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Aune S, Bonnevie-Svendsen M, Nyborg C, Trøseid M, Seljeflot I, Hisdal J, Helseth R. Gut leakage and cardiac biomarkers after prolonged strenuous exercise in highly trained endurance athletes. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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2
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Bratseth V, Nordeng J, Helseth R, Solheim S, Åkra S, Arnesen H, Chiva-Blanch G, Seljeflot I. Circulating microvesicles in association with the NLRP3 inflammasome in coronary thrombi from STEMI patients. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.169] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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3
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Bratseth V, Watne L, Seljeflot I, Helseth R. Delirium is associated with the nets component dsDNA in serum and cerebrospinal fluid. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.162] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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4
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Kluge K, Langseth MS, Andersen G, Halvorsen S, Eritsland J, Hansen CH, Arnesen H, Tonnessen T, Seljeflot I, Helseth R. Complement activation is associated with neutrophil extracellular traps and all-cause mortality in ST-elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The complement system and neutrophil extracellular traps (NETs) are both parts of the innate immune system, and have been implicated in the ischemia-reperfusion injury in patients with ST-elevation myocardial infarction (STEMI). There is experimental evidence of reciprocal activation between the complement system and NETs. Any such link in patients with STEMI has not been investigated.
Purpose
To investigate a potential association between complement activation and clinical outcomes after STEMI, and assess any interplay between complement activation and NETs in this situation.
Methods
Patients with ST-elevation myocardial infarction were included at a median of 18 hours after percutaneous coronary intervention (n=864). The terminal complement complex (TCC) was measured by ELISA as a marker of complement activation. As markers of NETs were myeloperoxidase-deoxynucleic acid (MPO-DNA) and citrullinated histone 3 (CitH3) measured by ELISAs, while double stranded DNA (dsDNA) was measured by a nucleic acid stain. Patients were followed for a median of 4.6 years. The primary endpoint was a composite of new myocardial infarction, unscheduled revascularization, stroke, hospitalization for heart failure and death, whichever occurred first. All-cause mortality was also recorded.
Results
The composite endpoint occurred in 184 (21.3%) patients, while 70 (8.1%) died during follow-up. When dichotomizing at median TCC, the group with above-median TCC levels did not have an increased risk of reaching the composite endpoint (hazard ratio (HR): 1.069, 95% CI: [0.801, 1.428], p=0.651). However, this group exhibited an increased risk of all-cause mortality (HR: 1.650, 95% CI: [1.020, 2.671], p=0.041). This risk persisted when adjusting for age, sex, hypertension and LDL-cholesterol (HR: 1.673, 95% CI: [1.014, 2.761], p=0.044), but the significance was lost when adjusting for NT-proBNP (HR: 1.492, 95% CI: [0.885, 2.515], p=0.133). TCC was correlated to dsDNA (r=0.127, p<0.001) and CitH3 (r=0.102, p=0.003), but not MPO-DNA. The group with both TCC and dsDNA in the highest quartile exhibited a significantly higher incidence of all-cause mortality than the remaining population (17.6% vs, 7.2%, p=0.002). When examining the predictive value of TCC and dsDNA on all-cause mortality in ROC curve analysis, the area under the curve (AUC) for TCC was 0.549 (95% CI: [0.472, 0.625]), while the AUC for dsDNA was 0.653 (95% CI: [0.584, 0.722]). When combining TCC and dsDNA the predictive value was marginally higher than for TCC alone (AUC: 0.649, 95% CI: [0.579, 0.720])
Conclusion
In this STEMI population, complement activation measured by TCC was not associated with the primary composite endpoint, but was associated with increased risk of death. TCC was weakly correlated with markers of NETs. Despite a high mortality rate in patients with high levels of TCC and dsDNA, combining these variables did not increase the prognostic value compared to TCC alone.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Stein Erik Hagen's Foundation for Clinical Heart Research Survival according to cox regression
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Affiliation(s)
- K Kluge
- University of Oslo, Oslo, Norway
| | | | - G.Ø Andersen
- Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway
| | | | - J Eritsland
- Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway
| | - C H Hansen
