| 1. |
- Bunck, M. C., et al.
(författare)
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Exenatide treatment did not affect bone mineral density despite body weight reduction in patients with type 2 diabetes
- 2011
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Ingår i: Diabetes, obesity & metabolism. - : Wiley. - 1463-1326 .- 1462-8902. ; 13:4, s. 374-377
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Tidskriftsartikel (refereegranskat)abstract
- Preclinical studies suggest that incretin-based therapies may be beneficial for the bone; however, clinical data are largely lacking. We assessed whether the differential effects of these therapies on body weight differed with respect to their effect on bone mineral density (BMD) and markers of calcium homeostasis in patients with type 2 diabetes (T2D). Sixty-nine metformin-treated patients with T2D were randomized to exenatide twice daily (n = 36) or insulin glargine once daily (n = 33). Total body BMD, measured by dual-energy X-ray absorptiometry, and serum markers of calcium homeostasis were assessed before and after 44-week treatment. Exenatide or insulin glargine treatment decreased body weight by 6%. Endpoint BMD was similar in both groups after 44-week therapy (LSmean +/- s.e.m. between-group difference -0.002 +/- 0.007 g/cm(2) ; p = 0.782). Fasting serum alkaline phosphatase, calcium and phosphate remained unaffected. Forty-four-week treatment with exenatide or insulin glargine had no adverse effects on bone density in patients with T2D, despite differential effects on body weight.
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| 2. |
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| 3. |
- Bunck, M. C., et al.
(författare)
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Exenatide affected circulating cardiovascular risk biomarkers independently of changes in body composition
- 2010
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Ingår i: Diabetes Care. - 0149-5992. ; 33:8, s. 1734-1737
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To study the effect of exenatide on body composition and circulating cardiovascular risk biomarkers. RESEARCH DESIGN AND METHODS Metformin-treated patients with type 2 diabetes (N = 69) were randomized to exenatide or insulin glargine and treated for 1 year. Body composition was evaluated by dual-energy X-ray absorptiometry. Additionally, body weight, waist circumference, and cardiovascular biomarkers were measured. RESULTS Treatment with exenatide for 1 year significantly reduced body weight, waist circumference, and total body and trunkal fat mass by 6, 5, 11, and 13%, respectively. In addition, exenatide increased total adiponectin by 12% and reduced high-sensitivity C-reactive protein by 61%. Insulin glargine significantly reduced endothelin-1 by 7%. These changes were statistically independent of the change in total body fat mass and body weight. CONCLUSIONS Exenatide treatment for 1 year reduced body fat mass and improved the profile of circulating biomarkers of cardiovascular risk. No significant changes were seen with insulin glargine except a trend for reduced endothelin-1 levels.
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| 4. |
- Salomonsson, S., et al.
(författare)
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A Population-based Investigation of the Autoantibody Profile in Mothers of Children with Atrioventricular Block
- 2011
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Ingår i: Scandinavian Journal of Immunology. - Oxford : Blackwell Publishing. - 0300-9475 .- 1365-3083. ; 74:5, s. 511-517
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to investigate the antigen specificity and occurrence of individual autoantibodies in mothers of children diagnosed with atrioventricular (AV) block in a nation-wide setting. Patients with AV block detected before 15 years of age were identified using national quality registries as well as a network of pediatric and adult cardiologists and rheumatologists at the six university hospitals in Sweden. Patients with gross heart malformations, surgically or infectiously induced blocks were excluded. Blood samples were obtained from the mothers and maternal autoantibody profile, including the occurrence of antibodies against Ro52, Ro60, La, SmB, SmD, RNP-70k, RNP-A, RNP-C, CENP-C, Scl-70, Jo-1, ribosomal RNP and histones was investigated in 193 mothers of children with AV block by immunoblotting and ELISA. Autoantibody reactivity was detected in 48% (93/193) of the mothers of children with AV block. In autoantibody-positive mothers, the vast majority, 95% (88/93), had antibodies against Ro52, while 63% (59/93) had autoantibodies to Ro60 and 58% (54/93) had autoantibodies to La. In addition, 13% (12/93) of the autoantibody-positive mothers had antibodies to other investigated antigens besides Ro52, Ro60 and La, and of these anti-histone antibodies were most commonly represented, detected in 8% (7/93) of the mothers. In conclusion, this Swedish population-based study confirms that maternal autoantibodies may associate with heart block in the child. Further, our data demonstrate a dominant role of Ro52 antibodies in association with AV block.
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| 5. |
- Broman, T, et al.
(författare)
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Molecular Detection of Persistent Francisella tularensis Subspecies holarctica in Natural Waters
- 2011
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Ingår i: International Journal of Microbiology. - : Hindawi Publishing Corporation. - 1687-918X .- 1687-9198. ; 2011, s. Article ID 851946-
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Tidskriftsartikel (refereegranskat)abstract
- Tularemia, caused by the bacterium Francisella tularensis, where F. tularensis subspecies holarctica has long been the cause of endemic disease in parts of northern Sweden. Despite this, our understanding of the natural life-cycle of the organism is still limited. During three years, we collected surface water samples (n = 341) and sediment samples (n = 245) in two areas in Sweden with endemic tularemia. Real-time PCR screening demonstrated the presence of F. tularenis lpnA sequences in 108 (32%) and 48 (20%) of the samples, respectively. The 16S rRNA sequences from those samples all grouped to the species F. tularensis. Analysis of the FtM19InDel region of lpnA-positive samples from selected sampling points confirmed the presence of F. tularensis subspecies holarctica-specific sequences. These sequences were detected in water sampled during both outbreak and nonoutbreak years. Our results indicate that diverse F. tularensis-like organisms, including F. tularensis subsp. holarctica, persist in natural waters and sediments in the investigated areas with endemic tularemia.
