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  • 1. Aleksandrova, Krasimira
    et al.
    Boeing, Heiner
    Jenab, Mazda
    Bueno-de-Mesquita, H. Bas
    Jansen, Eugene
    van Duijnhoven, Franzel J. B.
    Rinaldi, Sabina
    Fedirko, Veronika
    Romieu, Isabelle
    Riboli, Elio
    Gunter, Marc J.
    Westphal, Sabine
    Overvad, Kim
    Tjonneland, Anne
    Halkjaer, Jytte
    Racine, Antoine
    Boutron-Ruault, Marie-Christine
    Clavel-Chapelon, Francoise
    Kaaks, Rudolf
    Lukanova, Annekatrin
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Mattiello, Amalia
    Pala, Valeria
    Palli, Domenico
    Tumino, Rosario
    Vineis, Paolo
    Buckland, Genevieve
    Sanchez, Maria-Jose
    Amiano, Pilar
    Maria Huerta, Jose
    Barricarte, Aurelio
    Menendez, Virginia
    Peeters, Petra H.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Palmqvist, Richard
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Allen, Naomi E.
    Crowe, Francesca L.
    Khaw, Kay-Tee
    Wareham, Nickolas
    Pischon, Tobias
    Leptin and soluble leptin receptor in risk of colorectal cancer in the European prospective investigation into Cancer and nutrition cohort2012In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 72, no 20, p. 5328-5337Article in journal (Refereed)
    Abstract [en]

    Leptin, a peptide hormone produced primarily by the adipocytes, is hypothesized to play a role in the pathogenesis of colorectal cancer (CRC). Soluble leptin receptor (sOB-R) may regulate leptin's physiologic functions; however its relation to CRC risk is unknown. This study explored the association of leptin and sOB-R with risk of CRC in a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 1,129 incident CRC cases (713 colon, 416 rectal) were matched within risk sets to 1,129 controls. Conditional logistic regression was used to calculate relative risks (RR) and 95% confidence intervals (CI). After multivariable adjustment including body mass index (BMI), waist circumference, and baseline leptin concentrations, sOB-R was strongly inversely associated with CRC (RR comparing the highest quintile vs. the lowest, 0.55; 95% CI, 0.40-0.76; P-trend = 0.0004) and colon cancer (RR, 0.42; 95% CI, 0.28-0.63, P-trend = 0.0001); whereas no association was seen for rectal cancer (RR adjusted for BMI and waist circumference, 0.83; 95% CI, 0.48-1.44, P-trend = 0.38). In contrast, leptin was not associated with risk of CRC (RR adjusted for BMI and waist circumference, 0.85; 95% CI, 0.56-1.29, P-trend = 0.23). Additional adjustments for circulating metabolic biomarkers did not attenuate these results. These novel findings suggest a strong inverse association between circulating sOB-R and CRC risk, independent of obesity measures, leptin concentrations, and other metabolic biomarkers. Further research is needed to confirm the potentially important role of sOB-R in CRC pathogenesis. Cancer Res; 72(20); 5328-37. (C) 2012 AACR.

  • 2.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Karpe, Fredrik
    NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK.
    Sjöström, Lars-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Riklund, Katrine
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Association of adipose tissue blood flow with fat depot sizes and adipokines in women2012In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 36, no 6, p. 783-789Article in journal (Refereed)
    Abstract [en]

    Objective: To explore possible associations between adipose tissue (AT) blood flow (ATBF), AT depot sizes and adipocyte-derived hormones (adipokines) in women.

    Subjects: In all, 43 healthy women were divided into four groups: normal-weight (n=11) and obese (n=11) pre-menopausal women and normal-weight (n=10) and obese (n=11) post-menopausal women.

    Methods: Fasting levels of adipokines were obtained, and a single-slice computed tomography scan at the level of L4-L5 was used to estimate fat depot sizes. ATBF was assessed by xenon washout while in a fasting state and after oral glucose load. We also measured glucose, insulin and non-esterified fatty acids.

    Results: Total, subcutaneous and visceral AT areas strongly correlated with ATBF (all P<0.001). Circulating leptin levels strongly and inversely correlated with ATBF (P=0.001), but this association did not remain after adjustment for body mass index. Adiponectin was not associated with blood flow.

    Conclusion: ATBF is closely linked to subcutaneous and visceral AT size. Further analyses are needed to determine possible mediators of this association, including mechanistic studies to assess a putative role for leptin as a significant modulator of blood flow. International Journal of Obesity advance online publication, 26 July 2011; doi:10.1038/ijo.2011.152.

