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Kleyko, D., Osipov, E. & Wiklund, U. (2019). A Hyperdimensional Computing Framework for Analysis of Cardiorespiratory Synchronization During Paced Deep Breathing. IEEE Access, 7, 34403-34415
Åpne denne publikasjonen i ny fane eller vindu >>A Hyperdimensional Computing Framework for Analysis of Cardiorespiratory Synchronization During Paced Deep Breathing
2019 (engelsk)Inngår i: IEEE Access, E-ISSN 2169-3536, Vol. 7, s. 34403-34415Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Autonomic function during deep breathing (DB) is normally scored based on the assumption that the heart rate is synchronized with the breathing. We have observed individuals with subtle arrhythmias during DB, where an autonomic function cannot be evaluated. This paper presents a novel method for analyzing cardiorespiratory synchronization: feature-based analysis of the similarity between heart rate and respiration using the principles of hyperdimensional computing. Heart rate and respiration signals were modeled using Fourier series analysis. Three feature variables were derived and mapped to binary vectors in a high-dimensional space. Using both synthesized data and recordings from patients/healthy subjects, the similarity between the feature vectors was assessed using Hamming distance (high-dimensional space), Euclidean distance (original space), and with a coherence-based index. Methods were evaluated via the classification of the similarity indices into three groups. The distance-based methods achieved good separation of signals into classes with different degrees of cardiorespiratory synchronization, also providing identification of patients with low cardiorespiratory synchronization but high values of conventional DB scores. Moreover, binary high-dimensional vectors allowed an additional analysis of the obtained Hamming distance. Feature-based similarity analysis using hyperdimensional computing is capable of identifying signals with low cardiorespiratory synchronization during DB due to arrhythmias. Vector-based similarity analysis could be applied to other types of feature variables than based on spectral analysis. The proposed methods for robustly assessing cardiorespiratory synchronization during DB facilitate the identification of individuals where the evaluation of the autonomic function is problematic or even impossible, thus increasing the correctness of the conventional DB scores.

sted, utgiver, år, opplag, sider
Institute of Electrical and Electronics Engineers (IEEE), 2019
Emneord
Deep breathing test, deep breathing index, similarity analysis, heart rate variability, hyperdimensional computing
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-158768 (URN)10.1109/ACCESS.2019.2904311 (DOI)000463487400001 ()
Tilgjengelig fra: 2019-05-08 Laget: 2019-05-08 Sist oppdatert: 2019-05-08bibliografisk kontrollert
Almby, K. E., Abrahamsson, N., Lundqvist, M. H., Hammara, U., Thombare, K., Panagiotou, A., . . . Eriksson, J. W. (2019). Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery. European Journal of Endocrinology, 181(2), 161-171
Åpne denne publikasjonen i ny fane eller vindu >>Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery
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2019 (engelsk)Inngår i: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 181, nr 2, s. 161-171Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objectives: The aim of the study was to explore the role of GLP-1 receptor activation on the counter-regulation and symptoms of hypoglycemia in subjects who have undergone gastric bypass surgery (GBP).

Design: Experimental hyperinsulinemic–hypoglycemic clamp study.

Methods: Twelve post-GBP subjects participated in a randomized cross-over study with two hyperinsulinemic, hypoglycemic clamps (glucose nadir 2.7 mmol/L) performed on separate days with concomitant infusions of the GLP-1 analog exenatide or with saline, respectively. Continuous measurements of metabolites and counter-regulatory hormones as well as assessments of heart rate variability and symptoms of hypoglycemia were performed throughout the clamps.

Results: No effect of GLP-1 receptor activation on counter-regulatory hormones (glucagon, catecholamines, cortisol, GH) or glucose infusion rate was seen, but we found indications of a downregulation of the sympathetic relative to the parasympathetic nerve activity, as reflected in heart rate variability. No significant differences in symptom of hypoglycemia were observed.

