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Träfflista för sökning "hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) ;srt2:(1990-1999);pers:(Ahren B)"

Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) > (1990-1999) > Ahren B

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1.
  • Bergenfelz, A, et al. (författare)
  • Intraoperative fall in plasma levels of intact parathyroid hormone after removal of one enlarged parathyroid gland in hyperparathyroid patients
  • 1991
  • Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 157:2, s. 12-109
  • Tidskriftsartikel (refereegranskat)abstract
    • Plasma levels of intact parathyroid hormone (PTH) were measured intraoperatively before and after removal of one enlarged gland in 20 hyperparathyroid patients. In 13 patients with a single parathyroid adenoma, plasma levels of intact PTH-(1-84) had declined at 15 min after removal of the adenoma by 86.5 +/- 4.4% of baseline in the antecubital vein and by 85.6 +/- 4.2% in the ipsilateral internal jugular vein. In seven patients with parathyroid hyperplasia, the corresponding figures for decline at 15 min after removal of one enlarged parathyroid gland were only 26.6 +/- 6.4% and 7.8 +/- 29.4%. The fall in PTH levels was significantly less in hyperplasia than in adenoma (p less than 0.001). Thus 15 min after removal of one enlarged parathyroid gland, the decline in plasma level of intact PTH may distinguish between single adenoma and multiglandular disease as the cause of hyperparathyroidism.
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  • Bergenfelz, A, et al. (författare)
  • Hyperthyroxinemia after surgery for primary hyperparathyroidism
  • 1994
  • Ingår i: Langenbecks Archiv für Chirurgie. - 0023-8236. ; 379:3, s. 81-178
  • Tidskriftsartikel (refereegranskat)abstract
    • Episodes of transient thyrotoxicosis after surgery for primary hyperparathyroidism have previously been described, and surgical trauma to the thyroid gland has been suggested as an etiologic factor. However, there are several links between the thyroid and parathyroid hormonal systems, and therefore other explanations are possible as well. In this study we investigate pre- and postoperative serum levels of thyroid hormones in 20 patients operated upon because of primary hyperparathyroidism. The mean (SD) serum levels of T4 increased from 16(2) pmol/l preoperatively to 21(6) pmol/l on the fourth postoperative day (P < 0.01), and four (20%) of the patients developed biochemical thyrotoxicosis in the immediate postoperative period. The serum levels of T4 on the fourth postoperative day correlated highly with preoperative serum levels of PTH (r = 0.75; P < 0.001). This suggests that biochemical thyrotoxicosis in the immediate postoperative period after operation for primary hyperparathyroidism is not uncommon and could be related to the disease rather than to surgical trauma.
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4.
  • Bergenfelz, A, et al. (författare)
  • Immunoheterogeneity of parathyroid hormone pre- and postoperatively in primary hyperparathyroidism
  • 1995
  • Ingår i: Langenbecks Archiv für Chirurgie. - 0023-8236. ; 380:2, s. 24-119
  • Tidskriftsartikel (refereegranskat)abstract
    • In primary hyperparathyroidism (pHPT), a preferential release of intact PTH (i-PTH) versus carboxylterminal PTH fragments is known to occur. We studied whether the release of amino-terminal PTH fragments (N-PTH) is also changed. Serum levels of i-PTH and N-PTH were determined under basal conditions and following oral intake of calcium in six patients with pHPT before and immediately after surgery and in seven healthy subjects. In the patients, baseline levels of both i-PTH and N-PTH were increased preoperatively. The increase was larger in i-PTH compared to N-PTH. Therefore, the N/i ratio was reduced compared to healthy subjects (P < 0.05). On the first postoperative day, serum i-PTH decreased to a larger extent than N-PTH, which increased the N/i ratio above that in healthy subjects (P < 0.05). On the 5th postoperative day, the N/i ratio was normalized. Preoperatively, the suppressibility of i-PTH calcium was impaired in the patients (P < 0.05), whereas the suppressibility of N-PTH was normal, resulting in unchanged N/i ratio during the oral calcium load. In contrast, the N/i ratio increased normally during the calcium load at day 5 postoperatively (P < 0.05). We therefore conclude that: (1) in pHPT, circulating PTH immunoheterogeneity is altered with a preferential release of intact PTH compared to N-terminal PTH fragments and this alteration is normalized after surgery, (2) the secretion of intact PTH and N-terminal PTH shows different sensitivity to inhibition by calcium.
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5.
  • Söderberg, Stefan, et al. (författare)
  • Leptin is a risk marker for first-ever hemorrhagic stroke in a population-based cohort.
