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Arlien-Søborg, M. C., Dal, J., Heck, A., Stochholm, K., Husted, E., Feltoft, C. L., . . . Jørgensen, J. O. (2024). Acromegaly management in the nordic countries: a Delphi consensus survey. Clinical Endocrinology
Öppna denna publikation i ny flik eller fönster >>Acromegaly management in the nordic countries: a Delphi consensus survey
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2024 (Engelska)Ingår i: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

Objective: Acromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.

Methods: A Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1−7). Consensus was defined as ≥80% of panelists rating their agreement as ≥5 or ≤3 on the Likert-type scale.

Results: Consensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.

Conclusion: This consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2024
Nyckelord
acromegaly, Delphi, dopamine agonist, growth hormone, growth hormone receptor antagonist, insulin-like growth factor i, somatostatin
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
urn:nbn:se:umu:diva-226954 (URN)10.1111/cen.15095 (DOI)001244261400001 ()38865284 (PubMedID)2-s2.0-85195918201 (Scopus ID)
Forskningsfinansiär
Pfizer AB
Tillgänglig från: 2024-06-24 Skapad: 2024-06-24 Senast uppdaterad: 2024-06-24Bibliografiskt granskad
Rolandsson, O., Tornevi, A., Steneberg, P., Edlund, H., Olsson, T., Andreasson, U., . . . Blennow, K. (2024). Acute hyperglycemia induced by hyperglycemic clamp affects plasma Amyloid-β in type 2 diabetes. Journal of Alzheimer's Disease, 99(3), 1033-1046
Öppna denna publikation i ny flik eller fönster >>Acute hyperglycemia induced by hyperglycemic clamp affects plasma Amyloid-β in type 2 diabetes
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2024 (Engelska)Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 99, nr 3, s. 1033-1046Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Individuals with type 2 diabetes (T2D) have an increased risk of cognitive symptoms and Alzheimer's disease (AD). Mis-metabolism with aggregation of amyloid-β peptides (Aβ) play a key role in AD pathophysiology. Therefore, human studies on Aβ metabolism and T2D are warranted.

Objective: The objective of this study was to examine whether acute hyperglycemia affects plasma Aβ1-40 and Aβ1-42 concentrations in individuals with T2D and matched controls.

Methods: Ten participants with T2D and 11 controls (median age, 69 years; range, 66-72 years) underwent hyperglycemic clamp and placebo clamp (saline infusion) in a randomized order, each lasting 4 hours. Aβ1-40, Aβ1-42, and insulin-degrading enzyme (IDE) plasma concentrations were measured in blood samples taken at 0 and 4 hours of each clamp. Linear mixed-effect regression models were used to evaluate the 4-hour changes in Aβ1-40 and Aβ1-42 concentrations, adjusting for body mass index, estimated glomerular filtration rate, and 4-hour change in insulin concentration.

Results: At baseline, Aβ1-40 and Aβ1-42 concentrations did not differ between the two groups. During the hyperglycemic clamp, Aβ decreased in the control group, compared to the placebo clamp (Aβ1-40: p = 0.034, Aβ1-42: p = 0.020), IDE increased (p = 0.016) during the hyperglycemic clamp, whereas no significant changes in either Aβ or IDE was noted in the T2D group.

Conclusions: Clamp-induced hyperglycemia was associated with increased IDE levels and enhanced Aβ40 and Aβ42 clearance in controls, but not in individuals with T2D. We hypothesize that insulin-degrading enzyme was inhibited during hyperglycemic conditions in people with T2D.