  • 3.
    Andersson, T. A.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Larsen, F.
    Karolinska Inst, Stockholm, Sweden.
    Carlberg, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Pulmonary embolism in Sweden, a national cohort and survival analysis2012In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 33, no suppl. 1, p. 29-29Article in journal (Other academic)
  • 4.
    Andersson, T.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Carlberg, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Larsen, F.
    Soderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Searching for CTEPH: a Swedish National Follow-Up after en Episode of Acute Pulmonary Embolism2016In: The Journal of Heart and Lung Transplantation, ISSN 1053-2498, E-ISSN 1557-3117, Vol. 35, no 4, p. S149-S149Article in journal (Other academic)
  • 5.
    Andersson, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Incidence of acute pulmonary embolism, related comorbidities and survival: analysis of a Swedish national cohort2017In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 17, article id 155Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the study was to determine the incidence of acute pulmonary embolism (PE) in Sweden and any regional differences. To assess short-and long-term survival analysis after an episode of PE, before and after excluding patients with known malignancies, and to determine the most common comorbidities prior to the PE event. Methods: All in-hospital patients, including children, diagnosed with acute PE in 2005 were retrieved from the Swedish National Patient Registry (NPR) and incidence rates were calculated. All registered comorbidities from 1998 until the index events were collected and survival up to 4 years after the event were calculated and compared to matched controls. Results: There were 5793 patients of all ages diagnosed with acute PE in 2005 resulting in a national incidence of 0.6/1000/year. The mean age was 70 years and 52% were women. The most frequent comorbidities were cardiac-, vascular-, infectious-and gastrointestinal diseases, injuries and malignancies. The mortality rates were more than doubled in patients with recent PE compared to that in a matched control group (49.1% vs 21.9%), and the excess mortality remained after exclusion of deaths occurring within one year and after exclusion of patients with any malignancy prior to the event. Conclusions: PE is associated with high age as well as with multiple comorbidities, and with an increased shortand long-term mortality. This study highlights the importance of a proper follow-up after an acute PE.

  • 6.
    Barath, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Mills, Nicholas L
    Lundbäck, Magnus
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Törnqvist, Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Lucking, Andrew J
    Langrish, Jeremy P
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Christoffer
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics, Energy Technology and Thermal Process Chemistry.
    Westerholm, Roger
    Löndahl, Jakob
    Donaldson, Ken
    Mudway, Ian S
    Sandström, Thomas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Newby, David E
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Impaired vascular function after exposure to diesel exhaust generated at urban transient running conditions2010In: Particle and fibre toxicology, ISSN 1743-8977, Vol. 7, no 1, p. 19-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Traffic emissions including diesel engine exhaust are associated with increased respiratory and cardiovascular morbidity and mortality. Controlled human exposure studies have demonstrated impaired vascular function after inhalation of exhaust generated by a diesel engine under idling conditions.

    OBJECTIVES: To assess the vascular and fibrinolytic effects of exposure to diesel exhaust generated during urban-cycle running conditions that mimic ambient 'real-world' exposures.

    METHODS: In a randomised double-blind crossover study, eighteen healthy male volunteers were exposed to diesel exhaust (approximately 250 mug/m3) or filtered air for one hour during intermittent exercise. Diesel exhaust was generated during the urban part of the standardized European Transient Cycle. Six hours post-exposure, vascular vasomotor and fibrinolytic function was assessed during venous occlusion plethysmography with intra-arterial agonist infusions.

    MEASUREMENTS AND MAIN RESULTS: Forearm blood flow increased in a dose-dependent manner with both endothelial-dependent (acetylcholine and bradykinin) and endothelial-independent (sodium nitroprusside and verapamil) vasodilators. Diesel exhaust exposure attenuated the vasodilatation to acetylcholine (P < 0.001), bradykinin (P < 0.05), sodium nitroprusside (P < 0.05) and verapamil (P < 0.001). In addition, the net release of tissue plasminogen activator during bradykinin infusion was impaired following diesel exhaust exposure (P < 0.05).

    CONCLUSION: Exposure to diesel exhaust generated under transient running conditions, as a relevant model of urban air pollution, impairs vasomotor function and endogenous fibrinolysis in a similar way as exposure to diesel exhaust generated at idling. This indicates that adverse vascular effects of diesel exhaust inhalation occur over different running conditions with varying exhaust composition and concentrations as well as physicochemical particle properties. Importantly, exposure to diesel exhaust under ETC conditions was also associated with a novel finding of impaired of calcium channel-dependent vasomotor function. This implies that certain cardiovascular endpoints seem to be related to general diesel exhaust properties, whereas the novel calcium flux-related effect may be associated with exhaust properties more specific for the ETC condition, for example a higher content of diesel soot particles along with their adsorbed organic compounds.

  • 7.
    Benckert, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lilja, Mikael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Improved metabolic health among the obesein six population surveys 1986 to 2009: the Northern Sweden MONICA study2015In: BMC Obesity, ISSN 2052-9538, Vol. 2, no 7Article in journal (Refereed)
    Abstract [en]

    Background

    The incidence of CVD is decreasing in spite of increasing BMI in the population. We examined trends in metabolic health among overweight and obese individuals and the influence of lifestyle and socioeconomic status. Six cross sectional population surveys in the Northern Sweden MONICA Study between 1986 and 2009. 8 874 subjects 25 to 64 years participated (74% participation rate). Metabolic health was defined as a total cholesterol level below 5.0 mmol/l, blood pressure below 140/90 mmHg and not having diabetes. In 2009 the age span 25 to 74 years was studied.

    Results

    The prevalence of metabolic health among obese subjects increased by 7.9 % per year (95% confidence interval 5.4; 10.5), reaching 21.0% in 2009. The corresponding figures for overweight subjects were 5.9% per year (4.6; 7.3), reaching 18% in 2009, whereas for the normal-weight subjects, the increase was 6.2% per year (5.3; 7.2), reaching 39% in 2009. The prevalence of metabolic health among subjects with abdominal obesity increased by 5.8% (4.6; 7.0) per year, reaching 17.3% in 2009. Among those with no abdominal obesity the increase was 6.2% (5.2; 7.1), reaching 38% in 2009 (p = <0.001 for all groups). Only among non-obese men and obese women did the increase continue between 2004 and 2009. In the other groups a slight decline or levelling off was noted.