  • 1999
  • Ingår i: Stroke. - 0039-2499 .- 1524-4628. ; 30:2, s. 328-337
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: Leptin, important for body weight regulation, may be involved in the pathogenesis of the insulin resistance syndrome, associated with cardiovascular disease. We tested to determine whether leptin is a risk marker for first-ever stroke in a nested case-referent study.METHODS: We identified 113 patients with first-ever stroke (94 with ischemic and 19 with hemorrhagic stroke) who, before the stroke, had participated in population-based health surveys in northern Sweden. Referents were matched for sex, age, date and type of health survey, and geographic region. Blood pressure (BP), body mass index (BMI), and presence of smoking, diabetes, and hypertension were recorded. Total cholesterol, insulin, and leptin were analyzed in stored samples. Risk markers for first-ever stroke were analyzed by conditional logistic regression analysis.RESULTS: Patients with hemorrhagic stroke had higher levels of BMI and systolic and diastolic BPs. Leptin levels were 72% and 59% higher in males and females, respectively, with hemorrhagic stroke versus referents. Patients with ischemic stroke more often had hypertension, diabetes mellitus, and higher fasting glucose and insulin levels. A diagnosis of hypertension and elevated systolic and diastolic BPs were significant risk markers for first-ever hemorrhagic stroke in univariate analysis. High leptin (OR=20.55; 95% CI, 1.12 to 376.7) levels together with hypertension (OR=16.28; 95% CI, 1.49 to 177.3) remained as significant risk markers in a multivariate model. The combination of high leptin and high systolic or diastolic BP were associated with a profoundly increased risk for hemorrhagic stroke (OR=22.11; 95% CI, 1.57 to 310.9). Diabetes, hypertension, and obesity (BMI >/=27), together with high levels of insulin, glucose, systolic and diastolic BP, were significant risk markers for first-ever ischemic stroke in univariate analysis. Hypertension (OR=2.10; 95% CI, 1.14 to 3.86) remained as an independent risk marker in a multivariate model.CONCLUSIONS: Plasma leptin is strongly associated with an increased risk for first-ever hemorrhagic stroke, independent of other risk markers for cardiovascular disease. Leptin may be an important link in the development of cardiovascular disease in obesity.
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6.
  • Söderberg, Stefan, et al. (författare)
  • Leptin is associated with increased risk of myocardial infarction.
  • 1999
  • Ingår i: Journal of Internal Medicine. - 0954-6820 .- 1365-2796. ; 246:4, s. 409-418
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES AND DESIGN: Leptin is involved in the regulation of bodyweight and metabolism in man and might also be involved in the pathophysiology of the insulin resistance syndrome, which is associated with the development of cardiovascular diseases. We tested whether leptin is a risk factor for acute myocardial infarction (AMI) in a nested case-referent study.SUBJECTS AND METHODS: Sixty-two men with first-ever AMI were identified who, prior to AMI, had participated in population-based health surveys in Northern Sweden. Referents were matched for sex, age, date and type of health survey, and geographical region. Blood pressure, body mass index (BMI) and the presence of smoking, diabetes and hypertension were recorded. Total cholesterol, apolipoprotein A-1 (apo A-1), apolipoprotein B (apo B), plasminogen activator inhibitor (PAI-1), insulin, and leptin were analysed in stored samples. Their influences on first-ever AMI were analysed by conditional logistic regression analysis.RESULTS: Men with first-ever AMI had higher BMI, plasma insulin and leptin, and diastolic blood pressure than the referents. Furthermore, they had lower plasma apo A-1 and were more often smokers. Smoking, high leptin, PAI-1 and cholesterol, and low apo A-1 levels were significant risk factors for first-ever AMI in univariate analysis. High leptin (OR 8.97; 95% CI: 1.73-46.5) and cholesterol (OR 5.18; 95% CI: 1.34-20.0) levels remained significant risk factors for AMI in a multivariate model. High apo A-1 was protective (OR = 0.13; 95% CI: 0.03-0.55). The combination of high leptin and low apo A-1 was associated with a particularly pronounced increased risk for AMI.CONCLUSION: Plasma leptin strongly predicts first-ever AMI. Our data support the hypothesis that leptin is an important link in the development of cardiovascular disease in obesity.
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7.
  • Söderberg, Stefan, et al. (författare)
  • Plasma leptin levels are associated with abnormal fibrinolysis in men and postmenopausal women.
