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  • 1.
    Rydén, Mireille
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Garvin, Peter
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Occupational and Environmental Medicine Centre.
    Ernerudh, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Provitamin A carotenoids are independently associated with matrix metalloproteinase-9 in plasma samples from a general population2012In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 272, no 4, p. 371-384Article in journal (Refereed)
    Abstract [en]

    Background and aim:  Carotenoids in plasma are inversely associated with cardiovascular risk. Low levels can be explained by low dietary intake but also by a number of other factors including inflammatory activity. Given that matrix metalloproteinase (MMP)-9 has an important role in inflammation and cardiovascular disease, we hypothesized that circulating MMP-9 levels would be inversely related to total or single carotenoids in a general population cohort. Methods:  A well-characterized population-based cohort of 285 Swedish men and women (45-69 years) was used for the present study. The intake of carotenoid-rich fruits and vegetables was estimated from a food frequency questionnaire. Levels of MMP-9, C-reactive protein (CRP), interleukin (IL)-6 and six major carotenoids [β-cryptoxanthine, α-carotene, β-carotene, lutein (+ zeaxanthin) and lycopene] were determined in plasma. Results:  Lower plasma levels of total and single carotenoids were associated with lower dietary intake of carotenoids, older age, male sex, lower physical activity, higher alcohol consumption, higher body mass index (BMI), higher systolic and diastolic blood pressures, lower levels of total cholesterol and HDL cholesterol and higher levels of CRP, IL-6 and MMP-9. After multivariate adjustments, plasma levels of total carotenoids and provitamin A carotenoids (β-cryptoxanthine, α-carotene and β-carotene) remained independently associated with sex, dietary intake of carotenoids, BMI, HDL cholesterol and MMP-9, while associations with CRP and IL-6 were not maintained. Neither dietary intake of carotenoid-rich fruits and vegetables, nor vitamin supplement use was associated with MMP-9, CRP or IL-6 levels. Conclusion:  Plasma carotenoids were associated with a variety of factors including age, sex, dietary intake and metabolic variables. A new finding was the independent relationship in plasma between low provitamin A carotenoids and high MMP-9, suggesting a link between these carotenoids, matrix turnover and arterial remodelling. © 2012 The Association for the Publication of the Journal of Internal Medicine.

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  • 2.
    Rydén, Mireille
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Hedbäck, Bo
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Does Stress Reduction Change the Levels of Cortisol Secretion in Patients With Coronary Artery Disease?2009In: JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION, ISSN 1932-7501, Vol. 29, no 5, p. 314-317Article in journal (Refereed)
    Abstract [en]

    PURPOSE: It has been shown that behavioral therapy has effects on Stress behavior in patients with coronary artery disease Salivary cortisol measurements are widely used to assess psychological stress, stress reactivity or both The aim of this study was to investigate whether improved stress behavior in type A patients with coronary artery disease involved changes in cortisol secretion pattern METHODS: Twenty-four male patients were identified as type A individuals and completed a 12-month cognitive-behavioral stress management program Stress behavior was evaluated by using a validated questionnaire Morning and evening salivary cortisol levels were measured over 3 consecutive clays at baseline and after 12 months. RESULTS: Although the patients showed a significant improvement in psychosocial well-being after 12 months, their basal cortisol levels of diurnal rhythm of cortisol did not change There was no Correlation between stress score and cortisol levels CONCLUSIONS. The value of salivary cortisol as both a stress marker and a new cardiovasular risk factor has been discussed but the data from this small Pilot Study raise the question of its utility as a stress marker in cardiac rehabilitation

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  • 3.
    Rydén, Mireille
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Garvin, Peter
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Carotenoid levels in plasma: can dietary intake and inflammation explain variability?2011Conference paper (Refereed)
    Abstract [en]

    Purpose: Low plasma levels of carotenoids and low dietary intake of carotenoids are both linked to increased cardiovascular risk. The supply of carotenoids depends on dietary sources. However, it has also been shown that inflammation may have major influence on plasma carotenoids. The aim of this study was to examine the association of plasma carotenoids with dietary intake of carotenoids and a panel of inflammatory markers including matrix metalloproteinase (MMP)-9.

    Methods: A population-based cohort consisting of 285 Swedish men and women (45-69 years) was studied. Fruit and vegetable consumption was estimated from a validated 92-item semi-quantitative food-frequency questionnaire. Plasma levels of C-reactive protein, interleukin (IL)-6, IL-8, myeloperoxidase and MMP-9 were determined as were plasma concentrations of 5 major carotenoids: lutein, β-crypthoxanthine, lycopen, α-carotene and β-carotene.

    Result: Lower plasma levels of lipid-adjusted carotenoids (low vs top tertile) were significantly associated with higher age, male sex, higher body mass index (BMI), higher systolic and diastolic blood pressure, higher IL-6 and MMP-9 levels and lower intake of carotenoid-rich food. Low dietary intake of carotenoids was related to male sex, smoking and low plasma carotenoids. After adjustment for age, sex, BMI, blood pressure, physical activity, smoking, dietary intake, IL-6 and MMP-9, plasma carotenoids remained associated with age (Beta= -0.17, p<0.01), sex (Beta=0.19, p<0.01), BMI (Beta= -0.19, p<0.01), dietary intake (Beta=0.21, p<0.01) and MMP-9 (Beta= -0.13, p<0.05). However, these associations differed among individual carotenoids, e.g. the correlation to MMP-9 was restricted to α-carotene (Beta= -0.13, p<0.05) and the correlation to sex was restricted to α-carotene (Beta=0.23, p<0.001) and β-carotene (Beta=0.18, p<0.01).

