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Hedenstedt A, Reid S, Sayadi A, Eloranta ML, Skoglund E, Bolin K, Frodlund M, Lerang K, Jönsen A, Rantapää-Dahlqvist S, Bengtsson AA, Rudin A, Molberg Ø, Sjöwall C, Sandling JK, Leonard D. B cell polygenic risk scores associate with anti-dsDNA antibodies and nephritis in systemic lupus erythematosus. Lupus Sci Med 2023; 10:e000926. [PMID: 37844960 PMCID: PMC10582984 DOI: 10.1136/lupus-2023-000926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/09/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE B cell function and autoantibodies are important in SLE pathogenesis. In this work, we aimed to investigate the impact of cumulative SLE B cell genetics on SLE subphenotype and autoantibody profile. METHODS Female patients with SLE (n=1248) and healthy controls (n=400) were genotyped using Illumina's Global Screening Array. Two polygenic risk scores (PRSs), one representing B cell genes and the other B cell activation genes, were calculated for each individual using risk loci for SLE in genes assigned to B cell-related pathways according to the Kyoto Encyclopedia of Genes and Genomes, Gene Ontology and Reactome Databases. RESULTS Double-stranded DNA (dsDNA) antibodies were more prevalent among patients with a high compared with a low SLE B cell PRS (OR 1.47 (1.07 to 2.01), p=0.018), and effect sizes were augmented in patients with human leucocyte antigen (HLA) risk haplotypes HLA-DRB1*03:01 and HLA-DRB1*15:01 (DRB1*03/15 -/- (OR 0.99 (0.56 to 1.77), p=0.98; DRB1*03/15 +/- or -/+ (OR 1.64 (1.06 to 2.54), p=0.028; and DRB1*03/15 +/+ (OR 4.47 (1.21 to 16.47), p=0.024). Further, a high compared with a low B cell PRS was associated with low complement levels in DRB1*03/15 +/+ patients (OR 3.92 (1.22 to 12.64), p=0.022). The prevalence of lupus nephritis (LN) was higher in patients with a B cell activation PRS above the third quartile compared with patients below (OR 1.32 (1.00 to 1.74), p=0.048). CONCLUSIONS High genetic burden related to B cell function is associated with dsDNA antibody development and LN. Assessing B cell PRSs may be important in order to determine immunological pathways influencing SLE and to predict clinical phenotype.
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Affiliation(s)
- Anna Hedenstedt
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sarah Reid
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ahmed Sayadi
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Maija-Leena Eloranta
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Elisabeth Skoglund
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Karin Bolin
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Martina Frodlund
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping University, Linkoping, Sweden
| | - Karoline Lerang
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - Andreas Jönsen
- Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - Anders A Bengtsson
- Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anna Rudin
- Department of Rheumatology and Inflammation Research, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Øyvind Molberg
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - Christopher Sjöwall
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping University, Linkoping, Sweden
| | - Johanna K Sandling
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dag Leonard
- Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Skoglund E, Stål P, Lundberg TR, Gustafsson T, Tesch PA, Thornell LE. Skeletal muscle morphology, satellite cells, and oxidative profile in relation to physical function and lifelong endurance training in very old men. J Appl Physiol (1985) 2023; 134:264-275. [PMID: 36548511 DOI: 10.1152/japplphysiol.00343.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
In the current study, we compared muscle morphology in three advanced aging cohorts that differed in physical function, including a unique cohort of lifelong endurance athletes. Biopsies from the vastus lateralis muscle of seven lifelong endurance athletes (EAs) aged 82-92 yr, and 19 subjects from the Uppsala Longitudinal Study of Adult Men (ULSAM) aged 87-91 yr were analyzed. ULSAM subjects were divided into high- (n = 9, HF) and low- (n = 10, LF) function groups based on strength and physical function tests. The analysis included general morphology, fiber type and cross-sectional area, capillarization, deficient cytochrome c oxidase (COX) activity, number of myonuclei and satellite cells, and markers of regeneration and denervation. Fibers with central nuclei and/or nuclear clumps were observed in all groups. EA differed from LF and HF by having a higher proportion of type I fibers, 52% more capillaries in relation to fiber area, fewer COX-negative fibers, and less variation in fiber sizes (all P < 0.05). There were no differences between the groups in the number of myonuclei and satellite cells per fiber, and no significant differences between LF and HF (P > 0.05). In conclusion, signs of aging were evident in the muscle morphology of all groups, but neither endurance training status nor physical function influenced signs of regeneration and denervation processes. Lifelong endurance training, but not higher physical function, was associated with higher muscle oxidative capacity, even beyond the age of 80.NEW & NOTEWORTHY Here we show that lifelong endurance training, but not physical function, is associated with higher muscle oxidative capacity, even beyond the age of 80 yr. Neither endurance training status nor physical function was significantly associated with satellite cells or markers of regeneration and denervation in muscle biopsies from these very old men.
