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Barmano, N., Charitakis, E., Kronstrand, R., Walfridsson, U., Karlsson, J.-E., Walfridsson, H. & Nyström, F. H. (2019). The association between alcohol consumption, cardiac biomarkers, left atrial size and re-ablation in patients with atrial fibrillation referred for catheter ablation. PLoS ONE, 14(4), Article ID e0215121.
Open this publication in new window or tab >>The association between alcohol consumption, cardiac biomarkers, left atrial size and re-ablation in patients with atrial fibrillation referred for catheter ablation
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 4, article id e0215121Article in journal (Refereed) Published
Abstract [en]

Background

Information on alcohol consumption in patients undergoing radiofrequency ablation (RFA) of atrial fibrillation (AF) is often limited by the reliance on self-reports. The aim of this study was to describe the long-term alcohol consumption, measured as ethyl glucuronide in hair (hEtG), in patients undergoing RFA due to AF, and to examine potential associations with cardiac biomarkers, left atrial size and re-ablation within one year after the initial RFA.

Methods

The amount of hEtG was measured in patients referred for RFA, and a cut-off of 7 pg/mg was used. N-terminal pro B-type natriuretic peptide (NT-proBNP) and the mid-regional fragment of pro atrial natriuretic peptide (MR-proANP) were examined and maximum left atrium volume index (LAVI) was measured. The number of re-ablations was examined up to one year after the initial RFA. Analyses were stratified by gender, and adjusted for age, systolic blood pressure, body mass index, presence of heart failure and heart rhythm for analyses regarding NT-proBNP, MR-proANP and LAVI and heart rhythm being replaced by type of AF for analyses regarding re-ablation.

Results

In total, 192 patients were included in the study. Median (25th– 75th percentile) NT-proBNP in men with hEtG ≥ 7 vs. < 7 pg/mg was 250 (96–695) vs. 130 (49–346) pg/ml (p = 0.010), and in women it was 230 (125–480) vs. 230 (125–910) pg/ml (p = 0.810). Median MR-proANP in men with hEtG ≥ 7 vs. < 7 pg/mg was 142 (100–224) vs. 117 (83–179) pmol/l (p = 0.120) and in women it was 139 (112–206) vs. 153 (93–249) pmol/l (p = 0.965). The median of maximum LAVI was 30.1 (26.7–33.9) vs. 25.8 (21.4–32.0) ml/m2 (p = 0.017) in men, and 25.0 (18.9–29.6) vs. 25.7 (21.7–34.6) ml/m2 (p = 0.438) in women, with hEtG ≥ 7 vs. < 7 pg/ml, respectively. Adjusted analyses showed similar results, except for MR-proANP turning out significant in men with hEtG ≥ 7 vs. < 7 pg/mg (p = 0.047). The odds ratio of having a re-ablation was 3.5 (95% CI 1.3–9.6, p = 0.017) in men with hEtG ≥ 7 vs. < 7 pg/mg, while there was no significant difference in women.

Conclusions

In male patients with AF and hEtG ≥ 7 pg/mg, NT-proBNP and MR-proANP were higher, LA volumes larger, and there was a higher rate of re-ablations, as compared to men with hEtG < 7 pg/mg. This implies that men with an alcohol consumption corresponding to an hEtG-value ≥ 7, have a higher risk for LA remodelling that could potentially lead to a deterioration of the AF situation.

Place, publisher, year, edition, pages
San Francisco, CA, United States: Public Library of Science, 2019
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-157020 (URN)10.1371/journal.pone.0215121 (DOI)000463992600055 ()30970005 (PubMedID)2-s2.0-85064164504 (Scopus ID)
Note

Funding agencies: County Council of Ostergotland [LIO-280731, LIO-445511]; Carldavid Jonsson Research Foundation; Linkoping University; Biosense Webster; Johnson Johnson; Heart Foundation

Available from: 2019-05-23 Created: 2019-05-23 Last updated: 2019-06-12Bibliographically approved
Fridell, S., Ström, E., Agebratt, C., Leanderson, P., Guldbrand, H. & Nyström, F. H. (2018). A randomised study in young subjects of the effects of eating extra fruit or nuts on periodontal inflammation. BDJ open, 3, Article ID 17022.
Open this publication in new window or tab >>A randomised study in young subjects of the effects of eating extra fruit or nuts on periodontal inflammation
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2018 (English)In: BDJ open, ISSN 2056-807X, Vol. 3, article id 17022Article in journal (Refereed) Published
Abstract [en]

Objectives/Aims:

Fruit is often advocated as a healthy source of nutrients and vitamins. However, the high contents of sugars in many fruits could potentially counteract positive effects on the teeth.