Ort, förlag, år, upplaga, sidor
IOS Press, 2024
Nyckelord
Alzheimer's disease, amyloid-β, cognition, endocrinology and metabolism specialty, hyperglycemia, type 2 diabetes
Nationell ämneskategori
Neurovetenskaper
Identifikatorer
urn:nbn:se:umu:diva-225948 (URN)10.3233/JAD-230628 (DOI)38728183 (PubMedID)2-s2.0-85194944157 (Scopus ID)
Forskningsfinansiär
Region VästerbottenDiabetesförbundetVetenskapsrådet, 2023-00356Vetenskapsrådet, 2022-01018Vetenskapsrådet, 2019-02397Vetenskapsrådet, 2017-00915Vetenskapsrådet, 2022-00732EU, Horisont Europa, 101053962Familjen Erling-Perssons StiftelseStiftelsen Gamla TjänarinnorHjärnfonden, FO2022-0270Hjärnfonden, FO2017-0243Hjärnfonden, ALZ2022-0006EU, Horisont 2020, 860197Alzheimerfonden, AF-930351Alzheimerfonden, AF-939721Alzheimerfonden, AF-968270
Tillgänglig från: 2024-06-12 Skapad: 2024-06-12 Senast uppdaterad: 2024-07-02Bibliografiskt granskad
Bäcklund, N., Lundstedt, S., Tornevi, A., Wihlbäck, A.-C., Olsson, T., Dahlqvist, P. & Brattsand, G. (2024). Salivary cortisol and cortisone can circumvent confounding effects of oral contraceptives in the short synacthen test. Journal of Clinical Endocrinology and Metabolism, 109(7), 1899-1906
Öppna denna publikation i ny flik eller fönster >>Salivary cortisol and cortisone can circumvent confounding effects of oral contraceptives in the short synacthen test
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2024 (Engelska)Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 109, nr 7, s. 1899-1906Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Context: Adrenal insufficiency (AI) is usually diagnosed by low plasma cortisol levels following a short Synacthen test (SST). Most plasma cortisol is bound to corticosteroid-binding globulin, which is increased by estrogen in combined estrogen-progestin oral contraceptives (COCs). Women with AI using COCs are therefore at risk of having an apparently normal plasma cortisol level during SST, which would not adequately reflect AI.

Objective: To test whether salivary cortisol or cortisone during SST is more robust against the COC effect and to calculate the lower reference limits (LRLs) for these to be used as tentative diagnostic cutoffs to exclude AI.

Methods: Forty-one healthy women on COCs and 46 healthy women without exogenous estrogens performed an SST with collection of plasma and salivary samples at 0, 30, and 60 min after Synacthen injection. The groups were compared using regression analysis with age as covariate and the LRLs were calculated parametrically.

Results: SST-stimulated plasma cortisol levels were significantly higher in the COC group versus controls, while mean salivary cortisol and cortisone levels were slightly lower in the COC group. Importantly, COC use did not significantly alter LRLs for salivary cortisol or cortisone. The smallest LRL difference between groups was seen for salivary cortisone.

Conclusion: Salivary cortisol and especially salivary cortisone are considerably less affected by COC use than plasma cortisol during SST. Due to similar LRLs, a common cutoff for salivary cortisol and cortisone during SST can be used to exclude AI in premenopausal women irrespective of COC use.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2024
Nyckelord
short Synacthen test, salivary cortisol, salivary cortisone, oral contraceptives, adrenal insufficiency, reference limits
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
urn:nbn:se:umu:diva-222629 (URN)10.1210/clinem/dgad763 (DOI)001140071500001 ()38173358 (PubMedID)2-s2.0-85196301347 (Scopus ID)
Forskningsfinansiär
Region VästerbottenUmeå universitet
Tillgänglig från: 2024-03-22 Skapad: 2024-03-22 Senast uppdaterad: 2024-07-02Bibliografiskt granskad
Imamovic, M., Bäcklund, N., Lundstedt, S., Brattsand, G., Aardal, E., Olsson, T. & Dahlqvist, P. (2023). Confounding effects of liquorice, hydrocortisone, and blood contamination on salivary cortisol but not cortisone. Endocrine Connections, 12(1), Article ID e220324.
Öppna denna publikation i ny flik eller fönster >>Confounding effects of liquorice, hydrocortisone, and blood contamination on salivary cortisol but not cortisone
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2023 (Engelska)Ingår i: Endocrine Connections, E-ISSN 2049-3614, Vol. 12, nr 1, artikel-id e220324Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To determine the effects of liquorice consumption, topical hydrocortisone, and blood contamination on salivary cortisol and cortisone concentrations.

