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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Endokrinologi och diabetes) > Mälardalens universitet

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1.
  • Isaksson, Johan, et al. (författare)
  • Early psychosocial adversity and cortisol levels in children with attention-deficit/hyperactivity disorder
  • 2013
  • Ingår i: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 22:7, s. 425-432
  • Tidskriftsartikel (refereegranskat)abstract
    • Previous studies suggest a different regulation of the hypothalamus-pituitary-adrenal axis (HPA-axis) with lower diurnal cortisol levels, especially in the morning, in children with attention-deficit/hyperactivity disorder (ADHD) compared with controls. Since exposure to foetal and childhood psychosocial adversity has been associated with both ADHD and HPA-axis functioning, such exposures may explain these low cortisol levels in ADHD via early programming of the HPA-axis. Thus, our main aim was to retrospectively study foetal and early childhood exposures to psychosocial adversity in children with ADHD and to relate these exposures to cortisol levels. Saliva samples were collected during a regular weekday in children, 6-17 years old, with clinically confirmed ADHD (n = 197) and non-affected comparisons (n = 221) for radioimmunoassay analysis of cortisol. Parental rating scales were used for categorising subtypes of ADHD and degree of exposure to adversity. Children with ADHD had more reports of at least one rated foetal adversity (p = 0.041) and childhood adversity (p < 0.001) than comparisons. The association between low morning cortisol levels and ADHD-symptoms remained when analyses were adjusted for adversities, age, sex, sampling time and symptoms of oppositional defiant disorder. No relation was found between exposures to foetal/childhood adversity and cortisol levels except for a positive relation between childhood adversity and cortisol morning increase in children with ADHD. The hypothesis that early adversity may influence the HPA-axis, leading to lower cortisol levels in children with ADHD, was not supported by our findings.
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2.
  • Leu Agelii, Monica, 1977, et al. (författare)
  • Low vitamin D status in relation to cardiovascular disease and mortality in Swedish women - Effect of extended follow-up
  • 2017
  • Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 0939-4753 .- 1590-3729. ; 27:12, s. 1143-1151
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: The impact of vitamin D concentrations on subsequent cardiovascular disease (CVD) and overall mortality has been generally examined for periods under two decades. The magnitude of the association may depend on follow-up length. We aimed to investigate the relationship between baseline vitamin D and risk of total CVD, stroke and all-cause mortality over three decades of follow-up. Secondly, we aimed to assess how follow-up affects the associations. Methods and results: Concentrations of 25-hydroxyvitamin D (25D) were measured in a population-based sample of 1227 middle-aged women using serum collected at baseline and categorized into low (lowest 25D quartile) vs high 25D status (upper three 25D quartiles). Hazard ratio (HR) of the endpoints was estimated for low 25D. The impact of follow-up was examined in intermediary analyses where follow-up was interrupted up to four times, each time decreasing it by five years. There were 596 cardiovascular events and 635 participants died. During the first 17 years, the low 25D group experienced a 29% higher CVD risk and 3.3-fold higher stroke risk after accounting for confounders. Longer follow-up diminished significantly these risks and 25D status had no contribution at 32 years. For mortality, the decline over time was less dramatic, with HR = 1.96 (1.25; 3.08) at 17 years and HR = 1.42 (1.17; 1.72) at 37 years. Conclusion: Low 25D status increased the risk for all endpoints, but a lengthy follow-up diminished these risks towards the null. The impact of follow-up depends on the outcome. Future studies of 25D and disease should use repeated 25D assessments. (C) 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B. V. All rights reserved.
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3.
  • Sjörs, Anna, et al. (författare)
  • Long-term follow-up of cortisol awakening response in patients treated for stress-related exhaustion
  • 2012
  • Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 2:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Studies on hypothalamus-pituitary-adrenal (HPA) axis activity in stress-related exhaustion Design: HPA axis activity was assessed through the cortisol awakening response (CAR). Salivary cortisol Setting: An outpatient clinic specialising in stress-related illness. Participants: Patients with clinically diagnosed stress-related exhaustion (n = 162) and healthy controls Primary and secondary outcome measures: The primary measure was CAR measured as the difference Results: Patients showed similar CAR as the controls and their CAR did not change significantly during Conclusions: The authors conclude that CAR does not seem to discriminate clinically defined patients
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4.
