| 1. |
- Niklasson, Bo, et al.
(författare)
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Prenatal viral exposure followed by adult stress produces glucose intolerance in a mouse model
- 2006
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 49:9, s. 2192-2199
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis: It has been suggested that the uterine environment may influence metabolic disease occurring later in adult life, and that adult stress may promote disease outcome. Using a mouse model, we tested whether in utero exposure to Ljungan virus (LV) followed by adult exposure to stress produces diabetes. The influence of the timing of viral exposure over the course of pregnancy was also tested. Materials and methods: Pregnant CD-1 mice were exposed i.p. to LV on pregnancy days 4, 8, 12 or 17. Adult male mice from these pregnancies were stressed by being kept in shared cages. Stress only, LV exposure in utero only, and no-stress/no virus exposure groups were also followed. Outcome variables included bodyweight, epididymal fat weight, baseline glucose, glucose tolerance tests (60 and 120 min) and serum insulin. Results: We demonstrated that male mice developed a type 2-like diabetes, including obesity, as adults if infected during pregnancy with LV. Diabetes at the age of 11 weeks was more severe in mice whose mothers were infected earlier than in those whose mothers were infected later in pregnancy. Only animals infected in utero and kept under stress developed diabetes; infection or stress alone did not cause disease. Conclusions/interpretation: This work demonstrates that a type 2 diabetes-like disease can be virus-induced in a mouse model. Early in utero viral insults can set the stage for disease occurring during adult life, but the final manifestation of diabetes is dependent on the combination of early viral exposure and stress in adult life.
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| 2. |
- Rundberg, Jenny, et al.
(författare)
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Mental symptoms, psychotropic drug use and alcohol consumption in immigrated middle-aged women. The Women's Health in Lund Area (WHILA) Study.
- 2006
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 60:6, s. 480-485
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to analyse mental symptoms, psychotropic drug use and alcohol consumption, in immigrant women born in Finland, the other Nordic countries, Eastern Europe, Western Europe and countries outside Europe, compared with Swedish-born women, and furthermore, to study if age at immigration may have an influence. All women (n = 10,766) aged 50 - 59 years and living in the Lund area of southern Sweden received a postal invitation to a health survey named the Women's Health in Lund Area; 64.2% (n = 6917) participated. The participants answered a questionnaire including prevalence of mental symptoms during the past 3 months, regular use of psychotropic drugs, alcohol consumption during an average week, country of birth and age at immigration. Severe mental symptoms were more common among most immigrant groups compared with native Swedes, but the association to country of birth was not significant after adjustment for possible confounders. Regular use of hypnotics was more common among Nordic immigrants only (odds ration, OR = 4.4). East European and non-European immigrants less often were alcohol consumers (OR = 1.6 and OR = 3.8). Heavy drinking was more common among non-Nordic immigrants who immigrated at a younger age than at an older age. Furthermore, it was found that although East European and non-European immigrants had a higher educational level, they were less often gainfully employed compared with native Swedes. In middle-aged women, country of birth as well as age at immigration are important factors to consider in relation to alcohol consumption, but these factors may be of less importance considering mental health.
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| 3. |
- Akesson, A, et al.
(författare)
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Cadmium-induced effects on bone in a population-based study of women
- 2006
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Ingår i: Environmental Health Perspectives. - : Environmental Health Perspectives. - 1552-9924 .- 0091-6765. ; 114:6, s. 830-834
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Tidskriftsartikel (refereegranskat)abstract
- High cadmium exposure is known to cause bone damage, but the association between low-level cadmium exposure and osteoporosis remains to be clarified. Using a population-based women's health survey in southern Sweden [Women's Health in the Lund Area (WHILA)] with no known historical cadmium contamination, we investigated cadmium-related effects on bone in 820 women (53-64 years of age). We measured cadmium in blood and urine and lead in blood, an array of markers of bone metabolism, and forearm bone mineral density (BMD). Associations were evaluated in multiple linear regression analysis including information on the possible confounders or effect modifiers: weight, menopausal status, use of hormone replacement therapy, age at menarche, alcohol consumption, smoking history, and physical activity. Median urinary cadmium was 0.52 mu g/L adjusted to density (0.67 mu g/g creatinine). After multivariate adjustment, BMD, parathyroid hormone, and urinary deoxypyridinoline (U-DPD) were adversely associated with concentrations of urinary cadmium (p < 0.05) in all subjects. These associations persisted in the group of never-smokers, which had the lowest cadmium exposure (mainly dietary). For U-DPD, there was a significant interaction between cadmium and menopause (p = 0.022). Our results suggest negative effects of low-level cadmium exposure on bone, possibly exerted via increased bone resorption, which seemed to be intensified after menopause. Based on the prevalence of osteoporosis and the low level of exposure, the observed effects, although slight, should be considered as early signals of potentially more adverse health effects.
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| 4. |
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| 5. |
- Monz, B, et al.