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
| | | | | | | | - R Helseth
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
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Nordeng J, Helseth R, Aakra S, Hoffmann P, Schandiz H, Roald B, Bendz B, Arnesen H, Solheim S, Seljeflot I. Plaque and remodeling markers in coronary thrombi. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Matrix Metalloproteinases (MMPs) and their inhibitors are considered to be of importance in development of atherosclerotic coronary artery disease. MMP-9 has been associated with unstable atherosclerotic plaques and rupture, as well as left ventricular remodeling after myocardial infarction (MI), whereas MMP-2 seems to be more related to progression of stable plaques. MMP activity is modulated by Tissue Inhibitors of Metalloproteinases (TIMPs). TIMP-1 has been associated with cardiac remodeling post MI, and TIMP-2 has been discussed to inhibit plaque development and destabilization. The extracellular MMP Inducer, EMMPRIN, stimulates both MMPs and TIMPs, and has been found upregulated on the surface of monocytes in patients with acute MI, and associated with MMP-9 activity.
Purpose
To study whether genes encoding MMP-2, MMP-9, TIMP-1, TIMP-2 and EMMPRIN are expressed in coronary thrombi and in circulating leukocytes from STEMI patients, and whether these are related to the degree of myocardial injury measured by troponin T, and time from symptoms to PCI.
Methods
Intracoronary thrombi were aspirated from 33 patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. The thrombi were snap-frozen in RNA-later solution for gene expression analyses. Peripheral blood samples with Pax-gene tubes were drawn at end of the PCI procedure. RNA was isolated from the thrombi and leukocytes, and the actual genes relatively quantified by RT PCR. Peak troponin T was collected from clinical records.
Results
Genes coding for the five different markers were present in 84–100% of the thrombi. Median peak troponin T was 3434 m/L. The expression of TIMP-1 in the thrombi correlated significantly to peak troponin T (r=0.393, p=0.026), and dividing peak troponin T values into quartiles, the median value of TIMP-1 mRNA in Q4 was 2.5-fold higher compared to Q1–3 (p=0.107). Peak troponin T also correlated to the expression of TIMP-1 in circulating leukocytes (r=0.469, p=0.006), and in Q4 of troponin T, the median value was 1.6-fold higher compared to Q1–3 (p=0.056). There were no significant correlations between the other measured genes and troponin T, and also no associations of any genes expressed in the thrombi or in circulating leukocytes to time from symptom to PCI (median 152 min).
Conclusion
Genes coding for MMP-2, MMP-9, TIMP-1, TIMP-2 and EMMPRIN were highly expressed in human coronary thrombi. The positive correlation between peak troponin T and the expression of TIMP-1 both in thrombi and in circulating leukocytes at time of PCI in patients with STEMI, may indicate that the role of TIMP-1 is important in cardiac remodeling immediately post-MI.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Stein Erik Hagens Foundation for Clinical Heart Research
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Affiliation(s)
- J Nordeng
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
| | - R Helseth
- Oslo University Hospital Ulleval, Cardiology, Oslo, Norway
| | - S Aakra
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
| | - P Hoffmann
- Oslo University Hospital Ulleval, Cardiology, Section for Interventional Cardiology, Oslo, Norway
| | - H Schandiz
- Akershus University Hospital, Department of Pathology, Oslo, Norway
| | - B Roald
- Oslo University Hospital Ulleval, Department of Pathology, Oslo, Norway
| | - B Bendz
- Oslo University Hospital Rikshospitalet, Cardiology, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
| | - S Solheim
- Oslo University Hospital Ulleval, Cardiology, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
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6
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Aune SK, Cwikiel J, Flaa A, Arnesen H, Solheim S, Awoyemi A, Troeseid M, Seljeflot I, Helseth R. Gut leakage markers in response to strenuous exercise in patients with suspected coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Although regular physical activity is associated with reduced risk of cardiovascular disease (CVD), acute vigorous exercise seems to transiently increase the risk of acute coronary events in patients with underlying CVD. Some studies have reported regular physical activity to associate with microbial diversity, whereas elevated levels of gut leakage markers have been shown after strenuous exercise in healthy individuals. Any predictive value of a temporary increase in gut leakage markers on the risk of coronary events in susceptible individuals is unknown.
