| 1. |
- Nilsson, Peter, et al.
(author)
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The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese.
- 2002
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In: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 252:1, s. 70-78
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Journal article (peer-reviewed)abstract
- Objective. To study effects on non-cancer mortality of observational weight loss in middle-aged men stratified for body mass index (BMI), taking a wide range of possible confounders into account. Design. Prospective, population based study. Setting. Male population of Malmö, Sweden. Participants. In all 5722 men were screened twice with a mean time interval of 6 years in Malmö, southern Sweden. They were classified according to BMI category at baseline (<21, 22-25, overweight: 26-30, and obesity: 30+ kg m-2) and weight change category until second screening (weight stable men defined as having a baseline BMI ± 0.1 kg m-2 year-1 at follow-up re-screening). Main outcome measures. Non-cancer mortality calculated from national registers during 16 years of follow-up after the second screening. Data from the first year of follow-up were excluded to avoid bias by mortality caused by subclinical disease at re-screening. Results. The relative risk (RR; 95% CI) for non-cancer mortality during follow-up was higher in men with decreasing BMI in all subgroups: RR 2.64 (1.46-4.71, baseline BMI <21 kg m-2), 1.39 (0.98-1.95, baseline BMI 22-25 kg m-2), and 1.71 (1.18-2.47, baseline BMI 26+ kg m-2), using BMI-stable men as reference group. Correspondingly, the non-cancer mortality was also higher in men with increasing BMI, but only in the obese group (baseline BMI 26+ kg m-2) with RR 1.86 (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m-2) men with decreased BMI had an increased non-cancer mortality compared with BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for nonsmoking overweight men who increased their BMI compared with BMI-stable men was also significant (P=0.006), but not in corresponding obese men (P=0.094). Conclusions. Weight loss in self-reported healthy but overweight middle-aged men, without serious disease, is associated with an increased non-cancer mortality, which seems even more pronounced in obese, nonsmoking men, as compared with corresponding but weight-stable men. The explanation for these observational findings is still enigmatic but could hypothetically be because of premature ageing effects causing so-called weight loss of involution.
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| 2. |
- Rosengren, Björn, et al.
(author)
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Inferior physical performance test results of 10,998 men in the MrOS Study is associated with high fracture risk.
- 2012
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In: Age and ageing. - : Oxford University Press (OUP). - 1468-2834 .- 0002-0729. ; 41:3, s. 339-44
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Journal article (peer-reviewed)abstract
- Background: most fractures are preceded by falls. Objective: the aim of this study was to determine whether tests of physical performance are associated with fractures. Subjects: a total of 10,998 men aged 65 years or above were recruited. Methods: questionnaires evaluated falls sustained 12 months before administration of the grip strength test, the timed stand test, the six-metre walk test and the twenty-centimetre narrow walk test. Means with 95% confidence interval (95% CI) are reported. P < 0.05 is a statistically significant difference. Results: fallers with a fracture performed worse than non-fallers on all tests (all P < 0.001). Fallers with a fracture performed worse than fallers with no fractures both on the right-hand-grip strength test and on the six-metre walk test (P < 0.001). A score below –2 standard deviations in the right-hand-grip strength test was associated with an odds ratio of 3.9 (95% CI: 2.1–7.4) for having had a fall with a fracture compared with having had no fall and with an odds ratio of 2.6 (95% CI: 1.3–5.2) for having had a fall with a fracture compared with having had a fall with no fracture. Conclusion: the right-hand-grip strength test and the six-metre walk test performed by old men help discriminate fallers with a fracture from both fallers with no fracture and non-fallers.
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| 3. |
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| 4. |
- Norinder, A, et al.
(author)
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Costs for screening, intervention and hospital treatment generated by the Malmö Preventive Project: a large-scale community screening programme.