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Affiliation(s)
- Elisabeth Skoglund
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Per Stål
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Tommy R Lundberg
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Gustafsson
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Per A Tesch
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Eric Thornell
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
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Skoglund E, Lundberg TR, Rullman E, Fielding RA, Kirn DR, Englund DA, von Berens Å, Koochek A, Cederholm T, Berg HE, Gustafsson T. Functional improvements to 6 months of physical activity are not related to changes in size or density of multiple lower-extremity muscles in mobility-limited older individuals. Exp Gerontol 2021; 157:111631. [PMID: 34813901 DOI: 10.1016/j.exger.2021.111631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/25/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023]
Abstract
Older adults are encouraged to engage in multicomponent physical activity, which includes aerobic and muscle-strengthening activities. The current work is an extension of the Vitality, Independence, and Vigor in the Elderly 2 (VIVE2) study - a 6-month multicenter, randomized, placebo-controlled trial of physical activity and nutritional supplementation in community dwelling 70-year-old seniors. Here, we examined whether the magnitude of changes in muscle size and quality differed between major lower-extremity muscle groups and related these changes to functional outcomes. We also examined whether daily vitamin-D-enriched protein supplementation could augment the response to structured physical activity. Forty-nine men and women (77 ± 5 yrs) performed brisk walking, muscle-strengthening exercises for the lower limbs, and balance training 3 times weekly for 6 months. Participants were randomized to daily intake of a nutritional supplement (20 g whey protein + 800 IU vitamin D), or a placebo. Muscle cross-sectional area (CSA) and radiological attenuation (RA) were assessed in 8 different muscle groups using single-slice CT scans of the hip, thigh, and calf at baseline and after the intervention. Walking speed and performance in the Short Physical Performance Battery (SPPB) were also measured. For both CSA and RA, there were muscle group × time interactions (P < 0.01). Significant increases in CSA were observed in 2 of the 8 muscles studied, namely the knee extensors (1.9%) and the hip adductors (2.8%). For RA, increases were observed in 4 of 8 muscle groups, namely the hip flexors (1.1 HU), hip adductors (0.9 HU), knee extensors (1.2 HU), and ankle dorsiflexors (0.8 HU). No additive effect of nutritional supplementation was observed. While walking speed (13%) and SPPB performance (38%) improved markedly, multivariate analysis showed that these changes were not associated with the changes in muscle CSA and RA after the intervention. We conclude that this type of multicomponent physical activity program results in significant improvements in physical function despite relatively small changes in muscle size and quality of some, but not all, of the measured lower extremity muscles involved in locomotion.
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Affiliation(s)
- Elisabeth Skoglund
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobles Allé 8B, 141 52 Huddinge, Sweden & Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden; Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 564, 751 22 Uppsala, Sweden.
| | - Tommy R Lundberg
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobles Allé 8B, 141 52 Huddinge, Sweden & Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Eric Rullman
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobles Allé 8B, 141 52 Huddinge, Sweden & Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
| | - Dylan R Kirn
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
| | - Davis A Englund
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
| | - Åsa von Berens
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 564, 751 22 Uppsala, Sweden; Stockholm Gerontology Research Center, Sveavägen 155, 113 46 Stockholm, Sweden.
| | - Afsaneh Koochek
- Department of food studies, nutrition and dietetics, Uppsala University, Box 560, 751 22 Uppsala, Sweden.
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 564, 751 22 Uppsala, Sweden.
| | - Hans E Berg
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden & Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden.