Materials and methods:

We recruited 30 healthy non-obese participants who were randomised to either supplement their diet with extra fruits or nuts, each at +7 kcal/kg body weight/day, for 2 months.

Results:

Fructose intake increased from 9.1±6.0 to 25.6±9.6 g/day, P<0.0001, in the fruit group and was reduced from 12.4±5.7 to 6.5±5.3 g/day, P=0.007, in the nut group. Serum-vitamin C increased in both groups (fruit: P=0.017; nuts: P=0.009). α-Tocopherol/cholesterol ratio increased in the fruit group (P=0.0033) while β-carotene/cholesterol decreased in the nut group (P<0.0001). The amount of subjects with probing pocket depths ⩾4 mm in the fruit group was reduced (P=0.045) according to blinded examinations, and the difference in the changes in probing pockets ⩾4 mm was also statistically significant between the food groups (P=0.010).

Conclusion:

A large increase of fruit intake, compared with nuts, had a favourable effect on periodontal status in some respects, despite the high sugar contents. To search for potential protective micronutrients in fruit that protect the teeth could be an aim for further research.

Place, publisher, year, edition, pages
Nature Publishing Group, 2018
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:liu:diva-152523 (URN)10.1038/bdjopen.2017.22 (DOI)29607092 (PubMedID)
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-10-07Bibliographically approved
Nowak, C., Carlsson, A. C., Östgren, C. J., Nyström, F., Alam, M., Feldreich, T., . . . Arnlov, J. (2018). Multiplex proteomics for prediction of major cardiovascular events in type 2 diabetes. Diabetologia, 61(8), 1748-1757
Open this publication in new window or tab >>Multiplex proteomics for prediction of major cardiovascular events in type 2 diabetes
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2018 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 61, no 8, p. 1748-1757Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis Multiplex proteomics could improve understanding and risk prediction of major adverse cardiovascular events (MACE) in type 2 diabetes. This study assessed 80 cardiovascular and inflammatory proteins for biomarker discovery and prediction of MACE in type 2 diabetes. Methods We combined data from six prospective epidemiological studies of 30-77-year-old individuals with type 2 diabetes in whom 80 circulating proteins were measured by proximity extension assay. Multivariable-adjusted Cox regression was used in a discovery/replication design to identify biomarkers for incident MACE. We used gradient-boosted machine learning and lasso regularised Cox regression in a random 75% training subsample to assess whether adding proteins to risk factors included in the Swedish National Diabetes Register risk model would improve the prediction of MACE in the separate 25% test subsample. Results Of 1211 adults with type 2 diabetes (32% women), 211 experienced a MACE over a mean (+/- SD) of 6.4 +/- 2.3 years. We replicated associations (amp;lt; 5% false discovery rate) between risk of MACE and eight proteins: matrix metalloproteinase (MMP)-12, IL-27 subunit alpha (IL-27a), kidney injury molecule (KIM)-1, fibroblast growth factor (FGF)-23, protein S100-A12, TNF receptor (TNFR)-1, TNFR-2 and TNF-related apoptosis-inducing ligand receptor (TRAIL-R)2. Addition of the 80-protein assay to established risk factors improved discrimination in the separate test sample from 0.686 (95% CI 0.682, 0.689) to 0.748 (95% CI 0.746, 0.751). A sparse model of 20 added proteins achieved a C statistic of 0.747 (95% CI 0.653, 0.842) in the test sample. Conclusions/interpretation We identified eight protein biomarkers, four of which are novel, for risk of MACE in community residents with type 2 diabetes, and found improved risk prediction by combining multiplex proteomics with an established risk model. Multiprotein arrays could be useful in identifying individuals with type 2 diabetes who are at highest risk of a cardiovascular event.

