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Thunström S, Thunström E, Naessén S, Berntorp K, Kitlinski ML, Ekman B, Wahlberg J, Bergström I, Bech-Hanssen O, Krantz E, Laine CM, Bryman I, Landin-Wilhelmsen K. Reply to "Comment on aortic size predicts aortic dissection in Turner syndrome - A 25-year prospective cohort study" by Salman Khazaei. Int J Cardiol 2023; 380:56. [PMID: 36907450 DOI: 10.1016/j.ijcard.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Affiliation(s)
- Sofia Thunström
- Department of Clinical Genetics, Sahlgrenska University Hospital Gothenburg, Sweden; Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Erik Thunström
- Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sabine Naessén
- Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden
| | - Kerstin Berntorp
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | | | - Bertil Ekman
- Department of Endocrinology, Linköping University Hospital, Department of Internal Medicine, Norrköping Hospital, Sweden; Department of Health, Medicine and Caring Sciences, University of Linköping, Linköping, Sweden
| | - Jeanette Wahlberg
- Department of Endocrinology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ingrid Bergström
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism & Diabetes, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Odd Bech-Hanssen
- Department of Clinical Physiology, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily Krantz
- Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christine M Laine
- Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Endocrine Out-patient Clinic, Carlanderska Hospital, Gothenburg, Sweden
| | - Inger Bryman
- Reproductive Medicine, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital Gothenburg, Sweden; Department of Obstetrics and Gynecology, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Internal Medicine, and Section for Endocrinology, Sahlgrenska University Hospital Gothenburg, Sweden
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Thunström S, Thunström E, Naessén S, Berntorp K, Laczna Kitlinski M, Ekman B, Wahlberg J, Bergström I, Bech-Hanssen O, Krantz E, Laine CM, Bryman I, Landin-Wilhelmsen K. Aortic size predicts aortic dissection in Turner syndrome - A 25-year prospective cohort study. Int J Cardiol 2023; 373:47-54. [PMID: 36410543 DOI: 10.1016/j.ijcard.2022.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Women with Turner syndrome (TS) have an increased risk of aortic dissection. The current recommended cutoff to prevent aortic dissection in TS is an aortic size index (ASI) of ≥2.5 cm/m2. This study estimated which aortic size had the best predictive value for the risk of aortic dissection, and whether adjusting for body size improved risk prediction. METHODS A prospective, observational study in Sweden, of women with TS, n = 400, all evaluated with echocardiography of the aorta and data on medical history for up to 25 years. Receiver operating characteristic (ROC) curves, sensitivity and specificity were calculated for the absolute ascending aortic diameter (AAD), ascending ASI and TS specific z-score. RESULTS There were 12 patients (3%) with aortic dissection. ROC curves demonstrated that absolute AAD and TS specific z-score were superior to ascending ASI in predicting aortic dissection. The best cutoff for absolute AAD was 3.3 cm and 2.12 for the TS specific z-score, respectively, with a sensitivity of 92% for both. The ascending ASI cutoff of 2.5 cm/m2 had a sensitivity of 17% only. Subgroup analyses in women with an aortic diameter ≥ 3.3 cm could not demonstrate any association between karyotype, aortic coarctation, bicuspid aortic valve, BMI, antihypertensive medication, previous growth hormone therapy or ongoing estrogen replacement treatment and aortic dissection. All models failed to predict a dissection in a pregnant woman. CONCLUSIONS In Turner syndrome, absolute AAD and TS-specific z-score were more reliable predictors for aortic dissection than ASI. Care should be taken before and during pregnancy.