  • Andersson, Per, et al. (författare)
  • Knowledge about cardiovascular risk factors among obese individuals.
  • 2006
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:4
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Obesity is an important biological risk factor for cardiovascular disease (CVD).AIMS: The main aim of this study was to answer the question whether obese individuals differ from individuals with normal weight with regard to knowledge about risk factors for CVD. A further aim was to replicate previous findings that obese individuals are at higher risk of developing other biological risk factors for CVD.METHOD: Normal weights, BMI<25 kg/m(2) (n=385), and obese, BMI> or =30 kg/m(2) (n=159), individuals were identified from a screening program conducted among 50-year-old inhabitants of the County of Västmanland, Sweden. Participants answered questions regarding their gender, level of education, and items relating to knowledge about cardiovascular risk factors. Total cholesterol and blood glucose levels, height, weight and blood pressure were measured.RESULTS: Obese individuals did not differ significantly from individuals with a normal weight regarding knowledge of cardiovascular risk factors when education was controlled for. Obesity and low level of education are associated with other risk factors for CVD such as high blood pressure and high serum cholesterol.CONCLUSION: Obese individuals are at an increased risk of developing other risk factors for CVD but are just as knowledgeable about risk factors for CVD as normal weighting individuals.
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5.
  • Griep, Rosane Harter, et al. (författare)
  • Gender, work-family conflict, and weight gain: four-year follow-up of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
  • 2022
  • Ingår i: Cadernos de Saúde Pública. - : FapUNIFESP (SciELO). - 0102-311X .- 1678-4464. ; 38:4
  • Tidskriftsartikel (refereegranskat)abstract
    • This study sought to analyze the effect of work-to-family conflict (demands from work that affect one’s family/personal life), family-to-work conflict (demands from family/personal life that affect work), and lack of time for self-care and leisure due to professional and domestic demands on the incidence of weight gain and increase in waist circumference by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Our study included 9,159 ELSA-Brasil participants (4,413 men and 4,746 women) who attended baseline (2008-2010) and the first follow-up visit (2012-2014). Weight gain and increase in waist circumference were defined as an annual increase ≥ 75th percentile, i.e., ≥ 1.21kg/year and ≥ 1.75cm/year, respectively for women; and ≥ 0.96kg/year and ≥ 1.41cm/year respectively for men. Associations were estimated by Poisson regression applying robust variance with the R software. Analyses were stratified by gender and adjusted for socioeconomic variables. Adjusted models showed a higher risk of weight gain among women who reported family-to-work conflict frequently and sometimes (relative risk - RR = 1.37 and RR = 1.15, respectively) and among those who reported frequent lack of time for self-care and leisure (RR = 1.13). Among men, time-based work-to-family conflict (RR = 1.17) and strain-based work-to-family conflict (RR = 1.24) were associated with weight gain. No associations were observed between work-family conflict domains and increase in waist circumference. These findings suggest that occupational and social health promotion programs are essential to help workers balance work and family life to reduce weight gain.
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6.
  • Ljung, Thomas, 1961-, et al. (författare)
  • Central and peripheral glucocorticoid receptor function in abdominal obesity.
  • 2002
  • Ingår i: Journal of endocrinological investigation. - 0391-4097 .- 1720-8386. ; 25:3, s. 229-35
  • Tidskriftsartikel (refereegranskat)abstract
    • Abdominal obesity seems to be associated with a moderately deranged feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis where central glucocorticoid receptors (GR) are involved. Therefore, functions of central and peripheral GR were compared in this study. Furthermore, since trinucleotide repeats in early exons of steroid hormone receptor genes influence transcription, and therefore may influence receptor density, this was also studied. Ten middle-aged men, 5 with abdominal obesity and 5 controls, were studied. The suppression of dexamethasone (dex) on serum cortisol was used in dose-response tests to assess the function of central GR. Abdominal adipose tissue biopsies were incubated and exposed to cortisol in different concentrations, and the function of the peripheral GR assayed as induction of lipoprotein lipase (LPL) activity. Aberrant expansion of exonic trinucleotide repeats in the first coding exon of the GR gene was studied by sequencing of genomic DNA. Results showed that men with abdominal obesity showed less inhibition of serum cortisol by dex, particularly at lower concentrations, while in the controls cortisol secretion was inhibited in an apparent dose-response manner. LPL activity in adipose tissue was lower in abdominal obese men than in controls. However, the sensitivity to cortisol was not different between the groups. There was no evidence for expansion of trinucleotide repeats. These results suggest that the central GR and the peripheral GR in adipose tissue exhibit functional differences in abdominal obesity.