(författare)
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A description of health care provision and access to treatment for women with urinary incontinence in Europe - A five-country comparison
- 2005
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Ingår i: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 52:Suppl 2, s. 3-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Female urinary incontinence is a prevalent condition, but only about one-third of women seek treatment. Objectives: To describe the health care provision for women with urinary incontinence from a European perspective, selecting France, Germany, Spain, Sweden, and the United Kingdom as examples, and to investigate whether specific barriers for treatment exist. Methods: Available health care system information, a literature review and clinical expert information identified patterns of treatment provision. Results: In Spain, Sweden, and the UK, access to medical care in general is primarily through the general practitioners. However, in Spain and Sweden, women with urinary incontinence can directly visit specialists. In France and Germany, women have equal access to either general practitioners or specialists. Aside from general practitioners. gynaecologists play a major role ill urinary incontinence care in all countries except the UK. In Germany, urologists are also involved in initial female urinary incontinence cared however, only in about 16% of women. There are no waiting lists in France and Germany for appointments with physicians or procedures, contrary to Spain, which has long waiting lists. Access to general practitioners in the UK is unrestricted whereas advanced diagnosis and treatment in secondary care requires long waits. A specific Swedish policy mandates that no woman is required to wait longer than,3 months for incontinence visits and related surgery. In Sweden and the UK, specialist nurses and other health care workers provide incontinence set-vices. Almost all treatment options for urinary incontinence are at least in part reimbursed. However, various co-payments and fees in France, Germany, Spain and Sweden exist and constitute out-of-pocket expenses for women if no complementary additional private health insurance is available. In some countries, financial incentives for physicians to provide incontinence services are low, raising concerns about their interest to engage in continued patient care. Conclusions: Information about service provision in Europe for women with urinary incontinence is limited and makes it difficult to understand barriers to treatment seeking. A broad European perspective may promote optimised treatment access in the future for this widespread and under-recognised condition.
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| 6. |
- Monz, B, et al.
(författare)
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Patient-reported impact of urinary incontinence - Results from treatment seeking women in 14 European countries
- 2005
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Ingår i: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 52:Suppl 2, s. 24-34
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe the patient-reported impact of urinary incontinence (UI) in treatment-seeking women in Europe. Design: PURE was a non-interventional, observational study, which aimed to describe the direct costs of treatment for European women seeking treatment for UI. A secondary Study objective was to describe the impact of UI on health-related quality of life (HRQoL) by UI subtype and severity of disease. This paper presents the results from quality of life assessments as well as bothersomeness and interference with daily activities from the first study observation. Subjects: Nine thousand four hundred and eighty-seven European women who had UI symptoms in the last 12 months were enrolled. Their UI symptoms were frequently those defined as mixed urinary incontinence (MUI) and were moderate to severe in nature. Measurements: HRQoL was assessed at the first observation using the urinary Incontinence-specific Quality of Life Questionnaire (I-QOL) and the EQ-5D, a generic quality of life questionnaire. Data collected from EQ-5D provided insight into the patients' general health perception, while the I-QOL data indicated how affected the women were about their UI symptoms. Higher EQ-5D and I-QOL scores represent better quality of life. Patients were asked to indicate how much UI symptoms limited selected activities and to indicate the degree to which they found their symptoms to be bothersome. Results: Overall, the median self-rated health status on the EQ-5D visual analogue scale (VAS) was 70.0 and the median EQ-5D health state index was 0.85, with small but noticeable differences observed between countries. Of the five health dimensions of the EQ-5D, patients' self-care appeared to be the least affected by UI, with fewer than 10% of the women reporting that they had some problems. Between 20 and 40% of patients had some problems with their mobility and usual activities, or had pain/discomfort or anxiety/depression. However, the impact of existing co-morbidity was not assessed and may have affected some women's scoring of the EQ-5D domains. The mean total I-QOL score overall was 57.7 and of the three subscales of the I-QOL, psychosocial impact had the highest overall scores, representing fewer problems, with lower scores observed for the avoidance and limiting behaviour subscale, and even lower scores for the social embarrassment subscale. The greatest patient-reported impact of UI symptoms on activities was on exercise, with more than 45% of patients moderately to totally limited in this activity. In most of the countries, more than 60% of the women reported that they were moderately to extremely bothered by their UI symptoms. Conclusions: There was considerable impact of UI on HRQoL in a treatment seeking population, as demonstrated by the disease-specific quality of life scale and by the high percentage of patients who were bothered by their symptoms.
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| 7. |
- Qader, Saleem, et al.
(författare)
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Could Quality of Life Impact the Prevalence of Metabolic Syndrome? Results from a Population-Based Study of Swedish Women: The Women's Health in the Lund Area Study.
- 2008
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Ingår i: Metabolic syndrome and related disorders. - : Mary Ann Liebert Inc. - 1557-8518 .- 1540-4196.