Place, publisher, year, edition, pages
SPRINGER, 2018
Keywords
Biomarkers; Major adverse cardiovascular event; Proteomics; Risk; Type 2 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-149837 (URN)10.1007/s00125-018-4641-z (DOI)000437432200006 ()29796748 (PubMedID)
Note

Funding Agencies|European Union Horizon 2020 project [634869]; Swedish Research Council [2012-2215, 2015-03477]; Landstinget Dalarna (Falun, Sweden); Dalarna University (Falun, Sweden); Sparbanksstiftelsen Nya [552, 693, 932, 2297]; Region Vastmanland (Vasteras, Sweden); Swedish Medical Association; Swedish Heart-Lung Foundation [20150429]

Available from: 2018-08-02 Created: 2018-08-02 Last updated: 2019-05-01
Agebratt, C., Ström, E., Romu, T., Dahlqvist Leinhard, O., Borga, M., Leandersson, P. & Nyström, F. H. (2016). A Randomized Study of the Effects of Additional Fruit and Nuts Consumption on Hepatic Fat Content, Cardiovascular Risk Factors and Basal Metabolic Rate. PLoS ONE, 11(1), e0147149
Open this publication in new window or tab >>A Randomized Study of the Effects of Additional Fruit and Nuts Consumption on Hepatic Fat Content, Cardiovascular Risk Factors and Basal Metabolic Rate
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 1, p. e0147149-Article in journal (Refereed) Published
Abstract [en]

Background

Fruit has since long been advocated as a healthy source of many nutrients, however, the high content of sugars in fruit might be a concern.

Objectives

To study effects of an increased fruit intake compared with similar amount of extra calories from nuts in humans.

Methods

Thirty healthy non-obese participants were randomized to either supplement the diet with fruits or nuts, each at +7 kcal/kg bodyweight/day for two months. Major endpoints were change of hepatic fat content (HFC, by magnetic resonance imaging, MRI), basal metabolic rate (BMR, with indirect calorimetry) and cardiovascular risk markers.

Results

Weight gain was numerically similar in both groups although only statistically significant in the group randomized to nuts (fruit: from 22.15±1.61 kg/m2 to 22.30±1.7 kg/m2, p = 0.24 nuts: from 22.54±2.26 kg/m2 to 22.73±2.28 kg/m2, p = 0.045). On the other hand BMR increased in the nut group only (p = 0.028). Only the nut group reported a net increase of calories (from 2519±721 kcal/day to 2763±595 kcal/day, p = 0.035) according to 3-day food registrations. Despite an almost three-fold reported increased fructose-intake in the fruit group (from 9.1±6.0 gram/day to 25.6±9.6 gram/day, p<0.0001, nuts: from 12.4±5.7 gram/day to 6.5±5.3 gram/day, p = 0.007) there was no change of HFC. The numerical increase in fasting insulin was statistical significant only in the fruit group (from 7.73±3.1 pmol/l to 8.81±2.9 pmol/l, p = 0.018, nuts: from 7.29±2.9 pmol/l to 8.62±3.0 pmol/l, p = 0.14). Levels of vitamin C increased in both groups while α-tocopherol/cholesterol-ratio increased only in the fruit group.

Conclusions

Although BMR increased in the nut-group only this was not linked with differences in weight gain between groups which potentially could be explained by the lack of reported net caloric increase in the fruit group. In healthy non-obese individuals an increased fruit intake seems safe from cardiovascular risk perspective, including measurement of HFC by MRI.

Keywords
Fruits Basal metabolic rate measurement Fats Vitamin C Fructoses Diet Fatty liver Magnetic resonance imaging
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-124605 (URN)10.1371/journal.pone.0147149 (DOI)000368529100062 ()26788923 (PubMedID)
Note

Funding agencies: County Council of Ostergotland; Linkoping University, Department of Medical and Health Sciences

Available from: 2016-02-05 Created: 2016-02-05 Last updated: 2019-06-14
Romu, T., Camilla, V., Dahlqvist Leinhard, O., Tallberg, J., Dahlström, N., Persson, A., . . . Nyström, F. (2016). A randomized trial of cold-exposure on energy expenditure and supraclavicular brown adipose tissue volume in humans. Metabolism: Clinical and Experimental, 65(6), 926-934
Open this publication in new window or tab >>A randomized trial of cold-exposure on energy expenditure and supraclavicular brown adipose tissue volume in humans
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2016 (English)In: Metabolism: Clinical and Experimental, ISSN 0026-0495, E-ISSN 1532-8600, Vol. 65, no 6, p. 926-934Article in journal (Refereed) Published
Abstract [en]

Objective

To study if repeated cold-exposure increases metabolic rate and/or brown adipose tissue (BAT) volume in humans when compared with avoiding to freeze.