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Affiliation(s)
- Sofia Thunström
- Department of Clinical Genetics, Sahlgrenska University Hospital Gothenburg, Sweden; Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Erik Thunström
- Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sabine Naessén
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Berntorp
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | | | - Bertil Ekman
- Department of Endocrinology, Linköping University Hospital, Department of Internal Medicine, Norrköping Hospital, Sweden; Department of Health, Medicine and Caring Sciences, University of Linköping, Linköping, Sweden
| | - Jeanette Wahlberg
- Department of Endocrinology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ingrid Bergström
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism & Diabetes, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Odd Bech-Hanssen
- Department of Clinical Physiology, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily Krantz
- Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christine M Laine
- Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinic of Endocrinology, Hospital of Halland, Sweden
| | - Inger Bryman
- Reproductive Medicine, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital Gothenburg, Sweden; Department of Obstetrics and Gynecology, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Internal Medicine, Section for Endocrinology, Sahlgrenska University Hospital Gothenburg, Sweden
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Forslund M, Landin-Wilhelmsen K, Krantz E, Trimpou P, Schmidt J, Brännström M, Dahlgren E. Health-Related Quality of Life in perimenopausal women with PCOS. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4902052] [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: 11/06/2022]
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Kontogeorgos G, Mamasoula Z, Krantz E, Trimpou P, Landin-Wilhelmsen K, Laine CM. Low health-related quality of life in hypoparathyroidism and need for PTH analog. Endocr Connect 2022; 11:EC-21-0379.R2. [PMID: 34825891 PMCID: PMC8789022 DOI: 10.1530/ec-21-0379] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/26/2021] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Hypoparathyroidism (HypoPT) is a rare endocrine disorder in which insufficient levels of parathyroid hormone (PTH) lead to low serum calcium (S-Ca) levels and muscular cramps. The aim was to study the health-related quality of life (HRQoL) and comorbidities in patients with HypoPT compared with the general population and to estimate the need of treatment with PTH analog. DESIGN Patients with HypoPT were identified and compared with a population sample. Short Form-36 (SF-36) and EuroQol-5 Dimensions Visual Analogue Scale questionnaires were used. All patients were followed up at the Sahlgrenska University Hospital outpatient clinic. METHODS From the medical records between 2007 and 2020, 203 patients with HypoPT were identified and compared with a population sample (n = 414) from the World Health Organization's (WHO) MONICA project, Gothenburg, Sweden. Of the 203 patients who met the diagnostic criteria, 164 were alive and 65% answered the HRQoL questionnaires. RESULTS Patients with HypoPT, 80% postsurgical, and controls had similar age (60 years) and sex distribution (80% women). Patients had lower SF-36 summary component scores for physical (40.0 (interquartile range (IQR): 21) vs 51.2 (IQR: 14.6); P < 0.001) and mental (43.1 (IQR:17.4) vs 56.1(IQR:13.3); P < 0.001) well-being, irrespective of etiology or calcium levels. Individuals with HypoPT had more medications and lower renal function but not higher mortality than controls. Low HRQoL together with low calcium was present in 23% of individuals with HypoPT. CONCLUSION HRQoL was markedly lower in patients with HypoPT than in controls and independent of S-Ca levels. Treatment with PTH analog could be considered at least among patients with both low HRQoL and low calcium levels.
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Affiliation(s)
- Georgios Kontogeorgos
- Section for Geriatrics and Emergency Medicine, Department of Medicine, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Correspondence should be addressed to G Kontogeorgos:
| | - Zoi Mamasoula
- Section for Geriatrics and Emergency Medicine, Department of Medicine, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily Krantz
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Penelope Trimpou
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section for Endocrinology, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section for Endocrinology, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christine M Laine
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Endocrine Out-Patient Clinic, Carlanderska Hospital, Gothenburg, Sweden
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Mejaddam A, Krantz E, Höskuldsdóttir G, Fändriks L, Mossberg K, Eliasson B, Trimpou P, Landin-Wilhelmsen K. Comorbidity and quality of life in obesity-a comparative study with the general population in Gothenburg, Sweden. PLoS One 2022; 17:e0273553. [PMID: 36194568 PMCID: PMC9531784 DOI: 10.1371/journal.pone.0273553] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/11/2022] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Obesity is considered to have a detrimental impact on health-related quality of life (HRQoL). OBJECTIVE To compare HRQoL in a well-defined group of people with obesity with a population-based control group from the general public. DESIGN Observational cross-sectional cohort study with a reference population. SETTING The Regional Obesity Center at the Department of Medicine at Sahlgrenska University Hospital, Gothenburg, Sweden. PARTICIPANTS People with obesity (n = 1122) eligible for surgical and non-surgical obesity treatment in routine care were included consecutively between 2015 and 2017 into the BASUN study. Men and women from the WHO-MONICA-GOT project were used as a reference population (n = 414). MAIN OUTCOME MEASURES HRQoL was measured with the RAND-36/Short Form-36 questionnaire (SF-36) and a Visual Analogue Scale (VAS) for self-related health (SRH). Prescription drugs for hypertension, diabetes mellitus, depression, and anxiety were taken as a proxy for these conditions. RESULTS People with obesity rated their overall HRQoL lower than the reference population according to the SRH-VAS. Lower scores were reported on physical and social functioning, vitality, general and mental health after adjustment for age and use of prescription drugs (considered a proxy for burden of disease, or comorbidities) using the RAND-36/SF-36 questionnaire. Use of some psychopharmacological agents was more common in patients with obesity. CONCLUSION People with obesity seeking help with weight reduction are more likely to have lower physical and mental self-reported HRQoL than the general population.