| | - Thomas Gustafsson
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobles Allé 8B, 141 52 Huddinge, Sweden & Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
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Skoglund E, Grönholdt-Klein M, Rullman E, Thornell LE, Strömberg A, Hedman A, Cederholm T, Ulfhake B, Gustafsson T. Longitudinal Muscle and Myocellular Changes in Community-Dwelling Men Over Two Decades of Successful Aging-The ULSAM Cohort Revisited. J Gerontol A Biol Sci Med Sci 2021; 75:654-663. [PMID: 31002330 DOI: 10.1093/gerona/glz068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Indexed: 12/25/2022] Open
Abstract
Participants of the population-based Uppsala longitudinal study of adult men (ULSAM) cohort reaching more than 88 years of age (survivors, S) were investigated at age 70, 82, and 88-90 and compared at 70 years with non-survivors (NS) not reaching 82 years. Body composition, muscle mass and muscle histology were remarkably stable over 18 years of advanced aging in S. Analysis of genes involved in muscle remodeling showed that S had higher mRNA levels of myogenic differentiation factors (Myogenin, MyoD), embryonic myosin (eMyHC), enzymes involved in regulated breakdown of myofibrillar proteins (Smad2, Trim32, MuRF1,) and NCAM compared with healthy adult men (n = 8). S also had higher mRNA levels of eMyHC, Smad 2, MuRF1 compared with NS. At 88 years, S expressed decreased levels of Myogenin, MyoD, eMyHC, NCAM and Smad2 towards those seen in NS at 70 years. The gene expression pattern of S at 70 years was likely beneficial since they maintained muscle fiber histology and appendicular lean body mass until advanced age. The expression pattern at 88 years may indicate a diminished muscle remodeling coherent with a decline of reinnervation capacity and/or plasticity at advanced age.
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Affiliation(s)
- Elisabeth Skoglund
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Sweden.,Department of Integrative Medical Biology, Umeå University, Sweden
| | | | - Eric Rullman
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anna Strömberg
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Anu Hedman
- Heart Centre East-Tallinn Central Hospital, Estonia
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Sweden
| | - Brun Ulfhake
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Gustafsson
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
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von Berens Å, Obling SR, Nydahl M, Koochek A, Lissner L, Skoog I, Frändin K, Skoglund E, Rothenberg E, Cederholm T. Sarcopenic obesity and associations with mortality in older women and men - a prospective observational study. BMC Geriatr 2020; 20:199. [PMID: 32517653 PMCID: PMC7285448 DOI: 10.1186/s12877-020-01578-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 05/07/2020] [Indexed: 01/06/2023] Open
Abstract
Background The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components. Methods Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2, fat mass > 30%/ > 42% or waist circumference ≥ 88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively. Results SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2–8.9)) of dying within 10 years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival. Conclusions SO was observed in 4–11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within 10 years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
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Affiliation(s)
- Å von Berens
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden.
| | - S R Obling
- Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark
| | - M Nydahl
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - A Koochek
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - L Lissner
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden
| | - I Skoog
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology Unit, University of Gothenburg, SU Sahlgrenska, 41345, Gothenburg, Sweden
| | - K Frändin
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology Unit, University of Gothenburg, SU Sahlgrenska, 41345, Gothenburg, Sweden
| | - E Skoglund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden
| | - E Rothenberg
- Kristianstad University, Food and Meal Science, Högskolan Kristianstad, 291 88, Kristianstad, Sweden
| | - T Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 561, 751 22, Uppsala, Sweden.,Theme Ageing, Karolinska University Hospital, 14157, Huddinge, Sweden
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Berg HE, Truong D, Skoglund E, Gustafsson T, Lundberg TR. Threshold‐automated CT measurements of muscle size and radiological attenuation in multiple lower‐extremity muscles of older individuals. Clin Physiol Funct Imaging 2020; 40:165-172. [DOI: 10.1111/cpf.12618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/30/2019] [Accepted: 12/31/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Hans E. Berg
- Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden
- Department of Orthopaedic Surgery Karolinska University Hospital Stockholm Sweden
| | - Daniel Truong
- Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden
- Department of Orthopaedic Surgery Karolinska University Hospital Stockholm Sweden
| | - Elisabeth Skoglund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism Uppsala University Uppsala Sweden
- Division of Clinical Physiology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
- Unit of Clinical Physiology Karolinska University Hospital Stockholm Sweden
| | - Thomas Gustafsson
- Division of Clinical Physiology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
- Unit of Clinical Physiology Karolinska University Hospital Stockholm Sweden
| | - Tommy R. Lundberg
- Division of Clinical Physiology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
- Unit of Clinical Physiology Karolinska University Hospital Stockholm Sweden
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Skoglund E, Westerlind E, Persson H, Sunnerhagen K. Self-perceived impact of stroke: A longitudinal comparison between one and five years post-stroke. J Rehabil Med 2019; 51:660-664. [DOI: 10.2340/16501977-2595] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Von Berens A, Skoglund E, Hedman S, Kinnander A, Roelsgaard Obling S, Rothenberg E, Cederholm T. PT02.4: Sarcopenic Obesity - Prevalence and Mortality in 88-Year Old Swedish Men (ULSAM). Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30293-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Roelsgaard Obling S, Hedman S, Skoglund E, Kinnander A, Behrens Å, Cederholm T, Rothenberg E. MON-P031: Sarcopenic Obesity - Prevalence and Mortality in 75 Year Old Swedes (H70/Kvinnostudien). Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30665-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Fast and simple analytical methods for the determination of inositol bis- to hexakisphosphates or only inositol hexakisphosphate in foods and feces are presented. The methods are both faster and simpler with regard to analytical detection and sample pretreatment as compared to previously reported methods. The samples are pretreated using extraction and centrifugal ultrafiltration and analyzed using high-performance ion chromatography (HPIC) with gradient or isocratic elution. The analytes are detected using ultraviolet detection after postcolumn reaction. The methods are efficient, highly selective, and appropriate for analyzing inositol phosphates in food and feces samples. The between- and within-day variances were generally below 8 and 5% (relative standard deviation), respectively, for the presented HPIC method with gradient elution.
