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  • 1.
    Carlsson, A
    et al.
    Skåne University Hospital SUS.
    Kockum, I
    Karolinska Institute.
    Lindblad, B
    Queen Silvia Childrens Hospital.
    Engleson, L
    Skåne University Hospital SUS.
    Nilsson, A
    Lund University.
    Forsander, G
    Queen Silvia Childrens Hospital.
    Karlsson, A-K
    Queen Silvia Childrens Hospital.
    Kernell, A
    Sachs Childrens Hospital.
    Ludvigsson, Johnny
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Marcus, C
    Karolinska Institute.
    Zachrisson, I
    Karolinska Institute.
    Ivarsson, S-A
    Lund University.
    Lernmak, A
    Lund University.
    Low risk HLA-DQ and increased body mass index in newly diagnosed type 1 diabetes children in the Better Diabetes Diagnosis study in Sweden2012In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 36, no 5, p. 718-724Article in journal (Refereed)
    Abstract [en]

    Objective: Type 1 diabetes and obesity has increased in childhood. We therefore tested the hypothesis that type 1 diabetes human leukocyte antigen DQ (HLA-DQ) risk genotypes may be associated with increased body mass index (BMI). less thanbrgreater than less thanbrgreater thanDesign: The type 1 diabetes high-risk HLA-DQ A1*05:01-B1*02:01/A1*03:01-B1*03:02 genotype along with lower risk DQ genotypes were determined at the time of clinical onset by PCR and hybridization with allele-specific probes. BMI was determined after diabetes was stabilized. less thanbrgreater than less thanbrgreater thanSubjects: A total of 2403 incident type 1 diabetes children below 18 years of age were ascertained in the Swedish national Better Diabetes Diagnosis (BDD) study between May 2005 to September 2009. All children classified with type 1 diabetes, including positivity for at least one islet autoantibody, were investigated. less thanbrgreater than less thanbrgreater thanResults: Overall, type 1 diabetes HLA-DQ risk was negatively associated with BMI (Pandlt;0.0008). The proportion of the highest risk A1*05:01-B1*02:01/A1*03:01-B1*03:02 genotype decreased with increasing BMI (Pandlt;0.0004). However, lower risk type 1 diabetes DQ genotypes were associated with an increased proportion of patients who were overweight or obese (Pandlt;0.0001). Indeed, the proportion of patients with the low-risk A1*05:01-B1*02:01/A1*05:01-B1*02:01 genotype increased with increasing BMI (Pandlt;0.003). The magnitude of association on the multiplicative scale between the A1*05:01-B1*02:01/A1*05:01-B1*02:01 genotype and increased BMI was significant (Pandlt;0.006). The odds ratio in patients with this genotype of being obese was 1.80 (95% confidence interval 1.21-2.61; Pandlt;0.006). The increased proportion of overweight type 1 diabetes children with the A1*05:01-B1*02:01 haplotype was most pronounced in children diagnosed between 5 and 9 years of age. less thanbrgreater than less thanbrgreater thanConclusions: Susceptibility for childhood type 1 diabetes was unexpectedly found to be associated with the A1*05:01-B1*02:01/A1*05:01-B1*02:01 genotype and an increased BMI. These results support the hypothesis that overweight may contribute to the risk of type 1 diabetes in children positive for HLA-DQ A1*05:01-B1*02:01.

  • 2.
    Ekberg, Joakim
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Angbratt, Marianne
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Valter, L.
    Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Nordwall, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Norrköping.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    History matters: childhood weight trajectories as a basis for planning community-based obesity prevention to adolescents2012In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 36, no 4, p. 524-528Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To use epidemiological data and a standardized economic model to compare projected costs for obesity prevention in late adolescence accrued using a cross-sectional weight classification for selecting adolescents at age 15 years compared with a longitudinal classification. less thanbrgreater than less thanbrgreater thanMETHODS: All children born in a Swedish county (population 440 000) in 1991 who participated in all regular measurements of height and weight at ages 5, 10 and 15 years (n=4312) were included in the study. The selection strategies were compared by calculating the projected financial load resulting from supply of obesity prevention services from providers at all levels in the health care system. The difference in marginal cost per 1000 children was used as the primary end point for the analyses. less thanbrgreater than less thanbrgreater thanRESULTS: Using the cross-sectional selection strategy, 3.8% of adolescents at age 15 years were selected for evaluation by a pediatric specialist, and 96.2% were chosen for population-based interventions. In the trajectory-based strategy, 2.4% of the adolescents were selected for intensive pediatric care, 1.4% for individual clinical interventions in primary health care, 14.0% for individual primary obesity prevention using the Internet and 82.1% for population-based interventions. Costs for the cross-sectional selection strategy were projected to USD463 581 per 1000 adolescents and for the trajectory-based strategy were USD 302 016 per 1000 adolescents. less thanbrgreater than less thanbrgreater thanCONCLUSIONS: Using projections from epidemiological data, we found that by basing the selection of adolescents for obesity prevention on weight trajectories, the load on highly specialized pediatric care can be reduced by one-third and total health service costs for obesity management among adolescents reduced by one-third. Before use in policies and prevention program planning, our findings warrant confirmation in prospective cost-benefit studies.

