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Haukilahti MAE, Kentta TV, Aro A, Porthan K, Nieminen MS, Tikkanen J, Junttila MJ, Rissanen H, Salomaa V, Heliovaara M, Niiranen T, Hernesniemi J, Jula A, Knekt P, Huikuri HV. P4456Prognostic significance of electrocardiographic markers of sudden cardiac death differ between men and women. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4456] [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: 11/13/2022] Open
Affiliation(s)
- M A E Haukilahti
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - T V Kentta
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - A Aro
- Helsinki University Central Hospital, Division of Cardiology, Heart and Lung Center, Helsinki, Finland
| | - K Porthan
- Helsinki University Central Hospital, Division of Cardiology, Heart and Lung Center, Helsinki, Finland
| | - M S Nieminen
- Helsinki University Central Hospital, Division of Cardiology, Heart and Lung Center, Helsinki, Finland
| | - J Tikkanen
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - M J Junttila
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - H Rissanen
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - V Salomaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - M Heliovaara
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - T Niiranen
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - J Hernesniemi
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - A Jula
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - P Knekt
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - H V Huikuri
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
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Jousilahti P, Harald K, Jula A, Laatikainen T, Mannisto S, Peltonen M, Perola M, Puska P, Salomaa V, Tuomilehto J, Valsta L, Vartiainen E. 1192Salt intake and the risk of heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1192] [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: 11/13/2022] Open
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Tiainen K, Stenholm S, Strandberg T, Jula A, Koskinen S. DIABETES AS A PREDICTOR OF MUSCLE STRENGTH DECLINE AMONG INDIVIDUALS AGE 55 AND OLDER. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5087] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K. Tiainen
- School of Health Sciences and Gerontology Research Center,University of Tampere, Tampere, Finland,
| | - S. Stenholm
- School of Health Sciences and Gerontology Research Center,University of Tampere, Tampere, Finland,
- Department of Public Health, University of Turku, Turku, Finland,
| | - T. Strandberg
- Institute of Health Sciences/Geriatrics, University of Oulu and Unit of General Practice, Oulu University of Hospital, Oulu, Finland,
- Department of Medicine, University of Helsinki, Helsinki, Finland,
| | - A. Jula
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S. Koskinen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Hiirola A, Pirkola S, Karukivi M, Markkula N, Bagby RM, Joukamaa M, Jula A, Kronholm E, Saarijärvi S, Salminen JK, Suvisaari J, Taylor G, Mattila AK. An evaluation of the absolute and relative stability of alexithymia over 11years in a Finnish general population. J Psychosom Res 2017; 95:81-87. [PMID: 28314554 DOI: 10.1016/j.jpsychores.2017.02.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 10/08/2016] [Revised: 01/14/2017] [Accepted: 02/12/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We investigated if alexithymia, a personality construct with difficulties in emotional processing, is stable in the general population. METHODS Altogether 3083 unselected subjects aged 30 and older in Finland completed the 20-item Toronto Alexithymia Scale (TAS-20) in the longitudinal Health 2000 and Health 2011 general population surveys (BRIF8901). The stability of alexithymia at the 11-year follow-up was assessed with t-tests, correlations, and separate linear regression models with base-line and follow-up age, gender, marital status, education, and 12-month depressive and anxiety disorders as confounders. RESULTS The mean score (SD) of the TAS-20 for the whole sample was 44.2 (10.4) in 2000 and 44.2 (10.9) in 2011 (p=0.731). The mean score of the TAS-20 subscale Difficulty Identifying Feelings increased by 0.3 points, Difficulty Describing Feelings decreased by 0.6 points and Externally Oriented Thinking increased by 0.3 points. The effect sizes of the changes varied from negligible to small. Age had little effect except for the group of the oldest subjects (75-97years): the TAS-20 mean (SD) score was 49.1 (10.1) in 2000 and 53.1 (10.3) in 2011 (p<0.001), the effect size for the increase was medium. TAS-20 score in 2000 explained a significant proportion of variance in TAS-20 score in 2011. Controlling for all baseline confounders improved the model incrementally; the same applied to controlling for confounders at follow-up. Baseline depression or anxiety disorders were not associated with the TAS-20 scores in 2011, whereas current diagnoses were. CONCLUSIONS According to our large longitudinal study both the absolute and relative stability of alexithymia assessed with the TAS-20 are high in the adult general population.
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Affiliation(s)
- A Hiirola
- School of Health Sciences, University of Tampere, Tampere, Finland.
| | - S Pirkola
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - M Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| | - N Markkula
- National Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
| | - R M Bagby
- Department of Psychology, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - M Joukamaa
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - A Jula
- National Institute for Health and Welfare (THL), Turku, Finland
| | - E Kronholm
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki, Finland
| | - S Saarijärvi
- Department of Adolescent Psychiatry, University of Turku, Turku, Finland; Unit of Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - J K Salminen
- Department of Psychiatry, University of Turku, Turku, Finland
| | - J Suvisaari
- National Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland
| | - G Taylor
- Department of Psychiatry, University of Toronto and Mount Sinai Hospital, Toronto, Canada
| | - A K Mattila
- Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland
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Skogberg N, Laatikainen T, Jula A, Härkänen T, Vartiainen E, Koponen P. Contribution of sociodemographic and lifestyle-related factors to the differences in metabolic syndrome among Russian, Somali and Kurdish migrants compared with Finns. Int J Cardiol 2017; 232:63-69. [PMID: 28108130 DOI: 10.1016/j.ijcard.2017.01.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 12/04/2016] [Accepted: 01/04/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with a substantially increased risk for cardiovascular disease and diabetes. We examined the contribution of length of residence, socioeconomic position and lifestyle-related factors to the differences in the prevalence of MetS among migrants compared with Finns. METHODS Cross-sectional data from randomly sampled 30-64year-old health examination participants (318 Russian, 212 Somali, and 321 Kurdish origin migrants) of the Migrant Health and Wellbeing Survey (2010-2012) were used. Health 2011 Survey participants (n=786) were the reference group. RESULTS Compared with Finns, prevalence of MetS was significantly higher among all migrants except for Somali men. Among men, age-adjusted prevalence ratio (PR) of MetS compared with Finns was 1.71, 95% confidence interval (CI) 1.19-2.46 for Russians, PR 0.95 (95% CI 0.54-1.67) for Somali, and PR 2.10 (95% CI 1.51-2.93) for Kurds. Among women, respective PRs were 1.45 (95% CI 1.08-1.97) for Russians, PR 2.34 (95% CI 1.75-3.14) for Somali and PR 2.22 (95% CI 1.67-2.97) for Kurds. Adjustment for sociodemographic and lifestyle-related factors attenuated the differences in MetS among women but not men. CONCLUSIONS Further studies should aim at identifying factors related to elevated risk for MetS among Russian and Kurdish men. Interventions aiming at improving lifestyle-related factors are needed for reducing inequalities in the prevalence of MetS among migrant women. Effectiveness of interventions focusing on reducing overweight and obesity among Somali and Kurdish women should be evaluated.
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Affiliation(s)
- N Skogberg
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland.
| | - T Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Hospital District of North Karelia, Joensuu, Finland
| | - A Jula
- Department of Health, National Institute for Health and Welfare, Turku, Finland
| | - T Härkänen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - E Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Strandberg T, Levälahti E, Ngandu T, Solomon A, Kivipelto M, Kivipelto M, Ngandu T, Lehtisalo J, Laatikainen T, Soininen H, Strandberg T, Antikainen R, Jula A, Tuomilehto J, Peltonen M, Levälahti E, Lindström J, Rauramaa R, Pajala S, Hänninen T, Solomon A, Paajanen T, Mangialasche F. Health-related quality of life in a multidomain intervention trial to prevent cognitive decline (FINGER). Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2016.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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7
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Saksi J, Ijäs P, Jula A, Heikkilä H, Tuimala J, Dwivedi O, Tuomi T, Groop L, Jauhiainen M, Kovanen P, Lindsberg P. Evidence for enhanced de novo lipogenesis and uncoupling of obesity from type 2 diabetes risk in the low-expression variant carriers of fatty acid-binding protein 4. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.122] [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: 11/25/2022]
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Laine MK, Eriksson JG, Kujala UM, Kaprio J, Loo BM, Sundvall J, Bäckmand HM, Peltonen M, Jula A, Sarna S. Former male elite athletes have better metabolic health in late life than their controls. Scand J Med Sci Sports 2015; 26:284-90. [PMID: 25758211 DOI: 10.1111/sms.12442] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 12/22/2022]
Abstract
Elite-class athletes have longer life expectancy and lower risk for chronic noncommunicable diseases possibly because of physically active and healthier lifestyle. In this study, we assessed former male Finnish elite-class athletes' (n = 392) and their matched controls' (n = 207) body composition, and risk for the metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in later life. Compared with the controls, the former athletes had lower body fat percentage (24.8% vs 26.0%, P = 0.021), lower risk for MS [odds ratio (OR) 0.57, 95% confidence interval (CI) 0.40-0.81], and NAFLD (OR 0.61, 95% CI 0.42-0.88). High volume of current leisure-time physical activity (LTPA) was associated with lower body fat percentage (P for trend < 0.001). When current volume of LTPA increased 1 MET h/week, the risk of MS and NAFLD decreased (OR 0.99, 95% CI 0.98-0.99 and OR 0.97, 95% CI 0.96-0.98, respectively). Although a career as an elite-class athlete during young adulthood may help to protect from developing metabolic syndrome, present exercise levels and volume of LTPA seem equally important as well.
