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Lindström, Torbjörn
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Publications (10 of 68) Show all publications
Wärdig, R., Foldemo, A., Hultsjö, S., Lindström, T. & Bachrach-Lindström, M. (2016). An intervention with physical activity and lifestyle counseling improves health-related quality of life and shows small improvements in metabolic risk factors in persons with psychosis. Issues in Mental Health Nursing, 37(1), 43-52
Open this publication in new window or tab >>An intervention with physical activity and lifestyle counseling improves health-related quality of life and shows small improvements in metabolic risk factors in persons with psychosis
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2016 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 1, p. 43-52Article in journal (Refereed) Published
Abstract [en]

General purpose: To study the effects of a lifestyle intervention on health-related quality of life (HRQoL) and metabolic risk factors in persons with psychosis.

Methodology: A longitudinal intervention study with a matched reference sample.

Results: HRQoL measured by the EQ-VAS improved from 57.6 to 63.3 (17.8) in the intervention group (p=0.05). The HDL cholesterol concentration increased from 1.03 to 1.11 (0.19) mmol/l in the intervention group (p=0.02). There was no significant change in body weight.

Conclusion: A lifestyle intervention based on group meetings improves HRQoL in patients with psychosis. There are also small improvements in metabolic risk factors.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Health-related quality of life, lifestyle intervention, metabolic syndrome, physical health, psychosis
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:liu:diva-122367 (URN)10.3109/01612840.2015.1092187 (DOI)000369505500007 ()26818932 (PubMedID)
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2018-01-08Bibliographically approved
Jennersjö, P., Guldbrand, H., Björne, S., Länne, T., Fredrikson, M., Lindström, T., . . . Nyström, F. H. (2015). A prospective observational study of all-cause mortality in relation to serum 25-OH vitamin D-3 and parathyroid hormone levels in patients with type 2 diabetes. Diabetology and Metabolic Syndrome, 7(53)
Open this publication in new window or tab >>A prospective observational study of all-cause mortality in relation to serum 25-OH vitamin D-3 and parathyroid hormone levels in patients with type 2 diabetes
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2015 (English)In: Diabetology and Metabolic Syndrome, ISSN 1758-5996, E-ISSN 1758-5996, Vol. 7, no 53Article in journal (Refereed) Published
Abstract [en]

Background: Low levels of vitamin D have been related to increased mortality and morbidity in several non-diabetic studies. We aimed to prospectively study relationships between serum 25-OH vitamin D-3 (vitamin D) and of serum parathyroid hormone (PTH) to total mortality in type 2 diabetes. We also aimed to compare the levels of these potential risk-factors in patients with and without diabetes. Methods: The main study design was prospective and observational. We used baseline data from 472 men and 245 women who participated in the "Cardiovascular Risk factors in Patients with Diabetes-a Prospective study in Primary care" study. Patients were 55-66 years old at recruitment, and an age-matched non-diabetic sample of 129 individuals constituted controls for the baseline data. Carotid-femoral pulse-wave velocity (PWV) was measured with applanation-tonometry and carotid intima-media thickness (IMT) with ultrasound. Patients with diabetes were followed for all-cause mortality using the national Swedish Cause of Death Registry. Results: Levels of vitamin D were lower in patients with diabetes than in controls, also after correction for age and obesity, while PTH levels did not differ. Nine women and 24 men died during 6 years of median follow up of the final cohort (n = 698). Vitamin D levels were negatively related to all-cause mortality in men independently of age, PTH, HbA1c, waist circumference, 24-h systolic ambulatory-blood pressure (ABP) and serum-apoB (p = 0.049). This finding was also statistically significant when PWV and IMT were added to the analyses (p = 0.028) and was not affected statistically when medications were also included in the regression-analysis (p = 0.01). In the women with type 2 diabetes, levels of PTH were positively related with all-cause mortality in the corresponding calculations (p = 0.016 without PWV and IMT, p = 0.006 with PWV and IMT, p = 0.045 when also adding medications to the analysis), while levels of vitamin D was without statistical significance (p greater than 0.9). Conclusions: Serum vitamin D in men and serum PTH in women give prognostic information in terms of total-mortality that are independent of regular risk factors in addition to levels of ABP, IMT and PWV.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keywords
Arteriosclerosis; Calcium; Mortality; Parathyroid hormone; Type 2 diabetes; Vitamin D
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-120044 (URN)10.1186/s13098-015-0049-9 (DOI)000356219100001 ()26078787 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden; Futurum; King Gustaf V and Queen Victoria Freemason Foundation; GE Healthcare; Swedish Heart-Lung Foundation; Swedish Research Council [12661]; County Council of Ostergotland; Linkoping University, Department of Medical and Health Sciences