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7.
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8.
  • Rossen, Jenny, et al. (författare)
  • 'This is why I'm doing a lot of exercise' : A qualitative study of participant's experiences of the Sophia Step Study
  • 2018
  • Ingår i: International Diabetes Nursing. - : Informa UK Limited. - 2057-3316 .- 2057-3324.
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Support for physical activity (PA) is central in diabetes care. The Sophia Step Study is a three-armed randomised controlled trial aiming to evaluate different levels of support for increased PA in prediabetes and Type 2 diabetes. With the purpose to reveal the programme components and the mediating factors from the participants’ perspective this paper aims to report a qualitative exploration of adhering participants’ experiences after two years’ study participation.Methods: Semi-structured interviews were conducted with 18 participants (men, n = 11, women, n = 7, prediabetes, n = 5, Type 2 diabetes, n = 13, median age 68.5 years) who completed a two-year multi-component (n = 7), singlecomponent (n = 6) intervention or served as controls (n = 5) at a primary care center in Stockholm, Sweden. The interviews were analysed using content analysis with an inductive approach. Sophia Step Study is registered at ClinicalTrials.gov with Identifier: NCT02374788.Results: The participants recalled the frequent study assessments as providing feedback of health outcomes; positive reinforcement; a sense of sentinel and a personalised approach. Group meetings, pedometers and health check-ups were valued as resources for increased awareness and motivation of PA; establishment of new routines and control over the own health. The long program duration allowed for maintenance of awareness and routines for PAConclusion: Adhering participants in theory-based interventions, but also in the control group, identified key mediators to support for PA. Feedback of results, personalised encouragement, emotional support and selfmonitoring should be regarded in self-management of PA to optimise patient motivation and outcomes.
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9.
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10.
  • Teixeira, Pedro F., et al. (författare)
  • Assisting the implementation of screening for type 1 diabetes by using artificial intelligence on publicly available data
  • 2024
  • Ingår i: DIABETOLOGIA. - : SPRINGER. - 0012-186X .- 1432-0428. ; 67, s. 985-994
  • Tidskriftsartikel (refereegranskat)abstract
    • The type 1 diabetes community is coalescing around the benefits and advantages of early screening for disease risk. To be accepted by healthcare providers, regulatory authorities and payers, screening programmes need to show that the testing variables allow accurate risk prediction and that individualised risk-informed monitoring plans are established, as well as operational feasibility, cost-effectiveness and acceptance at population level. Artificial intelligence (AI) has the potential to contribute to solving these issues, starting with the identification and stratification of at-risk individuals. ASSET (AI for Sustainable Prevention of Autoimmunity in the Society; www.asset.healthcare) is a public/private consortium that was established to contribute to research around screening for type 1 diabetes and particularly to how AI can drive the implementation of a precision medicine approach to disease prevention. ASSET will additionally focus on issues pertaining to operational implementation of screening. The authors of this article, researchers and clinicians active in the field of type 1 diabetes, met in an open forum to independently debate key issues around screening for type 1 diabetes and to advise ASSET. The potential use of AI in the analysis of longitudinal data from observational cohort studies to inform the design of improved, more individualised screening programmes was also discussed. A key issue was whether AI would allow the research community and industry to capitalise on large publicly available data repositories to design screening programmes that allow the early detection of individuals at high risk and enable clinical evaluation of preventive therapies. Overall, AI has the potential to revolutionise type 1 diabetes screening, in particular to help identify individuals who are at increased risk of disease and aid in the design of appropriate follow-up plans. We hope that this initiative will stimulate further research on this very timely topic.
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