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Affiliation(s)
- N G Carlsson
- Department of Food Science, Chalmers University of Technology, S-402 29 Göteborg, Sweden
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Oien IJ, Skoglund E. [Continuing education in the Nordic countries]. Tidsskr Nor Laegeforen 2000; 120:2035-7. [PMID: 11008542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The Nordic Labour Market Agreement gives Nordic medical specialist the right to be certified in the other Nordic countries. The agreement also provides for cooperation on specialist training between the five countries. This article is mainly based on published statements from the joint working group for medical manpower forecasts and specialist training in the Nordic countries. There are great differences between the countries in the way specialist training is organised. An underlying assumption in the Nordic agreement is that the level and quality of specialist training is the same in all five countries; however, there does not seem to be a corresponding coordination between the training systems adopted.
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Affiliation(s)
- I J Oien
- Utdanningsavdelingen Den norske laegeforening, Oslo.
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Skoglund E, Taraldset A. [The manpower market for physicians in the Nordic countries 1980-2000]. Tidsskr Nor Laegeforen 2000; 120:2030-4. [PMID: 11008541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The ratio between population and active physicians in the Nordic countries has improved from 488 inhabitants per physician in 1980 to 315 in 2000. There is a large mobility of physicians between the countries, contributing to levelling out swings in demand and supply of manpower. Language and culture being similar, physicians can easily adjust to working in a neighbouring country. Iceland is special in this respect, as a surplus of Icelandic physicians has always found work in the other Nordic countries. Of course, their numbers are small relative to the total number of active physicians in the Nordic countries, now approximately 76,000. The number of students admitted to Nordic medical faculties has changed in line with swings in estimated future demand for manpower. Today, numbers are increasing again; this year, approximately 2,900 students will be admitted. Norway stands apart from the other Nordic countries in terms of medical manpower needs. During the last 20 years there has been a continuous shortage of physicians while all the other countries have been through periods of surplus and unemployment among physicians. Manpower forecasts in the early 1980s underestimated the growth in the health care system and hence the demand for medical manpower.
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Affiliation(s)
- E Skoglund
- Utdanningsavdelingen Den norske laegeforening, Oslo.
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Sandberg AS, Brune M, Carlsson NG, Hallberg L, Skoglund E, Rossander-Hulthén L. Inositol phosphates with different numbers of phosphate groups influence iron absorption in humans. Am J Clin Nutr 1999; 70:240-6. [PMID: 10426701 DOI: 10.1093/ajcn.70.2.240] [Citation(s) in RCA: 194] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inositol hexaphosphate (IP(6)) is a well-known inhibitor of iron absorption, whereas the effects of the less-phosphorylated derivatives of IP(6) are less known. OBJECTIVES The objective was to investigate the effects of inositol tri-, tetra-, and pentaphosphates (IP(3), IP(4), and IP(5), respectively) on iron absorption in humans. DESIGN Iron absorption was measured in 5 experiments from single meals by extrinsic labeling with (55)Fe and (59)Fe and determination of whole-body retention and the erythrocyte uptake of isotopes. In experiments 1-3 the meals contained white-wheat rolls to which 10 mg P as IP(5), IP(4), or IP(3), respectively, was added. Inositol 1,2,6-triphosphate [Ins(1,2, 6)P(3)] and a mixture of isomers of IP(4) and IP(5) were studied. White-wheat rolls contained 10 mg P as IP(3) + IP(4) and 2 mg P as IP(5) + IP(6) in experiment 4 and 20 mg P as IP(3) + IP(4) and 3 mg P as IP(5) + IP(6) in experiment 5; inositol phosphates were obtained via fermentation of sodium phytate. Each experiment had 8-11 subjects. RESULTS In experiment 1, iron absorption was reduced by 39%, whereas there was no significant effect on iron absorption in experiments 2 and 3. In experiments 4 and 5, iron absorption was reduced by 54% and 64%, respectively, suggesting that IP(3) and IP(4) contributed to the inhibitory effect. CONCLUSIONS IP(5) has an inhibitory effect on iron absorption, whereas IP(3) and IP(4) in isolated form have no such effect. IP(3) and IP(4) in processed food contribute to the negative effect on iron absorption, presumably by binding iron between different inositol phosphates. To improve iron absorption from cereals and legumes, degradation of inositol phosphates needs to be to less-phosphorylated inositol phosphates than IP(3).