Purpose
We aimed to explore gut leakage markers in response to a bout of strenuous exercise in patients with symptoms of chronic coronary syndrome (CCS). We hypothesized that gut leakage markers would increase after acute strenuous exercise, and that the increase would be higher in patients with angiographically verified CAD.
Methods
Patients referred to exercise stress testing or coronary angiography due to symptoms suggestive of CCS were included (n=327). A maximal exercise ECG stress test was performed using a bicycle ergometer. Venous blood samples were drawn at rest prior to the test and within 5 min after the test ended, for analysis of soluble cluster of differentiation 14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty-acid binding protein (I-FABP) by ELISAs. Quantification of lipopolysaccharide (LPS) and relative quantification of gene expression of the toll-like receptor 4 (TLR4) in circulating leukocytes was performed in a subset of patients (n=101). Patients then underwent coronary angiography, and were grouped according to the degree of CAD.
Results
Of the 287 patients who completed the exercise stress test and coronary angiography, 69 (24%) had no CAD, 88 (31%) had non-significant CAD and 130 (45%) had significant CAD. Mean exercise duration was 10:05±4:46 min and the duration did not differ between the groups. There were no significant differences in resting levels of gut leakage markers between the groups. In the total population, sCD14, LBP and LPS increased significantly after exercise (p<0.0001, all), whereas I-FABP did not. The gene expression of TLR4 decreased significantly after exercise (p<0.0001). There were no differences in exercise-induced changes in any of the measured markers between groups with no CAD, non-significant CAD and significant CAD.
Conclusion
In patients with symptoms suggestive of CCS, LPS, LBP and sCD14 increased significantly after strenuous exercise, suggesting that even short bouts of vigorous exercise are associated with gut leakage. The decrease in gene expression of TLR4 may be discussed to be compensatory to the increase in LPS or possibly reflecting an increase in TLR4 translation in response to LPS. The presence of CAD or not did not seem to impact exercise-induced increase in gut leakage markers.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Stein Erik Hagen Foundation for Clinical Heart Research, Olso, Norway
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Affiliation(s)
- S K Aune
- Oslo University Hospital Ulleval, Department of Cardiology, Center for Clinical Heart Research, Oslo, Norway
| | - J Cwikiel
- Oslo University Hospital Ulleval, Department of Cardiology, Center for Clinical Heart Research, Oslo, Norway
| | - A Flaa
- Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital Ulleval, Department of Cardiology, Center for Clinical Heart Research, Oslo, Norway
| | - S Solheim
- Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway
| | - A Awoyemi
- Oslo University Hospital Ulleval, Department of Cardiology, Center for Clinical Heart Research, Oslo, Norway
| | - M Troeseid
- Oslo University Hospital Rikshospitalet, Section of Clinical Immunology and Infectious diseases, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital Ulleval, Department of Cardiology, Center for Clinical Heart Research, Oslo, Norway
| | - R Helseth
- Oslo University Hospital Ulleval, Department of Cardiology, Center for Clinical Heart Research, Oslo, Norway
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Nordeng J, Helseth R, Aakra S, Hoffman P, Schandiz H, Roald B, Bendz B, Arnesen H, Solheim S, Seljeflot I. The inflammasome signaling axis in thrombi from STEMI patients is related to degree of myocardial injury. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The NLRP3-inflammasome and the IL-6-pathways, i.e. the inflammasome signaling axis, seems to be central mechanisms in the inflammatory response related to myocardial reperfusion injury after revascularization. The beneficial results shown by treating MI-patients with canakunimab, an antibody blocking IL1-β, in the CANTOS trial*, and by treatment of NSTEMI patients with the IL6-receptor antagonist tocilizumab**, are looked upon as proof of concept for inflammasome inhibition.
