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Cuthbertson DJ, Koskinen J, Brown E, Magnussen CG, Hutri-Kähönen N, Sabin M, Tossavainen P, Jokinen E, Laitinen T, Viikari J, Raitakari OT, Juonala M. Fatty liver index predicts incident risk of prediabetes, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Ann Med 2021; 53:1256-1264. [PMID: 34309471 PMCID: PMC8317942 DOI: 10.1080/07853890.2021.1956685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/12/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. METHODS At baseline (in 2001) 2020 participants, males and females, aged 24-39 years, were stratified according to body mass index (BMI), normal weight (<25 kg/m2), overweight (≥25-<30 kg/m2), or obese (≥30 kg/m2) and FLI (as high FLI ≥60 or low FLI <60). We examined the incidence of prediabetes/type 2 diabetes and NAFLD (ultrasound assessed) over 10 years to 2011 to determine the relative impact of FLI and BMI. RESULTS 514 and 52 individuals developed prediabetes and type 2 diabetes during follow-up. Such individuals were older, with higher BMI, serum glucose, insulin, alanine aminotransferase (ALT) and triglyceride (TG) concentrations than those who did not develop prediabetes or type 2 diabetes (n = 1454). The additional presence of high FLI significantly increased the risk of developing prediabetes and type 2 diabetes above the risk of being overweight/obese. Compared with normal weight, low FLI participants, the odds of prediabetes were ∼2-fold higher and the odds of type 2 diabetes were 9-10-fold higher respectively in the overweight/obese, high FLI group. No difference was observed between normal weight, low FLI and overweight/obese and low FLI groups. CONCLUSIONS An increased FLI significantly increases the odds of incident prediabetes, type 2 diabetes and NAFLD in individuals with overweight/obese highlighting the contributory role of liver fat accumulation in the pathophysiology of prediabetes/type 2 diabetes.Key messagesObesity is a risk factor for non-alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes.Additionally, NAFLD is more prevalent in people with prediabetes and type 2 diabetes when compared to age- and BMI-matched individuals.The presence of a raised fatty liver index (FLI) confers a significantly increased risk of developing prediabetes, type 2 diabetes and NAFLD above that conferred by being overweight/obese.The degree of elevation of FLI can risk stratify for incident prediabetes and type 2 diabetes in people with obesity.
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Affiliation(s)
- Daniel J. Cuthbertson
- Metabolism and Nutrition Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Heart Center, Kotka Central Hospital, Kotka, Finland
| | - Emily Brown
- Metabolism and Nutrition Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Costan G. Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Matthew Sabin
- Murdoch Children’s Research Institute, The Royal Children’s Hospital and University of Melbourne, Melbourne, Australia
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
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Smith KJ, Magnussen CG, Pahkala K, Koskinen J, Sabin MA, Hutri-Kähönen N, Kähönen M, Laitinen T, Tammelin T, Tossavainen P, Jokinen E, Viikari JSA, Juonala M, Raitakari OT. Youth to adult body mass index trajectories as a predictor of metabolically healthy obesity in adulthood. Eur J Public Health 2021; 30:195-199. [PMID: 31169878 DOI: 10.1093/eurpub/ckz109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adiposity in childhood and adolescence (youth) has been shown to associate with adult metabolic health. What is not known, is whether youth body mass index (BMI) associates with metabolically healthy obesity (MHO) in adulthood, and if so, the age when the BMI to MHO association emerges. This study aimed to determine if BMI trajectories from youth to adulthood differed between adults with MHO and metabolically unhealthy obesity (MUHO). METHODS The Cardiovascular Risk in Young Finns Study had measured weight and height up to eight times in individuals from youth (3-18 years in 1980) to adulthood (24-49 years). Adult MHO was defined as BMI ≥ 30 kg m-2, normal fasting glucose (<5.6 mmol l-1), triglycerides (<1.695 mmol l-1), high density lipoprotein cholesterol (≥1.295 mmol l-1 females, ≥1.036 mmol l-1 males), blood pressure (<130/85 mmHg) and no medications for these conditions. BMI trajectories were compared for adults with MHO and MUHO using multilevel mixed models adjusted for age, sex and follow-up time. RESULTS Mean (SD) follow-up time was 29 (3) years. Five hundred and twenty-four participants were obese in adulthood, 66 (12.6%) had MHO. BMI was similar through childhood, adolescence and young adulthood. BMI trajectories diverged at age 33, when individuals with MHO had at least 1.0 kg m-2 lower BMI than those with MUHO, significantly lower at 36 (-2.1 kg m-2, P = 0.001) and 42 years (-1.7 kg m-2; P = 0.005). CONCLUSION Adult MHO was characterized by lower adult BMI, not youth BMI. Preventing additional weight gain among adults who are obese may be beneficial for metabolic health.
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Affiliation(s)
- Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Matthew A Sabin
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute and Royal Children's Hospital, Melbourne, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere, Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine, Tampere University Hospital, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | | | - Eero Jokinen
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
| | - Jorma S A Viikari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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3
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Armstrong MK, Fraser BJ, Hartiala O, Buscot MJ, Juonala M, Wu F, Koskinen J, Hutri-Kähönen N, Kähönen M, Laitinen TP, Lehtimäki T, Viikari JSA, Raitakari OT, Magnussen CG. Association of Non-High-Density Lipoprotein Cholesterol Measured in Adolescence, Young Adulthood, and Mid-Adulthood With Coronary Artery Calcification Measured in Mid-Adulthood. JAMA Cardiol 2021; 6:661-668. [PMID: 33502454 DOI: 10.1001/jamacardio.2020.7238] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is associated with the presence of coronary artery calcification (CAC), a marker of heart disease in adulthood. However, the relative importance of non-HDL-C levels at specific life stages for CAC remains unclear. Objective To identify the relative association of non-HDL-C measured at distinct life stages (adolescence, young adulthood, mid-adulthood) with the presence of CAC measured in mid-adulthood. Design, Setting, and Participants The Cardiovascular Risk in Young Finns Study is a population-based prospective cohort study that started in 1980 with follow-up over 28 years. Participants from 3 population centers (Kuopio, Tampere, and Turku in Finland) represent a convenience sample drawn from the 3 oldest cohorts at baseline (aged 12-18 years in 1980). Data were collected from September 1980 to August 2008. Analysis began February 2020. Exposures Non-HDL-C levels were measured at 3 life stages including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years). Main Outcomes and Measures In 2008, CAC was determined from computed tomography and dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score ≥1) for analysis. Using a bayesian relevant life course exposure model, the relative association was determined between non-HDL-C at each life stage and the presence of CAC in mid-adulthood. Results Of 589 participants, 327 (56%) were female. In a model adjusted for year of birth, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid-lowering and antihypertensive medication use, and family history of heart disease, cumulative exposure to non-HDL-C across all life stages was associated with CAC (odds ratio [OR], 1.50; 95% credible interval [CrI], 1.14-1.92). At each life stage, non-HDL-C was associated with CAC and exposure to non-HDL-C during adolescence had the strongest association (adolescence: OR, 1.16; 95% CrI, 1.01-1.46; young adulthood: OR, 1.14; 95% CrI, 1.01-1.43; mid-adulthood: OR, 1.12; 95% CrI, 1.01-1.34). Conclusions and Relevance These data suggest that elevated non-HDL-C levels at all life stages are associated with coronary atherosclerosis in mid-adulthood. However, adolescent non-HDL-C levels showed the strongest association with the presence of CAC in mid-adulthood, and greater awareness of the importance of elevated non-HDL-C in adolescence is needed.
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Affiliation(s)
- Matthew K Armstrong
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Brooklyn J Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Olli Hartiala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Juha Koskinen
- Heart Center, Kymenlaakso Central Hospital, Kotka, Finland
| | - Nina Hutri-Kähönen
- Tampere University Hospital, Department of Pediatrics, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Tampere University Hospital, Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tomi P Laitinen
- Kuopio University Hospital, Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, Kuopio, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
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4
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Juonala M, Wu F, Sinaiko A, Woo JG, Urbina EM, Jacobs D, Steinberger J, Prineas R, Koskinen J, Sabin MA, Burgner DP, Burns TL, Bazzano L, Venn A, Viikari JS, Hutri-Kähönen N, Daniels SR, Dwyer T, Raitakari OT, Magnussen CG. Non-HDL Cholesterol Levels in Childhood and Carotid Intima-Media Thickness in Adulthood. Pediatrics 2020; 145:peds.2019-2114. [PMID: 32209701 PMCID: PMC7111486 DOI: 10.1542/peds.2019-2114] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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] [Accepted: 12/05/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Elevated non-high-density lipoprotein cholesterol (HDL-C) levels are used to identify children at increased cardiovascular risk, but the use of non-HDL-C in childhood to predict atherosclerosis is unclear. We examined whether the National Heart, Lung, and Blood Institute classification of youth non-HDL-C status predicts high common carotid artery intima-media thickness in adulthood. METHODS We analyzed data from 4 prospective cohorts among 4582 children aged 3 to 19 years who were remeasured as adults (mean follow-up of 26 years). Non-HDL-C status in youth and adulthood was classified according to cut points of the National Heart, Lung, and Blood Institute and the National Cholesterol Education Program Adult Treatment Panel III. High carotid intima-media thickness (cIMT) in adulthood was defined as at or above the study visit-, age-, sex-, race-, and cohort-specific 90th percentile of intima-media thickness. RESULTS In a log-binomial regression analysis adjusted with age at baseline, sex, cohort, length of follow-up, baseline BMI, and systolic blood pressure, children with dyslipidemic non-HDL-C were at increased risk of high cIMT in adulthood (relative risk [RR], 1.29; 95% confidence interval [CI], 1.07-1.55). Compared with the persistent normal group, the persistent dyslipidemia group (RR, 1.80; 95% CI, 1.37-2.37) and incident dyslipidemia (normal to dyslipidemia) groups (RR, 1.45; 95% CI, 1.07-1.96) had increased risk of high cIMT in adulthood, but the risk was attenuated for the resolution (dyslipidemia to normal) group (RR, 1.17; 95% CI, 0.97-1.41). CONCLUSIONS Dyslipidemic non-HDL-C levels predict youth at risk for developing high cIMT in adulthood. Those who resolve their non-HDL-C dyslipidemia by adulthood have normalized risk of developing high cIMT in adulthood.