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Affiliation(s)
- A S Sandberg
- Department of Food Science, Chalmers University of Technology, University of Göteborg, Sahlgrenska Hospital, Göteborg, Sweden.
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Abstract
Phytate, inositol hexaphosphate (InsP(6)), may be hydrolyzed to inositol phosphates with lower degree of phosphorylation, i.e., inositol penta- to monophosphates (InsP(5)-InsP(1)), during food processing. Each of these lower inositol phosphates exists in different isomeric forms. The objective of this study was to determine if different isomers of InsP(3)-InsP(5) (Ins(1,2,4)P(3), Ins(1,2,3)P(3), Ins(1,2,6)P(3), Ins(1,3,4)P(3), Ins(1,2,3,4)P(4), Ins(1,2,5,6)P(4), Ins(1,2,4,5,6)P(5), and Ins(1,3,4,5,6)P(5)) and InsP(6) affect the uptake of iron. We studied the iron absorption in vitro using the human intestinal epithelial cell line, Caco-2. Addition of a 2-fold molar excess of InsP(6) or InsP(5) in proportion to Fe (1 h incubation at 37 degrees C) reduced iron uptake by 46-52% (p < 0.001). Neither InsP(4) isomers nor InsP(3) isomers affected iron uptake significantly at 1 h incubation with a molar InsP:Fe level of 2:1. Iron uptake was shown to not be a function of the isomeric form of inositol phosphates. The inositol phosphate isomers did not seem likely to interact with each other through iron to form more stable iron complexes. At a molar InsP:Fe level of 20:1 an inhibitory effect of InsP(4) was found, while InsP(3) did not affect the iron absorption even at a 20-fold molar excess.
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Affiliation(s)
- E Skoglund
- Department of Food Science, Chalmers University of Technology, SE-402 29 Göteborg, Sweden.
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15
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Skoglund E. [Re-certification of specialists in Norway]. Nord Med 1998; 113:27-8. [PMID: 9465705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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16
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Skoglund E. [Unlimited demand for specialists?]. Tidsskr Nor Laegeforen 1996; 116:3321-2. [PMID: 9011986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- E Skoglund
- Utdanningsavdelingen, Den norske laegeforening, Lysaker
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17
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Gerner T, Grøttum K, Schreiner A, Olen IJ, Skoglund E. [Internship during continuing education should be prioritized]. Tidsskr Nor Laegeforen 1996; 116:2500-1. [PMID: 8928117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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18
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Brinchmann-Hansen A, Hoftvedt BO, Oien IJ, Skoglund E. [Mutual evaluation of teaching hospital departments. A way to improve the quality of specialist education]. Tidsskr Nor Laegeforen 1996; 116:2180-2. [PMID: 8801662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
In cooperation with four hospital departments, the Norwegian Medical Association piloted a method for combining internal and external evaluation of the departments' educational programmes for residents. The aim was to improve the quality of education in the departments. The ophthalmologic departments at two university hospitals and two pediatric departments at local hospitals have participated in the project. Written reports describing internal and external evaluations, based on reciprocal visits by representatives of the different departments have served as guidelines for improvement. The evaluation revealed inadequate opportunities for resident education in all the participating departments. The interesting and positive experiences were that, despite these findings, the reciprocal evaluations seemed to encourage and inspire the departments that were evaluated to develop better educational programmes for their residents. This paper shows the advantages reciprocal evaluation seems to have as a supplementary method for quality improvement in departments that educate residents.
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19
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Skoglund E. [Apply the children's convention also to refugees]. Lakartidningen 1994; 91:4235-6. [PMID: 7808116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- E Skoglund
- Stockholms läns landstings psykiska barna- och ungdomsvård (PBU)
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20
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Skoglund E. [Physicians' continuing and postgraduate education. Specialty education--from collegial advertisement stories to law-based specialist competence]. Tidsskr Nor Laegeforen 1986; 106:1220-6. [PMID: 3750285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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21
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Skoglund E. [We should work towards coordination of postgraduate training for doctors in the Scandinavian countries]. Nord Med 1981; 96:148-9. [PMID: 7243559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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