characterised by increases in PAI-1 activity, tPA antigen, protein C and protein S and low concentrations of tPA activity. Insulin sensitivity was independently and reversibly associated with PAI-1 (p = 0.014) and directly with tPA activity (p = 0.001). Insulin sensitivity was also significantly negatively associated with protein S and protein C and several components in the metabolic syndrome, however not remaining significant in multivariate analyses. Protein C and protein S were significantly associated with PAI-1 activity, tPA activity (negatively), tPA antigen and antithrombin III. In conclusion, the data indicated that insulin resistance and several of the clustering components in the metabolic syndrome are accompanied by increased plasma concentrations of the anticoagulatory proteins C and S which may represent a mechanism which counteracts the concomitantly occurring hypofibrinolysis.
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| 2. |
- Agewall, S, et al.
(författare)
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Multiple risk intervention trial in high risk hypertensive men: comparison of ultrasound intima-media thickness and clinical outcome during 6 years of follow-up
- 2001
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 249:1, s. 305-314
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objective was to analyse whether a favourable change in risk factors, caused by a comprehensive risk factor modification programme, affected intima-media thickness (IMT) in the common carotid artery, and whether any such change was associated with a change in cardiovascular events during a 6-year follow-up. DESIGN: Patients were randomized 1 : 1 to special intervention or usual care. SETTING: Hypertension Unit at university hospital. SUBJECTS: A total of 164 patients were randomized. Inclusion criteria were male, aged 50-72 years (at randomization) and one or more of the following: Serum cholesterol level > 6.5 mmol L(-1), smoking or diabetes mellitus. All patients were prescribed antihypertensive treatment since many years. In 142 men good quality ultrasound recording of the common carotid IMT were achieved at baseline, 119 were re-examined after 3.3 years, and 97 patients were available for examination after mean follow-up time of 6.2 years. Cardiovascular events were available for all randomized patients. INTERVENTIONS: The nonpharmacological special intervention programme was based on one information meeting followed by five weekly 2-h sessions with participation of patients and spouses. The diet recommendations were similar to established guidelines. Overweight patients were instructed to lose weight, and diabetic patients were systematically taught self-monitoring of blood glucose. Smokers were invited to a smoking cessation programme with five weekly meetings. Follow-up visits were thereafter scheduled every 6 months. Lipid lowering drugs were recommended in the intervention group if the treatment goals using nonpharmacological measures were not achieved. Patients in the usual care group were told to quit smoking and to lower their consumption of fat and glucose. Antihypertensive treatment (i.e., selection of drugs) was on purpose kept similar in the two groups. MAIN OUTCOME MEASURES: The IMT of the common carotid artery as measured by ultrasound. Cardiovascular events during follow-up. RESULTS: Significant net reductions were seen for serum cholesterol, triglycerides, fasting glucose and smoking. No difference in change in IMT was observed during follow-up between the two randomization groups. The explanation was that patients with positive plaque status at baseline had a much larger increase in IMT over time than patients with negative plaque status, and that patients with positive plaque status more often survived and were available for re-examination after 6 years in the intervention group than in the usual care group. Total mortality was lower in the intervention group, compared with the usual care group, 13 and 29%, respectively (P=0.028). CONCLUSIONS: In high risk populations, long-term studies with surrogate endpoints may be misleading because of missing data in patients where a large increase in IMT would have been observed, had they been re-examined. Another important conclusion from our study was that the gloomy prognosis for this patient category may be improved by a dedicated risk factor intervention programme. The improved prognosis was observed mainly in those patients at highest risk judged from history of cardiovascular disease or positive ultrasound plaque status at baseline.
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| 3. |
- Ahmad, Tashfeen, et al.
(författare)
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Peripheral quantitative computed tomography for the detection of diabetic osteopathy: a study in the Goto-Kakizaki rat.
