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Sökning: WFRF:(Sjöblad Sture)

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  • Odermarsky, Michal, et al. (författare)
  • Respiratory infection recurrence and passive smoking in early atherosclerosis in children and adolescents with typ 1 diabetes
  • 2008
  • Ingår i: European Journal of Clinical Investigation. - Wiley-Blackwell. - 0014-2972. ; 38:6, s. 381-388
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Optimal glucose control in juvenile type 1 diabetes mellitus is necessary but not sufficient to reduce the burden of cardiovascular events in later life. This emphasizes the importance of searching for other possible risk factors associated with diabetes. We investigated whether recurrent episodes of acute respiratory infections and exposure to tobacco smoke could influence vascular phenotypes for early atherosclerosis in children and adolescents with type 1 diabetes. MATERIALS AND METHODS: Common carotid artery elasticity and intima-media thickness along with circulating markers of lipid, inflammatory and glycaemic profiles were investigated in up to 98 children and adolescents with type 1 diabetes. The number of clinically manifest acute respiratory tract infections (RTI) during the past year, and the degree of exposure to environmental tobacco smoke (ETS), were assessed by separate questionnaires. RESULTS: Carotid artery compliance (CAC) was decreased in patients with high (>or= 4/year; n = 22) recurrence of RTI compared to the remaining patients (n = 40; P < 0.05). In a multivariate analysis, the number of RTI during the past year and HbA(1C) were independently associated with decreased CAC (P < 0.05 for both). The inverse relationship between RTI recurrence and CAC was strengthened by frequent exposure to ETS. CONCLUSIONS: High recurrence of respiratory infections in young type 1 diabetics is associated with increased stiffening of the carotid artery particularly in those often exposed to tobacco smoke.
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  • Aburawi, Elhadi, et al. (författare)
  • Acute respiratory viral infections aggravate arterial endothelial dysfunction in children with type 1 diabetes.
  • 2004
  • Ingår i: Diabetes Care. - American Diabetes Association. - 1935-5548. ; 27:11, s. 2733-2735
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite improvements in therapy for children with type 1 diabetes, the prevalence of cardiovascular morbidity in adulthood due to accelerated atherosclerosis remains significant (1). Similar to other cardiovascular risk factors, the diabetic state facilitates arterial endothelial injury, a primary event in the pathogenesis of atherosclerosis (2). Although several pediatric studies have reported an association of diabetes with arterial endothelial dysfunction (3,4), pathogenic animal studies have suggested that even though this disease predisposes to endothelial dysfunction and atherosclerosis, it might not be sufficient to cause them (5). Notably, type 1 diabetes increases the propensity for both chronic and acute infections in part by weakening the immune mechanisms (6). The risk is particularly increased for respiratory tract infections, but other infections have also been associated with diabetes (7). Furthermore, diabetic patients are at greater risk for infection-related mortality (8), and the excess risk appears to be linked to cardiovascular diseases (9). In the present study, we investigated whether viral respiratory tract infections in children with type 1 diabetes might impose an additional burden on the arterial endothelial function.
4.
  • Aburawi, Elhadi H., et al. (författare)
  • Effects of n-3 polyunsaturated fatty acids on left ventricular function and coronary flow in children with type 1 diabetes mellitus
  • 2011
  • Ingår i: ESC Congress, 2011,Paris, France,2011-08-27 - 2011-08-31. - Oxford University Press.
  • Konferensbidrag (refereegranskat)abstract
    • Purposes: It has earlier been suggested that dietary supplementation with N-3 Polyunsaturated Fatty Acids (n-3 PUFAs) could have beneficial effects on cardio- vascular system patients with type 1 diabetes mellitus (DM1). Whether the benefit also extends to coronary circulation has not been yet investigated. Methods: In a double-blind placebo controlled cross-over study, 33 children with DM1 duration of more than one year were randomly and equally assigned to either n-3 PUFAs (2 gm/day, Nycoplus® Omega-3) or placebo treatment for 4 weeks. Following a 4-week period recovery, the groups were crossovered with above treatments for another 4 weeks. Transthoracic Doppler echocardiography (TTDE) study was done on each visit; pre treatment, post treatment with n-3 PU- FAs on one occasion and with placebo on another and after one month recovery to assess left ventricular function and flow in the left anterior descending coronary artery (LAD). All data are mean±SD. Results: Of 33 recruited children, 28 (85%) completed the study. n-3 PUFAs treatment was associated with increase in both mean cardiac index (CI; from 2.7±0.4 to 3.7±0.8 l/min/m2, p<0.0001) and left ventricular fractional shortening (FS; from 31±2.5 to 39±3%, p<0.0001). In placebo treated groups there were no significant changes in these parameters. Also N-3 PUFAs treatment was as- sociated to decrease of both LAD peak flow velocity (PFVd; from 96±17 to 68±12 cm/s, p<0.0001) and LADs CF (from 105±31 to 66±15 ml/min, p<0.0001). Stop- ping n-3 PUFAs treatment and after one month recovery led to decrease of CI from 3.7±0.8 to 2.6±0.5 l/min/m2, p<0.0001 and mean FS from 39±3 to 32±2, p<0.0001. Mean PFVd increased from 68±12 to 90±12 cm/s, p<0.0001 and CF from 66±15 to 108±30 ml/min, p<0.0001. Conclusions: In patients with DM1, basal coronary flow parameters are in- creased, which could contribute to reduced coronary flow reserve. Treatment with n-3 PUFAs increases the cardiac index and LV systolic function and reverses the increased basal coronary flow, thereby improving the circumstances for better coronary flow reserve.