Conclusions/interpretation: Short-term exposure to a GLP-1 receptor agonist does not seem to impact the counter-regulatory hormonal and metabolic responses in post-GBP subjects during hypoglycemic conditions, suggesting that the improvement in symptomatic hypoglycemia post-GBP seen following treatment with GLP-1 receptor agonists may be mediated by mechanism not directly involved in counter-regulation.

sted, utgiver, år, opplag, sider
Bioscientifica, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-161569 (URN)10.1530/EJE-19-0171 (DOI)000472835100013 ()31176298 (PubMedID)
Forskningsfinansiär
Swedish Diabetes Association
Tilgjengelig fra: 2019-07-25 Laget: 2019-07-25 Sist oppdatert: 2019-07-25bibliografisk kontrollert
Alenius Dahlqvist, J., Sunnegårdh, J., Hanséus, K., Strömvall Larsson, E., Nygren, A., Dalén, M., . . . Rydberg, A. (2019). Pacemaker treatment after Fontan surgery: a Swedish national study. Congenital Heart Disease
Åpne denne publikasjonen i ny fane eller vindu >>Pacemaker treatment after Fontan surgery: a Swedish national study
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2019 (engelsk)Inngår i: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803Artikkel i tidsskrift (Annet vitenskapelig) Epub ahead of print
Abstract [en]

Objective: Fontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indications in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden.

Methods: We retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n = 599).

Results: After a mean follow‐up of 12.2 years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total cavopulmonary connection had a significantly lower prevalence of pacemaker implantation (6%) than patients with lateral tunnel (LT; 17%). Mortality did not differ between patients with (8%) and without pacemaker (5%). The most common pacemaker indication was sinus node dysfunction (SND) (64%). Pacemaker implantation due to SND was less common among patients with EC. Pacemaker implantation was significantly more common in patients with mitral atresia (MA; 44%), double outlet right ventricle (DORV; 24%) and double inlet left ventricle (DILV; 20%). In contrast, patients with pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome were significantly less likely to receive a pacemaker (3% and 6%, respectively).

Conclusions: Thirteen percent of Fontan patients received a permanent pacemaker, most frequently due to SND. EC was associated with a significantly lower prevalence of pacemaker than LT. Permanent pacemaker was more common in patients with MA, DORV, and DILV.

sted, utgiver, år, opplag, sider
Wiley-Blackwell, 2019
Emneord
Congenital heart disease, Fontan circulation, pacemaker treatment, sinus node dysfunction
HSV kategori
Forskningsprogram
pediatrik; kardiologi
Identifikatorer
urn:nbn:se:umu:diva-156716 (URN)10.1111/chd.12766 (DOI)
Forskningsfinansiär
Västerbotten County CouncilSwedish Heart Lung Foundation
Merknad

Originally included in thesis in manuscript form.

Tilgjengelig fra: 2019-02-25 Laget: 2019-02-25 Sist oppdatert: 2019-03-19
Alenius Dahlqvist, J., Wiklund, U., Karlsson, M., Hanseus, K., Stromvall-Larsson, E., Nygren, A., . . . Rydberg, A. (2019). Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?. Pediatric Cardiology, 40(4), 685-693
Åpne denne publikasjonen i ny fane eller vindu >>Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
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2019 (engelsk)Inngår i: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 40, nr 4, s. 685-693Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Sinus node dysfunction (SND) causes significant morbidity in patients after Fontan surgery. Heart rate variability (HRV) reflects the autonomic regulation of the heart, and changes in HRV have been associated with SND in adults. We aimed to study whether changes in HRV could be detected in 24-h electrocardiographic (ECG) recordings in Fontan patients with SND. We compared HRV results from two patient groups; patients with Fontan circulation who later required a pacemaker due to severe SND (n = 12) and patients with Fontan circulation and SND, without indication for pacemaker treatment (n = 11), with two control groups; patients with Fontan circulation without SND (n = 90) and healthy controls (n = 66). The Poincare plot index SD2 (representing changes in heart rate over 24-h) and the very low-frequency (VLF) HRV component were significantly higher in both SND groups, both compared with healthy controls and patients with Fontan circulation without SND. In SND patients with pacemakers, SD2 and VLF were slightly reduced compared to SND patients without pacemaker (p = 0.06). In conclusion, in Fontan patients with SND the HRV is significantly higher compared to healthy controls and Fontan patients without SND. However, in patients with severe SND requiring pacemaker, SD2 and VLF tended to be lower than in patients with SND without pacemaker, which could indicate a reduced diurnal HRV in addition to the severe bradycardia. This is a small study, but our results indicate that HRV analysis might be a useful method in the follow-up of Fontan patients regarding development of SND.