- 2003
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Ingår i: Investigative radiology. - 0020-9996. ; 38:3, s. 171-6
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE AND OBJECTIVE: To assess the utility of dual energy x-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT) in detecting trabecular and cortical bone changes in diabetes as a model of osteopenia. MATERIALS AND METHODS: The tibia from 10 type-2 diabetic Goto-Kakizaki (GK) rats and 10 control Wistar rats were analyzed by DEXA, pQCT, and ash weight determination. RESULTS: DEXA of GK rats showed a significant reduction in mineral content (32%) and density (24%) of the metaphysis, but not of the diaphysis. PQCT disclosed that the reduction of density predominantly pertained to the trabecular bone (reduced by 62%). Periosteal and endosteal circumferences of the diaphyses were increased and cortical thickness was unchanged leading to increased moment of inertia. CONCLUSIONS: This study suggests that in osteopathic conditions, cortical and trabecular bone should be separately examined within specific subregions to obtain relevant information. Loss of metaphyseal trabecular bone seems to be a predominant feature in diabetic rats. Moreover, there is increased moment of inertia in the diaphysis implying increased strength. These diagnostic features of diabetic osteopathy can only be assessed by pQCT. It may prove that similar changes occur in human type-2 diabetes, which could explain the susceptibility to periarticular fracture and Charcot arthropathy.
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| 4. |
- Ahmad, T, et al.
(författare)
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Skeletal changes in type-2 diabetic Goto-Kakizaki rats.
- 2003
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Ingår i: The Journal of endocrinology. - : Bioscientifica. - 0022-0795 .- 1479-6805. ; 178:1, s. 111-6
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Tidskriftsartikel (refereegranskat)abstract
- We characterized appendicular and axial bones in rats with type-2 diabetes in five female Goto-Kakizaki (GK) rats, a strain developed from the Wistar rat showing spontaneous type-2 diabetes, and five age- and sex-matched non-diabetic Wistar rats. The humerus, tibia, metatarsals and vertebral bodies were analysed by peripheral quantitative computerized tomography (pQCT). In diabetic rats, the height of the vertebral bodies and length of the humerus were decreased while the length of the metatarsals was increased. A decreased cross-sectional area was found in the vertebral end-plate region and the tibial metaphysis. Notably, the diaphysis in all long bones showed expansion of periosteal and endosteal circumference. In tibia this resulted in increased cortical thickness, whereas in humerus and metatarsal it was unchanged. Areal moment of inertia was increased in all diaphyses suggesting greater bending strength. The most conspicuous finding in diabetic rats pertained to trabecular osteopenia. Thus, trabecular bone mineral density was significantly reduced in all bones examined, by 33-53%. Our pQCT study of axial and appendicular bones suggests that the typical feature of diabetic osteopathy in the GK rat is loss of trabecular bone and expansion of the diaphysis. The loss of metaphyseal trabecular bone if also present in diabetic patients may prove to underlie the susceptibility to periarticular fracture and Charcot arthropathy. The findings suggest that the risk of fracture in diabetes varies according to the specific sub-regions of a bone. The approach described may prove to be useful in the early detection of osteopathy in diabetic patients who may be amenable to preventive treatment.
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| 5. |
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| 6. |
- Albin, Maria, et al.
(författare)
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Incidence of asthma in female Swedish hairdressers.
- 2002
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 59:2, s. 119-23.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the risk of asthma in hairdressers. METHODS: The incidence of asthma was retrospectively estimated in a Swedish nationwide study including all female hairdressers certified from vocational schools from 1970 to 1995, and a stratified sample of women from the general population were referents. A postal questionnaire included questions on respiratory tract symptoms, atopy, smoking, working periods as a hairdresser, and number of specific hair treatments performed/week. Reported exposures were validated by occupational hygienists. Rate ratios of incidence (IRRs) of asthma were estimated by Poisson regression, adjusted for calendar year of observation, hay fever, smoking, and region of domicile. RESULTS: The crude incidences of asthma/1000 person-years were: 3.9 during active years as a hairdresser, 2.8 among the hairdressers when not working in the profession, and 3.1 among the referents. The corresponding IRR for being an active hairdresser compared with the referents was 1.3 (95% confidence interval (95% CI) 1.0 to 1.6). Moderate effects on risk of asthma were found both from hairdressing work (IRR=1.6 (1.1 to 2.2) among never-smokers) and from smoking (IRR=1.6 (1.2 to 2.2) among referents). However, the combined effect from hairdressing work and smoking (IRR=1.5 (1.0 to 2.1)) was less than expected (p=0.02). No effect modification by respiratory atopy was found. The hairdressers most often performing hair bleaching treatments (IRR=1.5 (0.7 to 3.0)) or using hair spray (IRR=1.4 (0.8 to 2.4)) had, compared with the most infrequent users, a slightly, but not significantly higher incidence of asthma. Exposure to persulphates in hair bleach was estimated to be 0.04-0.15 mg/m(3) during mixing of the powder. Reported average number of bleaching treatments agreed well with those performed according to a diary. CONCLUSIONS: Active hairdressing work was associated with a moderately increased incidence of asthma among lifelong non-smokers. The results are moderately supportive, but not conclusive, of associations between asthma and exposure to hair bleach or hair spray.