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Affiliation(s)
- Ala Mejaddam
- Department of Internal Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Gothenburg, Sweden
- * E-mail:
| | - Emily Krantz
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Gothenburg, Sweden
- Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gudrún Höskuldsdóttir
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Gothenburg, Sweden
- Section for Endocrinology and Diabetology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Fändriks
- Department of Surgery, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Mossberg
- Department of Public Health and Community Medicine Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Eliasson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Gothenburg, Sweden
- Section for Endocrinology and Diabetology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Penelope Trimpou
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Gothenburg, Sweden
- Section for Endocrinology and Diabetology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Gothenburg, Sweden
- Section for Endocrinology and Diabetology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Dotevall A, Krantz E, Barrenäs M, Landin‐Wilhelmsen K. Hearing and Balance Exceed Initial Bone Mineral Density in Predicting Incident Fractures: A 25-Year Prospective Observational Study in Menopausal Women With Osteoporosis. JBMR Plus 2022; 6:e10551. [PMID: 35079673 PMCID: PMC8770996 DOI: 10.1002/jbm4.10551] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/22/2021] [Accepted: 09/05/2021] [Indexed: 11/25/2022] Open
Abstract
Hearing and balance deteriorate, and fracture incidence increases with age, especially in women. The aim of the present study was to investigate whether impaired hearing and body balance are stronger predictors of fractures than bone mass. Between 1995 and 1997, 80 women, aged 50 to 70 years, with primary osteoporosis, taking menopausal hormone therapy, mainly for menopausal symptoms, participated in a double-blind, randomized, placebo-controlled study of treatment with growth hormone versus placebo. All women received calcium 750 mg and vitamin D 400 U daily. They were then examined yearly until 2007 and followed up by registers until 2020. Hearing was assessed by audiometry. Body balance and fine motor function were tested according to the Bruininks-Oseretsky test. Bone properties were measured with DXA. Data on fractures were derived from the Gothenburg Hospital register. Over the 25-year follow-up, 50 women (63%) sustained 104 fractures, most often related to accidental falls. Thoracic and lumbar spine fractures were most common (36%). Other fractures occurred in the pelvis (14%), humerus (14%), hip (11%), and wrist (10%). Hearing impairment at baseline, measured as pure tone average-high (p = 0.007), pure tone average-mid (p = 0.003), and speech-recognition score (p = 0.025), was associated with a subsequent first fracture, as were worse body balance (p = 0.004), upper limb coordination (p = 0.044), and higher running-speed agility (p = 0.012). After adjustment for age and BMD, pure tone average-high (p = 0.036), pure tone average-mid (p = 0.028), and body balance (p = 0.039) were still significantly associated with incident fractures. Bone mineral content, BMD, and treatment at baseline were not associated with subsequent fracture. In conclusion, hearing and body balance at baseline exceeded initial BMD in predicting incident fractures in osteoporotic women regardless of treatment during 25-year follow-up. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Annika Dotevall
- Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of MedicineSahlgrenska University Hospital/ÖstraGothenburgSweden
| | - Emily Krantz
- Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Respiratory Medicine and AllergologySahlgrenska University HospitalGothenburgSweden
| | - Marie‐Louise Barrenäs
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Clinical Sciences, Division of OtorhinolaryngologyUmeå UniversityUmeåSweden
