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- Zethelius, Björn, 1962-
(författare)
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Proinsulin and Insulin Sensitivity as Predictors of Type 2 Diabetes Mellitus and Coronary Heart Disease : Clinical Epidemiological Studies with up to 27 Years of Follow-Up
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Defects in insulin secretion and insulin action are the major abnormalities in the development of Type 2 diabetes. Hyperinsulinemia is a risk marker for Type 2 diabetes and according to some, but not in all studies also for coronary heart disease (CHD). Conventional insulin assays measure immunoreactive insulin including proinsulin-like molecules. Proinsulin and insulin measured by specific methods, insulin sensitivity measured by the euglycemic insulin clamp and early insulin response after a glucose challenge give more detailed information and may be better estimates of true risk for Type 2 diabetes and CHD. This study examined relationships between proinsulin, insulin, insulin secretion and insulin sensitivity for the development of Type 2 diabetes and CHD. The investigation of the prognostic significance of proinsulin and insulin for the development of Type 2 diabetes and CHD was performed in prospective studies of 50-year and 70-year-old men in a population-based cohort. The results indicated, that increased proinsulin concentrations, was a marker of increased risk for Type 2 diabetes independent of measurements of insulin secretion and insulin sensitivity whereas insulin was not. Proinsulin was shown to be a predictor for CHD mortality and morbidity, respectively, independent of conventional risk factors, whereas insulin was not. Insulin sensitivity measured by the gold standard euglycemic insulin clamp at age 70 was a predictor of CHD morbidity, independently of established risk factors.In summary, these data provide evidence that an increased concentration of proinsulin and not an elevated plasma insulin level per se, that constitutes the association with Type 2 diabetes and CHD and that insulin resistance per se, is associated with CHD risk.
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| 2. |
- Ärnlöv, Johan, 1970-
(författare)
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Left Ventricular Function in Elderly Men : Metabolic, Hormonal, Genetic and Prognostic Implications
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Heart failure and left ventricular dysfunction are major causes of morbidity and mortality. In this thesis, metabolic, hormonal, genetic and prognostic aspects of echocardiographically determined left ventricular function were investigated in a fairly large longitudinal population-based study of men. The participants were examined both at age 50 and 70 years and were followed for mortality using the national cause-of-death registry.Several factors associated with the insulin resistance syndrome predicted left ventricular systolic dysfunction independent of myocardial infarction, hypertension, diabetes and the use of cardiovascular medication after twenty years follow-up. Plasma levels of N-terminal atrial natriuretic peptide (N-ANP) were significantly increased in men with left ventricular dysfunction in comparison to healthy men. However, the diagnostic accuracy was poor due to the extensive overlapping between the groups. Relations between a haplotype of the novel hUNC-93B1 gene and the E/A-ratio were found and validated in separate samples of the cohort. Myocardial performance index (a Doppler derived index of combined left ventricular systolic and diastolic function) and left ventricular ejection fraction were found to be predictors for cardiovascular mortality independent of traditional cardiovascular risk factors in a longitudinal analysis with a mean follow-up of seven years.In conclusion, this thesis showed that left ventricular function is influenced by metabolic, hormonal and genetic factors and that echocardiographic measurements of left ventricular function, such as the myocardial performance index, are strong independent risk factors for cardiovascular mortality in elderly men.
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| 3. |
- Rothenberg, Elisabeth, 1960, et al.
(författare)
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Dietary intake and energy metabolism
- 2004
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Ingår i: To become old: The Gerontological and Geriatric Population Studies in Göteborg, Sweden 1971-2002 Editor: Bertil Steen. - Göteborg : Göteborg University. - 9163171821 ; , s. 41-44
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Akner, Gunnar
(författare)
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Arbetsmetod
- 2003
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Ingår i: Evidensbaserad äldrevård. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). - 9187890836 ; , s. 45-50
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Akner, Gunnar
(författare)
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Background
- 2003
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Ingår i: Geriatric care and treatment. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). ; , s. 23-42
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Akner, Gunnar
(författare)
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Bakgrund
- 2003
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Ingår i: Evidensbaserad äldrevård. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). - 9187890836 ; , s. 25-44
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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