- 2002
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In: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 251:1, s. 44-52
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The purpose of this study was to estimate retrospectively the costs of health care resources used in the Malmö Preventive Project, Sweden and estimate the costs of in-patient care that were avoided because of early intervention. SETTING AND SUBJECTS: A large-scale community intervention programme was conducted from 1974 to 1992 in Malmö, Sweden with the aim of reducing morbidity and mortality of cardiovascular diseases (CVD), alcohol related illnesses, and breast cancer. Between 1974 and 1992, 33 336 male and female subjects were screened for hypertension, hyperlipidaemia, type-2 diabetes and alcohol abuse. Intervention programmes that included life-style modifications, follow-up visits with physicians and nurses and drug therapy were offered to about 25% of screened subjects. METHODS: Recruitment costs were generated through out the screening period. Intervention costs were estimated for 5 years after screening. Excess in-patient care costs were estimated by subtracting hospital consumption for an unscreened, matched cohort from that of the screened cohort over follow-up periods of 13-19 years. Intervention and excess in-patient care costs were estimated until 1996. RESULTS: The net expenditures for recruitment and intervention was SEK253 million and saved costs for in-patient care of SEK143 millions (1998 prices). Considering the opportunity cost of the resources used in the study, the net cost rises to about SEK200 millions. CONCLUSIONS: The results suggest that only part of the intervention costs were offset by reduction in future morbidity health care costs. This is in line with results from prospective analyses of other primary prevention programmes.
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| 5. |
- Buttazzoni, Christian, et al.
(author)
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A Pediatric Bone Mass Scan has Poor Ability to Predict Peak Bone Mass: An 11-Year Prospective Study in 121 Children.
- 2015
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In: Calcified Tissue International. - : Springer Science and Business Media LLC. - 1432-0827 .- 0171-967X. ; 96:5, s. 379-388
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Journal article (peer-reviewed)abstract
- This 11-year prospective longitudinal study examined how a pre-pubertal pediatric bone mass scan predicts peak bone mass. We measured bone mineral content (BMC; g), bone mineral density (BMD; g/cm(2)), and bone area (cm(2)) in femoral neck, total body and lumbar spine by dual-energy X-ray absorptiometry in a population-based cohort including 65 boys and 56 girls. At baseline all participants were pre-pubertal with a mean age of 8 years (range 6-9), they were re-measured at a mean 11 years (range 10-12) later. The participants were then mean 19 years (range 18-19), an age range that corresponds to peak bone mass in femoral neck in our population. We calculated individual BMC, BMD, and bone size Z scores, using all participants at each measurement as reference and evaluated correlations between the two measurements. Individual Z scores were also stratified in quartiles to register movements between quartiles from pre-pubertal age to peak bone mass. The correlation coefficients (r) between pre-pubertal and young adulthood measurements for femoral neck BMC, BMD, and bone area varied between 0.37 and 0.65. The reached BMC value at age 8 years explained 42 % of the variance in the BMC peak value; the corresponding values for BMD were 31 % and bone area 14 %. Among the participants with femoral neck BMD in the lowest childhood quartile, 52 % had left this quartile at peak bone mass. A pediatric bone scan with a femoral neck BMD value in the lowest quartile had a sensitivity of 47 % [95 % confidence interval (CI) 28, 66] and a specificity of 82 % (95 % CI 72, 89) to identify individuals who would remain in the lowest quartile at peak bone mass. The pre-pubertal femoral neck BMD explained only 31 % of the variance in femoral neck peak bone mass. A pre-pubertal BMD scan in a population-based sample has poor ability to predict individuals who are at risk of low peak bone mass.
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| 6. |
- Karlsson, Magnus, et al.
(author)
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Inferior physical performance tests in 10,998 men in the MrOS study is associated with recurrent falls
- 2012
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In: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 41:6, s. 740-746
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Journal article (peer-reviewed)abstract
- Background: recurrent fallers are at especially high risk for injuries. Objective: to study whether tests of physical performance are associated with recurrent falls. Subjects: a total of 10,998 men aged 65 years or above. Methods: questionnaires evaluated falls sustained 12 months preceding testing of grip strength, timed stand, 6-m walk and 20-cm narrow walk test. Means with 95% confidence interval (95% CI) are reported. P < 0.01 is a statistically significant difference. Results: in comparison to both occasional fallers and non-fallers, recurrent fallers performed more poorly on all the physical ability tests (all P < 0.001). A score below -2 standard deviations (SDs) in the right-hand grip strength test was associated with an odds ratio of 2.4 (95% CI 1.7, 3.4) for having had recurrent falls compared with having had no fall and of 2.0 (95% CI 1.3, 3.4) for having had recurrent falls compared with having had an occasional fall. Conclusion: low performance in physical ability tests are in elderly men associated with recurrent falls.