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| 7. |
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| 8. |
- Alm, Bernt, 1951, et al.
(författare)
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Breast feeding and the sudden infant death syndrome in Scandinavia, 1992-95.
- 2002
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 86:6, s. 400-2
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Tidskriftsartikel (refereegranskat)abstract
- To assess the effects of breast feeding habits on sudden infant death syndrome (SIDS).The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries between 1 September 1992 and 31 August 1995 were invited to participate, each with parents of four matched controls. The odds ratios presented were computed by conditional logistic regression analysis.After adjustment for smoking during pregnancy, paternal employment, sleeping position, and age of the infant, the adjusted odds ratio (95% CI) was 5.1 (2.3 to 11.2) if the infant was exclusively breast fed for less than four weeks, 3.7 (1.6 to 8.4) for 4-7 weeks, 1.6 (0.7 to 3.6) for 8-11 weeks, and 2.8 (1.2 to 6.8) for 12-15 weeks, with exclusive breast feeding over 16 weeks as the reference. Mixed feeding in the first week post partum did not increase the risk.The study is supportive of a weak relation between breast feeding and SIDS reduction.
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| 9. |
- Alm, Bernt, 1951, et al.
(författare)
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Living conditions in early infancy in Denmark, Norway and Sweden 1992-95: results from the Nordic Epidemiological SIDS study.
- 2000
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 89:2, s. 208-14
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to study living conditions of infants and their families in Scandinavia in the 1990s and to assess similarities and differences among the three Scandinavian countries. The emphasis is on health and normality rather than on diseases and other deviations from well-being. The subjects are the 869 controls in the Nordic Epidemiological SIDS study carried out between 1 September 1992 and 31 August 1995 in Norway, Denmark and Sweden. The controls were matched with the 244 SIDS cases for sex, age and maternity hospital. Parents of the SIDS cases and the controls filled in the same questionnaire on family, pregnancy, delivery, the neonatal and the post-perinatal period. The most striking findings were that 99% of the mothers went to regular maternity controls, 97% to well-baby clinics and 84% breastfed exclusively. On the other hand, 11% drank alcohol more than once a month during pregnancy and 29% smoked during pregnancy. Compared to official statistics, to the extent they exist, the differences were small. The material contains valuable information on normal infant care in Scandinavia in the 1990s. Living conditions of infants in Scandinavia are similar in the three countries. Differences exist, but only to a small extent.
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| 10. |
- Alm, Bernt, 1951, et al.
(författare)
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Vitamin A and sudden infant death syndrome in Scandinavia 1992-1995.
- 2003
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253. ; 92:2, s. 162-4
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Tidskriftsartikel (refereegranskat)abstract
- To assess the effect of vitamin supplementation on the risk of sudden infant death syndrome (SIDS).The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries were invited to participate together with parents of four matched controls between 1 September 1992 and 31 August 1995. The odds ratios presented are computed by conditional logistic regression analysis.The crude odds ratio in Scandinavia for not giving vitamin substitution was 2.8 (95% CI (1.9, 4.3)). This effect was statistically significant in Norway and Sweden, which use A and D vitamin supplementation, but not in Denmark, where only vitamin D supplementation is given. The odds ratios remained significant in Sweden when an adjustment was made for confounding factors (OR 28.4, 95% CI (4.7, 171.3)).We found an association between increased risk of sudden infant death syndrome and infants not being given vitamin supplementation during their first year of life. This was highly significant in Sweden, and the effect is possibly connected with vitamin A deficiency. This effect persisted when an adjustment was made for potential confounders, includingsocioeconomic factors.
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