Available from: 2015-07-06 Created: 2015-07-06 Last updated: 2017-12-04
Blomstrand, P., Engvall, M., Festin, K., Lindström, T., Länne, T., Maret, E., . . . Engvall, J. (2015). Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes.. European heart journal cardiovascular Imaging, 16(9), 1000-1007
Open this publication in new window or tab >>Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes.
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2015 (English)In: European heart journal cardiovascular Imaging, ISSN 2047-2412, Vol. 16, no 9, p. 1000-1007Article in journal (Refereed) Published
Abstract [en]

AIMS: The aim of the study was to determine whether left ventricular systolic function, in terms of global left ventricular longitudinal strain (GLS), and diastolic function, expressed as the ratio between early diastolic transmitral flow and mitral annular motion velocities (E/e'), can predict cardiovascular events in patients with diabetes mellitus type 2.

METHODS AND RESULTS: We prospectively investigated 406 consecutive patients, aged 55-65 years, with diabetes mellitus, who participated in the CARDIPP study. Echocardiography, pulse pressure (pp), and glycosylated haemoglobin (HbA1c) were analysed. Twelve cases of myocardial infarction and seven cases of stroke were identified during the follow-up period of 67 ± 17 months. Univariate Cox regression analysis showed that E/e' was a strong predictor of cardiovascular events (hazards ratio 1.12; 95% confidence interval 1.06-1.18, P < 0.001). E/e' was prospectively associated with cardiovascular events independent of age, sex, GLS, left ventricular ejection fraction (LVEF), pp, and HbA1c in multivariate analysis. Receiver operating characteristic curves showed that E/e' and HbA1c were the strongest predictors for cardiovascular events, both having an area under the curve (AUC) of 0.71 followed by LVEF with an AUC of 0.65 and GLS of 0.61. In a Kaplan-Meyer analysis, the cumulative probability of an event during the follow-up period was 8.6% for patients with an E/e' ratio >15 compared with 2.6% for patients with E/e' ≤15, P = 0.011.

CONCLUSION: In middle-aged patients with type 2 diabetes, E/e' is a strong predictor of myocardial infarction and stroke, comparable with HbA1c and superior to GLS and LVEF.

Place, publisher, year, edition, pages
Oxford University Press, 2015
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-115748 (URN)10.1093/ehjci/jev027 (DOI)000364539700011 ()25750201 (PubMedID)
Note

Funding agencies: FORSS; Research Council of Southeastern Sweden; King Gustaf V and Queen Victoria Freemason Foundation, Sweden; Linkoping University; Futurum-the Academy for Healthcare, Jonkoping County Council

Available from: 2015-03-18 Created: 2015-03-18 Last updated: 2017-03-27
Wärdig, R., Bachrach-Lindström, M., Hultsjö, S., Lindström, T. & Foldemo, A. (2015). Persons with psychosis perceptions of participating in a lifestyle intervention. Journal of Clinical Nursing, 24(13-14), 1815-1824
Open this publication in new window or tab >>Persons with psychosis perceptions of participating in a lifestyle intervention
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2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 1815-1824Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe how persons with psychosis perceive participation in a lifestyle intervention, and use these perceptions to present factors to for consideration in future interventions.

BACKGROUND:

Metabolic syndrome is common in persons with psychosis. A healthy lifestyle is the primary option for preventing and treating metabolic syndrome, which is why the importance of lifestyle interventions has come into focus among health care professionals. Identifying perceptions of participation in a lifestyle intervention can increase the understanding of how to design future interventions.

DESIGN:

A qualitative, phenomenographic approach was selected, using semi-structured interviews.