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| 6. |
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| 7. |
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| 8. |
- Eliasson, Ann-Christin, 1950-, et al.
(författare)
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Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy : an expert consensus
- 2014
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Ingår i: Developmental Medicine & Child Neurology. - : Mac Keith Press. - 0012-1622 .- 1469-8749. ; 56:2, s. 125-137
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to provide an overview of what is known about constraintinduced movement therapy (CIMT) in children with unilateral cerebral palsy (CP), to identify current knowledge gaps, and to provide suggestions for future research.METHOD: Nine experts participated in a consensus meeting. A comprehensive literature search was conducted and data were summarized before the meeting. The core model produced by the European network for Health Technology Assessment was used as a framework for discussion and to identify critical issues for future research.RESULTS: All models of CIMT have demonstrated improvements in the upper limb abilities of children with unilateral CP. A consensus was reached on 11 important questions to be further explored in future studies. The areas of highest priority included the effect of dosage, the effect of repeated CIMT, and the impact of predictive factors, such as age, on the response to CIMT. Consensus suggestions for future study designs and the use of validated outcome measures were also provided.INTERPRETATION: The CIMT construct is complex, and much remains unknown. It is unclear whether a specific model of CIMT demonstrates superiority over others and whether dosage of training matters. Future research should build upon existing knowledge and aim to provide information that will help implement CIMT in various countries with different healthcare resources and organizational structures.
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| 9. |
- Eliasson, Björn, 1959, et al.
(författare)
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Lowering of postprandial lipids in individuals with type 2 diabetes treated with alogliptin and/or pioglitazone: a randomised double-blind placebo-controlled study.
- 2012
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 55:4, s. 915-925
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: Pharmacological augmentation of glucagon-like peptide 1 receptor signalling by dipeptidyl peptidase 4 (DPP-4) inhibition reduced intestinal lipoprotein secretion in experimental studies, suggesting that DPP-4 inhibitors may ameliorate dyslipidaemia and thus reduce cardiovascular risk in patients with type 2 diabetes. We assessed the effects of alogliptin (Alo) and Alo co-administered with pioglitazone (Pio) vs placebo (Pbo) on triacylglycerol (TG)-rich lipoproteins in type 2 diabetes before and following a high-fat meal. METHODS: Seventy-one patients (age 18-70years), who did not reach HbA(1c) 6.5% (48mmol/mol) with lifestyle and/or metformin, sulfonylurea or glinide therapy, participated in this 16week, double-centre (university hospitals) Pbo-controlled parallel-group study. All participants, people doing measurements or examinations, and people assessing the outcomes were blinded to group assignment. Fasting TG 1.7-5.0mmol/l was among the entry criteria. Patients received a high-fat mixed meal before and 4 and 16weeks after randomisation (allocation by central office) to Alo (n=25), Alo/Pio (n=22) or Pbo (n=24). Blood was sampled at pre-specified intervals, starting at 15min before and ending 8h after meal ingestion. RESULTS: At week 16, Alo (n=25) and Alo/Pio (n=21) vs Pbo (n=24) produced similar significant reductions in total postprandial TG response (incremental AUC [iAUC]; p<0.001), as well as in chylomicron TG (p<0.001) and VLDL1 TG iAUCs (p<0.001 and p=0.012, respectively). Postprandial chylomicron apolipoprotein B-48 iAUC showed a significant decrease after Alo treatment (p=0.028), and a non-significant trend towards a decrease with Alo/Pio (p=0.213). The incidence of adverse events was low and consistent with previous studies. CONCLUSIONS/INTERPRETATION: Treatment with Alo and Alo/Pio produced significant reductions in postprandial TG and TG-rich lipoproteins, contributing to an improved overall cardiometabolic risk profile in type 2 diabetes. The data support the concept that incretins not only modulate glucose metabolism but also influence chylomicron metabolism in intestinal cells. TRIAL REGISTRATION: ClinicalTrials.gov number NCT00655863. FUNDING: The study was funded by Takeda Global Research & Development.
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| 10. |
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| 11. |
- Eliasson, Salomon, et al.