Design

Randomized, open, parallel-group trial.

Methods

Healthy non-selected participants were randomized to achieve cold-exposure 1 hour/day, or to avoid any sense of feeling cold, for 6 weeks. Metabolic rate (MR) was measured by indirect calorimetry before and after acute cold-exposure with cold vests and ingestion of cold water. The BAT volumes in the supraclavicular region were measured with magnetic resonance imaging (MRI).

Results

Twenty-eight participants were recruited, 12 were allocated to controls and 16 to cold-exposure. Two participants in the cold group dropped out and one was excluded. Both the non-stimulated and the cold-stimulated MR were lowered within the group randomized to avoid cold (MR at room temperature from 1841 ± 199 kCal/24 h to 1795 ± 213 kCal/24 h, p = 0.047 cold-activated MR from 1900 ± 150 kCal/24 h to 1793 ± 215 kCal/24 h, p = 0.028). There was a trend towards increased MR at room temperature following the intervention in the cold-group (p = 0.052). The difference between MR changes by the interventions between groups was statistically significant (p = 0.008 at room temperature, p = 0.032 after cold-activation). In an on-treatment analysis after exclusion of two participants that reported ≥ 8 days without cold-exposure, supraclavicular BAT volume had increased in the cold-exposure group (from 0.0175 ± 0.015 l to 0.0216 ± 0.014 l, p = 0.049).

Conclusions

We found evidence for plasticity in metabolic rate by avoiding to freeze compared with cold-exposure in a randomized setting in non-selected humans.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Brown adipose tissue; Cold exposure; Magnetic resonance imaging; Metabolic rate
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:liu:diva-128200 (URN)10.1016/j.metabol.2016.03.012 (DOI)000376145100013 ()27173471 (PubMedID)
Funder
Knut and Alice Wallenberg Foundation
Note

Funding agencies: Linkoping University; County Council of Ostergotland (LUA-ALF), Sweden; Swedish Research Council [2013-4466, 2012-1652, 2014-2516]; Knut and Alice Wallenberg Foundation; Sahlgrenskas University Hospital (LUA-ALF); European Union grant (DIABAT) [HEALTH-F2-