Design and methods: Thirty healthy volunteers were randomized to a low, medium, or high dose of liquorice. Late-night saliva samples were collected using a Salivette® collection device at baseline, during 1 week of daily liquorice consumption, and during 4 weeks' washout. Saliva sampling was also performed before and after the application of topical hydrocortisone on the skin. Furthermore, in a subgroup (n  = 16), saliva and venous blood were collected from each individual and mixed to achieve graded blood contamination in saliva. Salivary cortisol and cortisone were analyzed with liquid chromatography-tandem mass spectrometry.

Results: Significant increases in salivary cortisol concentrations were observed during medium- (+49%) and high-dose (+97%) liquorice intake, which returned to baseline 4 days after liquorice withdrawal. Topical hydrocortisone on fingers holding the collection swab increased salivary cortisol concentrations >1000-fold with concomitant pronounced elevation of the cortisol:cortisone ratio. Salivary cortisol increased significantly after contamination with blood ≥0.5%. Visual examination could safely detect these samples. Salivary cortisone concentrations were unaffected by liquorice consumption and blood contamination, and only marginally affected by topical hydrocortisone.

Conclusion: Liquorice, topical hydrocortisone, and blood contamination may all cause elevated salivary cortisol concentrations. Improved sampling instructions and visual examination of the sample may minimize these risks. Salivary cortisone is essentially unaffected by the different preanalytical confounders and may be used as a first-line screening test for Cushing's syndrome.

Ort, förlag, år, upplaga, sidor
Bioscientifica, 2023
Nyckelord
Cushing’s syndrome, salivary cortisol, salivary cortisone, liquorice, sample contamination
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
urn:nbn:se:umu:diva-208130 (URN)10.1530/ec-22-0324 (DOI)000971893300001 ()36383173 (PubMedID)2-s2.0-85151875249 (Scopus ID)
Forskningsfinansiär
Region Västerbotten
Tillgänglig från: 2023-05-10 Skapad: 2023-05-10 Senast uppdaterad: 2024-03-26Bibliografiskt granskad
Ragnarsson, O., Carlberg, B. & Olsson, T. (2023). Dietary salt restriction in primary aldosteronism. Journal of Internal Medicine, 294(1), 2-3
Öppna denna publikation i ny flik eller fönster >>Dietary salt restriction in primary aldosteronism
2023 (Engelska)Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 294, nr 1, s. 2-3Artikel i tidskrift, Editorial material (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2023
Nationell ämneskategori
Kardiologi Allmänmedicin
Identifikatorer
urn:nbn:se:umu:diva-206353 (URN)10.1111/joim.13625 (DOI)000957068400001 ()36945840 (PubMedID)2-s2.0-85150904246 (Scopus ID)
Tillgänglig från: 2023-04-26 Skapad: 2023-04-26 Senast uppdaterad: 2023-07-12Bibliografiskt granskad
Ragnarsson, O., Dahlqvist, P., Muth, A., Calissendorff, J. & Olsson, T. (2023). Mineralocorticoid receptor antagonists for primary aldosteronism - appropriate or not? [Letter to the editor]. European Journal of Endocrinology, 188(3), L1-L2
Öppna denna publikation i ny flik eller fönster >>Mineralocorticoid receptor antagonists for primary aldosteronism - appropriate or not?
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2023 (Engelska)Ingår i: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 188, nr 3, s. L1-L2Artikel i tidskrift, Letter (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
Oxford University Press, 2023
Nyckelord
adrenal vein sampling, adrenalectomy, mineralocorticoid receptor antagonist, primary aldosteronism
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
urn:nbn:se:umu:diva-206025 (URN)10.1093/ejendo/lvad020 (DOI)000953971500002 ()36757798 (PubMedID)2-s2.0-85150396850 (Scopus ID)
Tillgänglig från: 2023-03-28 Skapad: 2023-03-28 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Bäcklund, N., Brattsand, G., Lundstedt, S., Aardal, E., Bartuseviciene, I., Berinder, K., . . . Dahlqvist, P. (2023). Salivary cortisol and cortisone in diagnosis of Cushing's syndrome: a comparison of six different analytical methods. Clinical Chemistry and Laboratory Medicine, 61(10), 1780-1791
Öppna denna publikation i ny flik eller fönster >>Salivary cortisol and cortisone in diagnosis of Cushing's syndrome: a comparison of six different analytical methods
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2023 (Engelska)Ingår i: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 61, nr 10, s. 1780-1791Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: Salivary cortisol and cortisone at late night and after dexamethasone suppression test (DST) are increasingly used for screening of Cushing’s syndrome (CS). We aimed to establish reference intervals for salivary cortisol and cortisone with three liquid chromatography-tandem mass spectrometry (LC-MS/MS) techniques and for salivary cortisol with three immunoassays (IAs), and evaluate their diagnostic accuracy for CS.