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Ellegård L, Krantz E, Trimpou P, Landin-Wilhelmsen K. Health-related quality of life in hypothyroidism-A population-based study, the WHO MONICA Project. Clin Endocrinol (Oxf) 2021; 95:197-208. [PMID: 33665871 DOI: 10.1111/cen.14448] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore health-related quality of life (HRQoL) among subjects with hypothyroidism compared to subjects without hypothyroidism in the general population. HRQoL is important in clinical practice. Hypothyroidism is prevalent, mainly found in women, and increasing with age. DESIGN Cohort study of random population sample. PATIENTS Women and men, n = 414 (39-78 years) from the WHO MONICA project, Gothenburg, Sweden, participated. Hypothyroidism was defined as subjects having levothyroxine supplementation or serum thyroid-stimulating hormone (S-TSH) >4.2 mU/L. MEASUREMENTS Health-related quality of life was measured with Psychological General Well-Being Index (PGWB), Nottingham Health Profile (NHP), Short Form 36 Health Survey (SF-36) and a single item self-rated health scale (0-100), and stress was rated 1-6. The results were adjusted for age, sex and comorbidity using analysis of covariance (ANCOVA). RESULTS Hypothyroidism was found in 70 subjects (17%). They scored worse HRQoL than controls regarding Sleep (p < .001), Social isolation (p = .01) and Total NHP (p < .05), and had more medication in general 2.7 ± 2.5 vs. 1.8 ± 2.1, p < .05. Subjects with levothyroxine (n = 40) showed similar results as the total hypothyroid group. Subjects unaware of their newly detected elevated STSH (n = 30) showed lower HRQoL in Sleep (p < .01) and Pain (p < .05) in NHP. HRQoL was similar in subjects with and without positive thyroperoxidase antibodies (TPO-Ab) either in those with hypothyroidism (44% TPO-Ab) or controls (9% TPO-Ab). CONCLUSION Men and women with hypothyroidism in the general population reported having more issues with Sleep and Social isolation than those without hypothyroidism irrespective of TPO-Ab. Scores were similar in all of the other HRQoL domains measuredAQ5.
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Affiliation(s)
- Lotta Ellegård
- The Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily Krantz
- The Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Penelope Trimpou
- The Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- The Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Krantz E, Landin-Wilhelmsen K, Trimpou P, Bryman I, Wide U. Health-Related Quality of Life in Turner Syndrome and the Influence of Growth Hormone Therapy: A 20-Year Follow-Up. J Clin Endocrinol Metab 2019; 104:5073-5083. [PMID: 31009056 PMCID: PMC6760289 DOI: 10.1210/jc.2019-00340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 04/16/2019] [Indexed: 01/15/2023]
Abstract
CONTEXT The factors that affect the health-related quality of life (HRQoL) of women with Turner syndrome (TS) are controversial. OBJECTIVE The aim was to describe the HRQoL of women with TS with a focus on how given GH treatment and comorbidity influence HRQoL in adulthood and to compare HRQoL of women with TS with that of women in the general population. DESIGN Longitudinal cohort study, up to 20 years. SETTING The Turner Center at the Section for Endocrinology and Department of Reproductive Medicine at Sahlgrenska University Hospital, Gothenburg, Sweden. PARTICIPANTS Women with TS (n = 200), age range 16 to 78 years, were included consecutively and monitored every fifth year between 1995 and 2018. Women from the World Health Organization MONItoring of trends and determinants for CArdiovascular disease project were used as reference populations. INTERVENTIONS AND MAIN OUTCOME MEASURES HRQoL was measured using the Psychological General Well-Being index and the Nottingham Health Profile. Associations with somatic variables were assessed using longitudinal linear regression models. RESULTS HRQoL was not associated with GH treatment in TS in spite of a mean 5.7 cm taller height. HRQoL was only associated with height per se in one of 13 subscales (P < 0.01). HRQoL was negatively affected by higher age, higher age at diagnosis, and hearing impairment in TS. Women with TS reported a similar HRQoL to the reference population. CONCLUSIONS No association between previous GH treatment and HRQoL was found during the up to 20 years of follow-up in women with TS. HRQoL of women with TS and the reference population was similar.