  • 1999
  • Ingår i: Journal of Internal Medicine. - 0954-6820 .- 1365-2796. ; 245:5
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Leptin is a crucial mediator of satiety signals and energy balance, and its circulating levels are increased in obesity. It has recently been shown that plasma leptin levels in humans correlate with circulating insulin and to insulin secretion. This indicates that leptin may be an important link in metabolic consequences of the insulin resistance syndrome. Whether this includes abnormalities in fibrinolysis has not been studied.METHODS AND RESULTS: Healthy subjects (n = 165; 85 men and 80 women) from the Northern Sweden MONICA population were investigated. Anthropometric measurements, oral glucose tolerance tests and sampling for plasma leptin, lipids, fibrinogen and fibrinolytic variables were made. Leptin levels were 342% higher in women than in men and were in both sexes strongly correlated to body mass index (BMI). After adjustments for age and BMI, leptin levels correlated significantly to pre/post glucoseload insulin levels in both sexes. After further adjustment for baseline insulin levels, leptin levels were in males significantly associated with increased waist circumference (P<0.001), low HDL cholesterol (P<0.05), low tPA activity (P<0.01) and high PAI-1 activity (P<0.001). In postmenopausal females, a significant association between leptin and low tPA activity/high PAI-1 activity was seen after adjustment for age and BMI (P<0.05). Conclusions. Circulating levels of leptin are associated with components of the insulin resistance syndrome, including defective fibrinolysis, in men and postmenopausal women. This suggests that leptin may be involved in the mediation of consequences of insulin resistance.
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8.
  • Bergenfelz, A, et al. (författare)
  • Calcium metabolism after hemithyroidectomy
  • 1993
  • Ingår i: Hormone Research. - : S. Karger AG. - 0301-0163 .- 1423-0046. ; 39:1-2, s. 56-60
  • Tidskriftsartikel (refereegranskat)abstract
    • It is not known whether thyroid surgery evokes changes in calcium metabolism. We therefore studied 6 patients operated upon with hemithyroidectomy for benign thyroid diseases, preoperatively and at 3 months and 1 year postoperatively. We measured changes in serum levels of intact parathyroid hormone (PTH), vitamin D metabolites, ionized calcium, phosphate, osteocalcin, thyroid hormones and bone density. Further, the dynamic function of the parathyroid glands was investigated by an oral calcium load test pre- and at 3 months postoperatively. At follow-up, all patients were euthyroid. During the oral calcium load, serum levels of intact PTH were reduced by the same degree before and after hemithyroidectomy, showing normal parathyroid function. Serum levels of 1,25-dihydroxyvitamin D declined from 86 +/- 16 to 57 +/- 4 pmol/l (p < 0.01) at 1 year after hemithyroidectomy, and serum levels of phosphate increased slightly from 0.96 +/- 0.08 to 1.06 +/- 0.08 mmol/l (p < 0.05), whereas serum levels of ionized calcium, intact PTH, osteocalcin and bone density did not change. Our results demonstrate that thyroid operation evokes changes in vitamin D metabolism in spite of normal parathyroid function.
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9.
  • Bergenfelz, A, et al. (författare)
  • Functional recovery of the parathyroid glands after surgery for primary hyperparathyroidism
  • 1994
  • Ingår i: Surgery. - 0039-6060. ; 116:5, s. 36-827
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The immediate postoperative function of the parathyroid glands after surgery for primary hyperparathyroidism (pHPT) has not been established. We therefore examined the influences of hypercalcemia and hypocalcemia on serum parathyroid hormone (PTH) levels in the immediate postoperative period in patients with pHPT.METHODS: Ethylenediaminetetraacetic acid was infused in patients on the first (n = 5) and fourth (n = 6) postoperative days, and in patients at 1 year after surgery (n = 6), and in healthy subjects (n = 7). Calcium was given orally before operation and on the second and fifth postoperative days in six patients and in seven healthy subjects.RESULTS: The increased set point seen in pHPT was normalized on the first postoperative day, and the decreased PTH suppressibility by calcium was normal on the second postoperative day. However, on the fifth postoperative day an increased suppressibility of PTH was evident. During the ethylenediaminetetraacetic acid infusion test the secretory reserve for PTH increased after operation with increasing hypocalcemia-induced levels of intact PTH between the first and fourth postoperative days (p < 0.001), and between the fourth postoperative day and the test at 1 year (p < 0.05).CONCLUSIONS: In the immediate postoperative period after surgery for pHPT, baseline serum levels of PTH are rapidly normalized; this is followed by an increase in the secretory reserve for PTH secretion and the development of an increased sensitivity to calcium.
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