5.
  • Aburawi, Elhadi H., et al. (författare)
  • Effects of N-3 Polyunsaturated Fatty Acids on Left Ventricular Function and Coronary Flow in Children with Type 1 Diabetes Mellitus
  • 2011
  • Ingår i: Pediatric Research. - International Pediatric Foundation Inc.. - 1530-0447. ; 70:227
  • Konferensbidrag (refereegranskat)abstract
    • rposes: Dietary supplementation with N-3 Polyunsaturated Fatty Acids (n-3 PUFAs) could have beneficial effects on cardiovascular system in patients with type 1 diabetes mellitus (DM1). Methods: In a double-blind placebo controlled crossover study, 33 children with DM1 duration of more than one year were randomly and equally assigned to either n-3 PUFAs (2 gm/day, Nycoplus® Omega-3, 1000 mg) or placebo treatment for 8 weeks. Following a 4-week period recovery, the groups were crossovered with above treatments for another 8 weeks. Transthoracic Doppler echocardiography (TTDE) study was done on pre and post treatment visits, and after one month's treatment free recovery for left ventricular function and flow in the left anterior descending coronary artery (LAD). Results: Of recruited children 28 (85%) completed the study. n-3 PUFAs treatment was associated with increase in mean cardiac index (CI; from 2.7±0.4 to 3.7±0.8 l/min/m2, p< 0.0001) and left ventricular fractional shortening (FS; from 31±2.5 to 39±3%, p< 0.0001). The treatment decreased both LAD peak flow velocity (PFVd) from 96±17 to 68±12 cm/s, p< 0.0001 and LAD CF from 105±31 to 66±15 ml/min, p< 0.0001). One month after stopping the treatment CI decreased from 3.7±0.8 to 2.6±0.5 l/min/m2, p< 0.0001 and mean FS from 39±3 to 32±2, p< 0.0001. Mean PFVd increased from 68±12 to 90±12 cm/s, p< 0.0001 and CF from 66±15 to 108±30 ml/min, p< 0.0001. Conclusions: In patients with DM1 n-3 PUFA therapy increased cardiac index and LV systolic function. The basal coronary flow decrease improving the circumstances for better coronary flow reserve.
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  • Christesen, Henrik B. T., et al. (författare)
  • Rapid genetic analysis in congenital hyperinsulinism
  • 2007
  • Ingår i: Hormone Research. - Karger. - 0301-0163. ; 67:4, s. 184-188
  • Tidskriftsartikel (refereegranskat)abstract
    • Backgound: In severe, medically unresponsive congenital hyperinsulinism (CHI), the histological differentiation of focal versus diffuse disease is vital, since the surgical management is completely different. Genetic analysis may help in the differential diagnosis, as focal CHI is associated with a paternal germline ABCC8 or KCNJ11 mutation and a focal loss of maternal chromosome 11p15, whereas a maternal mutation, or homozygous/compound heterozygous ABCC8 and KCNJ11 mutations predict diffuse-type disease. However, genotyping usually takes too long to be helpful in the absence of a founder mutation. Methods: In 4 patients, a rapid genetic analysis of the ABBC8 and KCNJ11 genes was performed within 2 weeks on request prior to the decision of pancreatic surgery. Results: Two patients had no mutations, rendering the genetic analysis non-informative. Peroperative multiple biopsies showed diffuse disease. One patient had a paternal KCNJ11 mutation and focal disease confirmed by positron emission tomography scan and biopsies. One patient had a de novo heterozygous ABBC8 mutation and unexplained diffuse disease confirmed by positron emission tomography scan and biopsies. Conclusion: A rapid analysis of the entire ABBC8 and KCNJ11 genes should not stand alone in the preoperative assessment of patients with CHI, except for the case of maternal, or homozygous/compound heterozygous disease-causing mutations. Copyright (c) 2007 S. Karger AG, Basel.
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  • Holmquist, Peter, et al. (författare)
  • Early urinary changes in Tamm-Horsfall protein and epidermal growth factor in diabetic children
  • 2001
  • Ingår i: Pediatric Nephrology. - Springer. - 1432-198X. ; 16:6, s. 488-492
  • Tidskriftsartikel (refereegranskat)abstract
    • Both glomerular and tubular markers have been used to follow diabetic nephropathy. However, neither albumin nor proximal tubular markers have proven useful in prepubertal diabetes. Hence we studied two markers derived from the distal tubular cells, Tamm-Horsfall protein (THP) and epidermal growth factor (EGF), The urinary excretion of THP and EGF was examined in samples obtained during the first 20 days and 1 year after diagnosis of diabetes in children aged 4-15 years. Fourteen children without and 18 with ketonuria were examined, and 17 age-matched healthy children participated as controls. The excretion rate of EGF was increased at diagnosis, while that of THP was not. After 20 days of treatment the excretion of EGF had normalized, while the excretion of THP was decreased. Similar results were obtained after 1 year. In conclusion, in spite of good metabolic control a reduced excretion of THP persisted for at least 1 year after the diagnosis of diabetes. Whether the finding of reduced excretion of THP has any biological significance awaits further study.
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