(författare)
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Systematic and random errors between collocated satellite ice water path observations
- 2013
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Ingår i: Journal of Geophysical Research - Atmospheres. - : John Wiley & Sons. - 2169-897X .- 2169-8996. ; 118:6, s. 2629-2642
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Tidskriftsartikel (refereegranskat)abstract
- There remains large disagreement between IWP in observational datasets, largely because the sensors observe different parts of the ice particle size distribution. A detailed comparison of retrieved IWP from satellite observations in the Tropics ({plus minus}30{degree sign} latitude) in 2007 is made using collocated measurements. The DARDAR IWP dataset, based on combined Radar/Lidar measurements, is used as a reference as it provides arguably the best estimate of the total column IWP. For each dataset, usable IWP dynamic ranges are inferred from this comparison. IWP retrievals based on solar reflectance measurements, MODIS, and AVHRR-based CMSAF, and PATMOS-x, were found to be correlated with DARDAR over a large IWP range (~20-7000 g/m-2;). The random errors of the collocated datasets have a close to log-normal distribution, and the combined random error of MODIS and DARDAR is less than a factor of 2, which also sets the upper limit for MODIS alone. In the same way the upper limit for the random error of all considered datasets is determined. Datasets based on passive microwave measurements,MSPPS, MiRS, and CMO, are largely correlated with DARDAR for IWP values larger than approximately 700 g/m². The combined uncertainty between these datasets and DARDAR in this range is slightly less MODIS-DARDAR, but the systematic bias is nearly an order of magnitude.
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| 12. |
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| 13. |
- Hoppa, M. B., et al.
(författare)
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Multivesicular exocytosis in rat pancreatic beta cells
- 2012
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 55:4, s. 1001-1012
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Tidskriftsartikel (refereegranskat)abstract
- To establish the occurrence, modulation and functional significance of compound exocytosis in insulin-secreting beta cells. Exocytosis was monitored in rat beta cells by electrophysiological, biochemical and optical methods. The functional assays were complemented by three-dimensional reconstruction of confocal imaging, transmission and block face scanning electron microscopy to obtain ultrastructural evidence of compound exocytosis. Compound exocytosis contributed marginally (< 5% of events) to exocytosis elicited by glucose/membrane depolarisation alone. However, in beta cells stimulated by a combination of glucose and the muscarinic agonist carbachol, 15-20% of the release events were due to multivesicular exocytosis, but the frequency of exocytosis was not affected. The optical measurements suggest that carbachol should stimulate insulin secretion by similar to 40%, similar to the observed enhancement of glucose-induced insulin secretion. The effects of carbachol were mimicked by elevating [Ca2+](i) from 0.2 to 2 mu mol/l Ca2+. Two-photon sulforhodamine imaging revealed exocytotic events about fivefold larger than single vesicles and that these structures, once formed, could persist for tens of seconds. Cells exposed to carbachol for 30 s contained long (1-2 mu m) serpentine-like membrane structures adjacent to the plasma membrane. Three-dimensional electron microscopy confirmed the existence of fused multigranular aggregates within the beta cell, the frequency of which increased about fourfold in response to stimulation with carbachol. Although contributing marginally to glucose-induced insulin secretion, compound exocytosis becomes quantitatively significant under conditions associated with global elevation of cytoplasmic calcium. These findings suggest that compound exocytosis is a major contributor to the augmentation of glucose-induced insulin secretion by muscarinic receptor activation.
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| 14. |
- Johnston, Marston Sheldon, 1971, et al.
(författare)
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Diagnosing the average spatio-temporal impact of convective systems – Part 1: A methodology for evaluating climate models
- 2013
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Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 13:23, s. 12043-12058
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Tidskriftsartikel (refereegranskat)abstract
- An earlier method to determine the mean response of upper-tropospheric water to localised deep convective systems (DC systems) is improved and applied to the EC-Earth climate model. Following Zelinka and Hartmann (2009), several fields related to moist processes and radiation from various satellites are composited with respect to the local maxima in rain rate to determine their spatio-temporal evolution with deep convection in the central Pacific Ocean. Major improvements to the earlier study are the isolation of DC systems in time so as to prevent multiple sampling of the same event, and a revised definition of the mean background state that allows for better characterisation of the DC-system-induced anomalies. The observed DC systems in this study propagate westward at similar to 4 ms(-1). Both the upper-tropospheric relative humidity and the outgoing longwave radiation are substantially perturbed over a broad horizontal extent and for periods > 30 h. The cloud fraction anomaly is fairly constant with height but small maximum can be seen around 200 hPa. The cloud ice water content anomaly is mostly confined to pressures greater than 150 hPa and reaches its maximum around 450 hPa, a few hours after the peak convection. Consistent with the large increase in upper-tropospheric cloud ice water content, albedo increases dramatically and persists about 30 h after peak convection. Applying the compositing technique to EC-Earth allows an assessment of the model representation of DC systems. The model captures the large-scale responses, most notably for outgoing longwave radiation, but there are a number of important differences. DC systems appear to propagate east-ward in the model, suggesting a strong link to Kelvin waves instead of equatorial Rossby waves. The diurnal cycle in the model is more pronounced and appears to trigger new convection further to the west each time. Finally, the modelled ice water content anomaly peaks at pressures greater than 500 hPa and in the upper troposphere between 250 hPa and 500 hPa, there is less ice than the observations and it does not persist as long after peak convection. The modelled upper-tropospheric cloud fraction anomaly, however, is of a comparable magnitude and exhibits a similar longevity as the observations.
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| 15. |
- Johnston, Marston Sheldon, 1971, et al.
