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Manninen S, Lankinen M, de Mello V, Ågren J, Laaksonen D, Schwab U, Erkkilä A. The effect of camelina sativa oil and fish intakes on fatty acid compositions of blood lipid fractions. Nutr Metab Cardiovasc Dis 2019; 29:51-61. [PMID: 30454883 DOI: 10.1016/j.numecd.2018.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Blood lipid fractions serve as objective biomarkers of dietary fat intake. It is unclear which fatty acid pool most accurately reflects the dietary intakes of different n-3 PUFAs. We aimed to investigate the effect of fish and camelina sativa oil (CSO) intakes on fatty acid composition of erythrocyte membranes (EM), plasma phospholipids (PL), cholesteryl esters (CE) and triglycerides (TG). We also aimed to identify the most appropriate blood lipid fraction for assessing n-3 PUFA intake. METHODS AND RESULTS Altogether 79 volunteers with impaired glucose metabolism were randomly assigned either to CSO, fatty fish, lean fish or control groups for 12 weeks. Fatty acid compositions of lipid pools were measured by gas chromatography. The proportion of alpha-linolenic acid (ALA) increased in all lipid pools in the CSO group (false discovery rate (FDR) p < 0.001 for all). Similarly, the proportions of EPA and DHA increased in all lipid fractions in the fatty fish group (FDR p < 0.001 for EM, PL and CE; FDR p = 0.005 for TG; FDR p < 0.001 for EM, PL, CE; FDR p < 0.007 for TG, respectively). Changes in the dietary intakes of ALA, EPA and DHA correlated with the changes in their proportions in all lipid pools (r = 0.3-0.5, p < 0.05). CONCLUSION There is no difference in the ability of blood lipid fractions in reflecting the dietary intake of different n-3 PUFAs over a time period of 12 weeks in subjects with high baseline omega-3 index. This trial was registered in Clinicaltrials.gov (NCT01768429).
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Affiliation(s)
- S Manninen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
| | - M Lankinen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - V de Mello
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - J Ågren
- Institute of Biomedicine, Physiology, University of Eastern Finland, Kuopio, Finland
| | - D Laaksonen
- Institute of Biomedicine, Physiology, University of Eastern Finland, Kuopio, Finland; Institute of Clinical medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - U Schwab
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; Institute of Clinical medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - A Erkkilä
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Peltola E, Hannula P, Huhtala H, Metso S, Kiviniemi U, Vornanen M, Sand J, Laukkarinen J, Tiikkainen M, Schalin-Jäntti C, Arola J, Sirén J, Piiroinen A, Soinio M, Nuutila P, Söderström M, Hämäläinen H, Moilanen L, Laaksonen D, Pirinen E, Sundelin F, Ebeling T, Salmela P, Mäkinen MJ, Jaatinen P. Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland. Int J Endocrinol 2018; 2018:2059481. [PMID: 30425741 PMCID: PMC6218736 DOI: 10.1155/2018/2059481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/09/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Insulinomas are rare pancreatic tumours. Population-based data on their incidence, clinical picture, diagnosis, and treatment are almost nonexistent. The aim of this study was to clarify these aspects in a nationwide cohort of insulinoma patients diagnosed during three decades. DESIGN AND METHODS Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980-2010. RESULTS Seventy-nine patients were diagnosed with insulinoma over the research period. The median follow-up from diagnosis to last control visit was one (min 0, max 31) year. The incidence increased from 0.5/million/year in the 1980s to 0.9/million/year in the 2000s (p = 0.002). The median diagnostic delay was 13 months and did not change over the study period. The mean age at diagnosis was 52 (SD 16) years. The overall imaging sensitivity improved from 39% in the 1980s to 98% in the 2000s (p < 0.001). Seventy-one (90%) of the patients underwent surgery with a curative aim, two (3%) had palliative surgery, and 6 (8%) were inoperable. There were no significant differences in the types of surgical procedures between the 1980s, 1990s, and 2000s; tumour enucleations comprised 43% of the operations, distal pancreatic resections 45%, and pancreaticoduodenectomies 12%, over the whole study period. Of the patients who underwent surgery with a curative aim, 89% had a full recovery. Postoperative complications occurred in half of the patients, but postoperative mortality was rare. CONCLUSIONS The incidence of insulinomas has increased during the past three decades. Despite the improved diagnostic options, diagnostic delay has remained unchanged. To shorten the delay, clinicians should be informed and alert to consider the possibility of hypoglycemia and insulinoma, when symptomatic attacks are investigated in different sectors of the healthcare system. Developing the surgical treatment is another major target, in order to lower the overall complication rate, without compromising the high cure rate of insulinomas.