Purpose
To study whether genes encoding inflammasome-related proteins are present in coronary thrombi and in circulating cells from STEMI patients, and whether these are related to the degree of myocardial injury as measured by troponin T, and time from symptoms to PCI.
Methods
Intracoronary thrombi were aspirated from 33 patients with STEMI treated with primary PCI. The thrombi were snap-frozen in RNA-later solution for gene expression analyses. Peripheral blood samples with Pax-gene tubes were drawn at end of the PCI-procedure. mRNA of NLRP3, caspase1, IL1-β, IL18, IL6, IL6-receptor (IL6-R) and gp130 were isolated from the thrombi and leukocytes in peripheral blood, and relatively quantified by RT PCR. Peak troponin was collected from clinical records.
Results
Genes coding for the 7 different markers were present in 76–100% of the thrombi. The expression of NLRP3 in thrombi significantly correlated to peak troponin T (r=0.468, p=0.024). Dividing peak troponin T values into quartiles, the median value of NLRP3 mRNA in Q4 was 2.0-fold higher compared to Q1–3 (p=0.012). Peak troponin T also correlated with the expression in circulating leukocytes of NLRP3 (r=0.420, p=0.0149) and IL1-β (r=0.394, p=0.023), and borderline to caspase1 (r=0.321, p=0.069) and IL18 (r=0.310, p=0.079).
IL6-R expression in thrombi correlated significantly to peak troponin T (r=0.434, p=0.019), with a 2.5-fold higher median level in Q4 vs Q1–3 of troponin T (p=0.017). gp130 expression in thrombi correlated inversely with peak troponin T (r=−0.398, p=0.050), as did IL6-R expression in circulating leukocytes (r=−0.421, p=0.015). There were no significant correlations between genes expressed in the thrombi and time from symptom to PCI (median 152 minutes), whereas genes for IL6 in circulating leukocytes correlated inversely (r=−0.385, p=0.027).
Conclusion
The inflammasome signaling pathway was actively regulated in coronary thrombi and in circulating leukocytes from patients with STEMI. Genes encoding NLRP3 and IL6-R were increasingly expressed in thrombi from patients with increased myocardial damage, measured by troponin T, supporting the beneficial effects of medically targeting this pathway.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Stein Erik Hagens Foundation for Clinical Heart Research
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Affiliation(s)
- J Nordeng
- Ulleval University Hospital, Center for Clinical Heart Research and Department of Cardiology, Oslo, Norway
| | - R Helseth
- Ulleval University Hospital, Center for Clinical Heart Research and Department of Cardiology, Oslo, Norway
| | - S Aakra
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
| | - P Hoffman
- Ulleval University Hospital, Department of Radiology, Oslo, Norway
| | - H Schandiz
- Akershus University Hospital, Department of Pathology, Oslo, Norway
| | - B Roald
- Oslo University Hospital Ulleval, Department of Pathology, Oslo, Norway
| | - B Bendz
- Oslo University Hospital Rikshospitalet, Department of Cardiology, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital Ulleval, Center for Clinical Heart Research, Oslo, Norway
| | - S Solheim
- Ulleval University Hospital, Center for Clinical Heart Research and Department of Cardiology, Oslo, Norway
| | - I Seljeflot
- Ulleval University Hospital, Center for Clinical Heart Research and Department of Cardiology, Oslo, Norway
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8
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Langseth MS, Helseth R, Ritschel V, Solheim S, Arnesen H, Eritsland J, Andersen GØ, Halvorsen S, Seljeflot I, Opstad TB. 3402Markers of neutrophil extracellular traps as related to mortality in patients with ST-elevation myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3402] [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] [Indexed: 11/12/2022] Open
Affiliation(s)