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Affiliation(s)
- M K Laine
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Vantaa Health Center/Network of Academic Health Centers, University of Helsinki, Helsinki, Finland
| | - J G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Folkhälsan Research Centre, Helsinki, Finland.,Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland.,Vasa Central Hospital, Vasa, Finland
| | - U M Kujala
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.,Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - B-M Loo
- Population Research Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - J Sundvall
- Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - H M Bäckmand
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Health and Social Welfare Department, Vantaa, Finland
| | - M Peltonen
- Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - A Jula
- Population Research Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - S Sarna
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Skogberg N, Koponen P, Jula A, Laatikainen T. Association between socioeconomic position and health behavior with metabolic syndrome among migrants of Russian, Somali and Kurdish origin in Finland. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.032] [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: 11/14/2022] Open
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10
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Kivipelto M, Ngandu T, Lehtisalo J, Hänninen T, Jula A, Laatikainen T, Lindström J, Paajanen T, Pajala S, Peltonen M, Stigsdotter-Neely A, Levalahti E, Strandberg T, Tuomilehto J, Soininen H. O3.19: A multidomain two-year randomized controlled trial to prevent cognitive impairment – the FINGER study. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70147-0] [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: 10/24/2022]
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11
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Saksi J, Ijäs P, Mäyränpää M, Nuotio K, Isoviita P, Tuimala J, Lehtonen-Smeds E, Kaste M, Jula A, Sinisalo J, Nieminen M, Lokki M, Perola M, Kettunen J, Jauhiainen M, Kovanen P, Lindsberg P. The low-expression variant of fatty acid-binding protein 4 favors reduced manifestations of atherosclerotic disease and increased plaque stability. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.042] [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: 10/25/2022]
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12
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Kauppi M, Stenholm S, Impivaara O, Mäki J, Heliövaara M, Jula A. Fall-related risk factors and heel quantitative ultrasound in the assessment of hip fracture risk: a 10-year follow-up of a nationally representative adult population sample. Osteoporos Int 2014; 25:1685-95. [PMID: 24658297 DOI: 10.1007/s00198-014-2674-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 02/22/2014] [Indexed: 12/22/2022]
Abstract
UNLABELLED Maximal walking speed and quantitative ultrasound index (QUI) were significant and independent predictors of hip fracture among subjects aged ≥ 55 years. A model including readily available variables along with simple fall-related factors may be clinically useful in the assessment of hip fracture risk even without a QUI measurement. INTRODUCTION This study assessed fall-related risk factors along with heel bone quantitative ultrasound (QUS) measurements for the prediction of hip fracture during a mean follow-up of 9.8 years in a nationally representative population sample. METHODS The study population consisted of 2,300 subjects (1,331 women and 969 men) aged 55 years or over, who had participated in a comprehensive health survey in 2000-2001. Information on the subjects’ health and fall-related risk factors was obtained with interviews, questionnaires and tests carried out by specially trained professionals. QUS measurements were made by means of the Hologic Sahara device. First emerging cases of hip fracture were identified from the National Hospital Discharge Register. RESULTS During the follow-up, 96 subjects sustained a hip fracture. Slow maximal walking speed, low quantitative ultrasound index (QUI), high age, tallness, short waist circumference, Parkinson's disease and the number of central nervous system active medication were significant and independent predictors of hip fracture. The model including all of these risk factors explained 68 % of the variation in hip fracture risk. Excluding QUI from this model reduced the percentage to 66%. CONCLUSIONS Maximal walking speed and QUI were significant and independent predictors of hip fracture. A model including readily available variables such as age, gender, height and waist circumference along with simple fall-related factors may be of clinical use in the assessment of hip fracture risk even without a QUS measurement.
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Kaikkonen JE, Kresanov P, Ahotupa M, Jula A, Mikkilä V, Viikari JSA, Kähönen M, Lehtimäki T, Raitakari OT. High serum n6 fatty acid proportion is associated with lowered LDL oxidation and inflammation: The Cardiovascular Risk in Young Finns Study. Free Radic Res 2014; 48:420-6. [DOI: 10.3109/10715762.2014.883071] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Kauppi M, Impivaara O, Mäki J, Heliövaara M, Jula A. Quantitative ultrasound measurements and vitamin D status in the assessment of hip fracture risk in a nationally representative population sample. Osteoporos Int 2013; 24:2611-8. [PMID: 23595563 DOI: 10.1007/s00198-013-2355-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Received: 10/29/2012] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
Abstract
SUMMARY Adjusted for age, gender, height and weight, calcaneal quantitative ultrasound (QUS) and serum 25-hydroxyvitamin D (S-25(OH)D) proved to be significant predictors of hip fracture among subjects aged ≥50 years. Even if their contribution to the predictive power was modest, they may be useful in the assessment of hip fracture risk in the elderly. INTRODUCTION This study assessed calcaneal QUS measurements, S-25(OH)D and several other factors for the prediction of hip fracture risk in a nationally representative population sample. METHODS The study population consisted of 3,305 subjects (1,872 women), aged 50 years or over, who had participated in a comprehensive health survey. QUS measurements were made by means of the Hologic Sahara device. S-25(OH)D was measured by radioimmunoassay. Emerging cases of hip fracture were identified from the National Hospital Discharge Register. RESULTS During a mean follow-up of 8.4 years, 95 subjects sustained a hip fracture. After adjusting for age, gender, height, weight and each other, a 1 standard deviation increment in the quantitative ultrasound index (QUI) (21.7) and in S-25(OH)D (17.5 nmol/L) reduced the risk of hip fracture by 40 % (hazard ratio [HR] = 0.60, 95 % confidence interval [CI] = 0.42-0.86) and by 31 % (HR = 0.69, 95 % CI = 0.55-0.87), respectively. The predictive power of a model including age, gender, height and weight was improved by about 8 % after the addition of QUI and S-25(OH)D. Among subjects aged 75 years or over, the corresponding improvement was about 130 %. CONCLUSIONS QUI and S-25(OH)D were significant and independent predictors of hip fracture. However, their ability to increase the predictive power of a statistical model including readily available simple variables such as age, gender, height and weight was rather modest. Still, our findings suggest that QUI and S-25(OH)D may be of clinical use in the assessment of hip fracture risk particularly in the elderly.
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Affiliation(s)
- M Kauppi
- Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Peltolantie 3, 20720, Turku, Finland,
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15
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Turunen AW, Jula A, Suominen AL, Männistö S, Marniemi J, Kiviranta H, Tiittanen P, Karanko H, Moilanen L, Nieminen MS, Kesäniemi YA, Kähönen M, Verkasalo PK. Fish consumption, omega-3 fatty acids, and environmental contaminants in relation to low-grade inflammation and early atherosclerosis. Environ Res 2013; 120:43-54. [PMID: 23089109 DOI: 10.1016/j.envres.2012.09.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 09/20/2012] [Accepted: 09/24/2012] [Indexed: 05/03/2023]
Abstract
BACKGROUND Fish consumption and omega-3 polyunsaturated fatty acid (PUFA) intake are shown to protect from cardiovascular diseases (CVD). However, most fish contain environmental contaminants such as dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs), and methylmercury (MeHg) that may have adverse effects on cardiovascular health. OBJECTIVE Our aim was to elucidate the associations of fish consumption, omega-3 PUFAs, environmental contaminants with low-grade inflammation, early atherosclerosis, and traditional CVD risk factors. METHODS The Health 2000 survey participants (n=1173) represented the general Finnish population and the Fishermen study participants (n=255) represented a population with high fish consumption and high exposure to environmental contaminants. Model-adjusted geometric means and tests for linear trend were calculated for CVD risk factors by tertiles of fish consumption and serum omega-3 PUFAs, and additionally in the Fishermen study only, by tertiles of serum PCDD/F+PCB, and blood MeHg. RESULTS Serum triglyceride decreased across omega-3 PUFA tertiles in both sexes and studies. Insulin resistance, C-reactive protein, tumour necrosis factor α, and interleukin 6 decreased across omega-3 PUFA tertiles among the Health 2000 survey participants. Among the Fishermen study men, insulin resistance and arterial stiffness indicated by β-stiffness index tended to increase and the RR estimate for carotid artery plaque tended to decrease across tertiles of PCDD/F+PCB and MeHg. CONCLUSION Previously established hypotriglyceridemic and anti-inflammatory effects of omega-3 PUFAs were seen also in this study. The hypothesised favourable effect on insulin sensitivity and arterial elasticity was suggested to be counteracted by high exposure to environmental contaminants but the effect on plaque prevalence appeared not to be harmful.