Available from: 2016-05-22 Created: 2016-05-22 Last updated: 2019-06-14
Carlsson, A. C., Östgren, C. J., Nyström, F. H., Länne, T., Jennersjö, P., Larsson, A. & Arnlov, J. (2016). Association of soluble tumor necrosis factor receptors 1 and 2 with nephropathy, cardiovascular events, and total mortality in type 2 diabetes. Cardiovascular Diabetology, 15(1), 40
Open this publication in new window or tab >>Association of soluble tumor necrosis factor receptors 1 and 2 with nephropathy, cardiovascular events, and total mortality in type 2 diabetes
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2016 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 15, no 1, p. 40-Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2) contribute to experimental diabetic kidney disease, a condition with substantially increased cardiovascular risk when present in patients. Therefore, we aimed to explore the levels of sTNFRs, and their association with prevalent kidney disease, incident cardiovascular disease, and risk of mortality independently of baseline kidney function and microalbuminuria in a cohort of patients with type 2 diabetes. In pre-defined secondary analyses we also investigated whether the sTNFRs predict adverse outcome in the absence of diabetic kidney disease. Methods: The CARDIPP study, a cohort study of 607 diabetes patients [mean age 61 years, 44 % women, 45 cardiovascular events (fatal/non-fatal myocardial infarction or stroke) and 44 deaths during follow-up (mean 7.6 years)] was used. Results: Higher sTNFR1 and sTNFR2 were associated with higher odds of prevalent kidney disease [odd ratio (OR) per standard deviation (SD) increase 1.60, 95 % confidence interval (CI) 1.32-1.93, p &lt; 0.001 and OR 1.54, 95 % CI 1.21-1.97, p = 0.001, respectively]. In Cox regression models adjusting for age, sex, glomerular filtration rate and urinary albumin/creatinine ratio, higher sTNFR1 and sTNFR2 predicted incident cardiovascular events [hazard ratio (HR) per SD increase, 1.66, 95 % CI 1.29-2.174, p &lt; 0.001 and HR 1.47, 95 % CI 1.13-1.91, p = 0.004, respectively]. Results were similar in separate models with adjustments for inflammatory markers, HbA1c, or established cardiovascular risk factors, or when participants with diabetic kidney disease at baseline were excluded (p &lt; 0.01 for all). Both sTNFRs were associated with mortality. Conclusions/Interpretations: Higher circulating sTNFR1 and sTNFR2 are associated with diabetic kidney disease, and predicts incident cardiovascular disease and mortality independently of microalbuminuria and kidney function, even in those without kidney disease. Our findings support the clinical utility of sTNFRs as prognostic markers in type 2 diabetes.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
Keywords
Type 2 diabetes; TNF; Laplace regression; Incident cardiovascular disease; Mortality; Inflammation
National Category
Cardiac and Cardiovascular Systems General Practice
Identifiers
urn:nbn:se:liu:diva-126836 (URN)10.1186/s12933-016-0359-8 (DOI)000371581000001 ()26928194 (PubMedID)
Note

Funding Agencies|Swedish Research Council; Swedish Heart-Lung foundation; Thureus foundation; Marianne and Marcus Wallenberg Foundation; Dalarna University; Uppsala University

Available from: 2016-04-05 Created: 2016-04-05 Last updated: 2018-01-10
Wijkman, M., Länne, T., Östgren, C. J. & Nyström, F. H. (2016). Diastolic orthostatic hypertension and cardiovascular prognosis in type 2 diabetes: a prospective cohort study. Cardiovascular Diabetology, 15(83), 1-10
Open this publication in new window or tab >>Diastolic orthostatic hypertension and cardiovascular prognosis in type 2 diabetes: a prospective cohort study
2016 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 15, no 83, p. 1-10Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In patients with type 2 diabetes, the prognostic impact of an orthostatic rise in blood pressure is not known. Therefore, the aim of this study was to determine the prognostic implications of the diastolic orthostatic blood pressure response in a cohort of patients with type 2 diabetes. We also evaluated associations between different orthostatic blood pressure responses and markers of subclinical cardiovascular organ damage.

METHODS: Office blood pressures were measured in the sitting and in the standing position in 749 patients with type 2 diabetes who participated in the CARDIPP study (Cardiovascular Risk factors in Patients with Diabetes-a Prospective study in Primary care). Diastolic orthostatic hypertension was defined as a rise of diastolic blood pressure ≥10 mmHg and diastolic orthostatic hypotension was defined as a drop of diastolic blood pressure ≥10 mmHg. Recruitment took place between the years 2005-2008, and patients were followed until any of the primary outcome events (cardiovascular death or hospitalization for either myocardial infarction or stroke) occurred or until December 31st, 2014. Measurements of aortic pulse wave velocity and of carotid intima-media thickness were performed at base-line.

RESULTS: Diastolic orthostatic hypertension was found in 140 patients (18.7 %) and was associated with significantly lower risk of cardiovascular events (crude hazard ratio compared with patients with normal systolic and diastolic orthostatic blood pressure response: 0.450, 95 % C.I. 0.206-0.987, P = 0.046). Diastolic orthostatic hypotension was found in 31 patients (4.1 %) and was associated with higher values for aortic pulse wave velocity and carotid intima-media thickness, compared with patients with normal systolic and diastolic orthostatic blood pressure response.