Methods: Salivary samples at 08:00 h, 23:00 h and 08:00 h after a 1-mg DST were collected from a reference population (n=155) and patients with CS (n=22). Sample aliquots were analyzed by three LC-MS/MS and three IA methods. After establishing reference intervals, the upper reference limit (URL) for each method was used to calculate sensitivity and specificity for CS. Diagnostic accuracy was evaluated by comparing ROC curves.

Results: URLs for salivary cortisol at 23:00 h were similar for the LC-MS/MS methods (3.4–3.9 nmol/L), but varied between IAs: Roche (5.8 nmol/L), Salimetrics (4.3 nmol/L), Cisbio (21.6 nmol/L). Corresponding URLs after DST were 0.7–1.0, and 2.4, 4.0 and 5.4 nmol/L, respectively. Salivary cortisone URLs were 13.5–16.6 nmol/L at 23:00 h and 3.0–3.5 nmol/L at 08:00 h after DST. All methods had ROC AUCs ≥0.96.

Conclusions: We present robust reference intervals for salivary cortisol and cortisone at 08:00 h, 23:00 h and 08:00 h after DST for several clinically used methods. The similarities between LC-MS/MS methods allows for direct comparison of absolute values. Diagnostic accuracy for CS was high for all salivary cortisol and cortisone LC-MS/MS methods and salivary cortisol IAs evaluated.

Ort, förlag, år, upplaga, sidor
Walter de Gruyter, 2023
Nyckelord
Cushing's syndrome, immunoassay, LC-MS/MS, method comparison, salivary cortisol, salivary cortisone
Nationell ämneskategori
Analytisk kemi Endokrinologi och diabetes
Identifikatorer
urn:nbn:se:umu:diva-206793 (URN)10.1515/cclm-2023-0141 (DOI)000964106600001 ()37013440 (PubMedID)2-s2.0-85151863068 (Scopus ID)
Forskningsfinansiär
Region Västerbotten
Tillgänglig från: 2023-04-24 Skapad: 2023-04-24 Senast uppdaterad: 2024-03-26Bibliografiskt granskad
Mendham, A. E., Micklesfield, L. K., Karpe, F., Kengne, A. P., Chikowore, T., Kufe, C. N., . . . Goedecke, J. H. (2023). Targeted proteomics identifies potential biomarkers of dysglycaemia, beta cell function and insulin sensitivity in Black African men and women. Diabetologia, 66, 174-189
Öppna denna publikation i ny flik eller fönster >>Targeted proteomics identifies potential biomarkers of dysglycaemia, beta cell function and insulin sensitivity in Black African men and women
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2023 (Engelska)Ingår i: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 66, s. 174-189Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aims/hypothesis: Using a targeted proteomics approach, we aimed to identify and validate circulating proteins associated with impaired glucose metabolism (IGM) and type 2 diabetes in a Black South African cohort. In addition, we assessed sex-specific associations between the validated proteins and pathophysiological pathways of type 2 diabetes.

Methods: This cross-sectional study included Black South African men (n=380) and women (n=375) who were part of the Middle-Aged Soweto Cohort (MASC). Dual-energy x-ray absorptiometry was used to determine fat mass and visceral adipose tissue, and fasting venous blood samples were collected for analysis of glucose, insulin and C-peptide and for targeted proteomics, measuring a total of 184 pre-selected protein biomarkers. An OGTT was performed on participants without diabetes, and peripheral insulin sensitivity (Matsuda index), HOMA-IR, basal insulin clearance, insulin secretion (C-peptide index) and beta cell function (disposition index) were estimated. Participants were classified as having normal glucose tolerance (NGT; n=546), IGM (n=116) or type 2 diabetes (n=93). Proteins associated with dysglycaemia (IGM or type 2 diabetes) in the MASC were validated in the Swedish EpiHealth cohort (NGT, n=1706; impaired fasting glucose, n=550; type 2 diabetes, n=210).