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Affiliation(s)
- A W Turunen
- Department of Environmental Health, National Institute for Health and Welfare, Neulaniementie 4, P.O. Box 95, FI-70210 Kuopio, Finland.
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16
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Thomas MC, Moran JL, Harjutsalo V, Thorn L, Wadén J, Saraheimo M, Tolonen N, Leiviskä J, Jula A, Forsblom C, Groop PH. Hyperfiltration in type 1 diabetes: does it exist and does it matter for nephropathy? Diabetologia 2012; 55:1505-13. [PMID: 22322918 DOI: 10.1007/s00125-012-2485-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [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] [Received: 09/10/2011] [Accepted: 01/16/2012] [Indexed: 01/10/2023]
Abstract
AIMS/HYPOTHESIS Hyperfiltration is widely regarded as a contributing factor to the development of microalbuminuria and progressive nephropathy in type 1 diabetes. However, recent studies have questioned this conclusion. METHODS To address this conflicting evidence, we examined the association between hyperfiltration and progression to microalbuminuria in 2,318 adults with type 1 diabetes. We also compared the estimated GFR in our diabetic patients with rates observed in 6,247 adults from the Finnish general population, using age- and sex-specific z scores. RESULTS The distribution of estimated GFR in adults with type 1 diabetes and normoalbuminuria was not significantly different from that expected in the general population (p = 0.51, Mann-Whitney test). Type 1 diabetic patients with a higher estimated GFR were also no more likely to develop microalbuminuria over a median of 5.2 years of follow-up than those with normal estimated GFR. This was the case regardless of whether hyperfiltration was defined by an absolute threshold, deciles of estimated GFR or a z score, using creatinine- or cystatin-based clearance formulas in men or in women. CONCLUSIONS/INTERPRETATION Together with other studies, these data suggest that creatinine- or cystatin-based estimates of GFR do not predict the development of microalbuminuria in patients with type 1 diabetes. Moreover, in the absence of incipient or overt nephropathy, conventionally determined renal function in patients with type 1 diabetes appears no different from that in the general population. This is hardly surprising, given that these individuals, by all definitions, do not have kidney disease.
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Affiliation(s)
- M C Thomas
- Baker IDI Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC 8008, Australia.
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Tukiainen T, Kettunen J, Kangas AJ, Lyytikainen LP, Soininen P, Sarin AP, Tikkanen E, O'Reilly PF, Savolainen MJ, Kaski K, Pouta A, Jula A, Lehtimaki T, Kahonen M, Viikari J, Taskinen MR, Jauhiainen M, Eriksson JG, Raitakari O, Salomaa V, Jarvelin MR, Perola M, Palotie A, Ala-Korpela M, Ripatti S. Detailed metabolic and genetic characterization reveals new associations for 30 known lipid loci. Hum Mol Genet 2011; 21:1444-55. [DOI: 10.1093/hmg/ddr581] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Würtz P, Raiko J, Magnussen C, Soininen P, Kangas A, Tynkkynen T, Thomson R, Laatikainen R, Savolainen M, Jula A, Viikari J, Kähönen M, Lehtimäki T, Juonala M, Ala-Korpela M, Raitakari O. 21 COMPREHENSIVE METABOLIC PROFILING IMPROVES PREDICTION OF SUBCLINICAL ATHEROSCLEROSIS IN YOUNG ADULTS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70022-8] [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: 11/24/2022]
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19
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Abstract
UNLABELLED Hip fracture risk was assessed according to parity among postmenopausal women. Compared with nulliparous women, the fracture risk was lower in women with three or more births. INTRODUCTION Parity was assessed for long-term prediction of hip fracture in postmenopausal women. METHODS Postmenopausal women (n= 2,028) aged 45 or over with no history of hip fracture were studied. From 1978 to 1980, all of them had participated in a comprehensive health survey based on a nationally representative population sample. Emerging cases of hip fracture were identified from the National Hospital Discharge Register during a follow-up period extending up to 17 years. RESULTS The risk of hip fracture was lower among parous women compared with nulliparous women. The model adjusted for age showed a significant inverse association between parity as a continuous variable and the risk of hip fracture [RR = 0.74; 95% confidence interval (CI), 0.61-0.90] per an increment of one standard deviation (2.4 births). Adjusted for age, menopausal age, level of education, body mass index, vitamin D status, alcohol consumption, smoking history, leisure time physical activity, and self-rated health, the relative risk was 0.50 (95% CI, 0.32-0.79) for women with three or more births and 0.85 (95% CI, 0.55-1.32) for women with one to two births as compared with nulliparous women. CONCLUSION Parity, three or more births in particular, predicts a lowered risk of hip fracture in the long run.
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Affiliation(s)
- M Kauppi
- Division of Welfare and Health Promotion, National Institute for Health and Welfare, Peltolantie 3, 20720 Turku, Finland.
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20
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Jylhävä J, Haarala A, Kähönen M, Lehtimäki T, Jula A, Moilanen L, Kesäniemi YA, Nieminen MS, Hurme M. Pentraxin 3 (PTX3) is associated with cardiovascular risk factors: the Health 2000 Survey. Clin Exp Immunol 2011; 164:211-7. [PMID: 21391986 DOI: 10.1111/j.1365-2249.2011.04354.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Pentraxin 3 (PTX3) is a novel candidate immunoinflammatory marker that has been reported to be associated with cardiometabolic risk factors and to predict adverse outcomes in individuals with cardiovascular disease (CVD). Despite being a member of the same pentraxin protein family as C-reactive protein (CRP), PTX3 probably reflects different aspects of CVD pathogenesis. In this study, we assessed plasma PTX3 correlates and determinants in the Health 2000 Survey population, which comprised n = 403 insulin-resistant subjects, n = 845 hypercholesterolaemic subjects and n = 311 hypertensive subjects, all aged between 46 and 76 years. In insulin-resistant subjects the PTX3 concentration was found to correlate directly with age, pulse pressure and indoleamine 2,3-dioxygenase (IDO) enzyme activity and inversely with total and low-density lipoprotein (LDL) cholesterol. In hypercholesterolaemic subjects, the PTX3 concentration correlated directly with HDL cholesterol, systolic blood pressure and pulse pressure, whereas in hypertensive subjects, the PTX3 concentration correlated directly with systolic blood pressure, pulse pressure and IDO activity. No correlation was observed between the concentrations of PTX3 and CRP, adiposity indicators or indicators of subclinical atherosclerosis in any of the subject groups. PTX3 concentration variations were attributed to variations in LDL cholesterol and IDO activity in insulin-resistant subjects and to pulse pressure in hypercholesterolaemic and hypertensive subjects. These results indicate that, in individuals at high risk of CVD, the PTX3 concentration is associated with cardiovascular risk factors but not with subclinical atherosclerosis.
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Affiliation(s)
- J Jylhävä
- Department of Microbiology and Immunology, Medical School, University of Tampere, Finland.
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21
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Luotola K, Pietilä A, Zeller T, Moilanen L, Kähönen M, Nieminen MS, Kesäniemi YA, Blankenberg S, Jula A, Perola M, Salomaa V. Associations between interleukin-1 (IL-1) gene variations or IL-1 receptor antagonist levels and the development of type 2 diabetes. J Intern Med 2011; 269:322-32. [PMID: 21205020 DOI: 10.1111/j.1365-2796.2010.02294.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [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: 11/28/2022]
Abstract
OBJECTIVES To examine whether interleukin-1 receptor antagonist (IL-1Ra) is a predictor for clinically incident diabetes in subjects with metabolic syndrome (MetS) and whether its predictive power is independent of C-reactive protein (CRP), an established marker of inflammation. We further examined whether genetic variants at the interleukin-1 (IL-1) locus would predict clinically incident diabetes. DESIGN Two observational prospective cohort studies. SETTING Two separate cohorts, Health 2000 and FINRISK 1997, followed up for an average of 7.1 and 10.8 years, respectively. SUBJECTS Random population samples consisting of 5511 subjects aged 30-74 years in Health 2000 and 7374 subjects aged 25-74 years in FINRISK 1997. RESULTS During follow-up, 141 cases of clinically incident diabetes were observed amongst subjects with MetS at baseline in Health 2000 and 248 cases in FINRISK 97. After adjustment for multiple traditional risk factors of diabetes, including age and body mass index, IL-1Ra was a significant (P < 0.01) predictor of incident diabetes amongst men in both cohorts and amongst women in FINRISK 1997. Further adjustment for CRP reduced the hazard ratios only slightly. Genetic analyses produced nominally significant associations for three single-nucleotide polymorphisms: rs3213448 in IL-1 receptor antagonist (IL1RN), rs1143634 in IL-1 beta (IL1B) and rs1800587 in IL-1 alpha (IL1A). The two latter variants had an interaction with gender (P = 0.023 and 0.002, respectively) suggesting the presence of gender-specific associations with the risk of clinically incident diabetes. CONCLUSIONS IL-1Ra predicted the progression of MetS to clinically incident diabetes independently of CRP and other risk factors. Genetic variation in the IL-1 locus may have gender-specific associations with the risk of type 2 diabetes.