(författare)
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Diagnosing the average spatio-temporal impact of convective systems - Part 2: A model intercomparison using satellite data
- 2014
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Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 14:16, s. 8701-8721
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Tidskriftsartikel (refereegranskat)abstract
- The representation of the effect of tropical deep convective (DC) systems on upper-tropospheric moist processes and outgoing longwave radiation is evaluated in the EC-Earth3, ECHAM6, and CAM5 (Community Atmosphere Model) climate models using satellite-retrieved data. A composite technique is applied to thousands of deep convective systems that are identified using local rain rate maxima in order to focus on the temporal evolution of the deep convective processes in the model and satellite-retrieved data. The models tend to over-predict the occurrence of rain rates that are less than approximate to 3 mm h(-1) compared to Tropical Rainfall Measurement Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA). While the diurnal distribution of oceanic rain rate maxima in the models is similar to the satellite-retrieved data, the land-based maxima are out of phase. Despite having a larger climatological mean uppertropospheric relative humidity, models closely capture the satellite-derived moistening of the upper troposphere following the peak rain rate in the deep convective systems. Simulated cloud fractions near the tropopause are larger than in the satellite data, but the ice water contents are smaller compared with the satellite-retrieved ice data. The models capture the evolution of ocean-based deep convective systems fairly well, but the land-based systems show significant discrepancies. Over land, the diurnal cycle of rain is too intense, with deep convective systems occurring at the same position on subsequent days, while the satellite-retrieved data vary more in timing and geographical location. Finally, simulated outgoing longwave radiation anomalies associated with deep convection are in reasonable agreement with the satellite data, as well as with each other. Given the fact that there are strong disagreements with, for example, cloud ice water content, and cloud fraction, between the models, this study supports the hypothesis that such agreement with satellite-retrieved data is achieved in the three models due to different representations of deep convection processes and compensating errors.
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| 16. |
- Lind, M, et al.
(författare)
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The shape of the metabolic memory of HbA(1c): re-analysing the DCCT with respect to time-dependent effects.
- 2010
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 53:6, s. 1093-1098
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: We determined the shape of the metabolic memory of HbA(1c) and its contribution to retinopathy, as well as the importance of reducing HbA(1c) to prevent progression of retinopathy. METHODS: The relative risk contribution of HbA(1c) values at different points in time to current progression of retinopathy was determined in the DCCT patients. RESULTS: HbA(1c) 2 to 3 years earlier had the greatest relative risk contribution to current progression of retinopathy. HbA(1c) up to 5 years earlier made a greater contribution than current values, while values from 8 years earlier still had an important impact. When HbA(1c) had been at 8% for a long period and was subsequently lowered to 7%, the salutary effects did not begin to appear until 2 to 3 years after lowering. The hazard function for a constant level of HbA(1c) increased with time. The numbers needed to treat when reducing HbA(1c) from 8.3% to 8% from diagnosis was estimated to be 1,688 for the first 3 years and 13 for the period 9 to 12 years. Survival functions when reducing HbA(1c) from 8% to 7% show that pre-study glycaemic control dominates the effect on progression of retinopathy during the first years of a trial. CONCLUSIONS/INTERPRETATION: The most harmful effect of hyperglycaemia on progression of retinopathy in type 1 diabetes initially increases, but declines after roughly 5 years. The salutary effect of reducing HbA(1c) accelerates with time and becomes greater in clinical practice than has been previously understood. Clinical trials should preferably be designed for long periods or include patients with low previous glycaemic exposure to distinguish trial effects from those of the metabolic memory.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Stasiewicz, K., et al.
(författare)
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Acceleration of solar wind ions to 1 MeV by electromagnetic structures upstream of the Earth's bow shock
- 2013
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Ingår i: Europhysics letters. - : IOP Publishing. - 0295-5075 .- 1286-4854. ; 102:4, s. 49001-
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Tidskriftsartikel (refereegranskat)abstract
- We present measurements from the ESA/NASA Cluster mission that show in situ acceleration of ions to energies of 1MeV outside the bow shock. The observed heating can be associated with the presence of electromagnetic structures with strong spatial gradients of the electric field that lead to ion gyro-phase breaking and to the onset of chaos in ion trajectories. It results in rapid, stochastic acceleration of ions in the direction perpendicular to the ambient magnetic field. The electric potential of the structures can be compared to a field of moguls on a ski slope, capable of accelerating and ejecting the fast running skiers out of piste. This mechanism may represent the universal mechanism for perpendicular acceleration and heating of ions in the magnetosphere, the solar corona and in astrophysical plasmas. This is also a basic mechanism that can limit steepening of nonlinear electromagnetic structures at shocks and foreshocks in collisionless plasmas.
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| 21. |
- Afghahi, Henri, 1966, et al.