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Affiliation(s)
- Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, .,Contributed equally as co-first authors
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia;,Contributed equally as co-first authors
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jessica G. Woo
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and College of Medicine, University of Cincinnati and
| | - Elaine M. Urbina
- Division of Cardiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - David Jacobs
- Division of Epidemiology and Community Health, School of Public Health and
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota
| | - Ronald Prineas
- Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston‐Salem, North Carolina
| | - Juha Koskinen
- Heart Center, Kymenlaakso Central Hospital, Kotka, Finland
| | - Matthew A. Sabin
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
| | - David P. Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
| | - Trudy L. Burns
- Department of Pediatrics, University of Melbourne, Parkville, Australia;,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Lydia Bazzano
- Departments of Epidemiology and Biostatistics and Bioinformatics, Tulane University Health Sciences Center, Tulane University, New Orleans, Louisiana
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Jorma S.A. Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Stephen R. Daniels
- Department of Pediatrics, Children’s Hospital Colorado and School of Medicine, University of Colorado, Aurora, Colorado; and
| | - Terence Dwyer
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, and,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Costan G. Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland;,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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5
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Koskinen J, Juonala M, Dwyer T, Venn A, Petkeviciene J, Čeponienė I, Bazzano L, Chen W, Sabin MA, Burns TL, Viikari JSA, Woo JG, Urbina EM, Prineas R, Hutri-Kähönen N, Sinaiko A, Jacobs DR, Steinberger J, Daniels S, Raitakari O, Magnussen CG. Utility of Different Blood Pressure Measurement Components in Childhood to Predict Adult Carotid Intima-Media Thickness. Hypertension 2019; 73:335-341. [PMID: 30580683 DOI: 10.1161/hypertensionaha.118.12225] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Childhood blood pressure (BP) levels predict adult subclinical atherosclerosis. However, the best childhood BP component for prediction has not been determined. This study comprised 5925 participants aged 3 to 18 years from 6 cohorts who were followed into adulthood (mean follow-up 25.8±6.2 years). Childhood BP was measured by using a standard mercury sphygmomanometer in all cohorts. Study-specific carotid intima-media thickness ≥90th percentile was used to define subclinical atherosclerosis. Per SD change in the predictor, childhood systolic BP (SBP; age- and sex-adjusted odds ratio [95% CI], 1.24 [1.13-1.37]), mean arterial pressure (1.10 [1.07-1.13]), and pulse pressure (1.15 [1.05-1.27]) were associated with increased adulthood intima-media thickness. In age- and sex-adjusted analyses, area under the receiver operating characteristic curves for SBP ( C value [95% CI], 0.677 [0.657-0.704]) showed significantly improved prediction compared with diastolic BP (0.669 [0.646-0.693], P=0.006) or mean arterial pressure (0.674 [0.653-0.699], P=0.01). Pulse pressure provided a C value that was not different from SBP (0.676 [0.653-0.699], P=0.16). Combining different BP components did not improve prediction over SBP measurement alone. Based on the associations with adult carotid intima-media thickness, cut points for elevated SBP were 105 mm Hg for 3- to 6-year-old boys, 108 mm Hg for 3- to 6-year-old girls, 108 mm Hg for 7- to 12-year-old boys, 106 mm Hg for 7- to 12-year-old girls, 123 mm Hg for 13- to 18-year-old boys, and 115 mm Hg for 13- to 18-year-old girls. Our analyses suggest that several childhood BP measurement components are related to adulthood carotid intima-media thickness. Of these, SBP provided the best predictive ability.
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Affiliation(s)
- Juha Koskinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.R., C.G.M.), University of Turku, Finland.,Heart Center, Kymenlaakso Central Hospital, Kotka, Finland (J.K.)
| | - Markus Juonala
- Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.,Division of Medicine (M.J., J.S.A.V.), Turku University Hospital, Finland.,Murdoch Childrens Research Institute, Parkville, Victoria, Australia (M.J.)
| | - Terence Dwyer
- George Institute, University of Oxford, United Kingdom (T.D.)
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (A.V., C.G.M.)
| | - Janina Petkeviciene
- Faculty of Public Health, Medical Academy (J.P.), Lithuanian University of Health Sciences, Kaunas
| | - Indrė Čeponienė
- Department of Cardiology, Medical Academy (I.C.), Lithuanian University of Health Sciences, Kaunas
| | - Lydia Bazzano
- Department of Epidemiology and Department Biostatistics and Bioinformatics, Tulane University Health Sciences Center (L.B.), Tulane University, New Orleans, LA
| | - Wei Chen
- Department of Epidemiology, Tulane Center for Cardiovascular Health (W.C.), Tulane University, New Orleans, LA
| | - Matthew A Sabin
- Royal Children's Hospital, Parkville, Australia (M.A.S.).,Department of Pediatrics, University of Melbourne, Parkville, Australia (M.A.S.)
| | - Trudy L Burns
- Department of Epidemiology, College of Public Health, University of Iowa (T.L.B.)
| | - Jorma S A Viikari
- Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.,Division of Medicine (M.J., J.S.A.V.), Turku University Hospital, Finland
| | - Jessica G Woo
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH (J.G.W.)
| | - Elaine M Urbina
- The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (E.M.U.)
| | - Ronald Prineas
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (R.P.)
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland (N.H.-K.)
| | - Alan Sinaiko
- Department of Pediatrics (A.S.), University of Minnesota, Minneapolis
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health (D.R.J.), University of Minnesota, Minneapolis
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital (J.S.)
| | - Stephen Daniels
- Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora (S.D.)
| | - Olli Raitakari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.R., C.G.M.), University of Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Turku (O.R.), Turku University Hospital, Finland
| | - Costan G Magnussen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.R., C.G.M.), University of Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (A.V., C.G.M.)
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6
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Cuthbertson DJ, Brown E, Koskinen J, Magnussen CG, Hutri-Kähönen N, Sabin M, Tossavainen P, Jokinen E, Laitinen T, Viikari J, Raitakari OT, Juonala M. Longitudinal analysis of risk of non-alcoholic fatty liver disease in adulthood. Liver Int 2019; 39:1147-1154. [PMID: 30347485 DOI: 10.1111/liv.13993] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 06/28/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS We aimed to determine how childhood body mass index and metabolic health, along with the change in body mass index between childhood and adulthood, determine the risk of adult non-alcoholic fatty liver disease. METHODS Data from 2020 participants aged 3-18 years at baseline, followed up 31 years later, were examined to assess the utility of four childhood metabolic phenotypes (Metabolic Groups I: normal body mass index, no metabolic disturbances; II: normal body mass index, one or more metabolic disturbances; III: overweight/obese, no metabolic disturbances; IV: overweight/obese, one or more metabolic disturbances) and four life-course adiposity phenotypes (Adiposity Group 1: normal child and adult body mass index; 2, high child, normal adult body mass index; 3, normal child body mass index, high adult body mass index; 4, high child and adult body mass index) in predicting adult non-alcoholic fatty liver disease. RESULTS The risk for adult non-alcoholic fatty liver disease was similar across all four groups after adjustment for age, sex, lifestyle factors and adult body mass index. Risk of adult non-alcoholic fatty liver disease was not increased among individuals overweight/obese in childhood but non-obese in adulthood. In contrast, overweight or obese adults, irrespective of their youth body mass index status, had ~eight-fold to 10-fold increased risk (P < 0.001). CONCLUSIONS Childhood overweight/obesity, not metabolic health, is associated with increased risk for adult non-alcoholic fatty liver disease. However, the increased risk associated with childhood overweight/obesity can be largely removed by obtaining a normal body mass index by adulthood.