sted, utgiver, år, opplag, sider
Springer-Verlag New York, 2019
Emneord
Congenital heart disease, Fontan circulation, Pacemaker, Sinus node dysfunction, Heart rate variability, Poincare analysis
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-158740 (URN)10.1007/s00246-019-02092-5 (DOI)000463707500002 ()30918992 (PubMedID)
Tilgjengelig fra: 2019-05-20 Laget: 2019-05-20 Sist oppdatert: 2019-05-20bibliografisk kontrollert
Boles, U., Johansson, A., Wiklund, U., Sharif, Z., David, S., McGrory, S. & Henein, M. Y. (2018). Cytokine Disturbances in Coronary Artery Ectasia Do Not Support Atherosclerosis Pathogenesis. International Journal of Molecular Sciences, 19(1), Article ID 260.
Åpne denne publikasjonen i ny fane eller vindu >>Cytokine Disturbances in Coronary Artery Ectasia Do Not Support Atherosclerosis Pathogenesis
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2018 (engelsk)Inngår i: International Journal of Molecular Sciences, ISSN 1422-0067, E-ISSN 1422-0067, Vol. 19, nr 1, artikkel-id 260Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Coronary artery ectasia (CAE) is a rare disorder commonly associated with additional features of atherosclerosis. In the present study, we aimed to examine the systemic immune-inflammatory response that might associate CAE.

METHODS: Plasma samples were obtained from 16 patients with coronary artery ectasia (mean age 64.9 ± 7.3 years, 6 female), 69 patients with coronary artery disease (CAD) and angiographic evidence for atherosclerosis (age 64.5 ± 8.7 years, 41 female), and 140 controls (mean age 58.6 ± 4.1 years, 40 female) with normal coronary arteries. Samples were analyzed at Umeå University Biochemistry Laboratory, Sweden, using the V-PLEX Pro-Inflammatory Panel 1 (human) Kit. Statistically significant differences (p < 0.05) between patient groups and controls were determined using Mann-Whitney U-tests.

RESULTS: The CAE patients had significantly higher plasma levels of INF-γ, TNF-α, IL-1β, and IL-8 (p = 0.007, 0.01, 0.001, and 0.002, respectively), and lower levels of IL-2 and IL-4 (p < 0.001 for both) compared to CAD patients and controls. The plasma levels of IL-10, IL-12p, and IL-13 were not different between the three groups. None of these markers could differentiate between patients with pure (n = 6) and mixed with minimal atherosclerosis (n = 10) CAE.

CONCLUSIONS: These results indicate an enhanced systemic pro-inflammatory response in CAE. The profile of this response indicates activation of macrophages through a pathway and trigger different from those of atherosclerosis immune inflammatory response.

sted, utgiver, år, opplag, sider
Basel, Switzerland: MDPI, 2018
Emneord
atherosclerosis, coronary artery disease, coronary artery ectasia, cytokines, immune inflammatory response, macrophage activation
HSV kategori
Forskningsprogram
epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-144041 (URN)10.3390/ijms19010260 (DOI)000424407200254 ()29337902 (PubMedID)
Forskningsfinansiär
Swedish Heart Lung Foundation
Tilgjengelig fra: 2018-01-26 Laget: 2018-01-26 Sist oppdatert: 2019-09-23bibliografisk kontrollert
Wadell, K., Wiklund, U., Öhberg, F., Bergmann, E., Holmner, Å. & Blomberg, A. (2018). Longitudinal, home-based study of lung function, saturation and disease-related symptoms in COPD. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Åpne denne publikasjonen i ny fane eller vindu >>Longitudinal, home-based study of lung function, saturation and disease-related symptoms in COPD
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2018 (engelsk)Inngår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Artikkel i tidsskrift, Meeting abstract (Annet vitenskapelig) Published
Abstract [en]

Background: Many telehealth (TH) systems have been designed to identify signs of COPD exacerbations, but few previous studies have reported the nature of recorded lung function data and what variations to expect in stable versus unstable patients.