(författare)
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Risk factors for the development of albuminuria and renal impairment in type 2 diabetes—the Swedish National Diabetes Register (NDR)
- 2010
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Ingår i: Nephrology, Dialysis and Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 26:4, s. 1236-1243
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aim of this study was to identify clinical risk factors associated with the development of albuminuria and renal impairment in patients with type 2 diabetes (T2D). In addition, we evaluated if different equations to estimate renal function had an impact on interpretation of data. This was done in a nationwide population-based study using data from the Swedish National Diabetes Register. Methods. Three thousand and six hundred sixty-seven patients with T2D aged 30-74 years with no signs of renal dysfunction at baseline (no albuminuria and eGFR >60 mL/min/1.73 m(2) according to MDRD) were followed up for 5 years (2002-2007). Renal outcomes, development of albuminuria and/or renal impairment [eGFR < 60 mL/min/1.73 m(2) by MDRD or eCrCl > 60 mL/min by Cockgroft-Gault (C-G)] were assessed at follow-up. Univariate regression analyses and stepwise regression models were used to identify significant clinical risk factors for renal outcomes. Results. Twenty percent of patients developed albuminuria, and 11% renal impairment; thus, ~6-7% of all patients developed non-albuminuric renal impairment. Development of albuminuria or renal impairment was independently associated with high age (all P < 0.001), high systolic BP (all P < 0.02) and elevated triglycerides (all P < 0.02). Additional independent risk factors for albuminuria were high BMI (P < 0.01), high HbA1c (P < 0.001), smoking (P < 0.001), HDL (P < 0.05) and male sex (P < 0.001), and for renal impairment elevated plasma creatinine at baseline and female sex (both P < 0.001). High BMI was an independent risk factor for renal impairment when defined by MDRD (P < 0.01), but low BMI was when defined by C-G (P < 0.001). Adverse effects of BMI on HbA1c, blood pressure and lipids accounted for ~50% of the increase risk for albuminuria, and for 41% of the increased risk for renal impairment (MDRD). Conclusions. Distinct sets of risk factors were associated with the development of albuminuria and renal impairment consistent with the concept that they are not entirely linked in patients with type 2 diabetes. Obesity and serum triglycerides are semi-novel risk factors for development of renal dysfunction and BMI accounted for a substantial proportion of the increased risk. The equations used to estimate renal function (MDRD vs. C-G) had an impact on interpretation of data, especially with regard to body composition and gender.
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| 22. |
- Alssema, M, et al.
(författare)
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The evaluation of screening and early detection strategies for type 2 diabetes and impaired glucose tolerance (DETECT-2) update of the Finnish diabetes risk score for prediction of incident type 2 diabetes
- 2011
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 54:5, s. 1004-1012
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: The Finnish diabetes risk questionnaire is a widely used, simple tool for identification of those at risk for drug-treated type 2 diabetes. We updated the risk questionnaire by using clinically diagnosed and screen-detected type 2 diabetes instead of drug-treated diabetes as an endpoint and by considering additional predictors. METHODS: Data from 18,301 participants in studies of the Evaluation of Screening and Early Detection Strategies for Type 2 Diabetes and Impaired Glucose Tolerance (DETECT-2) project with baseline and follow-up information on oral glucose tolerance status were included. Incidence of type 2 diabetes within 5 years was used as the outcome variable. Improvement in discrimination and classification of the logistic regression model was assessed by the area under the receiver-operating characteristic (ROC) curve and by the net reclassification improvement. Internal validation was by bootstrapping techniques. RESULTS: Of the 18,301 participants, 844 developed type 2 diabetes in a period of 5 years (4.6%). The Finnish risk score had an area under the ROC curve of 0.742 (95% CI 0.726-0.758). Re-estimation of the regression coefficients improved the area under the ROC curve to 0.766 (95% CI 0.750-0.783). Additional items such as male sex, smoking and family history of diabetes (parent, sibling or both) improved the area under the ROC curve and net reclassification. Bootstrapping showed good internal validity. CONCLUSIONS/INTERPRETATION: The predictive value of the original Finnish risk questionnaire could be improved by adding information on sex, smoking and family history of diabetes. The DETECT-2 update of the Finnish diabetes risk questionnaire is an adequate and robust predictor for future screen-detected and clinically diagnosed type 2 diabetes in Europid populations.
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| 23. |
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Buehler, Stefan, et al.
(författare)
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A multi-instrument comparison of integrated water vapour measurements at a high latitude site
- 2012
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Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 12:22, s. 10925-10943
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Tidskriftsartikel (refereegranskat)abstract
- We compare measurements of integrated water vapour (IWV) over a subarctic site (Kiruna, Northern Sweden) from five different sensors and retrieval methods: Radiosondes, Global Positioning System (GPS), ground-based Fourier-transform infrared (FTIR) spectrometer, ground-based microwave radiometer, and satellite-based microwave radiometer (AMSU-B). Additionally, we compare also to ERA-Interim model reanalysis data. GPS-based IWV data have the highest temporal coverage and resolution and are chosen as reference data set. All datasets agree reasonably well, but the ground-based microwave instrument only if the data are cloud-filtered. We also address two issues that are general for such intercomparison studies, the impact of different lower altitude limits for the IWV integration, and the impact of representativeness error. We develop methods for correcting for the former, and estimating the random error contribution of the latter. A literature survey reveals that reported systematic differences between different techniques are study-dependent and show no overall consistent pattern. Further improving the absolute accuracy of IWV measurements and providing climate-quality time series therefore remain challenging problems.
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| 28. |
- Bunck, Mathijs C, et al.
(författare)
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Effects of Exenatide on Measures of {beta}-Cell Function After 3 Years in Metformin-Treated Patients With Type 2 Diabetes.