  • 3.
    Falkenberg, Melcher
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Steps towards the prevention of obesity and associated complications.1999In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 23, p. 20-22Article in journal (Refereed)
  • 4.
    Fjälldal, S.
    et al.
    Skåne Univ Hosp, Sweden.
    Follin, C.
    Skane Univ Hosp, Sweden.
    Gabery, S.
    Lund Univ, Sweden.
    Sundgren, P. C.
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Bjorkman-Burtscher, I. M.
    Skane Univ Hosp, Sweden; Lund Univ, Sweden; Lund Univ, Sweden.
    Latt, J.
    Skane Univ Hosp, Sweden.
    Mannfolk, P.
    Skane Univ Hosp, Sweden.
    Nordstrom, C. H.
    Skane Univ Hosp, Sweden.
    Rylander, L.
    Lund Univ, Sweden.
    Ekman, Bertil
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Cheong, R.
    Lund Univ, Sweden.
    Palsson, A.
    Skane Univ Hosp, Sweden.
    Petersen, A.
    Lund Univ, Sweden.
    Erfurth, E. M.
    Skane Univ Hosp, Sweden.
    Detailed assessment of hypothalamic damage in craniopharyngioma patients with obesity2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 43, no 3, p. 533-544Article in journal (Refereed)
    Abstract [en]

    Background/objectives Hypothalamic obesity (HO) occurs in 50% of patients with the pituitary tumor craniopharyngioma (CP). Attempts have been made to predict the risk of HO based on hypothalamic (HT) damage on magnetic resonance imaging (MRI), but none have included volumetry. We performed qualitative and quantitative volumetric analyses of HT damage. The results were explored in relation to feeding related peptides and body fat. Subjects/methods A cross-sectional study of childhood onset CPs involving 3 Tesla MRI, was performed at median 22 years after first operation; 41 CPs, median age 35 (range: 17-56), of whom 23 had HT damage, were compared to 32 controls. After exclusions, 35 patients and 31 controls remained in the MRI study. Main outcome measures were the relation of metabolic parameters to HT volume and qualitative analyses of HT damage. Results Metabolic parameters scored persistently very high in vascular risk particularly among HT damaged patients. Patients had smaller HT volumes compared to controls 769 (35-1168) mm(3) vs. 879 (775-1086) mm(3); P amp;lt; 0.001. HT volume correlated negatively with fat mass and leptin among CP patients (r(s) = -0.67; P amp;lt; .001; r(s) = -0.53; P = 0.001), and explained 39% of the variation in fat mass. For every 100 mm(3) increase in HT volume fat mass decreased by 2.7 kg (95% CI: 1.5-3.9; P amp;lt; 0.001). Qualitative assessments revealed HT damage in three out of six patients with normal volumetry, but HT damage according to operation records. Conclusions A decrease in HT volume was associated with an increase in fat mass and leptin. We present a method with a high inter-rater reliability (0.94) that can be applied by nonradiologists for the assessment of HT damage. The method may be valuable in the risk assessment of diseases involving the HT.

  • 5.
    Jones, A Wayne
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Rossner, S.
    Karolinska Hospital.
    False-positive breath-alcohol test after a ketogenic diet2007In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 31, no 3, p. 559-561Article in journal (Refereed)
    Abstract [en]

    A 59-year-old man undergoing weight loss with very low calorie diets (VLCD) attempted to drive a car, which was fitted with an alcohol ignition interlock device, but the vehicle failed to start. Because the man was a teetotaller, he was surprised and upset by this result. VLCD treatment leads to ketonemia with high concentrations of acetone, acetoacetate and beta-hydroxybutyrate in the blood. The interlock device determines alcohol ( ethanol) in breath by electrochemical oxidation, but acetone does not undergo oxidation with this detector. However, under certain circumstances acetone is reduced in the body to isopropanol by hepatic alcohol dehydrogenase (ADH). The ignition interlock device responds to other alcohols ( e. g. methanol, n-propanol and isopropanol), which therefore explains the false-positive result. This side effect of ketogenic diets needs further discussion by authorities when people engaged in safety-sensitive work ( e. g. bus drivers and airline pilots) submit to random breath-alcohol tests.