Aims: To evaluate the nature of individual diurnal, day-to-day and long-term variation in important prognostic markers of COPD exacerbations in a heterogeneous patient group by employing a newly developed TH system.

Methods: Eight women and five men with COPD performed measurements (FEV1, IC, SpO2 and CAT) three times per week during 4-6 months using the TH system. Feasibility was based on the repeatability and quality of the FEV1 and IC measurements, as defined by ERS/ATS guidelines. Short-term and long-term individual variations were assessed using the relative density and mean (SD) respectively.

Results: Close to 1100 FEV1 and IC measurements respectively were performed during a total of 240 patient weeks. The 2SD ranges for intra-individual variation were ± 210 mL and ± 350 mL for FEV1 and IC respectively. The values both increased and decreased without corresponding influence on symptoms (CAT) or SpO2 and no exacerbation was reported. However, it was unusual with a decrease of more than 50 mL per measurement in FEV1 between three consecutive measurement days.

Conclusions: This study reveals important and, to our knowledge, previously not reported information about short and long-term variability in lung function measurements in stable patients with COPD, of significance when defining criteria for detecting exacerbations with TH systems.

sted, utgiver, år, opplag, sider
European Respiratory Society, 2018
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-155993 (URN)10.1183/13993003.congress-2018.PA3828 (DOI)000455567104471 ()
Konferanse
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Tilgjengelig fra: 2019-02-07 Laget: 2019-02-07 Sist oppdatert: 2019-02-07bibliografisk kontrollert
Wiklund, U., Kadkhodaee, A., Andersson, K., Suhr, O. B. & Hörnsten, R. (2018). Normal scores of deep breathing tests: beware of dysrhythmia in transthyretin amyloidosis. Amyloid: Journal of Protein Folding Disorders, 25(1), 54-61
Åpne denne publikasjonen i ny fane eller vindu >>Normal scores of deep breathing tests: beware of dysrhythmia in transthyretin amyloidosis
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2018 (engelsk)Inngår i: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 25, nr 1, s. 54-61Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: The heart rate (HR) response to paced deep breathing (DB) is a common test of cardiac autonomic function, where high heart rate variability (HRV) is considered to reflect normal autonomic function. We evaluated the DB test in patients with hereditary transthyretin amyloid (ATTRm) amyloidosis, where autonomic dysregulation and atrial arrhythmias are common.Methods: Paced DB was performed during one minute (six breaths/min) in 165 recordings in adult ATTRm amyloidosis patients with the TTR Val30Met mutation, 42 hypertrophic cardiomyopathy (HCM) patients and 211 healthy subjects. HRV was scored by traditional DB indices and by a novel regularity index, estimating the fraction of the HRV that was coherent with the breathing pattern.Results: Twenty per cent of ATTRm amyloidosis patients presented with age-adjusted HRV scores within normal limits but poor regularity due to subtle atrial arrhythmias and cardiac conduction disturbances. Forty-seven per cent of ATTRm amyloidosis patients presented with HRV scores below normal limits, whereas HCM patients presented with higher HRV than ATTRm amyloidosis patients.Conclusions: Reduced HRV is common in ATTRm amyloidosis patients during DB, however, autonomic function cannot be evaluated in patients presenting with the combination of normal scores and low regularity, since their HR responses often reflects dysrhythmias.