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Affiliation(s)
- Elina Peltola
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
- Division of Internal Medicine, Seinäjoki Central Hospital, Finland
| | - Päivi Hannula
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, University of Tampere, Finland
| | - Saara Metso
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
| | - Ulla Kiviniemi
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
| | - Martine Vornanen
- Fimlab Laboratories, Pathology Department, Tampere University Hospital, Finland
| | - Juhani Sand
- Päijät-Häme Joint Authority for Health and Wellbeing, Finland
| | - Johanna Laukkarinen
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Finland
| | - Mirja Tiikkainen
- Endocrinology, Abdominal Center, Helsinki University Hospital, Finland
| | - Camilla Schalin-Jäntti
- Endocrinology, Abdominal Center, Helsinki University Hospital, Finland
- Endocrinology, Abdominal Center, University of Helsinki, Finland
| | - Johanna Arola
- Pathology, HUSLAB Helsinki University Hospital, Finland
- Pathology, University of Helsinki, Finland
| | - Jukka Sirén
- Abdominal Center, Helsinki University Hospital, Finland
| | | | - Minna Soinio
- Endocrinology, Department of Internal Medicine, Turku University Hospital, Finland
| | - Pirjo Nuutila
- Faculty of Medicine, University of Turku, Finland
- Endocrinology, Department of Internal Medicine, Turku University Hospital, Finland
| | | | - Hanna Hämäläinen
- Faculty of Health Sciences, School of Medicine, University of Eastern Finland, Finland
| | - Leena Moilanen
- Department of Medicine, Kuopio University Hospital, Finland
| | | | - Elina Pirinen
- Department of Clinical Pathology, Kuopio University Hospital, Finland
| | - Fia Sundelin
- Faculty of Medicine, University of Oulu, Finland
| | - Tapani Ebeling
- Faculty of Medicine, University of Oulu, Finland
- Endocrinology, Oulu University Hospital, Finland
| | - Pasi Salmela
- Endocrinology, Oulu University Hospital, Finland
| | - Markus J. Mäkinen
- Research Unit of Cancer and Translational Medicine, Department of Pathology, University of Oulu, Finland
- Department of Pathology, Oulu University Hospital, Finland
| | - Pia Jaatinen
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
- Division of Internal Medicine, Seinäjoki Central Hospital, Finland
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
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Lampinen EK, Eloranta AM, Haapala EA, Lindi V, Väistö J, Lintu N, Karjalainen P, Kukkonen-Harjula K, Laaksonen D, Lakka TA. Physical activity, sedentary behaviour, and socioeconomic status among Finnish girls and boys aged 6-8 years. Eur J Sport Sci 2017; 17:462-472. [PMID: 28276910 DOI: 10.1080/17461391.2017.1294619] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We studied differences in physical activity (PA), sedentary behaviour (SB), and the types of PA and SB between Finnish girls and boys and children from different socioeconomic backgrounds (SES). We assessed PA, SB, parental education, and household income using detailed questionnaires in a representative population sample of 486 children (238 girls, 248 boys) aged 6-8 years. Girls spent on average 1.7 h/day and boys 2.0 h/day in total PA (p = 0.002). Altogether 66% of girls and 54% of boys had less than 2 h of total PA per day (p = 0.012). Girls had lower levels of unsupervised PA (45 vs. 54 min/day, p = 0.001), supervised PA (1.5 vs. 1.9 h/week, p = 0.009), and PA during school recess (1.8 vs. 1.9 h/week, p = 0.032) than boys. Girls had higher levels of total SB (3.8 vs. 3.4 h/day, p = 0.015) but lower levels of screen-based SB (1.5 vs. 1.9 h/day, p < 0.001) than boys. Lower parental education and household income were associated with lower levels of supervised PA in girls (p = 0.011 and p = 0.008, respectively) and in boys (p = 0.006 and p = 0.003, respectively). Lower parental education and household income were also related to higher levels of screen-based SB in boys (p = 0.005 and p < 0.001, respectively) but not in girls. Girls have lower levels of total, unsupervised, and supervised PA, PA during recess, and screen-based SB but higher levels of total SB than boys. Lower parental education and household income are associated with lower levels of supervised PA in both genders and higher levels of screen-based SB in boys.