CONCLUSIONS: Diastolic orthostatic hypertension is common in patients with type 2 diabetes, and may be a novel marker for decreased cardiovascular risk in these patients.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Arterial stiffness, Blood pressure, Cardiovascular risk, Carotid intima-media thickness, Events, Orthostatic hypotension, Type 2 diabetes mellitus
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-129959 (URN)10.1186/s12933-016-0399-0 (DOI)000377852600001 ()27255168 (PubMedID)
Note

Funding agencies: FORSS; Research Council of Southeastern Sweden; King GustafV and Queen Victoria Freemason Foundation, Sweden

Available from: 2016-07-02 Created: 2016-07-02 Last updated: 2017-11-28Bibliographically approved
Fryk, E., Perman Sundelin, J., Strindberg, L., Pereira, M. J., Federici, M., Marx, N., . . . Jansson, P.-A. (2016). Microdialysis and proteomics of subcutaneous interstitial fluid reveals increased galectin-1 in type 2 diabetes patients. Metabolism: Clinical and Experimental, 65(7), 998-1006
Open this publication in new window or tab >>Microdialysis and proteomics of subcutaneous interstitial fluid reveals increased galectin-1 in type 2 diabetes patients
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2016 (English)In: Metabolism: Clinical and Experimental, ISSN 0026-0495, E-ISSN 1532-8600, Vol. 65, no 7, p. 998-1006Article in journal (Refereed) Published
Abstract [en]

Objective. To identify a potential therapeutic target for type 2 diabetes by comparing the subcutaneous interstitial fluid from type 2 diabetes patients and healthy men. Methods. Proteomics was performed on the interstitial fluid of subcutaneous adipose tissue obtained by microdialysis from 7 type 2 diabetes patients and 8 healthy participants. 851 proteins were detected, of which 36 (including galectin-1) showed significantly altered expression in type 2 diabetes. We also measured galectin-1 expression in: (1) adipocytes isolated from adipose tissue biopsies from these participants; (2) subcutaneous adipose tissue of 24 obese participants before, during and after 16 weeks on a very low calorie diet (VLCD); and (3) adipocytes isolated from 6 healthy young participants after 4 weeks on a diet and lifestyle intervention to promote weight gain. We also determined the effect of galectin-1 on glucose uptake in human adipose tissue. Results. Galectin-1 protein levels were elevated in subcutaneous dialysates from type 2 diabetes compared with healthy controls (p amp;lt; 0.05). In agreement, galectin-1 mRNA expression was increased in adipocytes from the type 2 diabetes patients (p amp;lt; 0.05). Furthermore, galectin-1 mRNA expression was decreased in adipose tissue after VLCD (p amp;lt; 0.05) and increased by overfeeding (p amp;lt; 0.05). Co-incubation of isolated human adipocytes with galectin-1 reduced glucose uptake (p amp;lt; 0.05) but this was independent of the insulin signal. Conclusion. Proteomics of the interstitial fluid in subcutaneous adipose tissue in vivo identified a novel adipokine, galectin-1, with a potential role in the pathophysiology of type 2 diabetes. (C) 2016 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC, 2016
Keywords
Microdialysis; Proteomics; Galectin-1; Obesity; Adipose tissue
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-130121 (URN)10.1016/j.metabol.2016.04.003 (DOI)000377922600006 ()27282870 (PubMedID)
Note

Funding Agencies|Swedish Research Council; EFSD grant - Sanofi Aventis; Swedish Diabetes Association; Sahlgrenska University Hospital

Available from: 2016-07-12 Created: 2016-07-11 Last updated: 2017-11-28
Jennersjö, P., Ludvigsson, J., Länne, T., Nyström, F. H. & Östgren, C. J. (2016). Pedometer-determined physical activity level and change in arterial stiffness in Type 2 diabetes over 4 years. Diabetic Medicine, 33(7), 992-997
Open this publication in new window or tab >>Pedometer-determined physical activity level and change in arterial stiffness in Type 2 diabetes over 4 years
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2016 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 33, no 7, p. 992-997Article in journal (Refereed) Published
Abstract [en]

Aim To explore prospectively the correlation between the level of pedometer-determined physical activity at the start of the study and the change in pulse wave velocity from baseline to 4 years later in people with Type 2 diabetes.

Methods We analysed data from 135 men and 53 women with Type 2 diabetes, aged 54–66 years. Physical activity was measured with waist-mounted pedometers on 3 consecutive days and the numbers of steps/day at baseline were classified into four groups: <5000 steps/day, 5000–7499 steps/day, 7500–9999 steps/day and ≥10 000 steps/day. Pulse wave velocity was measured using applanation tonometry over the carotid and femoral arteries at baseline and after 4 years.