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Affiliation(s)
- K Luotola
- Department of Medicine, Helsinki University Hospital, Helsinki, Finland.
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22
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Pajunen P, Rissanen H, Härkänen T, Jula A, Reunanen A, Salomaa V. The metabolic syndrome as a predictor of incident diabetes and cardiovascular events in the Health 2000 Study. Diabetes Metab 2010; 36:395-401. [PMID: 20673644 DOI: 10.1016/j.diabet.2010.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 04/23/2010] [Accepted: 04/26/2010] [Indexed: 10/19/2022]
Abstract
AIM The study aimed to examine the role of the metabolic syndrome (MetS) as a predictor of incident cardiovascular disease (CVD) events and incident diabetes, and to compare the various definitions of MetS. METHODS The population-based Health 2000 Study included 6105 individuals, aged 30-79 years, followed-up for 7 years. CVD during follow-up was defined as coronary death, acute myocardial infarction, coronary revascularization or stroke. MetS was defined according to the International Diabetes Federation (IDF), the 2005 National Cholesterol Education Program-Adult Treatment Panel III (ATP III), the World Health Organization (WHO) and the new Harmonization definitions. The Bayesian information criterion (BIC) was used to compare different Cox proportional-hazards regression models. RESULTS The highest prevalence estimates of MetS at baseline were observed with the Harmonization definition: 47.8% in men and 40.7% in women. During the follow-up, 238 cases of incident CVD and 172 cases of incident diabetes were observed. All definitions of MetS were significant predictors for incident CVD and diabetes. BIC suggested that the new Harmonization definition of MetS as one entity was a better predictor of the CVD endpoint than the sum of its components, but not for diabetes. Also, the Harmonization definition of MetS was a better predictor of CVD than the Framingham equation in women, but not in men. CONCLUSION Irrespective of definition, MetS is a significant predictor of incident CVD events and incident diabetes. Also, the new Harmonization definition may be a better predictor of incident CVD than the sum of its components.
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Affiliation(s)
- P Pajunen
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, Division of Welfare and Health Promotion, National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
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23
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Timonen P, Niskanen M, Suominen-Taipale L, Jula A, Knuuttila M, Ylöstalo P. Metabolic syndrome, periodontal infection, and dental caries. J Dent Res 2010; 89:1068-73. [PMID: 20647498 DOI: 10.1177/0022034510376542] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Only a few studies have examined the association of metabolic syndrome with periodontal infection and dental caries. The aim in this study was to examine the association of metabolic syndrome with periodontal infection and dental caries using the European Group for the Study of Insulin Resistance (EGIR) definition and its separate components. This study population consisted of dentate, non-diabetic individuals aged 30 to 64 years (N = 2050) who had never smoked. Relative risks (RR) were estimated with Poisson regression models. Metabolic syndrome was associated with teeth with deepened periodontal pockets 4 mm deep or deeper [adjusted RR 1.19 (95% CI 1.01-1.42)], with pockets 6 mm deep or deeper [adjusted RR 1.50 (95% CI 0.96-2.36)], and carious teeth [adjusted RR 1.25 (95% CI 0.93-1.70)]. The results suggest that metabolic syndrome or some of its components are associated weakly with periodontal infection.
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Affiliation(s)
- P Timonen
- Institute of Dentistry, University of Oulu, PO Box 5281, 90014 Oulu, Finland.
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24
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Raiko J, Magnussen C, Kivimäki M, Taittonen L, Laitinen T, Kähönen M, Hutri-Kähönen N, Jula A, Loo BM, Thomson R, Lehtimäki T, Viikari J, Raitakari O, Juonala M. P175 CARDIOVASCULAR RISK SCORES IN THE PREDICTION OF SUBCLINICAL ATHEROSCLEROSIS IN YOUNG ADULTS. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70242-7] [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: 11/30/2022]
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25
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Juonala M, Viikari JSA, Kahonen M, Taittonen L, Laitinen T, Hutri-Kahonen N, Lehtimaki T, Jula A, Pietikainen M, Jokinen E, Telama R, Rasanen L, Mikkila V, Helenius H, Kivimaki M, Raitakari OT. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J 2010; 31:1745-51. [DOI: 10.1093/eurheartj/ehq141] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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26
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Raiko JRH, Viikari JSA, Ilmanen A, Hutri-Kähönen N, Taittonen L, Jokinen E, Pietikäinen M, Jula A, Loo BM, Marniemi J, Lehtimäki T, Kähönen M, Rönnemaa T, Raitakari OT, Juonala M. Follow-ups of the Cardiovascular Risk in Young Finns Study in 2001 and 2007: levels and 6-year changes in risk factors. J Intern Med 2010; 267:370-84. [PMID: 19754855 DOI: 10.1111/j.1365-2796.2009.02148.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [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: 10/20/2022]
Abstract
OBJECTIVES To examine cardiovascular risk factor levels in 2007 and their 6-year changes between 2001 and 2007 using the data collected in the follow-ups of the Cardiovascular Risk in Young Finns Study. DESIGN Population-based follow-up study. SUBJECTS A total of 2204 healthy Finnish adults aged 30-45 years (1210 women; 994 men). MAIN OUTCOME MEASURES Levels in 2007 and changes between 2001 and 2007 of lipids, insulin, glucose, blood pressure, smoking, body mass index, alcohol consumption, waist and hip circumferences. RESULTS The mean serum total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride concentrations in 30- to 45-year-old adults were 5.05, 3.09, 1.34 and 1.40 mmol L(-1), respectively. Significant changes (P < 0.05) between 2001 and 2007 in 30- to 39-year-old subjects included a decrease in total cholesterol (-6.6% in men, -5.8% in women), LDL-cholesterol (-10.2% and -11.6%) and an increase in diastolic blood pressure (3.5% and 3.9%). Waist circumference (1.8% and 5.5%) and systolic blood pressure increased in 36-39 year olds (2.3% and 2.3%). HDL-cholesterol increased in 30- to 33-year-old women (5.8%) Glucose levels increased in 30- to 39-year-old women (3.7%) and 36- to 39-year-old men (3.6%). Smoking prevalence decreased in 36- to 39-year-old men from 29.8% to 22.2%. CONCLUSIONS The 6-year changes in total cholesterol, LDL-cholesterol and HDL-cholesterol in young Finns were favourable between 2001 and 2007. However, waist circumference, glucose and blood pressure levels increased. Therefore, continuous efforts are still needed in fighting against cardiovascular risk factors.
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Affiliation(s)
- J R H Raiko
- Department of Cardiovascular Research Center, University of Turku, Turku, Finland.