METHODS:

The sample consisted of 40 participants with a psychotic disorder, who had undergone a lifestyle intervention focusing on theoretical education in healthy eating and physical activities. The interviews were conducted in 2011 and 2012, six to seven months after the intervention had been completed.

RESULTS:

The findings comprise three categories that emphasise the need for a moderate intervention level that facilitates participation and thereby social interactions among group members. The experience of success in the intervention supported the perception of oneself as a capable individual. However, it could also be the opposite, another experience of failure.

CONCLUSION:

Content in moderation can facilitate participation, and participants can thereby achieve health benefits and find social contacts. In addition to physical activity and lifestyle habits, interventions should have a social focus and be continuous. Professional support is a prerequisite and should facilitate the participants' ability to mirror themselves against healthy people in society by introducing activities that ordinary people do.

RELEVANCE FOR CLINICAL PRACTICE:

Identifying perceptions of participation in a lifestyle intervention can increase the understanding of how to design and manage future interventions. This is also an aspect that is important to consider in everyday clinical practice.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-115726 (URN)10.1111/jocn.12782 (DOI)000356872900007 ()25664402 (PubMedID)
Available from: 2015-03-18 Created: 2015-03-18 Last updated: 2017-12-04
Vavruch, C., Länne, T., Fredrikson, M., Lindström, T., Östgren, C. J. & Nyström, F. H. (2015). Serum leptin levels are independently related to the incidence of ischemic heart disease in a prospective study of patients with type 2 diabetes. Cardiovascular Diabetology, 14(62)
Open this publication in new window or tab >>Serum leptin levels are independently related to the incidence of ischemic heart disease in a prospective study of patients with type 2 diabetes
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2015 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 14, no 62Article in journal (Refereed) Published
Abstract [en]

Background: New and clinically useful markers of cardiovascular risk are of essence in type 2 diabetes since ischemic heart disease is a major cause of death in these patients. Methods: We analyzed baseline data from 476 men and 244 women who participated in "Cardiovascular Risk factors in Patients with Diabetes -a Prospective study in Primary care" study. All participants had type 2 diabetes and were 55-66 years old at recruitment during year 2005 to 2008. Except for established traditional risk markers for vascular disease, we also estimated vascular complications non-invasively by performance of carotid-femoral pulse-wave velocity (PWV, with applanation-tonometry) and intima-media thickness of carotid arteries (IMT, with B-mode ultrasound). Patients were followed for incidence of ischemic heart disease mortality and morbidity until end of the year 2012, using the national Swedish Cause of Death and Hospitalization Registries. Results: During the follow-up period of a median of 6 years 47 men and 10 women died or were hospitalized for ischemic heart disease including myocardial infarction. Leptin levels were positively related to the hazard ratio (HR) in men (HR for each log 10 unit 4.9, CI 1.99 to 11.8) and women (HR 11.5, CI 1.47 to 89.7). Leptin predicted ischemic heart disease independently of age, HbA1c, BMI, systolic blood pressure and LDL-cholesterol/HDL-cholesterol ratio (men: HR 12.9 CI 3.2-53, women: HR 19.9, CI 1.2-327) This finding of increased risk related to high leptin levels was also statistically significant when carotid-femoral PWV and IMT were both added to the equations in men (hazard ratio 9.2 CI 2.1-41). Conclusions: Our data support the use of serum leptin in type 2 diabetes to add independent prognostic information in terms of ischemic heart disease when compared with traditional cardiovascular risk factors. In the men of the cohort this prognostic information was in addition also to data on IMT and PWV, two non-invasive measurements of the extent of vascular disease. The power to detect a similar relationship in women was less strong due to lower incidence of cardiovascular disease. Trial registration: ClinicalTrials. gov:

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2015
Keywords
Blood pressure; Intima media thickness; Ischemic heart disease; Leptin; Obesity; Pulse wave velocity; Type 2 diabetes
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-120066 (URN)10.1186/s12933-015-0208-1 (DOI)000356133200001 ()25994184 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden; Futurum; King Gustaf V and Queen Victoria Freemason Foundation; GE Healthcare; Swedish Heart-Lung Foundation; Swedish Research Council Grant [12661]; County Council of Ostergosland; Linkoping University, Department of Medical and Health Sciences