Results: We identified 73 proteins associated with dysglycaemia in the MASC, of which 34 were validated in the EpiHealth cohort. Among these validated proteins, 11 were associated with various measures of insulin dynamics, with the largest number of proteins being associated with HOMA-IR. In sex-specific analyses, IGF-binding protein 2 (IGFBP2) was associated with lower HOMA-IR in women (coefficient –0.35; 95% CI –0.44, –0.25) and men (coefficient –0.09; 95% CI –0.15, –0.03). Metalloproteinase inhibitor 4 (TIMP4) was associated with higher insulin secretion (coefficient 0.05; 95% CI 0.001, 0.11; p for interaction=0.025) and beta cell function (coefficient 0.06; 95% CI 0.02, 0.09; p for interaction=0.013) in women only. In contrast, a stronger positive association between IGFBP2 and insulin sensitivity determined using an OGTT (coefficient 0.38; 95% CI 0.27, 0.49) was observed in men (p for interaction=0.004). A posteriori analysis showed that the associations between TIMP4 and insulin dynamics were not mediated by adiposity. In contrast, most of the associations between IGFBP2 and insulin dynamics, except for insulin secretion, were mediated by either fat mass index or visceral adipose tissue in men and women. Fat mass index was the strongest mediator between IGFBP2 and insulin sensitivity (total effect mediated 40.7%; 95% CI 37.0, 43.6) and IGFBP2 and HOMA-IR (total effect mediated 39.1%; 95% CI 31.1, 43.5) in men.

Conclusions/interpretation: We validated 34 proteins that were associated with type 2 diabetes, of which 11 were associated with measures of type 2 diabetes pathophysiology such as peripheral insulin sensitivity and beta cell function. This study highlights biomarkers that are similar between cohorts of different ancestry, with different lifestyles and sociodemographic profiles. The African-specific biomarkers identified require validation in African cohorts to identify risk markers and increase our understanding of the pathophysiology of type 2 diabetes in African populations.

Ort, förlag, år, upplaga, sidor
Springer, 2023
Nyckelord
Adiposity, Beta cell function, Ethnicity, IGFBP2, Impaired glucose metabolism, Insulin clearance, Insulin secretion, Insulin sensitivity, Obesity, TIMP4, Type 2 diabetes
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
urn:nbn:se:umu:diva-199906 (URN)10.1007/s00125-022-05788-1 (DOI)000854821000001 ()36114877 (PubMedID)2-s2.0-85138286209 (Scopus ID)
Forskningsfinansiär
Region Västerbotten
Tillgänglig från: 2022-10-04 Skapad: 2022-10-04 Senast uppdaterad: 2022-12-30Bibliografiskt granskad
Pillon, N. J., Smith, J. A., Alm, P. S., Chibalin, A. V., Alhusen, J., Arner, E., . . . Zierath, J. R. (2022). Distinctive exercise-induced inflammatory response and exerkine induction in skeletal muscle of people with type 2 diabetes. Science Advances, 8(36), Article ID eabo3192.
Öppna denna publikation i ny flik eller fönster >>Distinctive exercise-induced inflammatory response and exerkine induction in skeletal muscle of people with type 2 diabetes
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2022 (Engelska)Ingår i: Science Advances, E-ISSN 2375-2548, Vol. 8, nr 36, artikel-id eabo3192Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Mechanistic insights into the molecular events by which exercise enhances the skeletal muscle phenotype are lacking, particularly in the context of type 2 diabetes. Here, we unravel a fundamental role for exercise-responsive cytokines (exerkines) on skeletal muscle development and growth in individuals with normal glucose tolerance or type 2 diabetes. Acute exercise triggered an inflammatory response in skeletal muscle, concomitant with an infiltration of immune cells. These exercise effects were potentiated in type 2 diabetes. In response to contraction or hypoxia, cytokines were mainly produced by endothelial cells and macrophages. The chemokine CXCL12 was induced by hypoxia in endothelial cells, as well as by conditioned medium from contracted myotubes in macrophages. We found that CXCL12 was associated with skeletal muscle remodeling after exercise and differentiation of cultured muscle. Collectively, acute aerobic exercise mounts a noncanonical inflammatory response, with an atypical production of exerkines, which is potentiated in type 2 diabetes.