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Turunen AW, Männistö S, Kiviranta H, Marniemi J, Jula A, Tiittanen P, Suominen-Taipale L, Vartiainen T, Verkasalo PK. Dioxins, polychlorinated biphenyls, methyl mercury and omega-3 polyunsaturated fatty acids as biomarkers of fish consumption. Eur J Clin Nutr 2010; 64:313-23. [DOI: 10.1038/ejcn.2009.147] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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28
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Jylhävä J, Haarala A, Eklund C, Pertovaara M, Kähönen M, Hutri-Kähönen N, Levula M, Lehtimäki T, Huupponen R, Jula A, Juonala M, Viikari J, Raitakari O, Hurme M. Serum amyloid A is independently associated with metabolic risk factors but not with early atherosclerosis: the Cardiovascular Risk in Young Finns Study. J Intern Med 2009; 266:286-95. [PMID: 19702793 DOI: 10.1111/j.1365-2796.2009.02120.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [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: 12/01/2022]
Abstract
BACKGROUND Serum amyloid A (SAA) is a sensitive marker of inflammation and its elevation has been implicated in obesity and in cardiovascular disease, yet data on its regulation in young adults or on its role in early atherosclerosis is scarce. We investigated which factors explain the variation in SAA and analysed whether SAA could be associated with preclinical atherosclerosis. METHODS Serum amyloid A levels were measured in participants of the Cardiovascular Risk in Young Finns Study (n = 2280, n = 1254 women, n = 1026 men). Correlates and determinants of SAA were analysed and the effect of SAA on subclinical atherosclerosis, measured as intima-media thickness (IMT) and carotid artery compliance, was evaluated with risk-factor adjusted models. RESULTS Serum amyloid A correlated directly and independently of BMI with C-reactive protein (CRP), waist circumference and leptin in both sexes, with total cholesterol, LDL cholesterol and ApolipoproteinA1 (ApoA1) in women and with triglycerides, insulin levels and insulin resistance in men. Use of combined oral contraceptives and intrauterine device was also associated with SAA levels. Determinants for SAA included CRP, leptin and ApoA1 in women, and CRP, leptin and HDL cholesterol in men. SAA levels correlated with carotid compliance in both sexes and with IMT in men, yet SAA had no independent effect on IMT or carotid compliance in multivariable analysis. CONCLUSIONS Serum amyloid A was associated with several metabolic risk factors but was not an independent predictor of IMT or carotid artery compliance. Further longitudinal studies will show whether SAA holds a prognostic value as a risk marker, analogously to CRP.
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Affiliation(s)
- J Jylhävä
- Department of Microbiology and Immunology, Medical School, University of Tampere, Tampere, Finland.
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Abstract
BACKGROUND The prevalence of asthma and obesity is increasing concomitantly, but many aspects of this link are unclear. Our objective was to examine whether obesity is associated with asthma in three time points of life, and whether immunomodulatory adipokines, leptin and adiponectin are linked to overweight-associated asthma. METHODS We studied the association between obesity and asthma at ages 3-18 years [mean (SD), 10 years (5), n = 3582, year 1980], 9-24 years [16 years (5), n = 2764, 1986] and 24-39 years [32 years (5), n = 2620, 2001] in a prospective cohort study and further tested for associations with serum leptin and adiponectin concentrations. Data on allergy status, smoking and other laboratory values (serum insulin, plasma C-reactive protein and serum lipid values) were also analyzed. RESULTS Allergy and parental asthma were significantly associated with asthma at all ages. At ages 24-39 years, but not earlier, body mass index (BMI) (odds ratio, OR 1.05; P = 0.019) and female gender (OR 1.56; P = 0.031) were independently associated with asthma. Increase in BMI was also associated with incident asthma during adulthood (OR 1.08; P = 0.030). Levels of leptin, adiponectin or any other obesity-related biomarker were not independently associated with asthma. CONCLUSIONS Asthma is linked with obesity in adults, but our results do not support a significant role for leptin, adiponectin or any other obesity-related biomarker studied in this association. Other factors should be sought for better understanding the connection between obesity and asthma.
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Affiliation(s)
- T Jartti
- The Department of Pediatrics, Turku University Hospital, PO Box 52, FIN-20520 Turku, Finland
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30
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Haukkamaa L, Moilanen L, Kattainen A, Luoto R, Kahonen M, Leinonen M, Jula A, Kesäniemi YA, Kaaja R. Pre-eclampsia is a risk factor of carotid artery atherosclerosis. Cerebrovasc Dis 2009; 27:599-607. [PMID: 19407443 DOI: 10.1159/000216834] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Accepted: 02/02/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A history of pre-eclampsia has been shown to be associated with an increased risk of subsequent coronary artery disease. The intima-media thickness of carotid arteries and the detection of plaques are useful measures as regards preclinical atherosclerosis. The aim of this study was to examine whether women with a history of pre-eclampsia more often show signs of atherosclerosis compared with 2 control groups. METHODS We used data from a large Finnish cross-sectional health examination survey. We had women with previous pre-eclampsia (n = 35) or pregnancy-induced hypertension (n = 61) and 2 control groups. Laboratory tests and physical examination were performed. Information on reproductive and medical history was obtained at the home interview. Carotid atherosclerosis was assessed by ultrasonography. RESULTS The women with previous pre-eclampsia had significantly (p = 0.008) more atherosclerotic plaques than the healthy parous controls. The intima-media thickness in the women with previous pre-eclampsia also tended to be higher than in the other groups, although the differences did not reach statistical significance. In logistic regression analysis, advanced age (OR: 1.08; 95% CI: 1.04-1.13; p < 0.001) and pre-eclampsia (OR: 3.63; 95% CI: 1.50-8.79; p = 0.004) were independent risk factors as regards plaque, and in linear regression analysis advanced age (estimate: 0.012; 95% CI: 0.010-0.014; p < 0.001), HDL cholesterol (estimate: -0.049; 95% CI: -0.088 to -0.010; p = 0.013), systolic blood pressure, BMI (estimate: 0.005; 95% CI: 0.000-0.009; p = 0.043) and high-sensitivity C-reactive protein (estimate: -0.003; 95% CI: -0.007 to -0.000; p = 0.048) were independent risk factors with respect to intima-media thickness. CONCLUSIONS Our data suggest that pre-eclampsia is an independent risk factor as regards developing plaque later in life.
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Affiliation(s)
- L Haukkamaa
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
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31
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Marjamaa A, Newton-Cheh C, Porthan K, Reunanen A, Lahermo P, Väänänen H, Jula A, Karanko H, Swan H, Toivonen L, Nieminen MS, Viitasalo M, Peltonen L, Oikarinen L, Palotie A, Kontula K, Salomaa V. Common candidate gene variants are associated with QT interval duration in the general population. J Intern Med 2009; 265:448-58. [PMID: 19019189 PMCID: PMC2668713 DOI: 10.1111/j.1365-2796.2008.02026.x] [Citation(s) in RCA: 45] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES QT interval prolongation is associated with increased risk of sudden cardiac death at the population level. As 30-40% of the QT-interval variability is heritable, we tested the association of common LQTS and NOS1AP gene variants with QT interval in a Finnish population-based sample. METHODS We genotyped 12 common LQTS and NOS1AP genetic variants in Health 2000, an epidemiological sample of 5043 Finnish individuals, using Sequenom MALDI-TOF mass spectrometry. ECG parameters were measured from digital 12-lead ECGs and QT intervals were adjusted for age, gender and heart rate with a nomogram (Nc) method derived from the present study population. RESULTS The KCNE1 D85N minor allele (frequency 1.4%) was associated with a 10.5 ms (SE 1.6) or 0.57 SD prolongation of the adjusted QT(Nc) interval (P=3.6 x 10(-11)) in gender-pooled analysis. In agreement with previous studies, we replicated the association with QT(Nc) interval with minor alleles of KCNH2 intronic SNP rs3807375 [1.6 ms (SE 0.4) or 0.08 SD, P=4.7 x 10(-5)], KCNH2 K897T [-2.6 ms (SE 0.5) or -0.14 SD, P=2.1 x 10(-7)] and NOSA1P variants including rs2880058 [4.0 ms (SE 0.4) or 0.22 SD, P=3.2 x 10(-24)] under additive models. CONCLUSIONS We demonstrate that each additional copy of the KCNE1 D85N minor allele is associated with a considerable 10.5 ms prolongation of the age-, gender- and heart rate-adjusted QT interval and could thus modulate repolarization-related arrhythmia susceptibility at the population level. In addition, we robustly confirm the previous findings that three independent KCNH2 and NOSA1P variants are associated with adjusted QT interval.
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Affiliation(s)
- A Marjamaa
- Research Program in Molecular Medicine, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland
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Koskinen T, Kähönen M, Jula A, Mattsson N, Laitinen T, Keltikangas-Järvinen L, Viikari J, Välimäki I, Rönnemaa T, Raitakari OT. Metabolic syndrome and short-term heart rate variability in young adults. The cardiovascular risk in young Finns study. Diabet Med 2009; 26:354-61. [PMID: 19388964 DOI: 10.1111/j.1464-5491.2009.02686.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [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: 11/29/2022]
Abstract
AIMS Heart rate variability (HRV) can be used to estimate autonomic nervous control of the cardiovascular system. In middle-aged subjects, the metabolic syndrome (MetS) is associated with lower HRV. We hypothesized that alterations in autonomic balance are already present in young adults with the MetS, and analysed the association of short-term HRV with the MetS (using the National Cholesterol Education Program definition), in 1889 subjects aged 24-39 years. METHODS Short-term (3 min) HRV analysis included high-frequency (HF), low-frequency (LF) and total (TP) spectral components of HRV and LF/HF ratio. RESULTS The presence of the MetS was associated with lower HF, LF and TP in men and women, and with higher LF/HF ratio in women. In men, waist circumference was the strongest individual MetS component that associated with HRV. After adjustments for age and heart rate, MetS was associated with lower HF and higher LF/HF ratio in women, but only with a lower TP in men (all P < 0.05). CONCLUSIONS MetS is associated with lower HRV in young adults. The individual components of MetS are differentially associated with HRV in men and in women. Our results are consistent with lower vagal activity and a possible increase in sympathetic predominance in women with the MetS. This sex difference in vagal activity and sympathovagal balance may partly explain the greater increase in cardiovascular risk associated with MetS in women than in men.