- 2011
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Ingår i: Diabetes care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 34:9, s. 2041-2047
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE We previously showed that exenatide (EXE) enhanced insulin secretion after 1 year of treatment, relative to insulin glargine (GLAR), with a similar glucose-lowering action. These effects were not sustained after a 4-week off-drug period. This article reports the results after additional 2 years of exposure. RESEARCH DESIGN AND METHODS Sixty-nine metformin-treated patients with type 2 diabetes were randomized to EXE or GLAR. Forty-six patients entered the 2-year extension study in which they continued their allocated therapy. Thirty-six completed (EXE: n = 16; GLAR: n = 20) the 3-year exposure period. Insulin sensitivity (M value) and β-cell function were measured by euglycemic hyperinsulinemic clamp followed by hyperglycemic clamp with arginine stimulation at pretreatment (week 52) and 4 weeks after discontinuation of study medication (week 56 and week 172). First-phase glucose stimulated C-peptide secretion was adjusted for M value and calculated as the disposition index (DI). RESULTS At 3 years, EXE and GLAR resulted in similar levels of glycemic control: 6.6 ± 0.2% and 6.9 ± 0.2%, respectively (P = 0.186). EXE compared with GLAR significantly reduced body weight (-7.9 ± 1.8 kg; P < 0.001). After the 4-week off-drug period, EXE increased the M value by 39% (P = 0.006) while GLAR had no effect (P = 0.647). Following the 4-week off-drug period, the DI, compared with pretreatment, increased with EXE, but decreased with GLAR (1.43 ± 0.78 and -0.99 ± 0.65, respectively; P = 0.028). CONCLUSIONS EXE and GLAR sustained HbA(1c) over the 3-year treatment period, while EXE reduced body weight and GLAR increased body weight. Following the 3-year treatment with EXE, the DI was sustained after a 4-week off-drug period. These findings suggest a beneficial effect on β-cell health.
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| 29. |
- Bunck, Mathijs C, et al.
(författare)
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One-year treatment with exenatide vs. insulin glargine: effects on postprandial glycemia, lipid profiles, and oxidative stress.
- 2010
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 212:1, s. 223-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of the present study was to investigate the effects of one-year treatment with exenatide or Insulin Glargine, followed by a 5-week off-drug period, on postprandial lipidaemia, glycaemia and measures of oxidative stress. METHODS: Sixty-nine metformin-treated patients with type 2 diabetes were randomised (using apermuted block randomisation scheme stratified by site and baseline HbA(1c) stratum (< or = 8.5% or >8.5%) of which 60 completed (exenatide n=30; Insulin Glargine n=30) the pre-treatment and on-drug meal test. Postprandial glucose, lipids and lipoproteins, and oxidative stress markers were studied at week -1, 51, and after a 5-week off-drug period following a breakfast and lunch mixed-meal containing 50 g fat, 75 g carbohydrates, and 35 g protein. RESULTS: 51-Week exenatide treatment resulted in a significant reduction of prandial glucose, triglycerides, apo-B48, calculated VLDL-C, FFA and MDA excursions whereas Insulin Glargine predominantly reduced fasting glucose, FFA and MDA. Changes in markers of oxidative stress were related to changes in postprandial glucose and triglyceride excursions, independent of treatment arm. All postprandial measures returned to pre-treatment values in both groups after 5-week cessation of study treatment. CONCLUSION: Exenatide showed beneficial effects on postprandial glycaemia and lipidaemia, and these effects were related to changes in the oxidative stress markers MDA and oxLDL during one year of treatment as compared to Insulin Glargine. Following cessation of both exenatide and Insulin Glargine measures returned to pre-treatment values, suggesting that ongoing treatment is necessary to maintain the beneficial effects of either therapy.
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| 30. |
- De Marinis, Yang, et al.
(författare)
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GLP-1 inhibits and adrenaline stimulates glucagon release by differential modulation of N- and L-type Ca2+ channel-dependent exocytosis.
- 2010
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Ingår i: Cell Metabolism. - : Elsevier BV. - 1550-4131. ; 11:6, s. 543-553
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Tidskriftsartikel (refereegranskat)abstract
- Glucagon secretion is inhibited by glucagon-like peptide-1 (GLP-1) and stimulated by adrenaline. These opposing effects on glucagon secretion are mimicked by low (1-10 nM) and high (10 muM) concentrations of forskolin, respectively. The expression of GLP-1 receptors in alpha cells is <0.2% of that in beta cells. The GLP-1-induced suppression of glucagon secretion is PKA dependent, is glucose independent, and does not involve paracrine effects mediated by insulin or somatostatin. GLP-1 is without much effect on alpha cell electrical activity but selectively inhibits N-type Ca(2+) channels and exocytosis. Adrenaline stimulates alpha cell electrical activity, increases [Ca(2+)](i), enhances L-type Ca(2+) channel activity, and accelerates exocytosis. The stimulatory effect is partially PKA independent and reduced in Epac2-deficient islets. We propose that GLP-1 inhibits glucagon secretion by PKA-dependent inhibition of the N-type Ca(2+) channels via a small increase in intracellular cAMP ([cAMP](i)). Adrenaline stimulates L-type Ca(2+) channel-dependent exocytosis by activation of the low-affinity cAMP sensor Epac2 via a large increase in [cAMP](i).