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Affiliation(s)
- Daniel J Cuthbertson
- Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Emily Brown
- Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Heart Center, Kymenlaakson keskussairaala, Kotka, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Matthew Sabin
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
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Koskinen J, Juonala M, Dwyer T, Venn A, Thomson R, Bazzano L, Berenson GS, Sabin MA, Burns TL, Viikari JSA, Woo JG, Urbina EM, Prineas R, Hutri-Kähönen N, Sinaiko A, Jacobs D, Steinberger J, Daniels S, Raitakari OT, Magnussen CG. Impact of Lipid Measurements in Youth in Addition to Conventional Clinic-Based Risk Factors on Predicting Preclinical Atherosclerosis in Adulthood: International Childhood Cardiovascular Cohort Consortium. Circulation 2017; 137:1246-1255. [PMID: 29170152 DOI: 10.1161/circulationaha.117.029726] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [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: 05/29/2017] [Accepted: 11/03/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Data suggest that the prediction of adult cardiovascular disease using a model comprised entirely of adult nonlaboratory-based risk factors is equivalent to an approach that additionally incorporates adult lipid measures. We assessed and compared the utility of a risk model based solely on nonlaboratory risk factors in adolescence versus a lipid model based on nonlaboratory risk factors plus lipids for predicting high-risk carotid intima-media thickness (cIMT) in adulthood. METHODS The study comprised 2893 participants 12 to 18 years of age from 4 longitudinal cohort studies from the United States (Bogalusa Heart Study and the Insulin Study), Australia (Childhood Determinants of Adult Health Study), and Finland (The Cardiovascular Risk in Young Finns Study) and followed into adulthood when cIMT was measured (mean follow-up, 23.4 years). Overweight status was defined according to the Cole classification. Hypertension was defined according to the Fourth Report on High Blood Pressure in Children and Adolescents from the National High Blood Pressure Education Program. High-risk plasma lipid levels were defined according to the National Cholesterol Education Program Expert Panel on Cholesterol Levels in Children. High cIMT was defined as a study-specific value ≥90th percentile. Age and sex were included in each model. RESULTS In univariate models, all risk factors except for borderline high and high triglycerides in adolescence were associated with high cIMT in adulthood. In multivariable models (relative risk [95% confidence interval]), male sex (2.7 [2.0-2.6]), prehypertension (1.4 [1.0-1.9]), hypertension (1.9 [1.3-2.9]), overweight (2.0 [1.4-2.9]), obesity (3.7 [2.0-7.0]), borderline high low-density lipoprotein cholesterol (1.6 [1.2-2.2]), high low-density lipoprotein cholesterol (1.6 [1.1-2.1]), and borderline low high-density lipoprotein cholesterol (1.4 [1.0-1.8]) remained significant predictors of high cIMT (P<0.05). The addition of lipids into the nonlaboratory risk model slightly but significantly improved discrimination in predicting high cIMT compared with nonlaboratory-based risk factors only (C statistics for laboratory-based model 0.717 [95% confidence interval, 0.685-0.748] and for nonlaboratory 0.698 [95% confidence interval, 0.667-0.731]; P=0.02). CONCLUSIONS Nonlaboratory-based risk factors and lipids measured in adolescence independently predicted preclinical atherosclerosis in young adulthood. The addition of lipid measurements to traditional clinic-based risk factor assessment provided a statistically significant but clinically modest improvement on adolescent prediction of high cIMT in adulthood.
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Affiliation(s)
- Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) .,Heart Center (J.K.)
| | - Markus Juonala
- Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.,Division of Medicine (M.J., J.S.A.V.)
| | - Terence Dwyer
- George Institute, University of Oxford, United Kingdom (T.D.).,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (T.D., A.V., C.G.M.)
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (T.D., A.V., C.G.M.)
| | - Russell Thomson
- Centre for Research in Mathematics, School of Computing, Engineering and Mathematics, Western Sydney University, Australia (R.T.)
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.B., G.S.B.)
| | - Gerald S Berenson
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.B., G.S.B.)
| | - Matthew A Sabin
- Murdoch Children's Research Institute, The Royal Children's Hospital and University of Melbourne, Australia (M.A.S.)
| | - Trudy L Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.)
| | - Jorma S A Viikari
- Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.,Division of Medicine (M.J., J.S.A.V.)
| | - Jessica G Woo
- Department of Pediatrics, Division of Biostatistics and Epidemiology (J.G.W.).,Department of Medicine, University of Cincinnati, OH (J.G.W.)
| | - Elaine M Urbina
- Department of Pediatrics, Division of Cardiology (E.M.U.), Cincinnati Children's Hospital Medical Center and University of Cincinnati, OH
| | - Ronald Prineas
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (R.P.)
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland (N.H.-K.)
| | | | - David Jacobs
- Division of Epidemiology and Community Health (D.J.), University of Minnesota, Minneapolis
| | | | - Stephen Daniels
- Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora (S.D.)
| | - Olli T Raitakari
- Research Center of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.).,Department of Clinical Physiology (O.T.R.), Turku University Hospital, Finland
| | - Costan G Magnussen
- Research Center of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.).,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (T.D., A.V., C.G.M.)
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8
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Koskinen J, Magnussen CG, Sinaiko A, Woo J, Urbina E, Jacobs DR, Steinberger J, Prineas R, Sabin MA, Burns T, Berenson G, Bazzano L, Venn A, Viikari JSA, Hutri-Kähönen N, Raitakari O, Dwyer T, Juonala M. Childhood Age and Associations Between Childhood Metabolic Syndrome and Adult Risk for Metabolic Syndrome, Type 2 Diabetes Mellitus and Carotid Intima Media Thickness: The International Childhood Cardiovascular Cohort Consortium. J Am Heart Assoc 2017; 6:JAHA.117.005632. [PMID: 28862940 PMCID: PMC5586423 DOI: 10.1161/jaha.117.005632] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background There is paucity of knowledge concerning the specific age in youth when the associations of metabolic syndrome (MetS) begin to be operative. Thus, we investigated the relation of age to the associations of childhood MetS with adult MetS, type 2 diabetes mellitus and high carotid intima‐media thickness. Methods and Results Five thousand eight‐hundred three participants were analyzed in 4 cohort studies (Cardiovascular Risk in Young Finns, Bogalusa Heart Study, Princeton Lipid Research Study, Insulin Study). International cutoffs and previously used 75th percentile cutoffs were used for children to define MetS and its components. Mean follow‐up period was 22.3 years. Logistic regression was used to calculate risk ratios and 95% confidence intervals. Childhood MetS and overweight were associated with over 2.4‐fold risk for adult MetS from the age of 5 years onward. Risk for type 2 diabetes mellitus was increased from the age of 8 (risk ratio, 2.6–4.1; 95% confidence interval, 1.35–6.76 and 1.12–7.24, respectively) onward for the 2 childhood MetS criteria based on international cut‐off values and for childhood overweight. Risk for high carotid intima‐media thickness was significant at ages 11 to 18 years in relation to childhood MetS or overweight (risk ratio, 2.44–4.22; 95% confidence interval, 1.55–3.55 and 2.55–5.66, respectively). Continuous childhood MetS score was associated with adult MetS from the age of 5, with type 2 diabetes mellitus from the age of 14 and with high carotid intima‐media thickness from the age of 11 years onward. Conclusions Adult MetS was predicted by MetS in childhood beginning at age 5. However, adult type 2 diabetes mellitus and subclinical atherosclerosis were not predicted by childhood data until after age 8. Body mass index measurement alone at the same age points provided similar findings.
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Affiliation(s)
- Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland .,Heart Center, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Jessica Woo
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Elaine Urbina
- Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | - Ronald Prineas
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Trudy Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Gerald Berenson
- Department of Epidemiology, Tulane Center for Cardiovascular Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Lydia Bazzano
- Departments of Epidemiology and Biostatistics and Bioinformatics, Tulane University Health Sciences Center, Tulane University, New Orleans, LA
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Olli Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Terence Dwyer
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
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9
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Magnussen CG, Cheriyan S, Sabin MA, Juonala M, Koskinen J, Thomson R, Skilton MR, Kähönen M, Laitinen T, Taittonen L, Hutri-Kähönen N, Viikari JSA, Raitakari OT. Continuous and Dichotomous Metabolic Syndrome Definitions in Youth Predict Adult Type 2 Diabetes and Carotid Artery Intima Media Thickness: The Cardiovascular Risk in Young Finns Study. J Pediatr 2016; 171:97-103.e1-3. [PMID: 26681473 DOI: 10.1016/j.jpeds.2015.10.093] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [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] [Received: 05/19/2015] [Revised: 10/02/2015] [Accepted: 10/29/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To examine the utility of continuous metabolic syndrome (cMetS) scores vs a dichotomous metabolic syndrome (MetS) definition in youth to predict adult type 2 diabetes mellitus (T2DM) and carotid intima-media thickness (IMT). STUDY DESIGN Participants (n = 1453) from the population-based, prospective, observational Cardiovascular Risk in Young Finns Study who were examined in youth (when aged 9-18 years) and re-examined 15-25 years later. Four cMetS scores were constructed according to procedures most often used in the literature that comprised the youth risk factor inputs of body mass index, blood pressure, glucose, insulin, high-density lipoprotein-cholesterol, and triglycerides. Adult outcomes included T2DM and high carotid IMT (≥ 90 th percentile). RESULTS For a 1 SD increase in cMetS scores in youth, participants had a 30%-78% increased risk of T2DM and 12%-61% increased risk of high carotid IMT. Prediction of adult T2DM and high carotid IMT using cMetS scores in youth was essentially no different to a dichotomous MetS definition with area under the receiver-operating characteristic curve ranging from 0.54-0.60 (continuous definitions) and 0.55-0.59 (dichotomous) with 95% CIs often including 0.5, and integrated discrimination improvement from -0.2% to -0.6%. CONCLUSIONS cMetS scores in youth are predictive of cardiometabolic outcomes in adulthood. However, they do not have increased predictive utility over a dichotomous definition of MetS.