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Affiliation(s)
- Emily Krantz
- Clinic of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Penelope Trimpou
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Bryman
- Department of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Forslund M, Landin-Wilhelmsen K, Krantz E, Trimpou P, Schmidt J, Brännström M, Dahlgren E. No difference in quality of life or depression/anxiety diagnosis between middle-aged women with PCOS and age-matched controls. Maturitas 2019. [DOI: 10.1016/j.maturitas.2019.04.125] [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: 10/26/2022]
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Demeke T, Osmancevic A, Gillstedt M, Krogstad AL, Angesjö E, Sinclair H, El-Gawad GA, Krantz E, Trimpou P, Landin-Wilhelmsen K. Comorbidity and health-related quality of life in Somali women living in Sweden. Scand J Prim Health Care 2019; 37:174-181. [PMID: 31057029 PMCID: PMC6567019 DOI: 10.1080/02813432.2019.1608043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 11/16/2018] [Indexed: 02/03/2023] Open
Abstract
Objective: To explore the relationship between low serum vitamin D levels and comorbidity in Somali women, immigrants to Sweden. Design and setting: Cohort study in a Primary Health Care Center and a University Hospital. Subjects: Somali women skin type V, n = 114, aged 18-56 years, from latitude 0-10○ N, living in Sweden, latitude 57○ N > 2 years were compared with women from a population sample, skin type II-III, n = 69, aged 38-56 years, the WHO MONICA study, Gothenburg, Sweden. Main outcome measures: Serum (S)-25(OH)D, S-parathyroid hormone (PTH), comorbidity and Health-Related Quality of Life (HRQoL) using the Short Form-36 (SF-36) and part of the EQ-5D questionnaires. All calculations were corrected for age. Results: Vitamin D deficiency (S-25(OH)D < 25 nmol/l) was found in 73% of the Somali women and in 1% of the controls (p < .0001). S-PTH was elevated (>6.9 pmol/l) in 26% and 9%, respectively (p < .004). Somali women used less medication, 16% vs. 55%, p < .0001) but more allergy medication, 11% vs. 7% (p = .006), had fewer fractures, 2% vs. 28% (p < .0001) and lower HRQoL in 7 out of 9 scales (p < .05-.001), than native controls. There were no differences in the prevalence of diabetes mellitus, hypothyroidism, positive thyroid peroxidase antibodies, vitamin B12 deficiency, celiac disease or hypertension. Conclusions: Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity was low. Both mental, and especially physical HRQoL scores were lower in the Somali women. The effects of long-lasting deficiency are unknown. Key points The aim was to explore the relationship between vitamin D deficiency (S-25(OH)D < 25 nmol/l) and comorbidity in immigrants. Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity of hypothyroidism, diabetes mellitus, hypertension, fractures and use of medications was low. Both mental, and especially physical, Health-Related Quality of Life were lower in the Somali women than in native Swedish women. The effects of long-lasting deficiency are unknown.
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Affiliation(s)
- Taye Demeke
- Angered Primary Health Care Centre, Gothenburg, Sweden
| | - Amra Osmancevic
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Gillstedt
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anne Lene Krogstad
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Angesjö
- Brämhult Primary Health Care Centre, Borås, Sweden
| | - Håkan Sinclair
- Department of Geriatric Medicine, South Älvsborg Hospital, Borås, Sweden
| | | | - Emily Krantz
- Department of Medicine, South Älvsborg Hospital, Borås, Sweden
| | - Penelope Trimpou
- Section for Endocrinology, Institution of Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Section for Endocrinology, Institution of Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden
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Krantz E, Wide U, Trimpou P, Bryman I, Landin-Wilhelmsen K. Comparison between different instruments for measuring health-related quality of life in a population sample, the WHO MONICA Project, Gothenburg, Sweden: an observational, cross-sectional study. BMJ Open 2019; 9:e024454. [PMID: 31005911 PMCID: PMC6500231 DOI: 10.1136/bmjopen-2018-024454] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The general aim was to meet the need for empirical comparative studies of health-related quality of life (HRQoL) assessment instruments, by evaluating and comparing the psychometric properties and results of three different, widely used, generic HRQoL instruments in a population sample. The specific aims were to evaluate the subscales of the different instruments that measure the same domain and to assess the association between the HRQoL measures and a single-item self-rated health scale. DESIGN An observational cross-sectional study. SETTING A population-based sample from Gothenburg, Sweden, was studied in 2008 in the WHO MONItoring of trends and determinants for CArdiovascular disease. PARTICIPANTS A total of 414 subjects were included, 77% women, age range 39-78 years. INTERVENTIONS The Nottingham Health Profile (NHP), the Short Form-36 questionnaire (SF-36), the Psychological General Well-Being Index (PGWB) and a self-rated health scale were used. OUTCOME MEASURES Scores were analysed for their psychometric properties, internal consistency (Cronbach's α), construct validity (Spearman's rank correlations and R2 coefficients) and discriminative ability for the presence of self-rated ill-health. RESULTS PGWB and SF-36 had higher Cronbach's α scores than NHP. All correlations calculated between the subscales that were conceptually similar were significant (p<0.01). All subscales could differentiate the presence of self-rated ill-health according to the self-rated health scale (p<0.001). The self-rated health scale correlated strongly with all of the three HRQoL instruments used. CONCLUSIONS There was a high concordance between the instruments within each domain that was conceptually similar. All three HRQoL instruments (PGWB, SF-36 and NHP) could discriminate the presence of self-rated ill-health. The simple and quick self-rated health scale correlated strongly with the more time-consuming PGWB, SF-36 and NHP. The result supports the existence of a strong association between the self-rated health scale and HRQoL in the general population.