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| 31. |
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| 32. |
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| 33. |
- Ekström, Nils, et al.
(författare)
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Glucose-lowering treatment and clinical results in 163 121 patients with type 2 diabetes: an observational study from the Swedish national diabetes register
- 2012
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Ingår i: Diabetes Obesity & Metabolism. - : Wiley. - 1462-8902 .- 1463-1326. ; 14:8, s. 717-726
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To analyse clinical characteristics and treatment results in unselected type 2 diabetes mellitus (T2DM) patients, with non-pharmacological treatment as well as the most commonly used pharmacological glucose-lowering treatment regimens, in everyday clinical practice. Methods: In this population-based cross-sectional study, information was linked from the Swedish National Diabetes Register, Prescribed Drug Register and Patient Register. T2DM patients with non-pharmacological treatment and T2DM patients continuously using the 12 most common pharmacological treatment regimens were included in the study (n = 163121). Results: There were statistically significant differences in clinical characteristics between the groups. Patients with insulin-based treatment regimens had the longest duration of diabetes and more cardiovascular risk factors than the T2DM-population in general. The proportion of patients reaching HbA1c =7% varied between 70.1% (metformin) and 25.0% [premixed insulin (PMI) + SU) in patients with pharmacological treatment. 84.8% of the patients with non-pharmacological treatment reached target. Compared to patients on metformin, patients on other pharmacological treatments had a lower likelihood, with hazard ratios ranging from 0.58; 95% confidence interval (CI), 0.540.63 to 0.97;0.940.99, of having HbA1c =7% (adjusted for covariates). Patients on insulin-based treatments had the lowest likelihood, while non-pharmacological treatment was associated with an increased likelihood of having HbA1c =7%. Conclusion: This nation-wide study shows insufficiently reached treatment goals for haemoglobin A1c (HbA1c) in all treatment groups. Patients on insulin-based treatment regimens had the longest duration of diabetes, more cardiovascular risk factors and the highest proportions of patients not reaching HbA1c target.
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| 34. |
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| 35. |
- Eliasson, E, et al.
(författare)
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Institutional profile: Karolinska Institutet
- 2012
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Ingår i: Pharmacogenomics. - : Future Medicine Ltd. - 1744-8042 .- 1462-2416. ; 13:16, s. 1887-1891
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Tidskriftsartikel (refereegranskat)abstract
- Research in pharmacogenomics has been intensive at Karolinska Institutet (KI) for approximately 25 years. Initial initiatives were focused on the identification and characterization of novel CYP2D6 alleles causing ultrarapid or defective drug metabolism. Such discoveries were possible owing to the early implementation of therapeutic drug monitoring and the access to individuals phenotyped with respect to drug metabolism. The translational work at KI has been of utmost importance for successful research, including functional characterization and clinical validation of allelic variants in drug metabolism, as well as discoveries of novel polymorphisms, recent examples being the CYP2C19 and UGT2B17 genes. The clinical pharmacology laboratory at KI campus Huddinge is one of the leading sites for therapeutic drug monitoring in northern Europe and obtains an increasing number of clinical requests, also important for pharmacogenetic research. Furthermore, the recently opened Center for Hematology and Regenerative Medicine, with a clear translational emphasis, offers an opportunity for studying drug metabolism and toxicity in vitro by use of human hepatocytes.
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| 36. |
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| 37. |
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| 38. |
- Eliasson, Mette, et al.
(författare)
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Streptococcus pneumoniae induces expression of the antibacterial CXC chemokine MIG/CXCL9 via MyD88-dependent signaling in a murine model of airway infection.
- 2010
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Ingår i: Microbes and Infection. - : Elsevier BV. - 1769-714X .- 1286-4579. ; 12, s. 565-573
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Tidskriftsartikel (refereegranskat)abstract
- MIG/CXCL9 belongs to the CXC family of chemokines and participates in the regulation of leukocyte-trafficking and angiogenesis. Certain chemokines, including human MIG/CXCL9, exert strong antibacterial activity in vitro, although the importance of this property in vivo is unknown. In the present study, we investigated the expression and a possible role for MIG/CXCL9 in host defense during mucosal airway infection caused by Streptococcus pneumoniae in vivo. We found that intranasal challenge of C57BL/6 wild-type mice with pneumococci elicited production of high levels of MIG/CXCL9 in the lungs via the MyD88-dependent signaling pathway. Whereas both human and murine MIG/CXCL9 showed efficient killing of S. pneumoniae in vitro, MIG/CXCL9 knock-out mice were not more susceptible to pneumococcal infection. Our data demonstrate that, in vivo this chemokine probably has a redundant role, acting together with other antibacterial peptides and chemokines, in innate and adaptive host defense mechanisms against pneumococcal infections.
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| 39. |
- Eliasson, S., et al.