- M S Langseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - R Helseth
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - V Ritschel
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - S Solheim
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - J Eritsland
- Oslo University Hospital, Department of Cardiology Ullevål, Oslo, Norway
| | - G Ø Andersen
- Oslo University Hospital, Department of Cardiology Ullevål, Oslo, Norway
| | - S Halvorsen
- Oslo University Hospital, Department of Cardiology Ullevål, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
| | - T B Opstad
- Oslo University Hospital, Center for Clinical Heart Research, Ulleval, Oslo, Norway
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Helseth R, Knudsen EC, Andersen GØ, Opstad TB, Eritsland J, Arnesen H, Seljeflot I. P2673Neutrophil extracellular traps (NETs) assessed by dsDNA and PAD4 mRNA in patients with ST-elevation myocardial infarction are associated with plasma glucose. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2673] [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] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Helseth
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
| | - E C Knudsen
- Oslo University Hospital, Department of Cardiology, Oslo, Norway
| | - G Ø Andersen
- Oslo University Hospital, Department of Cardiology, Oslo, Norway
| | - T B Opstad
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
| | - J Eritsland
- Oslo University Hospital, Department of Cardiology, Oslo, Norway
| | - H Arnesen
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
| | - I Seljeflot
- Oslo University Hospital, Center for Clinical Heart Research, Oslo, Norway
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Helseth R, Carlsen SM, Bollerslev J, Svartberg J, Øksnes M, Skeie S, Fougner SL. Preoperative octreotide therapy and surgery in acromegaly: associations between glucose homeostasis and treatment response. Endocrine 2016; 51:298-307. [PMID: 26179177 DOI: 10.1007/s12020-015-0679-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 02/19/2015] [Accepted: 06/29/2015] [Indexed: 01/15/2023]
Abstract
In acromegaly, high GH/IGF-1 levels associate with abnormal glucose metabolism. Somatostatin analogs (SSAs) reduce GH and IGF-1 but inhibit insulin secretion. We studied glucose homeostasis in de novo patients with acromegaly and changes in glucose metabolism after treatment with SSA and surgery. In this post hoc analysis from a randomized controlled trial, 55 de novo patients with acromegaly, not using antidiabetic medication, were included. Before surgery, 26 patients received SSAs for 6 months. HbA1c, fasting glucose, and oral glucose tolerance test were performed at baseline, after SSA pretreatment and at 3 months postoperative. Area under curve of glucose (AUC-G) was calculated. Glucose homeostasis was compared to baseline levels of GH and IGF-1, change after SSA pretreatment, and remission both after SSA pretreatment and 3 months postoperative. In de novo patients, IGF-1/GH levels did not associate with baseline glucose parameters. After SSA pretreatment, changes in GH/IGF-1 correlated positively to change in HbA1c levels (both p < 0.03). HbA1c, fasting glucose, and AUC-G increased significantly during SSA pretreatment in patients not achieving hormonal control (all p < 0.05) but did not change significantly in patients with normalized hormone levels. At 3 months postoperative, HbA1c, fasting glucose, and AUC-G were significantly reduced in both cured and not cured patients (all p < 0.05). To conclude, in de novo patients with acromegaly, disease activity did not correlate with glucose homeostasis. Surgical treatment of acromegaly improved glucose metabolism in both cured and not cured patients, while SSA pretreatment led to deterioration in glucose homeostasis in patients not achieving biochemical control.