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Affiliation(s)
- Eeva-Kaarina Lampinen
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland
| | - Aino-Maija Eloranta
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland
| | - Eero A Haapala
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland.,b Sport and Exercise Medicine, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland.,c University Medical Center Utrecht, Wilhelmina Children's Hospital , Utrecht , Netherlands
| | - Virpi Lindi
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland
| | - Juuso Väistö
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland
| | - Niina Lintu
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland
| | - Panu Karjalainen
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland
| | | | - David Laaksonen
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland.,e Department of Internal Medicine , Kuopio University Hospital , Kuopio , Finland
| | - Timo A Lakka
- a Institute of Biomedicine/Physiology, School of Medicine , University of Eastern Finland , Kuopio , Finland.,f Kuopio Research Institute of Exercise Medicine , Kuopio , Finland.,g Department of Clinical Physiology and Nuclear Medicine , Kuopio University Hospital , Kuopio , Finland
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Venäläinen T, Schwab U, Ågren J, de Mello V, Lindi V, Eloranta AM, Kiiskinen S, Laaksonen D, Lakka TA. Cross-sectional associations of food consumption with plasma fatty acid composition and estimated desaturase activities in Finnish children. Lipids 2015; 49:467-79. [PMID: 24659110 DOI: 10.1007/s11745-014-3894-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
Abstract
Plasma fatty acid (FA) composition is known to be an indicator of dietary fat quality, but the associations of other dietary factors with plasma FA composition remain unknown in children. We investigated the cross-sectional associations of food consumption with the proportions of FA and estimated desaturase activities in plasma cholesteryl esters (CE) and phospholipids (PL) among children. The subjects were a population sample of 423 children aged 6–8 years examined at baseline of The Physical Activity and Nutrition in Children (PANIC) Study. We assessed food consumption by food records and plasma FA composition by gas chromatography. We used linear regression models adjusted for age, sex, physical activity and total energy intake to analyze the associations. A higher consumption of vegetable oil-based margarine (fat 60–80 %) was associated with a higher proportion of linoleic and α-linolenic acids in plasma CE and PL. A higher consumption of high-fiber grain products was related to a lower proportion of oleic acid in CE and PL. The consumption of candy was directly associated with the proportion of palmitoleic and oleic acid in plasma CE. The consumption of vegetable oil-based margarine was inversely associated with estimated stearoyl-CoA-desaturase activity in plasma CE and PL and the consumption of candy was directly related to it in plasma CE. The results of our study suggest that plasma FA composition is not only a biomarker for dietary fat quality but also reflects the consumption of high-fiber grain products and foods high in sugar among children.