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Affiliation(s)
- Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Sanith Cheriyan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia; Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia; Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Russell Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Michael R Skilton
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Leena Taittonen
- Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
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10
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Juonala M, Sabin MA, Burgner D, Cheung M, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Jokinen E, Koskinen J, Tossavainen P, Laitinen T, Viikari JSA, Raitakari OT, Magnussen CG. Increased Body Mass Index in Parent-Child Dyads Predicts the Offspring Risk of Meeting Bariatric Surgery Criteria. J Clin Endocrinol Metab 2015; 100:4257-63. [PMID: 26312579 DOI: 10.1210/jc.2015-2524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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] [Indexed: 11/19/2022]
Abstract
CONTEXT Obesity in children is a major public health concern. OBJECTIVE This study examined the value of using parent-child dyads' adiposity status for predicting the individual's later eligibility for bariatric surgery (EBS). DESIGN, SETTING, AND PARTICIPANTS The cohort consisted of 2647 individuals from the longitudinal Cardiovascular Risk in Young Finns Study. Baseline information included own and parental body mass index (BMI) in 1980 (children aged 3-18 years), whereas adult follow-up assessment examined EBS 21-31 years later. MAIN OUTCOME MEASURE EBS in adulthood was defined as: 1) BMI greater than 40 kg/m(2) or 2) BMI greater than 35 kg/m(2) with at least one of the following metabolic complications: type 2 diabetes, hypertension, or dyslipidemia. RESULTS Addition of parents' BMI improved the prediction of adulthood EBS compared to the model including child's BMI, age, and sex (area under the curve values [95% confidence interval] (0.80 [0.74-0.85] vs 0.74 [0.68-0.81], P = .003). Obese children with an obese parent had a 21.2% chance of being EBS in adulthood. Compared to nonobese families, the risk ratio for EBS was 14.2 (95% confidence interval 8.0-25.2, P < .001) in obese children with an obese parent. The absolute risk of EBS was 30.9% if both child and parent were obese on more than one childhood assessment compared to 15.2% if they were obese only once, or 2.1% if they were never obese (P < .05). CONCLUSIONS These longitudinal data show that a combination of the child's and parents' BMI at baseline assessment is a useful predictive tool for assessing later EBS, and highlights the importance of accounting for parental BMI in the assessment of child obesity.
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Affiliation(s)
- Markus Juonala
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Matthew A Sabin
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - David Burgner
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Michael Cheung
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Mika Kähönen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Nina Hutri-Kähönen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Terho Lehtimäki
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Eero Jokinen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Juha Koskinen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Päivi Tossavainen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Tomi Laitinen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Jorma S A Viikari
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Olli T Raitakari
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Costan G Magnussen
- Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia
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Protopopova VS, Wester N, Caro MA, Gabdullin PG, Palomäki T, Laurila T, Koskinen J. Ultrathin undoped tetrahedral amorphous carbon films: thickness dependence of the electronic structure and implications for their electrochemical behaviour. Phys Chem Chem Phys 2015; 17:9020-31. [PMID: 25751653 DOI: 10.1039/c4cp05855k] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In this paper we show that the electronic properties of ultrathin tetrahedral amorphous carbon (ta-C) films are heavily dependent on their thickness. By using scanning tunnelling spectroscopy, Raman spectroscopy, and conductive atomic force microscopy, it was found that a decrease of ta-C thickness from 30 to 7 nm leads to (i) the narrowing of the band gap; (ii) appearance of shallower monoenergetic traps as well as the increase of their concentration; (iii) the increase of the equilibrium concentration of free charge carriers and their mobility; which were caused by (iv) the increase in the sp(2) fraction. However, beyond a certain ta-C thickness (7 nm) the electronic properties of the studied samples start to deteriorate, which is highly likely related to titanium oxide formation at the Ti/ta-C interface. The same tendency is observed for the sample with beforehand air-formed native titanium oxide at the interface. With respect to the last point, it is suggested that the ta-C layer has no uniform coverage if its thickness is small enough (less than 7 nm). The experimental results were rationalized by detailed atomistic simulations. By using the so-called "Tauc plot" we introduce the possibility of the coexistence of bulk and surface band gaps originating from the large increase in sp(2) bonded carbon atoms in the surface region compared to that in the bulk ta-C. The results from the simulations were found to be consistent with the experimental measurements. The previously stated variation in the electronic properties of the layers as a function of their thickness was also exhibited in the electrochemical properties of the samples. It appears that the thinner ta-C layers had more facile electron transfer kinetics as determined with a ferrocenemethanol (FcMeOH) outer sphere redox system. However, if the ta-C layer thickness was reduced too much, the films were not stable anymore.
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Affiliation(s)
- V S Protopopova
- Dept. of Materials Science and Engineering, School of Chemical Technology, Aalto University, P.O. Box 16200, FI-00076 Aalto, Espoo, Finland.
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12
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Sabin MA, Magnussen CG, Juonala M, Shield JPH, Kähönen M, Lehtimäki T, Rönnemaa T, Koskinen J, Loo BM, Knip M, Hutri-Kähönen N, Viikari JSA, Dwyer T, Raitakari OT. Insulin and BMI as predictors of adult type 2 diabetes mellitus. Pediatrics 2015; 135:e144-51. [PMID: 25535261 DOI: 10.1542/peds.2014-1534] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Fasting insulin concentrations are increasingly being used as a surrogate for insulin resistance and risk for type 2 diabetes (T2DM), although associations with adult outcomes are unclear. Our objective was to determine whether fasting insulin concentrations in childhood associate with later T2DM. METHODS Fasting insulin values were available from 2478 participants in the longitudinal Cardiovascular Risk in Young Finns Study at baseline age 3 to 18 years, along with data on adult T2DM (N = 84, mean age = 39.6 years). RESULTS Among 3- to 6-year-olds, a 1-SD increase in fasting insulin was associated with a relative risk (RR) of 2.04 (95% confidence interval [CI], 1.54-2.70) for later T2DM, which remained significant after we adjusted for BMI and parental history of T2DM. For those aged 9 to 18 years, a 1-SD increase in insulin was associated with an RR of 1.32 (95% CI, 1.06-1.65) for T2DM, but this became nonsignificant after we adjusted for BMI and parental history of T2DM. In the latter age group, a 1-SD increase in BMI was associated with an RR of 1.45 (95% CI, 1.21-1.73) for T2DM, with adjustment for insulin and parental history of T2DM not improving this association. BMI in younger children was not associated with later T2DM. In life course analyses, those with T2DM had higher fasting insulin levels in early childhood and later adulthood but not in peripubertal years. CONCLUSIONS Elevated fasting insulin concentrations in early childhood, but not adolescence, are independently associated with an elevated risk of T2DM in adulthood.
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Affiliation(s)
- Matthew A Sabin
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Australia;
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Julian P H Shield
- National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, University of Bristol and Royal Hospital for Children, Bristol, United Kingdom
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Finlab Laboratories, University of Tampere School of Medicine, Tampere, Finland
| | - Tapani Rönnemaa
- Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, and
| | - Britt-Marie Loo
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Population Studies Unit, Turku, Finland; and
| | - Mikael Knip
- Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Nina Hutri-Kähönen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Jorma S A Viikari
- Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Terence Dwyer
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Australia
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Departments of Clinical Physiology and Nuclear Medicine, and
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13
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Koskinen J, Magnussen CG, Sabin MA, Kähönen M, Hutri-Kähönen N, Laitinen T, Taittonen L, Jokinen E, Lehtimäki T, Viikari JSA, Raitakari OT, Juonala M. Youth overweight and metabolic disturbances in predicting carotid intima-media thickness, type 2 diabetes, and metabolic syndrome in adulthood: the Cardiovascular Risk in Young Finns study. Diabetes Care 2014; 37:1870-7. [PMID: 24742659 DOI: 10.2337/dc14-0008] [Citation(s) in RCA: 49] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our objective was to assess cardiovascular risk and metabolic complications in adulthood in subjects with or without overweight and metabolic disturbances (i.e., elevated blood pressure, glucose, triglycerides, low HDL cholesterol, and high LDL cholesterol) and their combinations as youth. RESEARCH DESIGN AND METHODS Using data from the population-based Cardiovascular Risk in Young Finns study, we examined the utility of four age- and sex-specific youth phenotypes (group I: normal weight, no metabolic disturbances; group II: normal weight, one or more metabolic disturbances; group III: overweight/obese, no metabolic disturbances; group IV: overweight/obese, one or more metabolic disturbances) in predicting adult high carotid intima-media thickness (IMT), type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS). The study included 1,617 participants 9-24 years of age at baseline who were followed up 21-25 years later. RESULTS IMT (mean ± SEM) was higher among participants in groups II (0.627 ± 0.005 mm, P = 0.05), III (0.647 ± 0.010 mm, P = 0.005), and IV (0.670 ± 0.010 mm, P < 0.0001) compared with group I (0.616 ± 0.003 mm). In addition, subjects in group IV had significantly higher IMT compared with those in group II (P = 0.002). Participants in groups II, III, and IV were at increased risk of the development of MetS in adulthood compared with those in the control group. For group II participants, the difference was attenuated after risk factor adjustments. Additionally, participants in group III and IV were at increased risk of the development of T2DM compared with those in groups I and II. CONCLUSIONS While metabolic risk factors associated with overweight increase future risk for MetS, T2DM, and increased IMT, overweight in isolation is also a risk factor. Therefore, overweight should be prevented and treated wherever possible.