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Affiliation(s)
- T Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.
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Niinisalo P, Raitala A, Pertovaara M, Oja SS, Lehtimäki T, Kähönen M, Reunanen A, Jula A, Moilanen L, Kesäniemi YA, Nieminen MS, Hurme M. Indoleamine 2,3-dioxygenase activity associates with cardiovascular risk factors: the Health 2000 study. Scand J Clin Lab Invest 2009; 68:767-70. [PMID: 18622801 DOI: 10.1080/00365510802245685] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Indoleamine 2,3-dioxygenase (IDO) is an important immunomodulator suppressing the activation of T lymphocytes, and its level in blood is increased in several autoimmune and inflammatory diseases. We have previously shown that this activity associates with several signs and risk factors of atherosclerosis in 24 to 39-year-old females. Now we repeat this analysis in an older population (n = 921, age range 46-76 years), i.e. in a population with more advanced atherosclerosis. IDO activity had a significant positive correlation in both sexes with carotid artery intima/media thickness (IMT), an early marker of atherosclerosis. In females, a significant negative correlation with HDL cholesterol and a positive correlation with triglycerides levels was observed. The association with IMT did not remain significant after adjustment with classical risk factors of atherosclerosis. It is thus concluded that IDO is a sensitive marker of atherosclerosis--or the inflammatory response associated with it--but does not have an independent role in the pathogenesis of this disease.
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Affiliation(s)
- P Niinisalo
- Department of Clinical Chemistry, Laboratory of Atherosclerosis Genetics, University of Tampere, Medical School, Tampere, Finland.
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Paiva H, Kahonen M, Lehtimaki T, Raitakari OT, Jula A, Viikari J, Alfthan G, Juonala M, Laaksonen R, Hutri-Kahonen N. Asymmetric dimethylarginine (ADMA) has a role in regulating systemic vascular tone in young healthy subjects: the cardiovascular risk in young Finns study. Am J Hypertens 2008; 21:873-8. [PMID: 18551100 DOI: 10.1038/ajh.2008.215] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study was designed to evaluate whether plasma asymmetric dimethylarginine (ADMA) has any role in predicting hemodynamic responses in clinically healthy young subjects. ADMA, as an endogenous nitric oxide (NO) synthase inhibitor, has been demonstrated to associate with hypertension and vascular reactivity in experimental but not undoubtedly in physiological settings. METHODS A total of 199 subjects aged 31.4 years (range 24-39 years) were studied. Plasma ADMA and symmetric dimethylarginine (SDMA) were assessed by isocratic high-pressure liquid chromatography using precolumn derivatization with o-phtaldialdehyde at baseline. Blood pressure (BP) was measured by casual measurements in the beginning of the study and after a follow-up period of 2.45 +/- 0.42 years (range, 1.86-3.19 years). Hemodynamic regulation was assessed by noninvasive methods after a follow-up. RESULTS Plasma ADMA had a negative association with resting systemic vascular resistance index (SVRI) (r = -0.23, P < 0.01) and pulse wave velocity (PWV) (r = -0.17, P < 0.05) and positive association with cardiac index (CI) (r = 0.21, P < 0.01) after the follow-up. Plasma ADMA had also negative association with responses of SVRI (r = -0.19, P < 0.01) and positive association with CI (r = 0.25, P < 0.001) in a hemodynamic reactivity test. In a multivariate linear model (R2 = 0.20, P < 0.00001), diastolic BP (R = 0.37, P < 0.00001) and ADMA (R = -0.20, P < 0.01) were significant predictors of SVRI. CONCLUSIONS These results suggest that plasma ADMA seems to play a role in the regulation of vascular tone in young healthy subjects.
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Simell O, Niinikoski H, Ronnemaa T, Raitakari OT, Lagstrom H, Laurinen M, Aromaa M, Hakala P, Jula A, Jokinen E, Valimaki I, Viikari J. Cohort Profile: The STRIP Study (Special Turku Coronary Risk Factor Intervention Project), an Infancy-onset Dietary and Life-style Intervention Trial. Int J Epidemiol 2008; 38:650-5. [DOI: 10.1093/ije/dyn072] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Raitakari OT, Juonala M, Ronnemaa T, Keltikangas-Jarvinen L, Rasanen L, Pietikainen M, Hutri-Kahonen N, Taittonen L, Jokinen E, Marniemi J, Jula A, Telama R, Kahonen M, Lehtimaki T, Akerblom HK, Viikari JS. Cohort Profile: The Cardiovascular Risk in Young Finns Study. Int J Epidemiol 2008; 37:1220-6. [DOI: 10.1093/ije/dym225] [Citation(s) in RCA: 536] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Koivistoinen T, Kööbi T, Jula A, Hutri-Kähönen N, Raitakari OT, Majahalme S, Kukkonen-Harjula K, Lehtimäki T, Reunanen A, Viikari J, Turjanmaa V, Nieminen T, Kähönen M. Pulse wave velocity reference values in healthy adults aged 26?75�years. Clin Physiol Funct Imaging 2007; 27:191-6. [PMID: 17445071 DOI: 10.1111/j.1475-097x.2007.00734.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [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: 11/29/2022]
Abstract
The stiffening of arteries is associated with various cardiovascular diseases. Arterial stiffening can be studied utilizing arterial pulse wave velocity (PWV), but the absence of reliable reference values for PWV has limited its use in clinical practice. The aim of this study was to establish a range of reference values for PWV. PWV was examined by measuring the time difference of systolic pulse waves in arteries from the aortic arch to the popliteal artery using whole-body impedance cardiography (ICG). The study population consisted of 799 individuals (age range 25-76 years), 283 of whom had no evidence of cardiovascular disease, and a low burden of risk factors was selected to represent an apparently healthy population. In healthy study population, PWV was higher in males (8 x 9 +/- 1 x 8 m s(-1)) than females (8 x 1 +/- 2 x 0 m s(-1), P<0 x 001). Young males had lower PWV values than old males. Correspondingly, young females also had lower PWV values than old females. PWV was clearly associated with age, and PWV was higher in young and middle-aged males than in females. There was no statistically significant difference between old males and females in PWV. In conclusion, whole-body ICG provides a practical method for PWV measurement. Reference values can be useful in the clinical management of patients, especially in detecting early vascular disease or an increased risk of cardiovascular complications.
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Affiliation(s)
- T Koivistoinen
- Department of Clinical Physiology, Medical School, University of Tampere, and Tampere University Hopsital, Tampere, Finland.
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Turunen A, Verkasalo P, Pukkala E, Kiviranta H, Jula A, Vartiainen T. Ischaemic Heart Disease and Other Mortality Among Fishermen and Their Wives in Finland. Epidemiology 2006. [DOI: 10.1097/00001648-200611001-01435] [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: 11/25/2022]
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Virtanen R, Jula A, Huikuri H, Kuusela T, Helenius H, Ylitalo A, Voipio-Pulkki LM, Kauma H, Kesäniemi YA, Airaksinen J. Increased pulse pressure is associated with reduced baroreflex sensitivity. J Hum Hypertens 2004; 18:247-52. [PMID: 15037873 DOI: 10.1038/sj.jhh.1001661] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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: 11/08/2022]
Abstract
Although pulse pressure (PP), heart rate variability (HRV) and baroreflex sensitivity (BRS) have been shown to predict cardiovascular events and mortality in various populations, their relationships have not been clarified. We examined these associations in two separate population-based samples of healthy middle-aged subjects. In population 1, data were obtained from 149 subjects (71 men and 78 women) aged 35-64 (mean 47.7) years, and in population 2, from 214 subjects (88 men and 126 women) aged 40-62 (mean 50.5) years. Increased 24-h ambulatory PP was related to decreased cross-spectral BRS independent of age and gender (beta=-0.28, P<0.001 for population 1; beta=-0.22, P=0.003 for population 2). This association remained significant when 24-h ambulatory diastolic blood pressure, body mass index, smoking and alcohol intake were added as covariates in the multivariate analysis. Increased ambulatory PP was also associated with increased beat-to-beat systolic arterial pressure variability. Associations between ambulatory PP and HRV were not significant after controlling for age and gender. Our results suggest that elevated PP does not affect overall HRV, but it interferes with baroreflex-mediated control of the heart rate. This association may be due to a common denominator, such as arterial stiffness, for PP and BRS.