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Tompuri T, Lintu N, Savonen K, Laitinen T, Laaksonen D, Jääskeläinen J, Lakka TA. Measures of cardiorespiratory fitness in relation to measures of body size and composition among children. Clin Physiol Funct Imaging 2014; 35:469-77. [PMID: 25164157 DOI: 10.1111/cpf.12185] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the exercise testing measures of cardiorespiratory fitness need to be scaled by body size or composition to enable comparison between individuals. Traditionally used weight-proportional measures are potentially confounded by body adiposity that hampers their interpretation and applicability in the clinical assessment of cardiorespiratory fitness. OBJECTIVE We aimed to find the most appropriate measure of body size or composition for scaling of measures of cardiorespiratory fitness among children. METHODS We assessed body weight and height, maximal workload (W MAX ) and maximal oxygen uptake (VO2 MAX ) using cycle ergometer exercise test with respiratory gas analysis and body lean mass (LM) and fat mass (FM) by dual-energy X-ray absorptiometry and by bioimpedance analysis among 38 children. The data were analysed using Pearson's coefficients for correlation and stepwise linear regression models. RESULTS Lean mass (r > 0.54) and height (r > 0.51) had stronger positive correlations with absolute W MAX and VO2 MAX than weight (r > 0.30) in girls and boys. None of the measures of body size or composition correlated with LM-proportional W MAX or VO2 MAX in girls or boys. Only LM correlated positively with height-proportional W MAX (r = 0.65) and VO2 MAX (r = 0.71) in boys. FM correlated negatively with weight-proportional W MAX (r < -0.58) and VO2 MAX (r < -0.64) in girls and boys. FM was even stronger determinant of weight-proportional W MAX (β = -0.68) and VO2 MAX (β = -0.61) than exercise performance in multivariate linear regression models. CONCLUSIONS While assessing cardiorespiratory fitness, LM is the most appropriate measure of body size or composition for scaling of W MAX and VO2 MAX, because scaling by body weight introduces confounding by body adiposity.
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Affiliation(s)
- Tuomo Tompuri
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland
| | - Niina Lintu
- Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - David Laaksonen
- Department of Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Valtonen M, Laaksonen D, Laukkanen J, Tolmunen T, Rauramaa R, Viinamäki H, Mursu J, Savonen K, Lakka T, Niskanen L, Kauhanen J. Sedentary Lifestyle And Emergence Of Hopelessness In Middle-aged Men. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000385193.89968.5b] [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: 11/21/2022]
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Laukkanen JA, Laaksonen D, Lakka TA, Savonen K, Rauramaa R, Mäkikallio T, Kurl S. Determinants of cardiorespiratory fitness in men aged 42 to 60 years with and without cardiovascular disease. Am J Cardiol 2009; 103:1598-604. [PMID: 19463522 DOI: 10.1016/j.amjcard.2009.01.371] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [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: 11/16/2008] [Revised: 01/31/2009] [Accepted: 01/31/2009] [Indexed: 11/17/2022]
Abstract
Good cardiorespiratory fitness has been found to protect against cardiovascular diseases and type 2 diabetes. The purpose of this study was to investigate determinants of directly measured cardiorespiratory fitness (maximal oxygen uptake [VO2max]), including age, body composition, prevalent diseases, cardiovascular and pulmonary functions, biochemical factors, physical activity, nutrition, smoking, and alcohol consumption, in a population-based study of 936 men 42 to 60 years of age. Variables that had the strongest direct associations with VO2max (milliliters per minute) in a linear multivariate step-up regression model were body weight, heart rate at maximal exercise, mean intensity and frequency of conditioning physical activity, intake of carbohydrates, blood hemoglobin, and forced expiratory volume in 1 second. The strongest inverse associations with VO2max were heart rate at rest, age, fasting serum insulin, waist-to-hip ratio, coronary heart disease, and asthma. This model accounted for 67% of the variation of VO2max. In conclusion, mean intensity, frequency, and duration of conditioning physical activity were associated directly with VO2max. However, measurements of the function of pulmonary and cardiovascular systems, carbohydrate intake, and body composition were powerful determinants of cardiorespiratory fitness, especially in older middle-aged men.