sted, utgiver, år, opplag, sider
Taylor & Francis Group, 2018
Emneord
HRV, heart rate variability, amyloidosis hereditary, transthyretin, autonomic function
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-146594 (URN)10.1080/13506129.2018.1434140 (DOI)000428570300008 ()29394116 (PubMedID)
Tilgjengelig fra: 2018-05-08 Laget: 2018-05-08 Sist oppdatert: 2019-05-22bibliografisk kontrollert
Wedekind, D., Kleyko, D., Osipov, E., Malberg, H., Zaunseder, S. & Wiklund, U. (2018). Robust Methods for Automated Selection of Cardiac Signals After Blind Source Separation. IEEE Transactions on Biomedical Engineering, 65(10), 2248-2258
Åpne denne publikasjonen i ny fane eller vindu >>Robust Methods for Automated Selection of Cardiac Signals After Blind Source Separation
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2018 (engelsk)Inngår i: IEEE Transactions on Biomedical Engineering, ISSN 0018-9294, E-ISSN 1558-2531, Vol. 65, nr 10, s. 2248-2258Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: Novel minimum-contact vital signs monitoring techniques like textile or capacitive electrocardiogram (ECG) provide new opportunities for health monitoring. These techniques are sensitive to artifacts and require handling of unstable signal quality. Spatio-temporal blind source separation (BSS) is capable of processing suchlike multichannel signals. However, BSS's permutation indeterminacy requires the selection of the cardiac signal (i.e., the component resembling the electric cardiac activity) after its separation from artifacts. This study evaluates different concepts for solving permutation indeterminacy.

Methods: Novel automated component selection routines based on heartbeat detections are compared with standard concepts, as using higher order moments or frequency-domain features, for solving permutation indeterminacy in spatio-temporal BSS. BSS was applied to a textile and a capacitive ECG dataset of healthy subjects performing a motion protocol, and to the MIT-BIH Arrhythmia Database. The performance of the subsequent component selection was evaluated by means of the heartbeat detection accuracy (ACC) using an automatically selected single component.

Results: The proposed heartbeat-detection-based selection routines significantly outperformed the standard selectors based on Skewness, Kurtosis, and frequency-domain features, especially for datasets containing motion artifacts. For arrhythmia data, beat analysis by sparse coding outperformed simple periodicity tests of the detected heartbeats. Conclusion: Component selection routines based on heartbeat detections are capable of reliably selecting cardiac signals after spatio-temporal BSS in case of severe motion artifacts and arrhythmia.

Significance: The availability of robust cardiac component selectors for solving permutation indeterminacy facilitates the usage of spatio-temporal BSS to extract cardiac signals in artifact-sensitive minimum-contact vital signs monitoring techniques.

sted, utgiver, år, opplag, sider
Institute of Electrical and Electronics Engineers (IEEE), 2018
Emneord
Biomedical signal processing, blind source separation, cardiac signals, electrocardiogram, dependent component analysis, permutation indeterminacy, sparse coding, spatio-temporal processing
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-152393 (URN)10.1109/TBME.2017.2788701 (DOI)000445233200013 ()29993470 (PubMedID)
Forskningsfinansiär
Swedish Research Council, 2015-04677
Tilgjengelig fra: 2018-10-08 Laget: 2018-10-08 Sist oppdatert: 2018-10-08bibliografisk kontrollert
Nicoll, R., Zhao, Y., Wiklund, U., Diederichsen, A., Mickley, H., Ovrehus, K., . . . Henein, M. (2017). Diabetes and male sex are key risk factor correlates of the extent of coronary artery calcification: a Euro-CCAD study. Journal of diabetes and its complications, 31(7), 1096-1102
Åpne denne publikasjonen i ny fane eller vindu >>Diabetes and male sex are key risk factor correlates of the extent of coronary artery calcification: a Euro-CCAD study
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2017 (engelsk)Inngår i: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 31, nr 7, s. 1096-1102Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background and Aims: Although much has been written about the conventional cardiovascular risk factor correlates of the extent of coronary artery calcification (CAC), few studies have been carried out on symptomatic patients. This paper assesses the potential ability of risk factors to associate with an increasing CAC score. Methods: From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62% male, from Denmark, France, Germany, Italy, Spain and the USA. All had conventional cardiovascular risk factor assessment and CI scanning for CAC scoring. Results: Among all patients, male sex (OR = 4.85, p < 0.001) and diabetes (OR = 236, p < 0.001) were the most important risk factors of CAC extent, with age, hypertension, dyslipidemia and smoking also showing a relationship. Among patients with CAC, age, diabetes, hypertension and dyslipidemia were associated with an increasing CAC score in males and females, with diabetes being the strongest dichotomous risk factor (p < 0.001 for both). These results were echoed in quantile regression, where diabetes was consistently the most important correlate with CAC extent in every quantile in both males and females. To a lesser extent, hypertension and dyslipidemia were also associated in the high CAC quantiles and the low CAC quantiles respectively. Conclusion: In addition to age and male sex in the total population, diabetes is the most important correlate of CAC extent in both sexes.