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Affiliation(s)
- R Helseth
- Department of Internal Medicine, Drammen Hospital, Vestre Viken, Drammen, Norway
| | - S M Carlsen
- Department of Endocrinology, Medical Clinic, St. Olavs University Hospital, 7006, Trondheim, Norway
- Unit for Applied Clinical Research, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - J Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - J Svartberg
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - M Øksnes
- Department of Medicine and Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - S Skeie
- Division of Medicine, Stavanger University Hospital, Stavanger, Norway
| | - S L Fougner
- Department of Endocrinology, Medical Clinic, St. Olavs University Hospital, 7006, Trondheim, Norway.
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Helseth R, Seljeflot I, Opstad T, Solheim S, Freynhofer M, Arnesen H, Huber K, Weiss T. Genes expressed in coronary thrombi are associated with ischemic time in patients with acute myocardial infarction. Thromb Res 2015; 135:329-33. [DOI: 10.1016/j.thromres.2014.11.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/29/2014] [Accepted: 11/30/2014] [Indexed: 11/17/2022]
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12
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Solheim S, Helseth R, Hoffmann P, Arnesen H, Seljeflot I. The profile of circulating Pentraxin 3 after PCI in patients with acute myocardial infarction or angina pectoris. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
OBJECTIVE High-grade glioma (HGG) is the commonest primary brain tumor in adults. We prospectively assessed outcome following surgery and adjuvant treatment for HGG in older patients. MATERIALS AND METHODS Patients ≥ 60 years undergoing craniotomies for gliomas WHO grade 3 and 4 at Oslo and Haukeland University Hospitals 2008-2009 were included (n = 80). Outcome was assessed at six months, and overall mortality evaluated at two years. RESULTS Forty-two males and 38 females of median age 68.5 (60-83) years were included, 35% attended a follow-up appointment at six months. Surgical mortality was 1.3%. Surgical morbidity included neurological sequela (10%), post-operative hematomas (3.8%) and hydrocephalus (1.3%). Median overall survival was 8.4 months and significantly increased by adjuvant radiochemotherapy. In univariate survival analyses, age ≥ 80 years, subtotal resection, American Society of Anesthesiology (ASA) scores 3-4, Karnofsky performance scale (KPS) < 70, and mini-mental state examination (MMSE) score < 25 significantly reduced survival. CONCLUSIONS Surgical treatment of HGG carries low mortality and acceptable morbidity in patients aged ≥ 60 years. There is improved survival following bimodal adjuvant treatment. Maximum tumor resection should be attempted. Treatment might be less beneficial in patients aged ≥ 80 years and in those with poor pre-operative function.
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Affiliation(s)
- A. Konglund
- Department of Neurosurgery; Oslo University Hospital; Oslo; Norway
| | - R. Helseth
- Department of Surgery; Buskerud Central Hospital; Drammen; Norway
| | - M. Lund-Johansen
- Department of Neurosurgery; Haukeland University Hospital; Bergen; Norway
| | | | - T. R. Meling
- Department of Neurosurgery; Oslo University Hospital; Oslo; Norway
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14
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Helseth R, Vanky E, Salvesen O, Carlsen SM. Gestational diabetes mellitus among Norwegian women with polycystic ovary syndrome: prevalence and risk factors according to the WHO and the modified IADPSG criteria. Eur J Endocrinol 2013; 169:65-72. [PMID: 23636445 DOI: 10.1530/eje-12-1107] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 12/14/2022]
Abstract
OBJECTIVE The consequences of the recently proposed International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria for gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS) are not known. We compared the prevalence rates and risk factors for GDM in PCOS women according to both the WHO and the modified IADPSG criteria. DESIGN Post hoc analyses from a randomized, multicenter study were used. METHODS Fasting and 2-h plasma glucose levels were measured using a 75 g oral glucose tolerance test. GDM was diagnosed according to both the WHO and the modified IADPSG criteria. RESULTS The prevalence rates of GDM according to the WHO and the modified IADPSG criteria were 9.2 and 15.0% at week 12, 18.7 and 18.7% at week 19, and 25.6 and 24.2% at week 32. Shorter stature and increased insulin levels were correlated with WHO-GDM, but not with modified IADPSG-GDM at weeks 12 and 19. Less weight gain in pregnancy predicted GDM according to both sets of criteria. GDM diagnosis was correlated with less maternal weight loss the first year post-partum. CONCLUSIONS No difference was found in the prevalence of GDM between the two sets of criteria used. Less weight gain in pregnancy was associated with GDM, independent of the diagnostic criteria used. Reduced weight loss the first year post-partum in women with GDM raises the question of whether GDM diagnosis per se or the fact that these women lose less weight after pregnancy predicts later diabetes mellitus.