    In 2009 women had a 27% higher prevalence of metabolic health than men. The prevalence of metabolic health among the obese was 19.8% which declined to 15.8% if subjects treated for hypertension or hypercholesterolemia were classified as not healthy. Overweight and obese subjects were less often metabolically healthy (odds ratio 0.54 and 0.59 respectively) compared with normal-weight subjects, independent of sex and age as were subjects with abdominal obesity (odds ratio 0.52). Adjustments for smoking, physical activity and education level did not influence any estimates.

    Conclusions

    This report shows a large increase in prevalence of metabolic health from 1986 to 2009 for all anthropometric categories. Metabolic health remains considerably less prevalent among overweight and obese subjects than among those with normal weight.

  • 8. Benedict, Christian
    et al.
    Axelsson, Tomas
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Heart Centre.
    Larsson, Anders
    Ingelsson, Erik
    Lind, Lars
    Schioeth, Helgi B.
    Fat Mass and Obesity-Associated Gene (FTO) Is Linked to Higher Plasma Levels of the Hunger Hormone Ghrelin and Lower Serum Levels of the Satiety Hormone Leptin in Older Adults2014In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 63, no 11, p. 3955-3959Article in journal (Refereed)
    Abstract [en]

    The mechanisms through which common polymorphisms in the fat mass and obesity-associated gene (FTO) drive the development of obesity in humans are poorly understood. Using cross-sectional data from 985 older people (50% females) who participated at age 70 years in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), circulating levels of ghrelin and leptin were measured after an overnight fast. In addition, subjects were genotyped for FTO rs17817449 (AA, n = 345 [35%]; AC/CA, n = 481 [48.8%]; CC, n = 159 [16.1%]). Linear regression analyses controlling for sex, selfreported physical activity level, fasting plasma glucose, and BMI were used. A positive relationship between the number of FTO C risk alleles and plasma ghrelin levels was found (P = 0.005; relative plasma ghrelin difference between CC and AA carriers = similar to 9%). In contrast, serum levels of the satiety-enhancing hormone leptin were inversely linked to the number of FTO C risk alleles (P = 0.001; relative serum leptin difference between CC and AA carriers = similar to 11%). These associations were also found when controlling for waist circumference. The present findings suggest that FTO may facilitate weight gain in humans by shifting the endocrine balance from the satiety hormone leptin toward the hunger-promoting hormone ghrelin.