Available from: 2015-07-06 Created: 2015-07-06 Last updated: 2017-12-04
Foldemo, A., Wärdig, R., Bachrach-Lindstrom, M., Edman, G., Holmberg, T., Lindström, T., . . . Osby, U. (2014). Health-related quality of life and metabolic risk in patients with psychosis. Schizophrenia Research, 152(1), 295-299
Open this publication in new window or tab >>Health-related quality of life and metabolic risk in patients with psychosis
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2014 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 152, no 1, p. 295-299Article in journal (Refereed) Published
Abstract [en]

Improved Health-related quality of life (HRQoL) is an alternative treatment goal for individuals with psychosis, who have up to two times greater prevalence of type 2 diabetes, hypertension and obesity than the general population. Aim: to compare HRQoL in patients with psychosis, especially schizophrenia, with a reference sample and explore the relationship between HRQoL and metabolic risk factors in these patients. Methods: a prospective cohort study was carried out in specialized psychiatric outpatient departments in Sweden. The patients were invited consecutively. A prospective population-based study of public health in the south-east of Sweden served as reference group. Patients were assessed with psychiatric questionnaires that included Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the questionnaire EQ5D, both for patients and the population, and several other health status outcomes were used. Results: At 73%, schizophrenia and schizoaffective disorder were the most common diagnoses in the patient group. The results in patients (n = 903) and population (n = 7238) showed significant differences in lower EQ5D among patients. According to the definition by the International Diabetes Federation (IDF), elevated blood pressure was the only metabolic risk associated with lower HRQoL in patients. Raised LDL-cholesterol levels were also significantly related to lower HRQoL. Conclusion: patients suffering from psychosis had significantly lower HRQoL regarding all components in EQ5D, except for the pain/discomfort component. Almost half of the patient group met the criteria for metabolic syndrome. According to the IDF criteria, elevated blood pressure was the only metabolic risk factor that had an impact on HRQoL.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Metabolic syndrome; Schizophrenia; Health-related quality of life; Reference group
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-104125 (URN)10.1016/j.schres.2013.11.029 (DOI)000329217000043 ()
Available from: 2014-02-07 Created: 2014-02-07 Last updated: 2017-12-06
Hedman, C. A., Frystyk, J., Lindström, T., Oskarsson, P. & Arnqvist, H. J. (2014). Intraperitoneal insulin delivery to patients with type 1 diabetes results in higher serum IGF-I bioactivity than continuous subcutaneous insulin infusion. Clinical Endocrinology, 81(1), 58-62
Open this publication in new window or tab >>Intraperitoneal insulin delivery to patients with type 1 diabetes results in higher serum IGF-I bioactivity than continuous subcutaneous insulin infusion
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2014 (English)In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 81, no 1, p. 58-62Article in journal (Refereed) Published
Abstract [en]

Objective

Type 1 diabetes (T1D) is associated with low IGF-I and altered levels of IGF-binding proteins (IGFBPs) in plasma. This may be of importance for insulin sensitivity and the risk of developing diabetic complications. We hypothesized that IGF-I bioactivity is affected by the route of insulin administration and that continuous intraperitoneal insulin infusion (CIPII) has a more pronounced effect than continuous subcutaneous insulin infusion (CSII).

Design and methods

We compared 10 patients with T1D on CIPII with 20 age- and sex-matched patients on CSII. Blood sampling was carried out 7–9 am after an overnight fast. All patients were C-peptide negative. IGF-I bioactivity was measured in vitro using a specific IGF-I kinase receptor activation (KIRA) assay. IGF-I was also measured by immunoassay together with IGF-II, IGFBP-1 and IGFBP-2.

Results

When compared with subcutaneous insulin, intraperitoneal insulin resulted in (CIPII vs CSII) higher IGF-I bioactivity (1·83 ± 0·76 vs 1·16 ± 0·24 μg/l; P = 0·02), IGF-I (120 ± 35 vs 81 ± 19 μg/l; P = 0·01) and IGF-II (1050 ± 136 vs 879 ± 110 μg/l; P = 0·02). By contrast, log-transformed IGFBP-1 was reduced (P = 0·013), whereas log-transformed IGFBP-2 was not different (P = 0·12). There was a positive correlation between IGF bioactivity and IGF-I (r = 0·69; P < 0·001) and an inverse correlation between IGF-I bioactivity and log10 IGFBP-1 (r = −0·68, P < 0·001).