sted, utgiver, år, opplag, sider
Elsevier, 2017
Emneord
Coronary calcification extent, Risk factors, Diabetes, Gender, Hypertension
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-137796 (URN)10.1016/j.jdiacomp.2017.03.013 (DOI)000404088700006 ()28499962 (PubMedID)
Tilgjengelig fra: 2017-07-27 Laget: 2017-07-27 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Abrahamsson, N., Borjesson, J. L., Sundbom, M., Wiklund, U., Karlsson, F. A. & Eriksson, J. W. (2016). Gastric Bypass Reduces Symptoms and Hormonal Responses in Hypoglycemia. Diabetes, 65(9), 2667-2675
Åpne denne publikasjonen i ny fane eller vindu >>Gastric Bypass Reduces Symptoms and Hormonal Responses in Hypoglycemia
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2016 (engelsk)Inngår i: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 65, nr 9, s. 2667-2675Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Gastric bypass (GBP) surgery, one of the most common bariatric procedures, induces weight loss and metabolic effects. The mechanisms are not fully understood, but reduced food intake and effects on gastrointestinal hormones are thought to contribute. We recently observed that GBP patients have lowered glucose levels and frequent asymptomatic hypoglycemic episodes. Here, we subjected patients before and after undergoing GBP surgery to hypoglycemia and examined symptoms and hormonal and autonomic nerve responses. Twelve obese patients without diabetes (8 women, mean age 43.1 years [SD 10.8] and BMI 40.6 kg/m(2) [SD 3.1]) were examined before and 23 weeks (range 19-25) after GBP surgery with hyperinsulinemic-hypoglycemic clamp (stepwise to plasma glucose 2.7 mmol/L). The mean change in Edinburgh Hypoglycemia Score during clamp was attenuated from 10.7 (6.4) before surgery to 5.2 (4.9) after surgery. There were also marked postsurgery reductions in levels of glucagon, cortisol, and catecholamine and the sympathetic nerve responses to hypoglycemia. In addition, growth hormone displayed a delayed response but to a higher peak level. Levels of glucagon-like peptide 1 and gastric inhibitory polypeptide rose during hypoglycemia but rose less postsurgery compared with presurgery. Thus, GBP surgery causes a resetting of glucose homeostasis, which reduces symptoms and neurohormonal responses to hypoglycemia. Further studies should address the underlying mechanisms as well as their impact on the overall metabolic effects of GBP surgery.

HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-126314 (URN)10.2337/db16-0341 (DOI)000382099800021 ()27313315 (PubMedID)
Tilgjengelig fra: 2016-11-02 Laget: 2016-10-03 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Prosjekter
Analys av interaktion mellan olika kardiovaskulära signaler baserat på linjära tillståndsmodeller [2008-03292_VR]; Umeå universitetInteraktiv kognitiv arkitektur för prediktion av dysfunktion i den autonoma regleringen av det kardiovaskulära systemet [2015-04677_VR]; Umeå universitet
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-1313-0934