  • 9. Bentham, James
    et al.
    Di Cesare, Mariachiara
    Stevens, Gretchen A.
    Zhou, Bin
    Bixby, Honor
    Cowan, Melanie
    Fortunato, Lea
    Bennett, James E.
    Danaei, Goodarz
    Hajifathalian, Kaveh
    Lu, Yuan
    Riley, Leanne M.
    Laxmaiah, Avula
    Kontis, Vasilis
    Paciorek, Christopher J.
    Riboli, Elio
    Ezzati, Majid
    Abdeen, Ziad A.
    Hamid, Zargar Abdul
    Abu-Rmeileh, Niveen M.
    Acosta-Cazares, Benjamin
    Adams, Robert
    Aekplakorn, Wichai
    Aguilar-Salinas, Carlos A.
    Agyemang, Charles
    Ahmadvand, Alireza
    Ahrens, Wolfgang
    Al-Hazzaa, Hazzaa M.
    Al-Othman, Amani Rashed
    Al Raddadi, Rajaa
    Ali, Mohamed M.
    Alkerwi, Ala'a
    Alvarez-Pedrerol, Mar
    Aly, Eman
    Amouyel, Philippe
    Amuzu, Antoinette
    Andersen, Lars Bo
    Anderssen, Sigmund A.
    Anjana, Ranjit Mohan
    Aounallah-Skhiri, Hajer
    Ariansen, Inger
    Aris, Tahir
    Arlappa, Nimmathota
    Arveiler, Dominique
    Assah, Felix K.
    Avdicova, Maria
    Azizi, Fereidoun
    Babu, Bontha V.
    Bahijri, Suhad
    Balakrishna, Nagalla
    Bandosz, Piotr
    Banegas, Jose R.
    Barbagallo, Carlo M.
    Barcelo, Alberto
    Barkat, Amina
    Barros, Mauro V.
    Bata, Iqbal
    Batieha, Anwar M.
    Batista, Rosangela L.
    Baur, Louise A.
    Beaglehole, Robert
    Ben Romdhane, Habiba
    Benet, Mikhail
    Bernabe-Ortiz, Antonio
    Bernotine, Gailute
    Bettiol, Heloisa
    Bhagyalaxmi, Aroor
    Bharadwaj, Sumit
    Bhargava, Santosh K.
    Bhatti, Zaid
    Bhutta, Zulfiqar A.
    Bi, Hongsheng
    Bi, Yufang
    Bjerregaard, Peter
    Bjertness, Espen
    Bjertness, Marius B.
    Bjorkelund, Cecilia
    Blokstra, Anneke
    Bo, Simona
    Bobak, Martin
    Boddy, Lynne M.
    Boehm, Bernhard O.
    Boeing, Heiner
    Boissonnet, Carlos P.
    Bongard, Vanina
    Bovet, Pascal
    Braeckman, Lutgart
    Bragt, Marjolijn C. E.
    Brajkovich, Imperia
    Branca, Francesco
    Breckenkamp, Juergen
    Brenner, Hermann
    Brewster, Lizzy M.
    Brian, Garry R.
    Bruno, Graziella
    Bueno-de-Mesquita, H. B(as)
    Bugge, Anna
    Burns, Con
    Cabrera de Leon, Antonio
    Cacciottolo, Joseph
    Cama, Tilema
    Cameron, Christine
    Camolas, Jose
    Can, Gunay
    Candido, Ana Paula C.
    Capuano, Vincenzo
    Cardoso, Viviane C.
    Carlsson, Axel C.
    Carvalho, Maria J.
    Casanueva, Felipe F.
    Casas, Juan-Pablo
    Caserta, Carmelo A.
    Chamukuttan, Snehalatha
    Chan, Angelique W.
    Chan, Queenie
    Chaturvedi, Himanshu K.
    Chaturvedi, Nishi
    Chen, Chien-Jen
    Chen, Fangfang
    Chen, Huashuai
    Chen, Shuohua
    Chen, Zhengming
    Cheng, Ching-Yu
    Chetrit, Angela
    Chiolero, Arnaud
    Chiou, Shu-Ti
    Chirita-Emandi, Adela
    Cho, Belong
    Cho, Yumi
    Christensen, Kaare
    Chudek, Jerzy
    Cifkova, Renata
    Claessens, Frank
    Clays, Els
    Concin, Hans
    Cooper, Cyrus
    Cooper, Rachel
    Coppinger, Tara C.
    Costanzo, Simona
    Cottel, Dominique
    Cowell, Chris
    Craig, Cora L.
    Crujeiras, Ana B.
    D'Arrigo, Graziella
    d'Orsi, Eleonora
    Dallongeville, Jean
    Damasceno, Albertino
    Damsgaard, Camilla T.
    Dankner, Rachel
    Dauchet, Luc
    De Backer, Guy
    De Bacque, Dirk
    de Gaetano, Giovanni
    De Hanauw, Stefaan
    De Smedt, Delphine
    Deepa, Mohan
    Deev, Alexander D.
    Dehghan, Abbas
    Delisle, Helene
    Delpeuch, Francis
    Deschamps, Valerie
    Dhana, Klodian
    Di Castelnuovo, Augusto F.
    Dias-da-Costa, Juvenal Soares
    Diaz, Alejandro
    Djalalinia, Shirin
    Do, Ha T. P.
    Dobson, Annette J.
    Donfrancesco, Chiara
    Donoso, Silvana P.
    Doering, Angela
    Doua, Kouamelan
    Drygas, Wojciech
    Dzerve, Vilnis
    Egbagbe, Eruke E.
    Eggertsen, Robert
    Ekelund, Ulf
    El Ati, Jalila
    Elliott, Paul
    Engle-Stone, Reina
    Erasmus, Rajiv T.
    Erem, Cihangir
    Eriksen, Loise
    Escobedo-de la Pena, Jorge
    Evans, Alun
    Faeh, David
    Fall, Caroline H.
    Farzadfar, Farshad
    Felix-Redondo, Francisco J.
    Ferguson, Trevor S.
    Fernandez-Berges, Daniel
    Ferrante, Daniel
    Ferrari, Marika
    Ferreccio, Catterina
    Ferrieres, Jean
    Finn, Joseph D.
    Fischer, Krista
    Monterubio Flores, Eric
    Foeger, Bernhard
    Foo, Leng Huat