  • 6.
    Lavebratt, C
    et al.
    Karolinska Institutet.
    Alpman, A
    Karolinska Institutet.
    Persson, Bengt
    Linköping University, The Institute of Technology. Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics .
    Arner, P
    Karolinska University Hospital.
    Hoffstedt, J
    Karolinska University Hospital.
    Common neuropeptide Y2 receptor gene variant is protective against obesity among Swedish men2006In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 30, p. 453-459Article in journal (Refereed)
  • 7. Lavebratt, C.
    et al.
    Sengul, S.
    Gu, H.F.
    Persson, Bengt
    Linköping University, The Institute of Technology. Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics .
    Nordfors, L.
    Östenson, C.-G.
    Efendic, S.
    Arner, P.
    Hoffstedt, J.
    Schalling, M.
    Association study between chromosome 10q26.11 and obesity among Swedish men2005In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 29, no 12, p. 1422-1428Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Proximal chromosome 10q26 was recently linked to waist/hip ratio in European and African-American families. The objective was to investigate whether genomic variation in chromosome 10q26.11 reflects variation in obesity-related clinical parameters in a Swedish population. DESIGN: Genetic association study of single-nucleotide polymorphisms (SNPs) in chromosome 10q26.11 and obesity-related clinical parameters was performed. Obesity was defined as body mass index (BMI)≥30 kg/m2. SUBJECTS: Swedish Caucasians comprising 276 obese and 480 nonobese men, 313 obese and 494 nonobese women, 177 obese and 163 nonobese patients with type 2 diabetes mellitus (T2DM), and 106 obese and 201 nonobese subjects with impaired glucose tolerance (IGT) patients. MEASUREMENTS: Genotypes of 11 SNPs at chromosome 10q26.11, and various obesity-related clinical parameters. RESULTS: Homozygosity of a common haplotype constructed by three SNPs, rs2185937, rs1797 and hCV1402327, covering an interval of 2.7 kb, was suggested to confer an increased risk for obesity of 1.5 among men (P=0.043). The C allele frequency and homozygous genotype frequency of the rs1797 tended to be higher among obese compared to among nonobese men (P=0.017 and 0.020, respectively). The distribution of BMI and diastolic blood pressure was higher among those with the C/C genotype (P=0.022 and 0.0061, respectively). The obese and the nonobese groups were homogeneous over BMI subgroups with regard to rs1797 risk genotype distribution. There was no tendency for association between rs1797 and obesity among neither women nor T2DM nor IGT patients. CONCLUSION: We show support for association between proximal chromosome 10q26.11 and obesity among Swedish men but not women through the analysis of a haplotype encompassing 2.7 kb. © 2005 Nature Publishing Group All rights reserved.

  • 8.
    Leppänen, M. H.
    et al.
    University of Jyvaskyla, Finland.
    Delisle Nyström, C.
    Karolinska Institute, Sweden.
    Henriksson, Pontus
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. University of Granada, Spain.
    Pomeroy, J.
    Marshfield Clin Research Fdn, WI USA.
    Ruiz, J. R.
    University of Granada, Spain.
    Ortega, F. B.
    University of Granada, Spain.
    Cadenas-Sanchez, C.
    University of Granada, Spain.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden.
    Physical activity intensity, sedentary behavior, body composition and physical fitness in 4-year-old children: results from the ministop trial2016In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 40, no 7, p. 1126-1133Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Existing knowledge on associations of physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness in preschoolers is limited. OBJECTIVE: To examine associations of PA and SB with body composition and physical fitness in healthy Swedish 4-year-old children. METHODS: We utilized baseline data collected in 2014 for the population-based MINISTOP trial (n = 307). Light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate-to-vigorous PA (MVPA) and SB were measured using accelerometry (ActiGraph-wGT3x-BT). Body composition was measured using air-displacement plethysmography, and physical fitness (that is, cardiorespiratory fitness, lower and upper body muscular strength and motor fitness) was measured using the PREFIT fitness test battery. Multiple linear regression models adjusted for relevant confounders, and in addition, isotemporal substitution models were applied. RESULTS: Greater MVPA was associated with lower fat mass percent (%FM, P = 0.015), and greater VPA and MVPA were associated with higher fat-free mass index (FFMI, P = 0.002 and P = 0.011). In addition, greater VPA and MVPA were associated with higher scores for all physical fitness tests (P = 0.042 to Pamp;lt;0.001). The results for MVPA were primarily due to VPA. SB was associated with weaker handgrip strength (P = 0.031) when PA was not adjusted, but after adjusting also for VPA, the significant association disappeared (P = 0.25). Substituting 5 min per day of SB, LPA or MPA with 5 min per day of VPA was associated with higher FFMI and better scores for cardiorespiratory fitness and motor fitness. Correspondingly, substituting 5 min per day of VPA with SB or LPA was associated with weaker performance for lower muscular strength. CONCLUSIONS: Time spent on VPA was associated with higher FFMI and better physical fitness. The results suggest that promoting VPA may be important to improve childhood body composition and physical fitness already at an early age.

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