Results The mean (±sd; range) number of steps/day was 8022 (±3765; 956–20 921). The participants with the lowest level of physical activity had a more pronounced increase in the change in pulse wave velocity compared with the participants with the highest. When change in pulse wave velocity was analysed as a continuous variable and adjusted for sex, age, diabetes duration, HbA1c, BMI, systolic blood pressure, pulse wave velocity at baseline, β-blocker use, statin use, unemployment, smoking and diabetes medication, the number of steps/day at baseline was significantly associated with a less steep increase in change in pulse wave velocity (P=0.005). Every 1000 extra steps at baseline corresponded to a lower increase in change in pulse wave velocity of 0.103 m/s.

Conclusions We found that a high level of pedometer-determined physical activity was associated with a slower progression of arterial stiffness over 4 years in middle-aged people with Type 2 diabetes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
National Category
Endocrinology and Diabetes General Practice Geriatrics Sport and Fitness Sciences Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-125910 (URN)10.1111/dme.12873 (DOI)000379930900018 ()26227869 (PubMedID)
Note

Funding agencies: Medical Research Council of Southeast Sweden; Centre for Medical Image Science and Visualization (CMIV), Linkoping University; GE Healthcare; Swedish Heart-Lung Foundation; Swedish Research Council [12661]; King Gustaf V and Queen Victoria Freemason Found

Available from: 2016-03-08 Created: 2016-03-08 Last updated: 2018-01-10Bibliographically approved
Carlsson, A. C., Östgren, C. J., Länne, T., Larsson, A., Nyström, F. H. & Ärnlöv, J. (2016). The association between endostatin and kidney disease and mortality in patients with type 2 diabetes. Diabetes & Metabolism, 42(5), 351-357
Open this publication in new window or tab >>The association between endostatin and kidney disease and mortality in patients with type 2 diabetes
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2016 (English)In: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 42, no 5, p. 351-357Article in journal (Refereed) Published
Abstract [en]

AIM: Circulating endostatin, a biologically active derivate of collagen XVIII, is considered to be a marker of kidney disease and a risk factor for its related mortality. However, less is known of the role of endostatin in diabetes and the development of diabetic nephropathy. For this reason, our study investigated the associations between circulating endostatin and the prevalence and progression of kidney disease, and its mortality risk in patients with type 2 diabetes (T2D).

METHODS: This was a cohort study of 607 patients with T2D (mean age: 61 years, 44% women). Estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation, was used to assess the patients' kidney function decline and mortality.

RESULTS: Of the total study cohort, 20 patients declined by ≥20% in eGFR over 4 years, and 44 died during the follow-up (mean duration: 6.7 years). At baseline, participants with diabetic nephropathy (defined as eGFR<60mL/min/1.73m(2)) and/or microalbuminuria [defined as a urinary albumin-to-creatinine ratio (ACR)>3g/mol] had higher median levels of endostatin than those without nephropathy (62.7μg/L vs 57.4μg/L, respectively; P=0.031). In longitudinal analyses adjusted for age, gender, baseline eGFR and ACR, higher endostatin levels were associated with a higher risk of decline (≥20% in eGFR, OR per 1 SD increase: 1.73, 95% CI: 1.13-2.65) and a higher risk of mortality (HR per 1 SD increase: 1.57, 95% CI: 1.19-2.07).

CONCLUSION: In patients with T2D, circulating endostatin levels can predict the progression of kidney disease and mortality independently of established kidney disease markers. The clinical usefulness of endostatin as a risk marker in such patients merits further studies.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Albumin-to-creatinine ratio, Angiogenesis, Chronic kidney disease, Community, Extracellular matrix remodeling, NIDDM
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-129960 (URN)10.1016/j.diabet.2016.03.006 (DOI)000392262700006 ()27080454 (PubMedID)
Note

Funding agencies: Swedish Research Council; Swedish Heart-Lung Foundation; Marianne and Marcus Wallenberg Foundation; European Union [634869]

Available from: 2016-07-02 Created: 2016-07-02 Last updated: 2017-11-28Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-1680-1000

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