    Forslund, Ann-Sofie
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. Högskolan Dalarna.
    Fortmann, Stephen P.
    Francis, Heba M.
    Francis, Damian K.
    do Carmo Franco, Maria
    Franco, Oscar H.
    Frontera, Guillermo
    Fuchs, Flavio D.
    Fuchs, Sandra C.
    Fujita, Yuki
    Furusawa, Takuro
    Gaciong, Zbigniew
    Gafencu, Mihai
    Gareta, Dickman
    Garnett, Sarah P.
    Gaspoz, Jean-Michel
    Gasull, Magda
    Gates, Louise
    Geleijnse, Johanna M.
    Ghasemian, Anoosheh
    Giampaoli, Simona
    Gianfagna, Francesco
    Giovannelli, Jonathan
    Giwercman, Aleksander
    Goldsmith, Rebecca A.
    Goncalves, Helen
    Gonzalez Gross, Marcela
    Gonzalez Rivas, Juan P.
    Bonet Gorbea, Mariano
    Gottrand, Frederic
    Graff-Iversen, Sidsel
    Grafnetter, Dusan
    Grajda, Aneta
    Grammatikopoulou, Maria G.
    Gregor, Ronald D.
    Grodzicki, Tomasz
    Grontved, Anders
    Gruden, Grabriella
    Grujic, Vera
    Gu, Dongfeng
    Gualdi-Russo, Emanuela
    Guan, Ong Peng
    Gudnason, Vilmundur
    Guerrero, Ramiro
    Guessous, Idris
    Guimaraes, Andre L.
    Gulliford, Martin C.
    Gunnlaugsdottir, Johanna
    Gunter, Marc
    Guo, Xiuhua
    Guo, Yin
    Gupta, Prakash C.
    Gureje, Oye
    Gurzkowska, Beata
    Gutierrez, Laura
    Gutzwiller, Felix
    Halkjaer, Jytte
    Hambleton, Ian R.
    Hardy, Rebecca
    Kumar, Rachakulla Hari
    Hata, Jun
    Hayes, Alison J.
    He, Jiang
    Hendriks, Marleen Ekisabeth
    Hernandez Cadena, Leticia
    Herrala, Sauli
    Heshmat, Ramin
    Hihtaniemi, Ilpo Tapani
    Ho, Sai Yin
    Ho, Suzanne C.
    Hobbs, Michael
    Hofman, Albert
    Hormiga, Claudi M.
    Horta, Bernardo L.
    Houti, Leila
    Howitt, Christina
    Htay, Thein Thein
    Htet, Aung Soe
    Htike, Maung Maung Than
    Hu, Yonghua
    Husseini, Abdullatif
    Huu, Chinh Nguyen
    Huybrechts, Inge
    Hwalla, Nahla
    Iacoviello, Licia
    Iannone, Anna G.
    Ibrahim, Mohsen M.
    Ikeda, Nayu
    Ikram, M. Arfan
    Irazola, Vilma E.
    Islam, Muhammad
    Ivkovic, Vanja
    Iwasaki, Masanori
    Jackson, Rod T.
    Jacobs, Jeremy M.
    Jafar, Tazeen
    Jamil, Kazi M.
    Jamrozik, Konrad
    Janszky, Imre
    Jasienska, Grazyna
    Jelakovic, Bojan
    Jiang, Chao Qiang
    Joffres, Michel
    Johansson, Mattias
    Jonas, Jost B.
    Jorgensen, Torben
    Joshi, Pradeep
    Juolevi, Anne
    Jurak, Gregor
    Juresa, Vesno
    Kaaks, Rudolf
    Kafatos, Anthony
    Kalter-Leibovici, Ofra
    Kapantais, Efthymios
    Kasaeian, Amir
    Katz, Joanne
    Kaur, Prabhdeep
    Kavousi, Maryam
    Keil, Ulrich
    Boker, Lital Keinan
    Keinanen-Kiukaanniemi, Sirkka
    Kelishadi, Roya
    Kemper, Han C. G.
    Kengne, Andre P.
    Kersting, Mathilde
    Key, Timothy
    Khader, Yousef Saleh
    Khalili, Davood
    Khang, Young-Ho
    Khaw, Kay-Tee H.
    Khouw, Ilse M. S. L.
    Kiechl, Stefan
    Killewo, Japhet
    Kim, Jeongseon
    Klimont, Jeannette
    Klumbiene, Jurate
    Koirala, Bhawesh
    Kolle, Elin
    Kolsteren, Patrick
    Korrovits, Paul
    Koskinen, Seppo
    Kouda, Katsuyasu
    Koziel, Slawomir
    Kratzer, Wolfgang
    Krokstad, Steinar
    Kromhout, Daan
    Kruger, Herculina S.
    Kubinova, Ruzena
    Kujala, Urho M.
    Kula, Krzysztof
    Kulaga, Zbigniew
    Kumar, R. Krishna
    Kurjata, Pawel
    Kusuma, Yadlapalli S.
    Kuulasmaa, Kari
    Kyobutungi, Catherine
    Laamiri, Fatima Zahra
    Laatikainen, Tiina
    Lachat, Carl
    Laid, Youcef
    Lam, Tai Hing
    Landrove, Orlando
    Lanska, Vera
    Lappas, Georg
    Larijani, Bagher
    Laugsand, Lars E.
    Bao, Khanh Le Nguyen
    Le, Tuyen D
    Leclercq, Catherine
    Lee, Jeannette
    Lee, Jeonghee
    Lehtimaki, Terho
    Lekhraj, Rampal
    Leon-Munoz, Luz M.
    Li, Yanping
    Lilly, Christa L.
    Lim, Wei-Yen
    Fernanda Lima-Costa, M.
    Lin, Hsien-Ho
    Lin, Xu
    Linneberg, Allan
    Lissner, Lauren
    Litwin, Mieczyslaw
    Liu, Jing
    Lorbeer, Roberto
    Lotufo, Paulo A.
    Eugenio Lozano, Jose
    Luksiene, Dalia
    Lundqvist, Annamari
    Lunet, Nuno
    Ma, Guansheng
    Ma, Jun
    Machado-Coelho, George L. L.
    Machi, Suka
    Maggi, Stefania
    Magliano, Dianna J.
    Maire, Bernard
    Makdisse, Marcia
    Malekzadeh, Reza
    Malhotra, Rahul