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| 7. |
- Detter, Fredrik, et al.
(author)
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A Six-Year Exercise Program Improves Skeletal Traits without Affecting Fracture Risk - a Prospective Controlled Study in 2621 Children
- 2014
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In: Journal of bone and mineral research. - : Wiley. - 0884-0431 .- 1523-4681. ; 29:6
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Journal article (peer-reviewed)abstract
- Most pediatric exercise intervention studies, that evaluates the effect on skeletal traits include volunteers and follow bone mass for less than three years. We present a population-based six-year controlled exercise intervention study in children with also bone structure and incident fractures as endpoints. Fractures were registered in 417 girls and 500 boys in the intervention group (3969 person-years) and 835 girls and 869 boys in the control group (8245 person-years), all aged 6-9 years at study start, during the six-year study period. Children in the intervention group had 40 minutes daily school physical education (PE) and the control group 60 minutes per week. In a sub-cohort with 78 girls and 111 boys in the intervention group and 52 girls and 54 boys in the control group, bone mineral density (g/cm2 ) and bone area (mm2 ) were measured repeatedly by dual energy X-ray absorptiometry (DXA). Peripheral quantitative computed tomography (pQCT) measured bone mass and bone structure at follow-up. There were 21.7 low and moderate energy related fractures per 1000 person-years in the intervention group and 19.8 fractures in the control group, leading to a Rate Ratio (RR) of 1.12 (0.85, 1.46). Girls in the intervention group, in comparison with girls in the control group, had 0.009 g/cm2 (0.003, 0.015) larger gain annually in spine BMD, 0.07 g (0.014, 0.123) larger gain in femoral neck BMC and 4.0 mm2 (0.5, 7.8) larger gain in femoral neck area, and at follow-up 24.1 g (7.6, 40.6) higher tibial cortical BMC (g) and 23.9 mm2 (5.27, 42.6) larger tibial cross-sectional area. Boys with daily PE had 0.006 g/cm2 (0.002, 0.010) larger gain annually in spine BMD than control boys but at follow-up no higher pQCT values than boys in the control group. Daily PE for six years in at study start 6-9 year old improves bone mass and bone size in girls and bone mass in boys, without affecting the fracture risk. (c) 2014 American Society for Bone and Mineral Research.
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| 8. |
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| 9. |
- Eriksson, Per, et al.
(author)
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Improved outcome in Wegener's granulomatosis and microscopic polyangiitis? A retrospective analysis of 95 cases in two cohorts
- 2009
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In: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 265:4, s. 496-506
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Journal article (peer-reviewed)abstract
- Mortality rates for Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) have decreased after the introduction of cyclophosphamide. Standardized mortality ratio (SMR) expresses the overall mortality of patients compared with the general population. The aims of this study were to compare survival in an old and a recent cohort of patients with WG and MPA using SMR and to determine predictors for death in both groups combined. Survival analyses were performed by Kaplan-Meier survival curves, SMR and proportional hazards regression models. The nephrology and rheumatology clinics at Linkoping University Hospital, Sweden. All patients diagnosed with WG or MPA in the catchment area during 1978-2005 were divided into two cohorts; patients diagnosed before (n = 32, old cohort) and after (n = 63, recent cohort) December 31, 1996. The two cohorts differed regarding the proportion of WG (75% vs. 56%, P = 0.03) and a tendency for more pronounced kidney involvement in the old cohort: 266 mu mol L-1 (16% dialysis-dependent) vs. 192 mu mol L-1 (5% dialysis-dependent), but were comparable regarding disease severity. SMR at 1 and 5 years were 2.1 (95% CI: 0.43-6.09) and 1.6 (95% CI: 0.6-3.2) in the recent cohort and 5.2 (95% CI: 1.07-15.14) and 2.5 (95% CI: 0.93-5.52) in the old cohort. Five-year survival was 87% and 81%. Serum creatinine, age, end-stage renal disease, diagnosis before 1997 and first relapse were independent predictors for death. Patient survival in WG and MPA analysed with SMR may be better than previously believed. Severe renal disease and disease relapse were the major predictors of reduced survival.
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| 10. |
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