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Affiliation(s)
- Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, FinlandDepartment of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, FinlandMenzies Research Institute Tasmania, Hobart, Tasmania, Australia
| | - Matthew A Sabin
- The Royal Children's Hospital, Murdoch Childrens Research Institute, and University of Melbourne, Melbourne, Victoria, Australia
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Leena Taittonen
- Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland
| | - Eero Jokinen
- Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital and Tampere University School of Medicine, Tampere, Finland
| | - Jorma S A Viikari
- Division of Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Division of Medicine, University of Turku and Turku University Hospital, Turku, Finland
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Lyytinen J, Berdova M, Hirvonen P, Liu XW, Franssila S, Zhou Q, Koskinen J. Interfacial mechanical testing of atomic layer deposited TiO2 and Al2O3 on a silicon substrate by the use of embedded SiO2 microspheres. RSC Adv 2014. [DOI: 10.1039/c4ra05807k] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel measurement technique is presented for interfacial mechanical evaluation of especially atomic layer deposited (ALD) thin films.
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Affiliation(s)
- J. Lyytinen
- Aalto University
- Department of Materials Science and Engineering
- Espoo, Finland
| | - M. Berdova
- Aalto University
- Department of Materials Science and Engineering
- Espoo, Finland
- Aalto University
- Micronova Nanofabrication Center
| | - P. Hirvonen
- Aalto University
- Department of Materials Science and Engineering
- Espoo, Finland
| | - X. W. Liu
- Aalto University
- Department of Materials Science and Engineering
- Espoo, Finland
| | - S. Franssila
- Aalto University
- Department of Materials Science and Engineering
- Espoo, Finland
- Aalto University
- Micronova Nanofabrication Center
| | - Q. Zhou
- Aalto University
- Department of Electrical Engineering and Automation
- Espoo, Finland
| | - J. Koskinen
- Aalto University
- Department of Materials Science and Engineering
- Espoo, Finland
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Magnussen CG, Koskinen J, Juonala M, Chen W, Srinivasan SR, Sabin MA, Thomson R, Schmidt MD, Nguyen QM, Xu JH, Skilton MR, Kähönen M, Laitinen T, Taittonen L, Lehtimäki T, Rönnemaa T, Viikari JS, Berenson GS, Raitakari OT. A Diagnosis of the Metabolic Syndrome in Youth That Resolves by Adult Life Is Associated With a Normalization of High Carotid Intima-Media Thickness and Type 2 Diabetes Mellitus Risk. J Am Coll Cardiol 2012; 60:1631-9. [DOI: 10.1016/j.jacc.2012.05.056] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 04/16/2012] [Accepted: 05/11/2012] [Indexed: 10/27/2022]
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Koskinen J, Magnussen CG, Kähönen M, Loo BM, Marniemi J, Jula A, Saarikoski LA, Huupponen R, Viikari JSA, Raitakari OT, Juonala M. Association of liver enzymes with metabolic syndrome and carotid atherosclerosis in young adults. The Cardiovascular Risk in Young Finns Study. Ann Med 2012; 44:187-95. [PMID: 21254896 DOI: 10.3109/07853890.2010.532152] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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: 02/06/2023] Open
Abstract
OBJECTIVE We examined whether metabolic syndrome (MetS) predicts increased alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) levels in young adults, whether spontaneous recovery from MetS has a favorable effect on liver enzyme activities, and whether these enzymes contribute to the atherogenicity of MetS (assessed by carotid intima-media thickness (IMT)). METHODS The study included 1,553 subjects (base-line age 31.5 ± 5.0 years). ALT and GGT were measured in 2007. MetS was diagnosed by the new Joint Interim Societies definition. RESULTS ALT and GGT levels were higher in subjects with MetS compared to those without in 2007. The association was independent of alcohol intake and BMI. In multivariable models adjusted for base-line age, LDL cholesterol, CRP, alcohol intake, and adiponectin, MetS in 2001 predicted increased ALT (β ± SEM = 0.320 ± 0.062, P < 0.0001 in men; 0.134 ± 0.059, P = 0.02 in women) and GGT (β ± SEM = 0.222 ± 0.067, P < 0.0001 in men; 0.236 ± 0.060, P < 0.0001 in women) levels after 6 years. Subjects with MetS only at base-line (2001) had lower ALT levels after 6 years compared to subjects with persistent and incident MetS. No statistically significant interaction for MetS*ALT (P = 0.81) or MetS*GGT (P = 0.92) on IMT was observed. CONCLUSION In young adults MetS may induce liver enzyme changes that indicate increased risk of non-alcoholic fatty liver disease, but we found no evidence that increased enzyme levels would amplify the atherogenicity of MetS.
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Affiliation(s)
- Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku, Finland.
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Koskinen J, Magnussen CG, Würtz P, Soininen P, Kangas AJ, Viikari JSA, Kähönen M, Loo BM, Jula A, Ahotupa M, Lehtimäki T, Ala-Korpela M, Juonala M, Raitakari OT. Apolipoprotein B, oxidized low-density lipoprotein, and LDL particle size in predicting the incidence of metabolic syndrome: the Cardiovascular Risk in Young Finns study. Eur J Prev Cardiol 2011; 19:1296-303. [DOI: 10.1177/1741826711425343] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [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: 11/17/2022]
Affiliation(s)
| | | | | | - Pasi Soininen
- University of Oulu, Oulu, Finland
- University of Eastern Finland, Kuopio, Finland
| | | | | | - Mika Kähönen
- University of Tampere and Tampere University Hospital, Tampere, Finland
| | | | - Antti Jula
- National Institute for Health and Welfare, Turku, Finland
| | | | - Terho Lehtimäki
- University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Mika Ala-Korpela
- University of Oulu, Oulu, Finland
- University of Eastern Finland, Kuopio, Finland
| | - Markus Juonala
- University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
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Juonala M, Saarikoski LA, Viikari JS, Oikonen M, Lehtimäki T, Lyytikäinen LP, Huupponen R, Magnussen CG, Koskinen J, Laitinen T, Taittonen L, Kähönen M, Kivimäki M, Raitakari OT. A longitudinal analysis on associations of adiponectin levels with metabolic syndrome and carotid artery intima-media thickness. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2011; 217:234-9. [DOI: 10.1016/j.atherosclerosis.2011.03.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/03/2011] [Accepted: 03/12/2011] [Indexed: 11/28/2022]
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Abstract
AbstractAmorphous LPCVD and PECVD Si3N4films have been patterned into fibers of various shapes using integrated circuit methods. A tensile test apparatus was developed which allows a simultaneous testing of up to 20 fibers. The average tensile strength of LPCVD Si3N4fibers with a 30 μm gauge section was 7.0 ± 0.4 GPa. The corresponding value for PECVD Si3N4was 2.4 ± 0.2 GPa. The following properties of the materials were measured: atomic composition (RBS, FRES), density, refractive index, internal stress, elastic modulus and micro hardness. A Weibull analysis of the tensile strength values was performed.
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Walter K, Kung H, Levine T, Tesmer J, Kodali P, Wood B, Rej D, Nastasi M, Koskinen J, Hirvonen JP. Characterization and Performance of Carbon Films Deposited by Plasma and Ion Beam Based Techniques. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-354-87] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractPlasma and ion beam based techniques have been used to deposit carbon-based films. The ion beam based method, a cathodic arc process, used a magnetically mass analyzed beam and is inherently a line-of-sight process. Two hydrocarbon plasma-based, non-line-of-sight techniques were also used and have the advantage of being capable of coating complicated geometries. The self-bias technique can produce hard carbon films, but is dependent on rf power and the surface area of the target. The pulsed-bias technique can also produce hard carbon films but has the additional advantage of being independent of rf power and target surface area. Tribological results indicated the coefficient of friction is nearly the same for carbon films from each deposition process, but the wear rate of the cathodic arc film was five times less than for the self-bias or pulsed-bias films. Although the cathodic arc film was the hardest, contained the highest fraction of sp3 bonds and exhibited the lowest wear rate, the cathodic arc film also produced the highest wear on the 440C stainless steel counterface during tribological testing. Thus, for tribological applications requiring low wear rates for both counterfaces, coating one surface with a very hard, wear resistant film may detrimentally affect the tribological behavior of the counterface.