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Affiliation(s)
- R Virtanen
- Department of Medicine, University of Turku, Turku, Finland.
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Virtanen R, Jula A, Kuusela T, Helenius H, Voipio-Pulkki LM. Reduced heart rate variability in hypertension: associations with lifestyle factors and plasma renin activity. J Hum Hypertens 2003; 17:171-9. [PMID: 12624607 DOI: 10.1038/sj.jhh.1001529] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [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: 11/09/2022]
Abstract
Limited information exists on the relations between heart rate variability, hypertension, lifestyle factors and renin-angiotensin-aldosterone system. A total of 191 newly diagnosed yet untreated hypertensive men and women, 35-54 years of age, were compared with an age- and gender-stratified random population sample of 105 normotensive men and women to find out independent determinants of heart rate variability. Heart rate variability was computed from 5-min ECG time series using the standard deviation of normal-to-normal RR intervals (SDNN), the square root of the mean of squared differences between adjacent normal RR intervals (RMSSD) and the fast Fourier transform spectral analysis. All absolute measures of heart rate variability were reduced in hypertension (P<0.001 for each, ANOVA). In multivariate regression analyses, reduced heart rate variability was independently associated with higher heart rate (P<0.001 for all absolute measures of heart rate variability), higher age (P=0.001 for SDNN, total and LF powers; P<0.001 for RMSSD and HF power) and higher mean arterial pressure (P<0.05 for total power, P<0.01 for the other absolute measures) but not with sodium and alcohol intakes, body mass index and smoking. Increased plasma renin activity (PRA) was an independent attributor of reduced HF power (P<0.05) and reduced RMSSD (P<0.01). Increased blood pressure and heart rate are associated with decreased heart rate variability without any direct effects on heart rate variability of lifestyle factors. High PRA is an independent determinant of diminished modulation of vagal activity.
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Affiliation(s)
- R Virtanen
- Department of Medicine, Turku University Central Hospital, Turku, Finland.
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Jula A. [Non-pharmacological treatment of hypertension]. Duodecim 2002; 115:950-6. [PMID: 11859529] [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: 02/23/2023]
Affiliation(s)
- A Jula
- Kansaneläkelaitoksen tutkimus- ja kehitysyksikkö Peltolantie 3 20720 Turku
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Laine H, Katoh C, Luotolahti M, Yki-Järvinen H, Kantola I, Jula A, Takala TO, Ruotsalainen U, Iida H, Haaparanta M, Nuutila P, Knuuti J. Myocardial oxygen consumption is unchanged but efficiency is reduced in patients with essential hypertension and left ventricular hypertrophy. Circulation 1999; 100:2425-30. [PMID: 10595955 DOI: 10.1161/01.cir.100.24.2425] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [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: 11/16/2022]
Abstract
BACKGROUND Patients with hypertension and left ventricular hypertrophy (LVH) are prone to develop heart failure. We tested the hypothesis that compensatory LVH is associated with normalization of myocardial oxygen consumption and that this occurs at the expense of a decrease in the ratio between cardiac work and oxygen consumption (efficiency). METHODS AND RESULTS Nine hypertensive men with LVH (LVH+) (age 42+/-2 years), left ventricular mass index (LVMI) 161+/-8 g/m(2), blood pressure (BP) 145+/-16/88+/-10 mm Hg (mean+/-SD); 8 hypertensive men without LVH (LVH-) (age 39+/-5 years, LVMI 107+/-15 g/m(2), BP 140+/-15/90+/-11 mm Hg); and 10 normotensive men (CONT) were studied. Myocardial blood flow, oxygen consumption, and glucose uptake were measured during euglycemic hyperinsulinemia using PET techniques. LV dimensions, volumes, and workload were determined by echocardiography, and efficiency was calculated. Myocardial workload (2.5+/-0.8 versus 3.0+/-0.6 versus 2. 3+/-0.5 mm Hg. mL. min(-1). g(-1) for CONT versus LVH- versus LVH+; P<0.05, LVH- versus LVH+), myocardial blood flow (0.84+/-0.16 versus 1.06+/-0.22 versus 0.81+/-0.09 mL. g(-1). min, respectively; P<0.05, LVH- versus other groups) and oxygen consumption (0.09+/-0.02 versus 0.14+/-0.03 versus 0.11+/-0.01 ml. g(-1). min(-1), respectively; P<0. 05, LVH- versus other groups) were increased in the LVH- group. Myocardial efficiency was reduced in the LVH+ group (18.1+/-4.1% versus 15.1+/-2.3% versus 13.5+/-1.9%, respectively; P<0.05, LVH+ versus CONT). CONCLUSIONS Myocardial oxygen consumption per unit weight is increased in hypertensive patients without LVH but is normal in those with LVH. The normalization of oxygen consumption via hypertrophy occurs at the expense of efficiency, which may predispose hypertensive patients with LVH to heart failure.
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Affiliation(s)
- H Laine
- Department of Medicine, and Clinical Physiology, University of Turku, Finland.
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Jula A, Seppänen R, Alanen E. Influence of days of the week on reported food, macronutrient and alcohol intake among an adult population in south western Finland. Eur J Clin Nutr 1999; 53:808-12. [PMID: 10556988 DOI: 10.1038/sj.ejcn.1600853] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [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: 11/08/2022]
Abstract
OBJECTIVE To study the influence of the days of the week on calculated food and nutrient intake. STUDY DESIGN Daily variation in food and nutrient intake was studied by using 4-, 5- and 7-d estimated food records, all including Friday, Saturday and Sunday. SUBJECTS AND SETTING Two groups of untreated hypertensive patients (60 men and 31 women, aged 31-55 y, and 132 men and 94 women, aged 35-54 y) and a random population sample of 131 men and 139 women, aged 35-64 y, all from the City of Turku and three neighbouring municipalities in south western Finland. RESULTS The intakes of meat and meat products, carbohydrate, alcohol and energy varied significantly across the week in all study groups with increased intakes of meat and meat products on Saturday and Sunday, of carbohydrate and alcohol on Friday and Saturday, and of energy on Friday, Saturday and Sunday. Food and nutrient intakes did not vary consistently with weekdays (Monday to Thursday) with the exception of alcohol intake being lowest on Monday. Macronutrient, alcohol and energy intake data calculated from the 5-d (Monday, Tuesday, Friday, Saturday and Sunday) and from 5 to 7 d converted food records were nearly equal to and correlated highly (r=0.96-0.98) with the data calculated from the 'true' 7 d records. CONCLUSION The daily variation in food and nutrient intakes should be taken into consideration when food diaries are recorded. 5-d food records including two weekdays (from Monday to Thursday) and Friday, Saturday and Sunday is recommended. SPONSORSHIP Social Insurance Institution of Finland.
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Affiliation(s)
- A Jula
- Research and Development Centre of the Social Insurance Institution, Peltolantie 3, FIN-20720 Turku, Finland.
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Abstract
To compare multiple clinic and home blood pressure (BP) measurements and ambulatory BP monitoring in the clinical evaluation of hypertension, we studied 239 middle-aged pharmacologically untreated hypertensive men and women who were referred to the study from the primary healthcare provider. Ambulatory BP monitoring was successfully completed for 233 patients. Clinic BP was measured by a trained nurse with a mercury sphygmomanometer and averaged over 4 duplicate measures. Self-recorded home BP was measured with a semiautomatic oscillometric device twice every morning and twice every evening on 7 consecutive days. Ambulatory BP was recorded with an auscultatory device. Two-dimensionally controlled M-mode echocardiography was successfully performed on 232 patients. Twenty-four-hour urinary albumin was determined by nephelometry. Clinic BP was 144.5+/-12.6/94.5+/-7.4 mm Hg, home BP (the mean of 14 self-recorded measures) was 138.9+/-13.1/92.9+/-8.6 mm Hg, home morning BP (the mean of the first 4 duplicate morning measures) was 137.1+/-13.7/92.4+/-9.2 mm Hg, daytime ambulatory BP was 148.3+/-13. 9/91.9+/-7.8 mm Hg, nighttime ambulatory BP was 125.5+/-16.4/75. 6+/-8.9 mm Hg, and 24-hour ambulatory BP was 141.7+/-14.0/87.2+/-7.6 mm Hg. Pearson correlation coefficients of clinic, home, home morning, and daytime ambulatory BPs to albuminuria and to the characteristics of the left ventricle were nearly equal. In multivariate regression analyses, 36% (P<0.0001) of the cross-sectional variation in left ventricular mass index was attributed to gender and home morning systolic BP in models that originally included age, gender, and clinic, self-measured home morning, and ambulatory daytime, nighttime, and 24-hour systolic and diastolic BPs. We concluded that carefully controlled nonphysician-measured clinic and self-measured home BPs, when averaged over 4 duplicate measurements, are as reliable as ambulatory BP monitoring in the clinical evaluation of untreated hypertension.