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: The metabolic syndrome is regarded as an important risk factor for diabetes mellitus and cardiovascular disease. Metabolic syndrome could be associated with impaired quality of life (QoL). Methods: The Women's Health in the Lund Area (WHILA) project covers 10,766 women born between December 2, 1935, and December 1, 1945, living in the Lund area, of Sweden by December 1, 1995. The primary objectives of this project were to survey perimenopausal women in this area and to evaluate their health status and lifestyles. We used the criteria for the metabolic syndrome, as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), which include three or more of five risk factors: central obesity, elevated serum triglycerides, low high-density lipoprotein cholesterol (HDL-C), and elevated blood pressure and fasting glucose. Analysis of most aspects of daily life and QoL according to the Gothenburg Quality of Life Instrument (GQL) was done. GQL refers to the WHO definition of health. Results: A total number of 6913 (64.2%) women with a mean age (56.1) years fulfilled the criteria for screening procedure in the WHILA study. A positive association between women with metabolic syndrome and the following aspects of quality of life were found: "Partnership," "free time," "memory," and being "appreciated outside home." However, "economy," "health," "body image," and "fitness" had a negative association to the metabolic syndrome. Conclusion: QoL is an important factor for metabolic syndrome. Apart from traditional biological factors, prevention of metabolic syndrome should also encompass QoL.
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| 8. |
- Qader, S S, et al.
(författare)
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Sociodemographic risk factors of metabolic syndrome in middle-aged women: results from a population-based study of Swedish women, The Women's Health in the Lund Area (WHILA) Study.
- 2008
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Ingår i: Climacteric. - : Informa UK Limited. - 1369-7137 .- 1473-0804. ; 11:6, s. 475-482
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Metabolic syndrome (MS) is a common health problem in menopausal women. According to The Adult Treatment Panel (ATP) III, MS includes the combination of three or more of the following risk factors: abdominal obesity, glucose intolerance, high blood pressure, high serum triglycerides and low levels of high density lipoprotein cholesterol. OBJECTIVES: To assess the prevalence of the MS in middle-aged women, and the relationships of sociodemographic factors to the MS. METHODS: This analysis covers 10,766 women born between December 2, 1935 and December 1, 1945, living in the Lund area of Sweden by December 1, 1995. RESULTS: We found that 11.6% of women with a mean (+/-standard deviation) age of 56.9 +/- 3.06 years had MS. Women with MS were older and had higher scores for body weight, body mass index, waist/hip ratio, pulse rate, pulse pressure, serum triglycerides and total serum cholesterol (p < 0.001 for all) compared to the control group. More MS women were smokers, less often consumers of alcohol, and less qualified. In addition, they had low-intensity physical activity at leisure time (p < 0.001) and high-intensity physical activity at work (p = 0.009). Premenopausal women and those treated with hormones had less MS (p < 0.001). Education, physical activity at leisure time, moderate intensity of physical activity at work, alcohol intake and smoking had strong association with MS but work status, household status and dietary habits had no significant association with MS. CONCLUSIONS: Sociodemographic features may contribute to MS. Hence, prevention of MS should encompass sociodemographic features.
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| 9. |
- Rundberg, Jenny, et al.
(författare)
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Few middle-aged women with severe mental symptoms use psychotropic drugs: The women's health in Lund area ( WHILA) study
- 2005
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 33:5, s. 384-391
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Tidskriftsartikel (refereegranskat)abstract
- Aims: In a population of middle-aged women a survey was carried out to ascertain the prevalence of mental symptoms and psychotropic drug use, and further to investigate whether severe mental symptoms are associated with social situation, alcohol consumption, smoking, and physical health. Methods: All women (n510,766) aged 50-59 years and living in the Lund area were invited to the WHILA study, a health survey including laboratory examinations and a self-administered questionnaire; 6,917 (64.2%) participated. This study is based on the questionnaire only. Results: During the past three months 25.4% (n=1,709) had been troubled by none or 1 mental symptom ( labelled "absent/slight''), 52.8% (n=3,555) by 2-6 mental symptoms ("moderate'') and 21.8% (n=1,471) by 7-10 mental symptoms ("severe"). Among women with severe mental symptoms 15.4% regularly used psychotropic drugs, mainly antidepressants. A multiple logistic regression analysis showed that women with severe mental symptoms had higher odds for living alone (OR 1.7; CI 1.3-2.2) or as single parents (OR 2.1; CI 1.2-3.6), being university-educated (OR 1.5; CI 1.1-2.0), being on long-term sick-leave (OR 8.8; CI 3.0-25.5), using hormone replacement therapy (OR 1.3; CI 1.1-1.6), and having severe physical symptoms (136.8; CI 89.2-209.7) compared with women with absent/slight mental symptoms. Conclusion: Mental symptoms were common among the participating women. The presence of severe mental symptoms was strongly associated with severe physical symptoms. Few women with severe mental symptoms used psychotropic drugs. Middle-aged women with severe mental symptoms need to be identified and provided with appropriate psychopharmacological, hormonal, and/or psychosocial treatment.
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| 10. |
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