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Hirvonen JP, Lappalainen R, Koskinen J, Likonen J, Pekkarinen M. Wear and Friction of Unio Crassus Shell in Dry Sliding Contact with Steel. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-330-133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTBiological materials such as shells possess a useful combination of mechanical properties. For instance, good fracture toughness combined with a relatively high hardness has been reported. The response of these properties to a tribological performance could presumably be very beneficial. Unfortunately no such research has been reported, although this kind of information is invaluable in possible utilization of biomimetic or biological processes in producing of materials.In this work chemical composition of Unio Crassus shells were characterized using secondary ion mass spectroscopy (SIMS) and Rutherford backscattering spectroscopy (RBS) and the microstructure was determined with X-ray diffraction (XRD) and scanning electron microscopy (SEM). Specimens of 20×10 mm in size with a thickness of a few millimetres were cut and mechanically polished followed by ultrasonic cleaning in deionized water. Wear and friction measurements were performed in a pin-on-disc tester with a hardened steel pin 6 mm in diameter as a counter face. Tests were carried out in a relative humidity of 50 % at room temperature with a sliding speed of 15 mm/s. The measurements indicate a friction coefficient of 0.3 – 0.4 which is reasonable low. Moreover, wear resistance was found to be excellent. The wear resistance of the material was similar to those of the best synthetic diamond-like carbon films. The storage of the specimen at room temperature for 150 days deteriorated the material resulting in much worse tribological properties.
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Magnussen CG, Koskinen J, Chen W, Thomson R, Schmidt MD, Srinivasan SR, Kivimäki M, Mattsson N, Kähönen M, Laitinen T, Taittonen L, Rönnemaa T, Viikari JSA, Berenson GS, Juonala M, Raitakari OT. Pediatric metabolic syndrome predicts adulthood metabolic syndrome, subclinical atherosclerosis, and type 2 diabetes mellitus but is no better than body mass index alone: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. Circulation 2010; 122:1604-11. [PMID: 20921439 DOI: 10.1161/circulationaha.110.940809] [Citation(s) in RCA: 210] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The clinical utility of identifying pediatric metabolic syndrome (MetS) is controversial. This study sought to determine the status of pediatric MetS as a risk factor for adult subclinical atherosclerosis (carotid intima-media thickness [cIMT]) and type 2 diabetes mellitus (T2DM) and compare and contrast this prediction with its individual components. METHODS AND RESULTS Using data from the population-based, prospective, observational Bogalusa Heart and Cardiovascular Risk in Young Finns studies, we examined the utility of 4 categorical definitions of youth MetS and their components in predicting adult high cIMT and T2DM among 1781 participants aged 9 to 18 years at baseline (1984 to 1988) who were then examined 14 to 27 years later (2001-2007) when aged 24 to 41 years. Youth with MetS were at 2 to 3 times the risk of having high cIMT and T2DM as adults compared with those free of MetS at youth. Risk estimates with the use of high body mass index were similar to those of MetS phenotypes in predicting adult outcomes. Comparisons of area under the receiver operating characteristic curve and net reclassification index suggested that prediction of adult MetS, high cIMT, and T2DM in adulthood with the use of youth MetS was either equivalent or inferior to classification based on high body mass index or overweight and obesity. CONCLUSIONS Youth with MetS are at increased risk of meaningful adult outcomes; however, the simplicity of screening for high BMI or overweight and obesity in the pediatric setting offers a simpler, equally accurate alternative to identifying youth at risk of developing adult MetS, high cIMT, or T2DM.
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Affiliation(s)
- Costan G Magnussen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku, Finland.
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Magnussen C, Koskinen J, Juonala M, Srinivasan S, Viikari J, Berenson G, Raitakari O. P179 PEDIATRIC METABOLIC SYNDROME IN PREDICTING METABOLIC SYNDROME, HIGH CAROTID INTIMA-MEDIA THICKNESS, AND TYPE II DIABETES MELLITUS IN ADULTHOOD. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70246-4] [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: 11/15/2022]
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Koskinen J, Magnussen CG, Taittonen L, Räsänen L, Mikkilä V, Laitinen T, Rönnemaa T, Kähönen M, Viikari JSA, Raitakari OT, Juonala M. Arterial structure and function after recovery from the metabolic syndrome: the cardiovascular risk in Young Finns Study. Circulation 2010; 121:392-400. [PMID: 20065161 DOI: 10.1161/circulationaha.109.894584] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The reversibility of ultrasonographic vascular changes associated with the metabolic syndrome (MetS) recovery is unknown. We examined whether spontaneous recovery from MetS (according to the International Diabetes Federation definition) has a favorable effect on vascular properties and evaluated the associations between lifestyle factors and MetS recovery. METHODS AND RESULTS We measured carotid artery intima-media thickness, distensibility, and brachial flow-mediated dilatation by ultrasound in 1673 subjects of the Young Finns Study cohort (age, 31.5+/-5.0 years in 2001) who participated in follow-up studies in 2001 and 2007. At baseline, no differences in intima-media thickness, carotid artery distensibility, or flow-mediated dilatation were observed between the recovery group (baseline-only MetS) and those with incident (only at follow-up) or persistent (both at baseline and follow-up) MetS. After 6 years, the recovery group had smaller intima-media thickness (mean+/-SEM, 0.62+/-0.01 versus 0.68+/-0.01 mm; P=0.0009) and higher carotid artery distensibility (1.98+/-0.07%/mm Hg versus 1.56+/-0.04%/mm Hg; P=0.001) compared with the persistent group and higher flow-mediated dilatation compared with the control group (9.91+/-0.51% versus 8.57+/-0.12%; P=0.03). The recovery group had reduced intima-media thickness progression compared with the persistent group (0.036+/-0.005 versus 0.079+/-0.010 mm; P=0.001) and reduced carotid artery distensibility change compared with the incident group (-0.12+/-0.05%/mm Hg versus -0.38+/-0.10%/mm Hg; P=0.03) over the 6-year follow-up. Differences in carotid artery distensibility levels were attenuated (P=0.11) after the inclusion of weight change in the models. MetS recovery was paralleled with significant reductions in waist circumference that independently correlated with increased physical activity and increased attention paid to health habits during the follow-up. CONCLUSIONS Recovery from the MetS was associated with positive effects on vascular properties during a 6-year follow-up period of young adults.
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Affiliation(s)
- Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Finland.
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Abstract
OBJECTIVE Our aim was to present recent studies of alcohol use disorders (AUDs) in patients with schizophrenia, estimate overall prevalence and characteristics affecting the prevalence of AUDs. METHOD We conducted a search using three literature databases and a manual search on articles published in 1996-2008. Meta-regression was used to study how prevalence is affected by different study characteristics. Articles that reported diagnoses according to DSM or ICD diagnostic systems were included. RESULTS Altogether 60 studies met our criteria. The median of current AUD prevalence was 9.4% (inter-quartile range, IQR 4.6-19.0, 18 studies) and median of lifetime AUD prevalence 20.6% (IQR 12.0-34.5, 47 studies). In studies using DSM-III-R median prevalence was higher than that in studies using DSM-IV, ICD-9 or ICD-10 (32/17/11/6%). CONCLUSION Approximately every fifth patient with schizophrenia had lifetime AUD diagnosis. When contrasted with the most recent review, there might be a descending trend in AUD prevalence in patients with schizophrenia.
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Affiliation(s)
- J Koskinen
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland.
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Koskinen J, Kähönen M, Viikari JSA, Taittonen L, Laitinen T, Rönnemaa T, Lehtimäki T, Hutri-Kähönen N, Pietikäinen M, Jokinen E, Helenius H, Mattsson N, Raitakari OT, Juonala M. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation 2009; 120:229-36. [PMID: 19581494 DOI: 10.1161/circulationaha.108.845065] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conventional risk factors and metabolic syndrome (MetS) are cross-sectionally associated with subclinical atherosclerosis in young adults. We evaluated the relations of conventional risk factors and MetS to the 6-year progression of carotid intima-media thickness (IMT) in a population of young adults. RESULTS AND METHODS The study included 1809 subjects (aged 32+/-5 years) who had IMT measured in 2001 and 2007. Risk factor measurements included low-density lipoprotein cholesterol, body mass index, C-reactive protein, smoking, and family history of coronary disease in addition to MetS components. We used European Group for the Study of Insulin Resistance, revised National Cholesterol Education Program, and International Diabetes Federation definitions to diagnose MetS in 2001. Waist circumference (P<0.0001), low-density lipoprotein cholesterol (P=0.01), and insulin (P=0.003) were directly associated with IMT progression in a multivariable model adjusted for age, sex, and baseline IMT (model R(2)=24%). When the MetS/European Group for the Study of Insulin Resistance definition was included in the model, it was directly associated with IMT progression (P=0.03), but its inclusion did not improve the model's predictive value. IMT increased 79+/-7 mum (mean+/-SEM) in subjects with MetS according to the MetS/European Group for the Study of Insulin Resistance definition and 42+/-2 mum in subjects without MetS (P<0.0001). In addition, the number of MetS components was linearly associated with IMT progression (P<0.0001). Similar results were seen with MetS/revised National Cholesterol Education Program and MetS/International Diabetes Federation definitions. CONCLUSIONS Obesity, high low-density lipoprotein cholesterol, and high insulin level predicted IMT progression in young adults. All MetS definitions identified young adults with accelerated IMT progression, but we found no evidence that MetS would predict IMT progression more than expected from the sum of its risk components.