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Affiliation(s)
- A Jula
- Research and Development Center of the Social Insurance Institution, Turku, Finland
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Abstract
Two hundred thirty-seven newly diagnosed yet untreated hypertensive men and women, 35 to 54 years of age, were compared with an age- and gender-stratified random population sample of 146 normotensive men and women to find out whether psychological distress symptoms, anger expression, and alexithymia are associated with elevated blood pressure and whether the possible associations are independent of sodium and alcohol intake, body mass index, and physical fitness. The independent attributes of mean arterial pressure were studied by multivariate regression analyses after combining the subjects in the hypertensive and control groups. Three questionnaires were used: the Brief Symptom Inventory (BSI-37), a 31-item version of the Spielberger State-Trait Anger Expression Inventory (STAXI), and the Toronto Alexithymia Scale (TAS-26). Total scores of the TAS-26 were higher (P<0.001) in hypertensive men and women than in their normotensive control subjects (75.6+/-7.8 vs 64.1+/-9.8 in men and 72.9+/-7.1 vs 57.5+/-11.5 in women). There were no differences between the study and control groups in psychological distress symptoms, including anxiety, depression, and hostility, or in anger expression. In multivariate regression analyses, higher age, male gender, higher sodium intake, lower physical fitness, and alexithymia were independently and highly significantly (P<0.01 for male gender, P<0.0001 for other variables) associated with increased blood pressure, explaining altogether 39.5% of the cross-sectional variation in mean arterial pressure. We conclude that alexithymia, that is, poor ability to experience and express emotions, is associated with elevated blood pressure independent of sodium and alcohol intake, body mass index, and physical fitness.
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Affiliation(s)
- A Jula
- Research and Development Centre of the Social Insurance Institution, Turku, Finland
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Abstract
Thirty-nine (39) middle-aged subjects with mild to moderate hypertension (WHO stages I-II) and 35 healthy normotensive controls from a community sample participated in this psychophysiological study, the aim of which was to study whether the electrodermal lability as an indicator of increased sympathetic activity is related to hypertension. Resting blood pressure was measured by using a mercury sphygmomanometer. Electrodermal activity was recorded with a constant voltage circuit. Bipolar skin electrodes were placed on the palmar side of the middle phalanges of the index and middle fingers of both hands. Six years after the electrodermal measurements, the possible use of reimbursed antihypertensive medication was checked in both groups, and blood pressure re-measured in the control group. Multivariate analysis controlling for age, gender and body mass showed that the electrodermal lability was increased in the hypertensive as compared to the normotensive group. This supports the hypothesis that the sympathetic nervous system tonus is increased at least, in some middle-aged subjects with mild to moderate hypertension.
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Affiliation(s)
- E Kronholm
- Research and Development Centre of the Social Insurance Institution, Turku, Finland
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Nuutila P, Mäki M, Laine H, Knuuti MJ, Ruotsalainen U, Luotolahti M, Haaparanta M, Solin O, Jula A, Koivisto VA. Insulin action on heart and skeletal muscle glucose uptake in essential hypertension. J Clin Invest 1995; 96:1003-9. [PMID: 7635936 PMCID: PMC185288 DOI: 10.1172/jci118085] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.0] [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: 01/26/2023] Open
Abstract
Essential hypertension is characterized by skeletal muscle insulin resistance but it is unknown whether insulin resistance also affects heart glucose uptake. We quantitated whole body (euglycemic insulin clamp) and heart and skeletal muscle (positron emission tomography and 18F-fluoro-2-deoxy-D-glucose) glucose uptake rates in 10 mild essential hypertensive (age 33 +/- 1 yr, body mass index 23.7 +/- 0.8 kg/m2, blood pressure 146 +/- 3/97 +/- 3 mmHg, VO2max 37 +/- 3 ml/kg per min) and 14 normal subjects (29 +/- 2 yr, 22.5 +/- 0.5 kg/m2, 118 +/- 4/69 +/- 3 mmHg, 43 +/- 2 ml/kg per min). Left ventricular mass was similar in the hypertensive (155 +/- 15 g) and the normotensive (164 +/- 13 g) subjects. In the hypertensives, both whole body (28 +/- 3 vs 44 +/- 3 mumol/kg per min, P < 0.01) and femoral (64 +/- 11 vs 94 +/- 8 mumol/kg muscle per min, P < 0.05) glucose uptake rates were decreased compared to the controls. In contrast, heart glucose uptake was 33% increased in the hypertensives (939 +/- 51 vs 707 +/- 46 mumol/kg muscle per min, P < 0.005), and correlated with systolic blood pressure (r = 0.66, P < 0.001) and the minute work index (r = 0.48, P < 0.05). We conclude that insulin-stimulated glucose uptake is decreased in skeletal muscle but increased in proportion to cardiac work in essential hypertension. The increase in heart glucose uptake in mild essential hypertensives with a normal left ventricular mass may reflect increased oxygen consumption and represent an early signal which precedes the development of left ventricular hypertrophy.
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Affiliation(s)
- P Nuutila
- Department of Medicine, Turku University Cyclotron/PET Center, University of Turku, Finland
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Abstract
The effects of long-term sodium restriction on plasma atrial natriuretic factor (ANF) concentrations, and the role of baseline plasma ANF concentration as an indicator of changes in haemodynamics and left ventricular hypertrophy during this treatment were studied in 40 middle-aged previously untreated mildly to moderately hypertensive men and women in a 6-month controlled randomized study. The main emphasis of the treatment programme was to reduce daily sodium intake to less than 70 mmol. Mean sodium excretion decreased from 148 +/- 74 mmol 24 h-1 to 79 +/- 71 mmol 24 h-1 in the treatment group, but remained unchanged in the control group (173 +/- 68 mmol 24 h-1 vs. 186 +/- 62 mmol 24 h-1; P less than 0.01 for the difference in changes between the groups). Mean plasma ANF concentrations in the treatment group were 52.4 +/- 20.7 (median 50) pg ml-1 at baseline and 38.7 +/- 26.3 (median 42) pg ml-1 at 6 months, and the corresponding values in the control group were 55.5 +/- 20.5 (median 50) pg ml-1 and 46.1 +/- 32.4 (median 50) pg ml-1, respectively (P = NS for the difference in changes). The ANF concentration decreased from 70 +/- 14 pg ml-1 to 32 +/- 26 pg ml-1 in treated subjects with a high baseline plasma ANF concentration (greater than 50 pg ml-1), but increased from 37 +/- 11 pg ml-1 to 45 +/- 27 pg ml-1 in subjects with a low baseline plasma ANF concentration (less than or equal to 50 pg ml-1) (difference in changes P less than 0.001). Compared with treated subjects with low baseline plasma ANF levels and with controls, treated subjects with high baseline plasma ANF levels showed a decrease (P less than 0.05) in interventricular septal and left posterior wall thicknesses, in relative wall thickness, and in peripheral resistance. These results suggest that in mildly to moderately hypertensive subjects long-term sodium restriction decreases high plasma ANF concentrations concomitantly with regression of concentric left ventricular hypertrophy, probably as a result of changes in haemodynamics.
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Affiliation(s)
- A Jula
- Rehabilitation Research Centre of the Social Insurance Institution, Turku, Finland
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Abstract
Ninety-one middle-aged men and women with untreated mild hypertension were allocated to a nopharmacological treatment group or to a control group. Members of the treatment group were instructed to reduce daily sodium intake to less than 70 mmol, to reduce the intake of saturated fat, to lose weight if necessary and to perform regular physical exercise and relaxation training. Adherence to and effects of the programme on blood pressure and serum lipids were monitored for 12 months. In the treatment group, daily sodium excretion decreased to and remained at 50% of its original level (P less than 0.001), and there was a significant reduction in saturated fat intake. The average weight reduction was modest. Adherence to physical exercise and relaxation training regimens was poor. The net decreases (difference in changes between treatment and control group) in blood pressure were greatest during the first 3 months: in men the decrease in systolic blood pressure was 11.3 mmHg (P less than 0.001) and in diastolic blood pressure 8.3 mmHg (P less than 0.001); in women the decrease in systolic blood pressure was 10.8 mmHg (P less than 0.01) and in diastolic blood pressure 6.4 mmHg (P less than 0.01). However, this decrease diminished during the last 3 months to approximately one half owing to blood pressure reduction in controls. Low density lipoprotein cholesterol levels decreased significantly in treated men and women.
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Affiliation(s)
- A Jula
- Rehabilitation Research Centre, Social Insurance Institution, Turku, Finland
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