    Rao, Kodavanti Mallikharjuna
    Malyutina, Sofia
    Manios, Yannis
    Mann, Jim I.
    Manzato, Enzo
    Margozzini, Paula
    Markey, Oonagh
    Marques-Vidal, Pedro
    Marrugat, Jaume
    Martin-Prevel, Yves
    Martorell, Reynaldo
    Masoodi, Shariq R.
    Mathiesen, Ellisiv B.
    Matsha, Tandi E.
    Mazur, Artur
    Mbanya, Jean Claude N.
    McFarlane, Shelly R.
    McGarvey, Stephen T.
    McKee, Martin
    McLachlan, Stela
    McLean, Rachael M.
    McNulty, Breige A.
    Yusof, Safiah Md
    Mediene-Benchekor, Sounnia
    Meirhaeghe, Aline
    Meisinger, Christa
    Menezes, Ana Maria B.
    Mensink, Gert B. M.
    Meshram, Indrapal I.
    Metspalu, Andres
    Mi, Jie
    Michaelsen, Kim F.
    Mikkel, Kairit
    Miller, Jody C.
    Francisco Miquel, Juan
    Jaime Miranda, J.
    Misigoj-Durakovic, Marjeta
    Mohamed, Mostafa K.
    Mohammad, Kazem
    Mohammadifard, Noushin
    Mohan, Viswanathan
    Yusoff, Muhammad Fadhli Mohd
    Molbo, Drude
    Moller, Niels C.
    Molnar, Denes
    Mondo, Charles K.
    Monterrubio, Eric A.
    Monyeki, Kotsedi Daniel K.
    Moreira, Leila B.
    Morejon, Alain
    Moreno, Luis A.
    Morgan, Karen
    Mortensen, Erik Lykke
    Moschonis, George
    Mossakowska, Malgorzata
    Mostafa, Aya
    Mota, Jorge
    Motlagh, Mohammad Esmaeel
    Motta, Jorge
    Mu, Thet Thet
    Muiesan, Maria Lorenza
    Mueller-Nurasyid, Martina
    Murphy, Neil
    Mursu, Jaakko
    Murtagh, Elaine M.
    Musa, Kamarul Imran
    Musil, Vera
    Nagel, Gabriele
    Nakamura, Harunobu
    Namesna, Jana
    Nang, Ei Ei K.
    Nangia, Vinay B.
    Nankap, Martin
    Narake, Sameer
    Maria Navarrete-Munoz, Eva
    Neal, William A.
    Nenko, Ilona
    Neovius, Martin
    Nervi, Flavio
    Neuhauser, Hannelore K.
    Nguyen, Nguyen D.
    Nguyen, Quang Ngoc
    Nieto-Martinez, Ramfis E.
    Ning, Guang
    Ninomiya, Toshiharu
    Nishtar, Sania
    Noale, Marianna
    Norat, Teresa
    Noto, Davide
    Al Nsour, Mohannad
    O'Reilly, Dermot
    Oh, Kyungwon
    Olayan, Iman H.
    Anselmo Olinto, Maria Teresa
    Oltarzewski, Maciej
    Omar, Mohd A.
    Onat, Altan
    Ordunez, Pedro
    Ortiz, Ana P.
    Osler, Merete
    Osmond, Clive
    Ostojic, Sergej M.
    Otero, Johanna A.
    Overvad, Kim
    Owusu-Dabo, Ellis
    Paccaud, Fred Michel
    Padez, Cristina
    Pahomova, Elena
    Pajak, Andrzej
    Palli, Domenico
    Palloni, Alberto
    Palmieri, Luigi
    Panda-Jonas, Songhomitra
    Panza, Francesco
    Parnell, Winsome R.
    Parsaeian, Mahboubeh
    Pecin, Ivan
    Pednekar, Mangesh S.
    Peeters, Petra H.
    Peixoto, Sergio Viana
    Peltonen, Markku
    Pereira, Alexandre C.
    Perez, Cynthia M.
    Peters, Annette
    Petkeviciene, Janina
    Peykari, Niloofar
    Pham, Son Thai
    Pigeot, Iris
    Pikhart, Hynek
    Pilav, Aida
    Pilotto, Lorenza
    Pistelli, Francesco
    Pitakaka, Freda
    Piwonska, Aleksandra
    Plans-Rubio, Pedro
    Poh, Bee Koon
    Porta, Miquel
    Portegies, Marileen L. P.
    Poulimeneas, Dimitrios
    Pradeepa, Rajendra
    Prashant, Mathur
    Price, Jacqueline F.
    Puiu, Maria
    Punab, Margus
    Qasrawi, Radwan F.
    Qorbani, Mostafa
    Bao, Tran Quoc
    Radic, Ivana
    Radisauskas, Ricardas
    Rahman, Mahmudur
    Raitakari, Olli
    Raj, Manu
    Rao, Sudha Ramachandra
    Ramachandran, Ambady
    Ramke, Jacqueline
    Ramos, Rafel
    Rampal, Sanjay
    Rasmussen, Finn
    Redon, Josep
    Reganit, Paul Ferdinand M.
    Ribeiro, Robespierre
    Rigo, Fernando
    de Wit, Tobias F. Rinke
    Ritti-Dias, Raphael M.
    Rivera, Juan A.
    Robinson, Sian M.
    Robitaille, Cynthia
    Rodri-guez-Artalejo, Fernando
    del Cristo Rodriguez-Perez, Maria
    Rodriguez-Villamizar, Laura A.
    Rojas-Martinez, Rosalba
    Rojroongwasinkul, Nipa
    Romaguera, Dora
    Ronkainen, Kimmo
    Rosengren, Annika
    Rouse, Ian
    Rubinstein, Adolfo
    Ruhli, Frank J.
    Rui, Ornelas
    Sandra Ruiz-Betancourt, Blanca
    Horimoto, Andrea R. V. Russo
    Rutkowski, Marcin
    Sabanayagam, Charumathi
    Sachdev, Harshpal S.
    Saidi, Olfa
    Salanave, Benoit
    Salazar Martinez, Eduardo
    Salomaa, Veikko
    Salonen, Jukka T.
    Salvetti, Massimo
    Sanchez-Abanto, Jose
    Sandjaja,
    Sans, Susana
    Santos, Diana A.
    Santos, Osvaldo