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Affiliation(s)
- Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Koskinen J, Stenholm T, Vaarno J, Soini A. O302 New immunometric concept for rapid MRSA screening without pure-culture. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70202-9] [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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Primachenko ON, Sorochinskaya OV, Pavlyuchenko VN, Ivanchev SS, Skrifvars M, Koskinen J, Karna T, Laamanen H. RUSS J APPL CHEM+ 2002; 75:1705-1708. [DOI: 10.1023/a:1022256624472] [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: 11/12/2022]
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Wade N, Shen J, Koskinen J, Cooks RG. Reactions of BBr(n)(+) (n = 0--2) at fluorinated and hydrocarbon self-assembled monolayer surfaces: observations of chemical selectivity in ion--surface scattering. J Mass Spectrom 2001; 36:717-725. [PMID: 11473394 DOI: 10.1002/jms.177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Ion-surface reactions involving BBr(n)(+) (n = 0--2) with a fluorinated self-assembled monolayer (F-SAM) surface were investigated using a multi-sector scattering mass spectrometer. Collisions of the B(+) ion yield BF(2)(+) at threshold energy with the simpler product ion BF(+)* appearing at higher collision energies and remaining of lower abundance than BF(2)(+) at all energies examined. In addition, the reactively sputtered ion CF(+) accompanies the formation of BF(2)(+) at low collision energies. These results stand in contrast with previous data on the ion-surface reactions of atomic ions with the F-SAM surface in that the threshold and most abundant reaction products in those cases involved the abstraction of a single fluorine atom. Gas-phase enthalpy data are consistent with BF(2)(+) being the thermodynamically favored product. The fact that the abundance of BF(2)(+) is relatively low and relatively insensitive to changes in collision energy suggests that this reaction proceeds through an entropically demanding intermediate at the vacuum--surface interface, one which involves interaction of the B(+) ion simultaneously with two fluorine atoms. By contrast with the reaction of B(+), the odd-electron species BBr(+)* reacts with the F-SAM surface to yield an abundant single-fluorine abstraction product, BBrF(+). Corresponding gas-phase ion--molecule experiments involving B(+) and BBr(+)* with C(6)F(14) also yield the products BF(+)* and BF(2)(+), but only in extremely low abundances and with no preference for double fluorine abstraction. Ion--surface reactions were also investigated for BBr(n)(+) (n = 0-2) with a hydrocarbon self-assembled monolayer (H-SAM) surface. Reaction of the B(+) ion and dissociative reactions of BBr(+)* result in the formation of BH(2)(+), while the thermodynamically less favorable product BH(+)* is not observed. Collisions of BBr(2)(+) with the H-SAM surface yield the dissociative ion-surface reaction products, BBrH(+) and BBrCH(3)(+). Substitution of bromine atoms on the projectile by hydrogen or alkyl radicals suggests that Br atoms may be transferred to the surface in a Br-for-H or Br-for-CH(3) transfer reaction in an analogous fashion to known transhalogenation reactions at the F-SAM surface. The results for the H-SAM surface stand in contrast to those for the F-SAM surface in that enhanced neutralization of the primary ions gives secondary ion signals one to two orders of magnitude smaller than those obtained when using the F-SAM surface, consistent with the relative ionization energies of the two materials.
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Affiliation(s)
- N Wade
- Department of Chemistry, Purdue University, West Lafayette, Indiana 47907, USA
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Pavlyuchenko VN, Sorochinskaya OV, Ivanchev SS, Klubin VV, Kreichman GS, Budtov VP, Skrifvars M, Halme E, Koskinen J. Hollow-particle latexes: Preparation and properties. ACTA ACUST UNITED AC 2001. [DOI: 10.1002/pola.1120] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Zimmermann P, Eiriö V, Koskinen J, Kujansuu E, Ranta T. Doppler assessment of the uterine and uteroplacental circulation in the second trimester in pregnancies at high risk for pre-eclampsia and/or intrauterine growth retardation: comparison and correlation between different Doppler parameters. Ultrasound Obstet Gynecol 1997; 9:330-338. [PMID: 9201877 DOI: 10.1046/j.1469-0705.1997.09050330.x] [Citation(s) in RCA: 61] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
During a 20-month period we studied 175 pregnant women at high risk for hypertensive disorders of pregnancy or intrauterine growth retardation, and 172 patients at low risk, in a prospectively designed cross-sectional trial. Using duplex pulsed wave Doppler ultrasound, we recorded blood velocity waveforms from both main uterine arteries, the uteroplacental arteries in the region of placental implantation and the umbilical artery at 21-24 weeks of gestation. Persistent notches in the main stem uterine arteries and elevated resistance indices of > 0.68 in the uterine arteries and > 0.38 in the uteroplacental arteries were defined as abnormal waveforms. The incidence of proteinuric pregnancy-induced hypertension (PPIH) and intrauterine growth retardation (IUGR) were recorded as main outcome measures. Doppler proved to be more efficient at predicting a complicated pregnancy in those patients who were at high risk: a positive medical history alone was associated with a three-fold greater risk of developing PPIH and/or IUGR. In the high-risk group a single pathological Doppler sign accounted for an additional three- to four-fold increased risk, and the combination of all three pathological signs, a seven-fold additional risk for later disease. In this group PPIH and/or IUGR was found in 58.3%, compared to 8.3% if Doppler results were normal. The criterion for the definition of pathological Doppler results, whether persistent notching, the resistance index (RI) of the main stem uterine artery, or the RI in the arteries of the uteroplacental bed, was of minor importance, as all Doppler parameters were strongly correlated. However, the combination of all parameters was superior to a single parameter, and a bilateral notch was superior to a unilateral notch in terms of minimizing false-positive results. However, Doppler was less powerful in the population at low risk. Here PPIH and/or IUGR was seen in 6.1-6.4% in the group with abnormal Doppler findings compared to 5.2% in pregnancies with normal findings. None of the patients showed bilateral notching. In conclusion, pathological Doppler velocimetry of the uterine and uteroplacental circulation was a powerful predictor of PPIH and/or IUGR in high-risk pregnancies, identifying a group in which 58.3% would suffer from disease later in pregnancy. A combination of several Doppler parameters was superior to a single parameter, although the parameters were strongly correlated with each other.
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Affiliation(s)
- P Zimmermann
- Department of Obstetrics and Gynecology, Päijät-Häme Central Hospital, Lahti, Finland
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Koskinen J, Koskinen M, Mutikainen I, Mannfors B, Elo H. Ethylmethylglyoxal Bis(amidinohydrazonium) Dichloride–Water (1/2). Acta Crystallogr C 1996. [DOI: 10.1107/s0108270196009535] [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: 11/10/2022] Open
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Zimmermann P, Albäck T, Koskinen J, Vaalamo P, Tuimala R, Ranta T. Doppler flow velocimetry of the umbilical artery, uteroplacental arteries and fetal middle cerebral artery in prolonged pregnancy. Ultrasound Obstet Gynecol 1995; 5:189-197. [PMID: 7788494 DOI: 10.1046/j.1469-0705.1995.05030189.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A total of 153 pregnant women, of at least 287 days' menstrual age, were studied in a prospectively designed cross-sectional trial. In addition to the non-stress test, contraction stress test, sonographic estimate of amniotic fluid and grade of placental maturation, Doppler measurements of the resistance index (RI) were taken in the umbilical artery, the uteroplacental arteries in the region of placental implantation and the fetal middle cerebral artery. Data were analyzed with regard to asphyxia and otherwise complicated fetal outcome. Furthermore, a possible relationship between grade of placental maturation, Doppler flow velocity waveforms and fetal outcome was investigated. Doppler resistance indices in the umbilical artery, uteroplacental arteries in the region of placental implantation and fetal middle cerebral artery did not change significantly with increasing gestation from 41 to 43 weeks. The grade of placental maturation on ultrasound examination was not related to fetal outcome or Doppler indices in the first two vessels. In all vessels examined in this study, the majority of Doppler measurements in pregnancies with subsequent asphyxia or otherwise complicated fetal outcome were within the 95% prediction interval for patients with normal fetal outcome. None of the patients showed absent diastolic flow in the umbilical artery. With the use of a cut-off value of RI = 0.62 in the umbilical artery, asphyxia could be predicted with 37% sensitivity and 75% specificity. Oligohydramnios and antpartum cardiotocography predicted asphyxia with 16% and 8% sensitivity and 95% and 96% specificity, respectively. Sensitivity for prediction of otherwise complicated fetal outcome by umbilical artery Doppler was only 7%.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Zimmermann
- Department of Obstetrics and Gynecology, Päijät-Häme Central Hospital, Lahti, Finland
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Fallon PJ, Veerasamy VS, Davis CA, Robertson J, Amaratunga GA, Milne WI, Koskinen J. Erratum: Properties of filtered-ion-beam-deposited diamondlike carbon as a function of ion energy. Phys Rev B Condens Matter 1994; 49:2287. [PMID: 10021613 DOI: 10.1103/physrevb.49.2287.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Fallon PJ, Veerasamy VS, Davis CA, Robertson J, Amaratunga GA, Milne WI, Koskinen J. Properties of filtered-ion-beam-deposited diamondlike carbon as a function of ion energy. Phys Rev B Condens Matter 1993; 48:4777-4782. [PMID: 10008965 DOI: 10.1103/physrevb.48.4777] [Citation(s) in RCA: 794] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Pulkkinen MO, Hippeläinen M, Holma P, Katainen P, Koskinen J, Mäkinen J, Pietarinen S. Vaginal progesterone after tubal pregnancy. Eur J Obstet Gynecol Reprod Biol 1993; 49:67-71. [PMID: 8365524 DOI: 10.1016/0028-2243(93)90122-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We studied the effect of vaginal progesterone (P) treatment during the luteal phase of patients who had had a tubal pregnancy (TP) and were planning another, in a prospective, randomized, double-blind trial. The outpatient clinics of two University hospitals and three central hospitals had 135 patients treated for tubal pregnancy: 100 with grossly normal fallopian tubes (supposing an accidentally abnormal luteal phase as a possible etiology of their first TP) and 35 with signs of earlier pelvic inflammatory disease (PID etiology). They were treated with vaginal P (25 mg b.i.d.) or placebo during cycle days 16-24, for 10 months. Serum P levels after a single vaginal or oral dose were compared. The rates of conception, delivery, spontaneous abortion and recurrent TP were recorded, and fetal and placental weight measured. Both vaginal and oral formulas of P provoked a physiological (24-43 nmol/l) rise in serum concentrations. P and placebo-treated cycles resulted in a nearly equal number of pregnancies (33/37 resp.). Of the 55 infants born 53 were to mothers without signs of earlier PID (53/100); only 2 (2/35) to mothers in whom signs had been present. Recurrent TP occurred in 9% of all pregnancies. Four out of six recurrent TPs were patients with signs of PID (4/35), but two were without such signs (2/100): one occurred during placebo and one during P-treated cycle. Prophylactic P treatment of patients at risk of recurrent TP does not improve fertility or prevent recurrent TP. This indicates, that the functional etiology of recurrent TP, as compared to infection, is not important.