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Affiliation(s)
- Jari Antero Laukkanen
- Kuopio Research Institute of Exercise Medicine, University of Kuopio, Kuopio, Finland.
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Kilpeläinen T, Lakka T, Laaksonen D, Laukkanen O, Lindström J, Eriksson J, Valle T, Hämäläinen H, Aunola S, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M. Physical Activity Modifies the Effect of SNPs of the SLC2A2 (GLUT2) and ABCC8 (SUR1) Genes on the Risk of Developing Type 2 Diabetes. Med Sci Sports Exerc 2007. [DOI: 10.1249/01.mss.0000272922.39016.2a] [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: 11/21/2022]
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Abstract
BACKGROUND AND PURPOSE The metabolic syndrome, a clustering of disturbed glucose and insulin metabolism, obesity and abdominal fat distribution, dyslipidemia, and hypertension is associated with cardiovascular diseases. The aim of this study was to examine the relationship of metabolic syndrome, as defined by National Cholesterol Education Program (NCEP) and World Health Organization (WHO) criteria, with the risk for stroke. METHODS Population-based cohort study with an average follow-up of 14.3 years from eastern Finland. A total of 1131 men with no history of cardiovascular disease and diabetes at baseline participated. Sixty-five strokes occurred, of which 47 were ischemic strokes. RESULTS Men with the metabolic syndrome as defined by the NCEP criteria had a 2.05-fold (95% CI, 1.03 to 4.11; P=0.042) risk for all strokes and 2.41-fold (95% CI, 1.12 to 5.32; P=0.025) risk for ischemic stroke, after adjusting for socioeconomic status, smoking, alcohol, and family history of coronary heart disease. Additional adjustment for ischemic changes during exercise test, serum low-density lipoprotein cholesterol, plasma fibrinogen, energy intake for saturated fats, energy expenditure of leisure time physical activity, and white blood cell count, the results remained significant. The risk ratios among men with metabolic syndrome as defined by the WHO criteria were 1.82 (95% CI, 1.01 to 3.26; P=0.046) for all strokes and 2.16 (95% CI, 1.11 to 4.19; P=0.022) for ischemic stroke. After further adjustment, the respective risks were 2.08 (95% CI, 1.12 to 3.87; P=0.020) and 2.47 (95% CI, 1.21 to 5.07; P=0.013). CONCLUSIONS The risk of any stroke is increased in men with metabolic syndrome, in the absence of stroke, diabetes and cardiovascular disease at baseline. Prevention of the metabolic syndrome presents a great challenge for clinicians with respect to stroke.
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Affiliation(s)
- Sudhir Kurl
- Research Institute of Public Health, University of Kuopio, Kuopio, Finland.
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Niskanen L, Laaksonen D, Nyysonen K. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.accreview.2004.08.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kankaanpää M, Laaksonen D, Taimela S, Kokko SM, Airaksinen O, Hänninen O. Age, sex, and body mass index as determinants of back and hip extensor fatigue in the isometric Sørensen back endurance test. Arch Phys Med Rehabil 1998; 79:1069-75. [PMID: 9749686 DOI: 10.1016/s0003-9993(98)90173-3] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.4] [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: 12/19/2022]
Abstract
OBJECTIVE To study the ability of a widely used isometric back endurance test to measure lumbar back erector muscle fatigue and to assess the influence of age, sex, and body mass index (BMI) on back and hip extensor muscle fatigability (EMG spectral indices). DESIGN Cross-sectional study of men and women without back problems. SETTING Occupational health center and rehabilitation clinic in Finland. SUBJECTS Experiment 1 consisted of 233 consecutive occupational health center customers (133 women, 100 men) without back problems. Experiment 2 consisted of 20 healthy women. INTERVENTION Subjects performed the isometric Sørensen back endurance test up to 240sec in experiment 1 and to the limit of endurance in experiment 2. OUTCOME MEASURES Raw surface EMG was recorded bilaterally over the belly of lumbar erector spinae muscles at L1-L2 and L4-L5 levels in experiment 1, and bilaterally over the medial paraspinal muscles at L1-L2, L3-L4, and L5-S1 levels and over the major hip extensor muscles (gluteus maximus and