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Affiliation(s)
- R Helseth
- Department of Medicine, Drammen Hospital, Vestre Viken, Norway
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Helseth R, Helseth E, Johannesen TB, Langberg CW, Lote K, Rønning P, Scheie D, Vik A, Meling TR. Overall survival, prognostic factors, and repeated surgery in a consecutive series of 516 patients with glioblastoma multiforme. Acta Neurol Scand 2010; 122:159-67. [PMID: 20298491 DOI: 10.1111/j.1600-0404.2010.01350.x] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [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: 11/30/2022]
Abstract
OBJECTIVES To study overall survival (OS), prognostic factors, and repeated surgery in glioblastoma multiforme (GBM). MATERIAL AND METHODS Retrospective study of 516 consecutive adult patients who underwent primary surgery for a GBM in year 2003-2008. RESULTS Median age at primary surgery was 63.7 years (range 18.0-88.0). Median OS was 9.9 months. Age > 60 years, poor preoperative ECOG score, bilateral tumor, biopsy rather than resection, and no temozolomide chemoradiotherapy were negative risk factors. Repeat surgery was performed in 65 patients (13%). Median time between first and second surgery was 7 months. Indications for second surgery were increasing neurological deficits (35.4%), raised ICP (33.8%), asymptomatic but reoperated because of tumor progression verified on MRI (20.0%), and epileptic seizures (11%). Patients who underwent repeated surgery had longer OS; 18.4 months vs 8.6 months (P < 0.001). CONCLUSIONS OS for adult GBM patients was 9.9 months. Negative prognostic factors were increasing age, poor neurological function, bilateral tumor involvement, biopsy instead of resection, and RT alone compared to temozolomide chemoradiotherapy. Our rate of repeated surgery for GBM was 13% and the main indications for second surgery were raised ICP and increasing neurological deficits. In a carefully selected group of patients, repeat surgery significantly prolongs OS.
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Affiliation(s)
- R Helseth
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
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Stanghelle JK, Helseth R, Roaldsen KS, Rand-Hendriksen S. [42 patients with post-polio syndrome. A retrospective study from Sunnaas hospital]. Tidsskr Nor Laegeforen 1991; 111:3159-62. [PMID: 1948938] [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: 12/29/2022] Open
Abstract
We describe a retrospective study of 42 patients admitted to Sunnaas Rehabilitation Hospital with suspect postpolio syndrome over a period of two years. The patients were 32 females and 10 males aged 28-74 years (mean 54 years). 29 were married or cohabitant, 31 had children, and 20 were in paid employment. The mean age at onset of polio was 12 years, with an average interval of 36 years between onset of polio and onset of new problems. The mean duration of new health problems was seven years. The most common such problems were pain in muscles and joints, general fatigue and new weakness of the muscles. 28 of the patients needed personal assistance to carry out everyday activities. 33 had braces, crutches or wheelchair for ambulation. Lung function was moderately reduced and physical working capacity was severely reduced. Physiotherapy, ergotherapy and technical aids were provided for 38 of the patients, 16 received assistance to organizing social support or help at home, 13 were helped to make practical changes in their homes, and eight were provided with a wheelchair. According to this study, most patients with the postpolio syndrome need interdisciplinary evaluation and management in a rehabilitation hospital.
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