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Affiliation(s)
- Emily Krantz
- Clinic of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Penelope Trimpou
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Bryman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Section of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Krantz E, Trimpou P, Landin-Wilhelmsen K. Response to the Letter by Salvatori R. J Clin Endocrinol Metab 2015; 100:L108. [PMID: 26544658 DOI: 10.1210/jc.2015-3461] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Emily Krantz
- Clinic for Internal Medicine (E.K.), Södra Älvsborgs Hospital, SE-501 82 Borås, Sweden; and Section for Endocrinology (P.T., K.L.-W.), Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Penelope Trimpou
- Clinic for Internal Medicine (E.K.), Södra Älvsborgs Hospital, SE-501 82 Borås, Sweden; and Section for Endocrinology (P.T., K.L.-W.), Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Clinic for Internal Medicine (E.K.), Södra Älvsborgs Hospital, SE-501 82 Borås, Sweden; and Section for Endocrinology (P.T., K.L.-W.), Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
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Krantz E, Trimpou P, Landin-Wilhelmsen K. Effect of Growth Hormone Treatment on Fractures and Quality of Life in Postmenopausal Osteoporosis: A 10-Year Follow-Up Study. J Clin Endocrinol Metab 2015; 100:3251-9. [PMID: 26312576 PMCID: PMC4570174 DOI: 10.1210/jc.2015-1757] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Growth hormone (GH) treatment increases bone mineral density (BMD) in women with postmenopausal osteoporosis. OBJECTIVE The objective was to report bone data, fractures, and quality of life (QoL) in a 10-year follow-up of women who had received GH for 3 years and compared with controls followed in parallel. DESIGN AND SETTING A follow-up of a double-blind, placebo-controlled study conducted at Sahlgrenska University Hospital was performed. PATIENTS Eighty women aged between 50 and 70 years with osteoporosis and estrogen hormone replacement were studied and compared with an age-matched random population sample of women (n = 120) from the World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease project (Gothenburg, Sweden). INTERVENTIONS Patients were randomized to GH 1.0 U or GH 2.5 U recombinant human GH or placebo sc daily during 3 years. All received calcium 750 mg and vitamin D 400 U and were followed up during 10 years. MAIN OUTCOME MEASURES BMD and bone mineral content were measured with dual-energy X-ray absorptiometry. QoL was estimated with the 36-item Short Form. RESULTS GH increased BMD and bone mineral content dose dependently in all regions (P = .01, GH 1.0 U, and P = .0006, GH 2.5 U vs placebo). After 10 years the number of fractures decreased from 56% to 28% (P = .0003) in patients evenly distributed between groups. In controls, fractures increased from 8% to 32% (P = .0008). QoL did not change during GH treatment or during the 10-year follow-up and did not differ compared with controls. CONCLUSION GH treatment was beneficial for bone and fracture outcome after 10 years but did not affect the QoL of the women with postmenopausal osteoporosis.