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Abstract
Doppler umbilical velocimetry is a useful clinical tool for antepartum fetal surveillance of pregnancies at risk of fetal compromise. Intrahepatic cholestasis of pregnancy is associated with an increased incidence of fetal death, which might due to the toxic effect of elevated maternal serum concentrations of bile acids. To study a possible effect of the concentration of bile acids on the umbilical circulation we performed pulse-wave Doppler velocimetry of the umbilical artery in 15 patients with intrahepatic cholestasis between 34 and 38 weeks of gestation. The findings were compared to the Doppler flow velocities of the umbilical artery of 129 normal pregnancies. Peak-systolic (A) and end-diastolic (B) velocities of two to three cardiac cycles were measured by electronic calipers and the Pourcelot (PR)-index (PR = (A - B)(A)) was calculated. Two of 29 Doppler measurements in patients with intrahepatic cholestasis were above two standard deviations (2 SD) of the values in normal pregnancies. No significant correlation was found between Doppler flow velocities and serum levels of bile acids (r = 0.20) or the levels of alanine aminotransferase (ALAT) (r = -0.05). The mean level of bile acids was 24 mumol/l with a maximum of 98 mumol/l. The mean level of ALAT was 165 IU/l with a maximum of 576 IU/l. Since even high levels of bile acids do not influence umbilical circulation, Doppler investigations of the umbilical artery seem to be of little value in studying the disease-specific risk of fetal compromise in pregnancies complicated by intrahepatic cholestasis.
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Affiliation(s)
- P Zimmermann
- Department of Obstetrics and Gynaecology, Päijät-Häme Central Hospital, Lahti, Finland
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Meurman JH, Torkko H, Hirvonen J, Koskinen J, Rytömaa I. Application of a new mechanical properties microprobe to study hardness of eroded bovine enamel in vitro. Scand J Dent Res 1990; 98:568-70. [PMID: 2091254 DOI: 10.1111/j.1600-0722.1990.tb01014.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A mechanical properties microprobe technique was used to study bovine tooth specimens that had been immersed in 50 ml of either cola beverage or sports drink for 1 min, 5 min, and 15 min. A Vickers diamond was used to analyze the test and control surfaces at 7V input. This corresponds to a 100 g load of a conventional indentation microhardness apparatus which was used for comparison. The results showed good agreement between the conventional and the microprobe hardness analyses. Enamel softening was found to be significant after 5 min immersion in both acidic drinks, while 1 min immersion did not cause softening. This shows that shorter immersion times than previously used can be applied in dental erosion studies in vitro. Compared with the conventional indentation microhardness measurements, however, the microprobe technique did not offer any advantage, such as assessment of the microelastic properties of enamel, probably because the biologic tissue did not allow reliable data collection during the loading and unloading phases of the instrument.
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Affiliation(s)
- J H Meurman
- Department of Cariology, University of Helsinki, Finland
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Meurman JH, Härkönen M, Näveri H, Koskinen J, Torkko H, Rytömaa I, Järvinen V, Turunen R. Experimental sports drinks with minimal dental erosion effect. Scand J Dent Res 1990; 98:120-8. [PMID: 2343273 DOI: 10.1111/j.1600-0722.1990.tb00950.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The effects of new experimental sports drinks on dental enamel were studied in vitro using bovine tooth specimens. Profilometric analysis was used to measure the loss of tooth material after immersion of the specimens in the drinks. Thereafter the specimens' surface hardness was measured and scanning electron microphotographs were taken. In addition, 13 commercial sports drinks and experimental drinks containing either citric acid or malic acid were tested for their capacity to dissolve hydroxyapatite in vitro. The erosive effect increased markedly with decreasing pH. The citric acid containing drinks were more erosive than malic acid containing drinks. No erosion was observed with the malic acid containing drink (pH 5.90) but the drink of similar composition containing citric acid caused an erosion 1.3 +/- 1.1 microns deep and a commercial citric acid containing drink caused a lesion 12.3 +/- 4.5 microns deep after 120 min immersion. Softening of enamel was greater in specimens immersed in citric acid than in those immersed in malic acid containing drink. The in vitro hydroxyapatite dissolving effect of the commercial sports drink samples studied (all having a pH under 4.22) was markedly greater (0.48-4.38 mmol/l) than that of the malic acid containing experimental drink (pH 5.50, Ca++ concentration in the supernatant 0.19 mmol/l) and of the similar citric acid containing drink (0.35 mmol/l). The hydroxyapatite dissolving effect of both drinks started to be marked at a pH level of about 5.0 but increased thereafter exponentially with decreasing pH. At pH levels above 4.0 the hydroxyapatite dissolving effect of citric acid containing drinks was greater than that of malic acid containing drinks.
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Affiliation(s)
- J H Meurman
- Department of Cariology, University of Helsinki, Finland
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Rytömaa I, Meurman JH, Koskinen J, Laakso T, Gharazi L, Turunen R. In vitro erosion of bovine enamel caused by acidic drinks and other foodstuffs. Scand J Dent Res 1988; 96:324-33. [PMID: 3166197 DOI: 10.1111/j.1600-0722.1988.tb01563.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The objective was to compare the erosive effect of some commonly used acidic drinks and milk products on a bovine tooth enamel model system. Conditions were selected to be sufficiently severe to cause erosion. Loss of material after erosion experiments was measured by recording the depth of the surface profile after repeated and prolonged exposure. Changes in the enamel surface were observed by scanning electron microscopy. The reparative mechanisms were studied by immersing test teeth in saliva, with or without (2 ppm) fluoride, after severe demineralization in the test products. According to the t-test for paired means, cola beverages and orange beverages differed from beer, coffee with or without sugar, strawberry yoghurt, buttermilk, and carbonated mineral water at the level P less than 0.01. Each of the last-mentioned test products differed from sports drinks, diet cola beverages and orange juice less significantly. In addition, bathing of teeth in saliva between exposures to the test products did not influence the erosive depth. The results, based on in vitro conditions that ensured erosion, are useful for comparative purposes but cannot be directly extended to the oral cavity under normal use conditions.
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Affiliation(s)
- I Rytömaa
- Department of Cariology, University of Helsinki, Finland
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Hirvonen JP, Koskinen J, Anttila A, Stone D, Paszkiet C. Characterization of ion-beam-induced carbon deposition on WCCo hard metal by microhardness, scratch and abrasive wear tests. ACTA ACUST UNITED AC 1987. [DOI: 10.1016/0025-5416(87)90231-x] [Citation(s) in RCA: 8] [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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Abstract
Forty-seven patients with temporomandibular joint dysfunction were studied. A total of 100 subjective symptoms localized in the ear were encountered in thirty-nine patients. The treatment of dysfunction eradicated or reduced 56% of these symptoms. A hearing defect was established audiometrically in eight cases and the probable cause was outside the masticatory apparatus in seven cases. There was conceviably a causal relationship in one case between the patient's cochlear hearing defect and temporomandibular joint dysfunction. The neuro-otological finding was pathological in nine cases, in three of which the causative agent was independent of the masticatory apparatus. The vestibular disturbance diagnosed in six cases may have originated from temporomandibular joint dysfunction, but this could not be confirmed.
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Abstract
Mouse preimplantation embryos were incubated with radioactive pregnenolone, progesterone or dehydroepiandrosterone for various periods of time. These substrates were not converted to metabolites even after incubation of 120 h. We suggest that preimplantation mouse embryo does not possess enzyme activities for steroid metabolism.
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