Ort, förlag, år, upplaga, sidor
NLM (Medline), 2022
Nationell ämneskategori
Fysiologi
Identifikatorer
urn:nbn:se:umu:diva-199460 (URN)10.1126/sciadv.abo3192 (DOI)000911968500015 ()36070371 (PubMedID)2-s2.0-85137461286 (Scopus ID)
Forskningsfinansiär
Novo Nordisk, 17OC0030088Knut och Alice Wallenbergs Stiftelse, 2018.0094Diabetesfonden, 2018-357Vetenskapsrådet, 2015-00165Centrum för Idrottsforskning, P2019-0140Centrum för Idrottsforskning, P2020-0064AstraZeneca, 2014-2019Novo Nordisk, 21SA0072747Hjärt-Lungfonden, 2017-0669Hjärt-Lungfonden, 2020-0627Diabetesfonden, 2018-336Novo Nordisk, 20SA0064144
Tillgänglig från: 2022-09-26 Skapad: 2022-09-26 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Franklin, K. A., Lindberg, E., Svensson, J., Larsson, C., Lindahl, B., Mellberg, C., . . . Ryberg, M. (2022). Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause: a randomised controlled trial. International Journal of Obesity, 46(10), 1833-1839
Öppna denna publikation i ny flik eller fönster >>Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause: a randomised controlled trial
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2022 (Engelska)Ingår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 46, nr 10, s. 1833-1839Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background/Objectives: Obesity is the main risk factor for obstructive sleep apnoea, commonly occurring in females who are overweight after menopause. We aimed to study the effect of a palaeolithic diet on sleep apnoea in females with overweight after menopause from the population.

Methods: Seventy healthy, non-smoking females with a mean age of 60 years and a mean BMI of 33 kg/m2 were randomised to a palaeolithic diet or to a control low-fat diet according to Nordic Nutritional Recommendations, for 2 years. The apnoea-hypopnoea index was measured and daytime sleepiness was estimated during the intervention.

Results: The mean apnoea-hypopnoea index at baseline was 11.6 (95% CI 8.6–14.5). The mean weight loss was 7.2 kg (95% CI 5.3–9.2 kg) in the palaeolithic diet group and 3.9 kg in the control group (95% CI 1.9–5.9 kg); p < 0.021 for the group difference. The reduction in weight corresponded to a reduction in the apnoea-hypopnoea index in the palaeolithic diet group (r = 0.38, p = 0.034) but not in the control group (r = 0.08, p = 0.69). The apnoea-hypopnoea index was reduced in the palaeolithic diet group when the weight was reduced by more than 8 kg. Daytime sleepiness according to the Epworth Sleepiness Scale score and the Karolinska Sleepiness Scale score was unaffected by dietary group allocation.

Conclusions: A substantial decrease in body weight of 8 kg was needed to achieve a reduction in sleep apnoea in this small trial of women who are overweight after menopause. The palaeolithic diet was more effective for weight reduction than a control low-fat diet and the reduction in sleep apnoea was related to the degree of weight decrement within this diet group.

Trial registration: Clinicaltrials.gov: NCT00692536.

Ort, förlag, år, upplaga, sidor
Springer Nature, 2022
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-198343 (URN)10.1038/s41366-022-01182-4 (DOI)000829692700001 ()35879528 (PubMedID)2-s2.0-85134643819 (Scopus ID)
Forskningsfinansiär
Hjärt-LungfondenVetenskapsrådetForte, Forskningsrådet för hälsa, arbetsliv och välfärdRegion Västerbotten
Tillgänglig från: 2022-08-01 Skapad: 2022-08-01 Senast uppdaterad: 2023-09-26Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0001-7768-1076

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