    Conclusion: In this population-based study, plasma carotenoids reflected dietary intake of carotenoids but to a minor extent. Also, levels of inflammatory markers explained very little of the variability in plasma carotenoids. Instead, age, sex and BMI independently influenced the levels of carotenoids. In cardiovascular risk management, we need to better understand the potential determinants of carotenoid levels in plasma.

  • 4.
    Rydén, Mireille
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Effects of simvastatin on carotenoid status in plasma2010Conference paper (Refereed)
    Abstract [en]

    Purpose: Carotenoids are potent antioxidants and immunomodulators mainly transported in the low density lipoprotein (LDL) fraction. It is well known that low plasma carotenoids are associated with cardiovascular disease incidence. We investigated whether simvastatin altered the carotenoid status in plasma.

    Methods: A randomized double-blind study design was used. Eighty volunteers with mild to moderate hypercholesterolemia received either simvastatin 40 mg or placebo for 6 weeks. Lipids, inflammatory markers, oxygenated carotenoids (lutein, zeaxanthin, beta-cryptoxanthin) and hydrocarbon carotenoids (alphacarotene, beta-carotene and lycopene) were measured in plasma.

    Results: After simvastatin therapy, total cholesterol, LDL, apolipoprotein B (apo B), oxidized LDL and C-reactive protein were significantly reduced. Simvastatin therapy also resulted in significantly reduced plasma levels of all crude major carotenoids. However, after adjustment for total cholesterol, LDL or apo B, all carotenoids except beta-cryptoxanthin increased during statin therapy (see Table). The carotenoids were inversely correlated with inflammatory markers but these correlations were abolished during simvastatin therapy.

    Conclusions: The increase in lipid-adjusted levels of carotenoids during simvastatin therapy suggest that lipoproteins had become enriched with carotenoids. The data highlight the risk to misinterpret the carotenoid status in individuals with statin therapy if relying on absolute plasma levels.

  • 5.
    Rydén, Mireille
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Kastbom, K.O.
    n/a.
    Jonasson, Lena
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Effects of Simvastatin on carotenoid status in plasma2010Conference paper (Other academic)
    Abstract [en]

    BACKGROUND AND AIMS: Carotenoids are potent antioxidants mainly transported in the low density lipoprotein (LDL) fraction. They may also influence the immune response and inverse associations with inflammatory markers have been reported. We investigated whether simvastatin, by exerting both lipid-lowering and anti-inflammatory effects, altered the carotenoid status in plasma.

    METHODS AND RESULTS: A randomized, double-blind, placebo-controlled study design was applied. Eighty volunteers with mild to moderate hypercholesterolemia received either simvastatin 40 mg or placebo for 6 weeks. Lipids, oxidized LDL (ox-LDL), C-reactive protein (CRP), interleukin (IL)-6, oxygenated carotenoids (lutein, zeaxanthin, beta-cryptoxanthin) and hydrocarbon carotenoids (alpha-carotene, beta-carotene, lycopene) were measured in plasma. Simvastatin use was associated with significant reductions in total cholesterol, LDL, ox-LDL and CRP. Simvastatin therapy also resulted in reduced plasma levels of both oxygenated and hydrocarbon carotenoids. However, when adjusted for lipids, all carotenoids except beta-cryptoxanthin showed significant increases after simvastatin therapy. Both crude and lipid-adjusted carotenoids were inversely correlated with CRP and IL-6 in plasma but the change in carotenoid status during simvastatin therapy was not specifically related to any changes in inflammatory markers.

    CONCLUSIONS: To summarize, the change in carotenoid status during simvastatin therapy was mainly attributed to the lowering of cholesterol and not to the suppression of inflammatory activity. After adjustment for lipids, the levels of lutein, lycopene, alpha-carotene and beta-carotene were significantly increased by simvastatin suggesting an increased ratio of carotenoids per particle.

  • 6.
    Rydén, Mireille
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Kastbom, K-O
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Effects of simvastatin on carotenoid status in plasma2010In: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 22, no 1, p. 66-71Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Carotenoids are potent antioxidants mainly transported in the low density lipoprotein (LDL) fraction. They may also influence the immune response and inverse associations with inflammatory markers have been reported. We investigated whether simvastatin, by exerting both lipid-lowering and anti-inflammatory effects, altered the carotenoid status in plasma.

    METHODS AND RESULTS: A randomized, double-blind, placebo-controlled study design was applied. Eighty volunteers with mild to moderate hypercholesterolemia received either simvastatin 40 mg or placebo for 6 weeks. Lipids, oxidized LDL (ox-LDL), C-reactive protein (CRP), interleukin (IL)-6, oxygenated carotenoids (lutein, zeaxanthin, beta-cryptoxanthin) and hydrocarbon carotenoids (alpha-carotene, beta-carotene, lycopene) were measured in plasma. Simvastatin use was associated with significant reductions in total cholesterol, LDL, ox-LDL and CRP. Simvastatin therapy also resulted in reduced plasma levels of both oxygenated and hydrocarbon carotenoids. However, when adjusted for lipids, all carotenoids except beta-cryptoxanthin showed significant increases after simvastatin therapy. Both crude and lipid-adjusted carotenoids were inversely correlated with CRP and IL-6 in plasma but the change in carotenoid status during simvastatin therapy was not specifically related to any changes in inflammatory markers.

    CONCLUSIONS: To summarize, the change in carotenoid status during simvastatin therapy was mainly attributed to the lowering of cholesterol and not to the suppression of inflammatory activity. After adjustment for lipids, the levels of lutein, lycopene, alpha-carotene and beta-carotene were significantly increased by simvastatin suggesting an increased ratio of carotenoids per particle.

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