Conclusion

The in vitro IGF-I bioactivity was higher in patients treated with CIPII compared with CSII supporting the theory that the route of insulin administration is of importance for the activity of the IGF system. Intraperitoneal insulin administration may therefore be beneficial by correcting the alterations of the IGF system in T1D.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-104324 (URN)10.1111/cen.12296 (DOI)000337735900009 ()23865977 (PubMedID)
Available from: 2014-02-16 Created: 2014-02-16 Last updated: 2017-12-06
Wärdig, R., Bachrach-Lindström, M., Hultsjö, S., Lindström, T. & Foldemo, A. (2014). Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis. In: : . Paper presented at The 4th Biennial Schizophrenia International Research Society Conference, 5-9 April 2014, Florens, Italy.
Open this publication in new window or tab >>Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis
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2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

 

 

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107561 (URN)
Conference
The 4th Biennial Schizophrenia International Research Society Conference, 5-9 April 2014, Florens, Italy
Available from: 2014-06-16 Created: 2014-06-16 Last updated: 2014-08-07
Guldbrand, H., Lindström, T., Dizdar, B., Bunjaku, B., Östgren, C. J., Nyström, F. H. & Bachrach-Lindström, M. (2014). Randomization to a low-carbohydrate diet advice improves health related quality of life compared with a low-fat diet at similar weight-loss in Type 2 diabetes mellitus. Diabetes Research and Clinical Practice, 106(2), 221-227
Open this publication in new window or tab >>Randomization to a low-carbohydrate diet advice improves health related quality of life compared with a low-fat diet at similar weight-loss in Type 2 diabetes mellitus
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2014 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 106, no 2, p. 221-227Article in journal (Refereed) Published
Abstract [en]

Aims

To compare the effects on health-related quality of life (HRQoL) of a 2-year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD) based on four group-meetings to achieve compliance. To describe different aspects of taking part in the intervention following the LFD or LCD.

Methods

Prospective, randomized trial of 61 adults with Type 2 diabetes mellitus. The SF-36 questionnaire was used at baseline, 6, 12 and 24 months. Patients on LFD aimed for 55–60 energy percent (E%) and those on LCD for 20 E% from carbohydrates. The patients were interviewed about their experiences of the intervention.

Results

Mean body-mass-index was 32.7 ± 5.4 kg/m2 at baseline. Weight-loss did not differ between groups and was maximal at 6 months, LFD: −3.99 ± 4.1 kg, LCD: −4.31 ± 3.6 kg (p < 0.001 within groups). There was an increase in the physical component score of SF-36 from 44.1 (10.0) to 46.7 (10.5) at 12 months in the LCD group (p < 0.009) while no change occurred in the LFD group (p < 0.03 between groups). At 12 months the physical function, bodily pain and general health scores improved within the LCD group (p values 0.042–0.009) while there was no change within the LFD group.

Conclusions

Weight-changes did not differ between the diet groups while improvements in HRQoL only occurred after one year during treatment with LCD. No changes of HRQoL occurred in the LFD group in spite of a similar reduction in body weight.

 

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Type 2 diabetes mellitus; Dietary intervention; Low-carbohydrate diet; SF-36
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-112690 (URN)10.1016/j.diabres.2014.08.032 (DOI)000346060500019 ()25271116 (PubMedID)
Available from: 2014-12-08 Created: 2014-12-08 Last updated: 2018-01-11Bibliographically approved
Wärdig, R., Bachrach-Lindström, M., Foldemo, A., Lindström, T. & Hultsjö, S. (2013). Conditions for a healthy lifestyle - from the perspective of individuals with psychosis. Paper presented at International congress on schizophrenia research,21-25/4 2013, Orlando, USA.
Open this publication in new window or tab >>Conditions for a healthy lifestyle - from the perspective of individuals with psychosis
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2013 (English)Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91806 (URN)
Conference
International congress on schizophrenia research,21-25/4 2013, Orlando, USA
Available from: 2013-05-02 Created: 2013-05-02 Last updated: 2013-05-02
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