(författare)
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Systematic and random errors between collocated satellite ice water path observations
- 2013
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Ingår i: Journal of Geophysical Research. - : American Geophysical Union (AGU). - 0148-0227 .- 2156-2202 .- 2169-897X. ; 118:6, s. 2629-2642
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Tidskriftsartikel (refereegranskat)abstract
- There remains large disagreement between ice-water path (IWP) in observational data sets, largely because the sensors observe different parts of the ice particle size distribution. A detailed comparison of retrieved IWP from satellite observations in the Tropics (+/- 30 degrees latitude) in 2007 was made using collocated measurements. The radio detection and ranging(radar)/light detection and ranging (lidar) (DARDAR) IWP data set, based on combined radar/lidar measurements, is used as a reference because it provides arguably the best estimate of the total column IWP. For each data set, usable IWP dynamic ranges are inferred from this comparison. IWP retrievals based on solar reflectance measurements, in the moderate resolution imaging spectroradiometer (MODIS), advanced very high resolution radiometer-based Climate Monitoring Satellite Applications Facility (CMSAF), and Pathfinder Atmospheres-Extended (PATMOS-x) datasets, were found to be correlated with DARDAR over a lar!
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| 40. |
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| 41. |
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| 42. |
- Haslemo, T, et al.
(författare)
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UGT1A4*3 encodes significantly increased glucuronidation of olanzapine in patients on maintenance treatment and in recombinant systems
- 2012
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Ingår i: Clinical Pharmacology and Therapeutics. - : Springer Science and Business Media LLC. - 0009-9236 .- 1532-6535. ; 92:2, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- Olanzapine, a world leader in antipsychotic drugs, is used in the treatment of schizophrenia and bipolar disorder. There is considerable interpatient variability in its hepatic clearance. Polymorphic glucuronidation of olanzapine by uridine diphosphate glucuronosyltransferase 1A4 (UGT1A4) was investigated retrospectively in patient samples taken for routine therapeutic drug monitoring (TDM) and in recombinant metabolic systems in vitro. Multivariate analyses revealed that patients who were heterozygous as well as those who were homozygous for the UGT1A4*3 allelic variant had significantly higher concentrations of the major metabolite olanzapine 10-N-glucuronide in serum (+38% (P = 0.011) and +246% (P < 0.001), respectively). This finding was in line with the significant increases in glucuronidation activity of olanzapine observed with recombinant UGT1A4.3 (Val-48) as compared with UGT1A4.1 (Leu-48) (1.3-fold difference, P < 0.001). By contrast, serum concentrations of the parent drug were not significantly influenced by UGT1A4 genotype. Our findings therefore indicate that UGT1A4-mediated metabolism is not a major contributor to interpatient variability in olanzapine levels. However, with respect to other drugs for which UGT1A4 has a dominant role in clearance, increased glucuronidation encoded by UGT1A4*3 might impact the risk for subtherapeutic drug exposure.
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| 43. |
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| 48. |
- Johansson, K, et al.
(författare)
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Adolescents' Perceived Safety and Security in Public Space-A Swedish Focus Group Study with a Gender Perspective
- 2012
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Ingår i: YOUNG. - : SAGE Publications. - 1103-3088 .- 1741-3222. ; 20:1, s. 69-88
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Outdoor areas are important for adolescents, since they often lack access to other spaces. Focus group discussions were conducted with 15–16 year old girls and boys in Stockholm and Uppsala Counties, Sweden, to explore their ideas regarding threats they face when moving in public space, including traffic. The threats which emerged as most prominent were lone rapists—mainly threatening girls—or gangs of adolescent boys—threatening boys with violence and girls mainly with (sexual) harassment. Traffic, though sometimes admitted to be a major safety risk, was perceived as more manageable. Boys and girls suggest coping with social risks by behaving opposite to the gendered idea of a ‘victim’—boys by being non-aggressive, girls by acting confidently. Boys portray themselves as level-headed, skilled and making rational risk assessments. Girls sometimes described themselves as behaving in an unsafe way in traffic, but not in relation to social/sexual threats.
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| 49. |
- Johnston, Marston Sheldon, 1971, et al.
(författare)
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The representation of tropical upper tropospheric water in EC Earth V2
- 2012
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Ingår i: Climate Dynamics. - : Springer Science and Business Media LLC. - 0930-7575 .- 1432-0894. ; 39:11, s. 2713-2731
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Tidskriftsartikel (refereegranskat)abstract
- Tropical upper tropospheric humidity, clouds, and ice water content, as well as outgoing longwave radiation (OLR), are evaluated in the climate model EC Earth with the aid of satellite retrievals. The Atmospheric Infrared Sounder and Microwave Limb Sounder together provide good coverage of relative humidity. EC Earth's relative humidity is in fair agreement with these observations. CloudSat and CALIPSO data are combined to provide cloud fractions estimates throughout the altitude region considered (500-100 hPa). EC Earth is found to overestimate the degree of cloud cover above 200 hPa and underestimate it below. Precipitating and non-precipitating EC Earth ice definitions are combined to form a complete ice water content. EC Earth's ice water content is below the uncertainty range of CloudSat above 250 hPa, but can be twice as high as CloudSat's estimate in the melting layer. CERES data show that the model underestimates the impact of clouds on OLR, on average with about 9 W m(-2). Regionally, EC Earth's outgoing longwave radiation can be similar to 20 W m(-2) higher than the observation. A comparison to ERA-Interim provides further perspectives on the model's performance. Limitations of the satellite observations are emphasised and their uncertainties are, throughout, considered in the analysis. Evaluating multiple model variables in parallel is a more ambitious approach than is customary.
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| 50. |
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