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Affiliation(s)
- Emily Krantz
- Clinic for Internal Medicine (E.K.), Södra Älvsborgs Hospital, SE-501 82 Borås, Sweden; and Section for Endocrinology (P.T., K.L.-W.), Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Penelope Trimpou
- Clinic for Internal Medicine (E.K.), Södra Älvsborgs Hospital, SE-501 82 Borås, Sweden; and Section for Endocrinology (P.T., K.L.-W.), Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Clinic for Internal Medicine (E.K.), Södra Älvsborgs Hospital, SE-501 82 Borås, Sweden; and Section for Endocrinology (P.T., K.L.-W.), Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
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Brown EL, Wald A, Hughes JP, Morrow RA, Krantz E, Mayer K, Buchbinder S, Koblin B, Celum C. High risk of human immunodeficiency virus in men who have sex with men with herpes simplex virus type 2 in the EXPLORE study. Am J Epidemiol 2006; 164:733-41. [PMID: 16896053 DOI: 10.1093/aje/kwj270] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The relation between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) acquisition was evaluated among 4,295 high-risk, HIV-negative men who have sex with men in an intensive behavioral intervention (colloquially referred to as "EXPLORE") study in the United States from 1999 to 2003. Sexual behavior data were obtained by computer-assisted self-interview, and sera were collected semiannually for HIV and HSV-2 serology. HSV-2 infection was classified as "recent incident" (at the first HSV-2 seropositive visit), "remote incident" (within 24 months of the first positive visit), and "prevalent" (for visits >24 months after the first HSV-2 positive visit). Baseline HSV-2 prevalence was 20.3%. HSV-2 incidence was 1.9 (95% confidence interval (CI): 1.6, 2.2) per 100 person-years; significant risk factors were African-American race, unprotected receptive anal intercourse, an HIV-positive male sex partner, and six or more male partners in the prior 6 months. The behavioral intervention did not reduce HSV-2 acquisition (adjusted hazard ratio (HR) = 1.2, 95% CI: 0.9, 1.6). Overall HIV incidence was 1.9 (95% CI: 1.7, 2.2) per 100 person-years. HIV risk was elevated among men who have sex with men with recent incident HSV-2 (adjusted HR = 3.6, 95% CI: 1.7, 7.8), remote incident HSV-2 (adjusted HR = 1.7, 95% CI: 0.8, 3.3), and prevalent HSV-2 (adjusted HR = 1.5, 95% CI: 1.1, 2.1) infection compared with HSV-2 seronegative participants. HIV intervention strategies targeting HSV-2 prevention and suppression among men who have sex with men should be evaluated.
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Affiliation(s)
- E L Brown
- Department of Epidemiology, University of Washington, Seattle, 98104, USA
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Abstract
OBJECTIVES Herpes simplex virus (HSV) 1 and HSV-2 reactivate preferentially in the oral and genital area, respectively. We aimed to define frequency and characteristics associated with oral shedding of HSV-2. METHODS Demographic, clinical and laboratory data of patients with documented HSV-2 infection and at least one oral viral culture obtained were selected from the University of Washington Virology Research Clinic database. RESULTS Of 1388 people meeting the entry criteria, 44 (3.2%) had HSV-2 isolated at least once from their mouths. In comparison with the 1344 people who did not have HSV-2 isolated from their mouth, participants with oral HSV-2 were more likely to be male (OR = 1.9, 95% CI 1.0 to 3.7), HIV positive (OR = 2.9, 95% CI 1.4 to 6.0), and homosexual (OR = 2.2, 95% CI 1.1 to 4.2), and to have collected a larger number of oral specimens (median 32 v 4, p<0.001). Of the 58 days with oral HSV-2 isolation, 15 (25%) occurred during newly acquired HSV-2 infection, 12 (21%) during a recurrence with genital lesions, three (5%) during a recurrence with oral lesions, and three (5%) during a recurrence with oral and genital lesions; 25 (43%) occurred during asymptomatic shedding. Oral HSV-2 was found less frequently than oral HSV-1 (0.06% v 1%, p<0.001) in people with HSV-1 and HSV-2 antibody, and less frequently than genital HSV-2 (0.09% v 7%, p<0.001). CONCLUSIONS Oral reactivation of HSV-2 as defined by viral isolation is uncommon and usually occurs in the setting of first episode of genital HSV-2 or during genital recurrence of HSV-2.
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Affiliation(s)
- A Wald
- University of Washington Virology Research Clinic, 600 Broadway, Suite 400, Seattle, WA 98122, USA.
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Zago AJ, Bersano EDP, Brendler J, Krantz E, Tessuto S. [Strategies of reperfusion in developing infarct]. Arq Bras Cardiol 1990; 55:329-38. [PMID: 2090078] [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: 12/30/2022] Open
Affiliation(s)
- A J Zago
- Hospital de Clínicas de Porto Alegre, RS
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Hallonsten AL, Helm G, Koch G, Krantz E, Schröder U. [Nitrous oxide analgesia in dentistry. Report of a clinical research]. Tandlakartidningen 1976; 68:640-5. [PMID: 150057] [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: 12/13/2022]
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Abstract
A case is presented of ascites and hydrothorax in association with struma ovarii. Nine previously reported cases are reviewed and the possible causes of the ascites and hydrothorax discussed.
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