biceps femoris) in experiment 2. In both experiments, time to endurance was recorded (in experiment 1 up to 240sec). The EMG spectral median frequency (MF) decrease over time was used for the assessment of back and hip extensor fatigability. RESULTS In experiment 1, the rate of change in paraspinal MF was greater in men than in women, indicating greater paraspinal fatigability in men. Multiple regression analysis indicated that the rate of MF decrease (fatigue) during the test was dependent on age and BMI in both sexes and that the effects of age and BMI were more pronounced in women than in men. Correlation analysis revealed that the rate of paraspinal muscle MF decrease was associated with endurance time and BMI in women and with endurance time and age in men. In experiment 2, the paraspinal muscles, as well as the hip extensor muscles, biceps femoris, and gluteus maximus, showed clear decreases in MF during the isometric endurance test in women. MF decrease was highly related to endurance time and BMI in women. CONCLUSIONS Lumbar paraspinal muscle fatigability during the Sørensen test is influenced by subject characteristics. Further, the hip extensor muscles also significantly fatigue, indicating load sharing between back and hip extensor muscles during the test. According to these results, the validity of this widely used back endurance test in specifically measuring lumbar paraspinal muscle endurance is questionable, as is the direct comparison of test results between women and men.
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Affiliation(s)
- M Kankaanpää
- Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, Finland
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Kankaanpää M, Taimela S, Laaksonen D, Hänninen O, Airaksinen O. Back and hip extensor fatigability in chronic low back pain patients and controls. Arch Phys Med Rehabil 1998; 79:412-7. [PMID: 9552107 DOI: 10.1016/s0003-9993(98)90142-3] [Citation(s) in RCA: 222] [Impact Index Per Article: 8.5] [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: 02/07/2023]
Abstract
OBJECTIVE To compare the lumbar paraspinal and gluteus maximus muscle fatigability between chronic low back pain patients and healthy controls by using electromyographic (EMG) spectral analysis during a maximal isometric endurance task. DESIGN A cross-sectional comparative study between chronic low back pain patients and healthy control subjects. SETTING Physical medicine and rehabilitation clinic in Finland. SUBJECTS Twenty women with nonspecific chronic low back pain (longer than 3 months) and 15 healthy controls. INTERVENTION Subjects performed maximal voluntary isometric back extensions (MVC) at 30 degrees forward flexion in a specially designed measurement unit. A 50% MVC load was used in isometric endurance test. OUTCOME MEASURES Low back pain intensity was assessed by using the visual analogue scale and functional disability by the Oswestry disability index. Time to endurance was measured. Bipolar surface EMG recordings were made over the lumbar paraspinal muscles (L3-L4, L5-S1) and over the gluteus maximus muscles. Average EMG (aEMG%), and initial spectral median frequency (MFinit) and change over time (MFslope) were computed. RESULTS Pain intensity and functional disability were higher and MVC and time to endurance were lower in the chronic low back pain group (p < .05). Similar muscle activity levels (aEMG%) and MFinit indicated similar muscle loading in both groups at the beginning of the endurance test. EMG spectral decreases (MFslope) indicated that lumbar paraspinal muscle fatigability was similar in both groups. In the chronic low back pain group, the gluteus maximus fatigued faster than in the control group (greater MFslope, p < .05). However, the shorter endurance time indicated greater fatigability in the chronic low back pain group in general (p < .05). CONCLUSIONS The chronic low back pain patients were weaker and fatigued faster than the healthy controls. The EMG fatigue analysis results suggest that the gluteus maximus muscles are more fatigable in chronic low back pain patients than in healthy control subjects during a sustained back extension endurance test.
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Affiliation(s)
- M Kankaanpää
- Department of Physical Medicine and Rehabilitation, Kuopio Univeristy Hospital, Finland
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