    dos Santos, Renata Nunes
    Santos, Rute
    Saramies, Jouko L.
    Sardinha, Luis B.
    Sarrafzadegan, Nizal
    Saum, Kai-Uwe
    Savva, Savvas C.
    Scazufca, Marcia
    Rosario, Angelika Schaffrath
    Schargrodsky, Herman
    Schienkiewitz, Anja
    Schmidt, Ida Maria
    Schneider, Ione J.
    Schultsz, Constance
    Schutte, Aletta E.
    Sein, Aye Aye
    Sen, Abhijit
    Senbanjo, Idowu O.
    Sepanlou, Sadaf G.
    Shalnova, Svetlana A.
    Sharma, Sanjib K.
    Shaw, Jonathan E.
    Shibuya, Kenji
    Shin, Dong Wook
    Shin, Youchan
    Shiri, Rahman
    Siantar, Rosalynn
    Sibai, Abla M.
    Silva, Antonio M.
    Santos Silva, Diego Augusto
    Simon, Mary
    Simons, Judith
    Simons, Leon A.
    Sjostrom, Michael
    Slowikowska-Hilczer, Jolanta
    Slusarczyk, Przemyslaw
    Smeeth, Liam
    Smith, Margaret C.
    Snijder, Marieke B.
    So, Hung-Kwan
    Sobngwi, Eugene
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Soekatri, Moesijanti Y. E.
    Solfrizzi, Vincenzo
    Sonestedt, Emily
    Song, Yi
    Sorensen, Thorkild I. A.
    Soric, Maroje
    Jerome, Charles Sossa
    Soumare, Aicha
    Staessen, Jan A.
    Starc, Gregor
    Stathopoulou, Maria G.
    Staub, Kaspar
    Stavreski, Bill
    Steene-Johannessen, Jostein
    Stehle, Peter
    Stein, Aryeh D.
    Stergiou, George S.
    Stessman, Jochanan
    Stieber, Jutta
    Stoeckl, Doris
    Stocks, Tanja
    Stokwiszewski, Jakub
    Stratton, Gareth
    Stronks, Karien
    Strufaldi, Maria Wany
    Sun, Chien-An
    Sundstroem, Johan
    Sung, Yn-Tz
    Sunyer, Jordi
    Suriyawongpaisal, Paibul
    Swinburn, Boyd A.
    Sy, Rody G.
    Szponar, Lucjan
    Tai, E. Shyong
    Tammesoo, Mari-Liis
    Tamosiunas, Abdonas
    Tang, Line
    Tang, Xun
    Tanser, Frank
    Tao, Yong
    Tarawneh, Mohammed Rasoul
    Tarp, Jakob
    Tarqui-Mamani, Carolina B.
    Taylor, Anne
    Tchibindat, Felicite
    Theobald, Holger
    Thijs, Lutgarde
    Thuesen, Betina H.
    Tjonneland, Anne
    Tolonen, Hanna K.
    Tolstrup, Janne S.
    Topbas, Murat
    Topor-Madry, Roman
    Torrent, Maties
    Toselli, Stefania
    Traissac, Pierre
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Trinh, Oanh T. H.
    Trivedi, Atul
    Tshepo, Lechaba
    Tulloch-Reid, Marshall K.
    Tuomainen, Tomi-Pekka
    Tuomilehto, Jaakko
    Turley, Maria L.
    Tynelius, Per
    Tzotzas, Themistoklis
    Tzourio, Christophe
    Ueda, Peter
    Ukoli, Flora A. M.
    Ulmer, Hanno
    Unal, Belgin
    Uusitalo, Hannu M. T.
    Valdivia, Gonzalo
    Vale, Susana
    Valvi, Damaskini
    van der Schouw, Yvonne T.
    Van Herck, Koen
    Minh, Hoang Van
    van Rossem, Lenie
    van Valkengoed, Irene G. M.
    Vanderschueren, Dirk
    Vanuzzo, Diego
    Vatten, Lars
    Vega, Tomas
    Velasquez-Melendez, Gustavo
    Veronesi, Giovanni
    Verschuren, W. M. Monique
    Verstraeten, Roosmarijn
    Victora, Cesar G.
    Viegi, Giovanni
    Viet, Lucie
    Viikari-Juntura, Eira
    Vineis, Paolo
    Vioque, Jesus
    Virtanen, Jyrki K.
    Visvikis-Siest, Sophie
    Viswanathan, Bharathi
    Vollenweider, Peter
    Voutilainen, Sari
    Vrdoljak, Ana
    Vrijheid, Martine
    Wade, Alisha N.
    Wagner, Aline
    Walton, Janette
    Mohamud, Wan Nazaimoon Wan
    Wang, Ming-Dong
    Wang, Qian
    Wang, Ya Xing
    Wannamethee, S. Goya
    Wareham, Nicholas
    Weerasekera, Deepa
    Whincup, Peter H.
    Widhalm, Kurt
    Widyahening, Indah S.
    Wiecek, Andrzej
    Wijga, Alet H.
    Wilks, Rainford J.
    Willeit, Johann
    Wilsgaard, Tom
    Wojtyniak, Bogdan
    Wong, Jyh Eiin
    Wong, Tien Yin
    Woo, Jean
    Woodward, Mark
    Wu, Frederick C.
    Wu, Jianfeng
    Wu, Shou Ling
    Xu, Haiquan
    Xu, Liang
    Yamborisut, Uruwan
    Yan, Weili
    Yang, Xiaoguang
    Yardim, Nazan
    Ye, Xingwang
    Yiallouros, Panayiotis K.
    Yoshihara, Akihiro
    You, Qi Sheng
    Younger-Coleman, Novie O.
    Yusoff, Ahmad F.
    Zainuddin, Ahmad A.
    Zambon, Sabina
    Zdrojewski, Tomasz
    Zeng, Yi
    Zhao, Dong
    Zhao, Wenhua
    Zheng, Yingfeng
    Zhou, Maigeng
    Zhu, Dan
    Zimmermann, Esther
    Cisneros, Julio Zuniga
    A century of trends in adult human height2016In: eLIFE, E-ISSN 2050-084X, Vol. 5, article id e13410Article in journal (Refereed)
    Abstract [en]

    Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.

  • 10. Bergström, G
    et al.
    Berglund, G
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Brandberg, J
    Engström, G
    Engvall, J
    Eriksson, M
    de Faire, U
    Flinck, A
    Hansson, M G
    Hedblad, B
    Hjelmgren, O
    Janson, C
    Jernberg, T
    Johnsson, Å
    Johansson, L
    Lind, L
    Löfdahl, C-G
    Melander, O
    Östgren, C J
    Persson, A
    Persson, M
    Sandström, Anette
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Schmidt, C
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Sundström, J
    Toren, K
    Waldenström, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Thoracic Center, Umeå University Hospital.
    Wedel, H
    Vikgren, J
    Fagerberg, B
    Rosengren, A
    The Swedish CArdioPulmonary BioImage Study: objectives and design.2015In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 278, no 6, p. 645-659Article in journal (Refereed)
    Abstract [en]

    Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.

  • 11. Boman, J
    et al.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Forsberg, J
    Birgander, L S
    Allard, A
    Persson, K
    Jidell, E
    Kumlin, U
    Juto, P
    Waldenström, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Wadell, G
    High prevalence of Chlamydia pneumoniae DNA in peripheral blood mononuclear cells in patients with cardiovascular disease and in middle-aged blood donors.1998In: Journal of Infectious Diseases, ISSN 0022-1899, E-ISSN 1537-6613, Vol. 178, no 1Article in journal (Refereed)
    Abstract [en]

    Nested polymerase chain reaction (nPCR) demonstrated the presence of Chlamydia pneumoniae-specific DNA in peripheral blood mononuclear cells (PBMC). PBMC samples were obtained from 103 consecutive patients (62 male, 41 female) aged 22-85 years (mean, 64) admitted for coronary angiography because of suspected coronary heart disease and from 52 blood donors (43 male, 9 female) aged 40-64 years (mean, 49). Of the 101 evaluable patients, 60 (59%) were identified by nPCR assay as C. pneumoniae DNA carriers; C. pneumoniae-specific microimmunofluorescence (MIF) serology confirmed exposure to the bacterium in 57 (95%) of the 60 nPCR-positive patients. Among the 52 blood donors, the nPCR assay identified 24 (46%) C. pneumoniae DNA carriers, all of whom were positive by C. pneumoniae-specific serology. Thirty-two patients (32%) and 23 blood donors (44%) were MIF antibody-positive but repeatedly nPCR-negative; Bartonella henselae- or Bartonella quintana-specific antibodies were not detected among any of these subjects. In this study, C. pneumoniae DNA was common in PBMC of patients with coronary heart disease and in middle-aged blood donors.

  • 12.
    Calcutteea, Avin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Global and regional right ventricular disturbances in pulmonary hypertensionArticle in journal (Other academic)
  • 13.
    Calcutteea, Avin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Center.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Center.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Center.
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Center.
    Global and regional right ventricular dysfunction in pulmonary hypertension2014In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 31, no 2, p. 164-171Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pulmonary hypertension (PH) is known to affect the right ventricular (RV) function.

    AIMS: To assess the extent of global and regional RV dysfunction in PH patients.

    METHODS: We performed a cross-sectional study on 20 controls (age 62 ± 15 years, 7 males) and 35 patients (age 67 ± 12 years, 13 males) with PH of mixed etiologies and assessed RV inflow and outflow tracts (OTs) function, using speckle tracking echocardiography (STE) based myocardial deformation and its time relations. RV inlet and OT dimensions (2D), inlet myocardial velocities (TDI), myocardial strain and strain rate (SR), TAPSE (M-mode), ejection and filling times (pulsed-wave [PW] Doppler), and pulmonary artery acceleration (PAc) were measured.

    RESULTS: RV inlet and OT were dilated (P < 0.001 for both) and TAPSE (P < 0.001), inlet velocities (P < 0.001), basal and mid-cavity strain, SR and longitudinal displacement reduced (P < 0.001 for all). The time to peak systolic SR at basal, mid-cavity (P < 0.001 for both), and RVOT (P = 0.007) was short as was that to peak displacement (P < 0.001 for all). The time to peak pulmonary ejection correlated with time to peak SR at RVOT (r = 0.7, P < 0.001) in controls, but with that of the mid-cavity in patients (r = 0.71, P < 0.001). PAc was faster (P = 0.001) and RV filling time shorter in patients (P = 0.03) with respect to controls.

    CONCLUSIONS: PH has drastic effects on RV structure and intrinsic myocardial function, significantly disturbing its ejection time relations and overall pump performance. Increased RV afterload results in RV configuration changes with the inflow tract determining peak ejection rather than OT.

  • 14. Cameron, A. J.
    et al.
    Magliano, D. J.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    A systematic review of the impact of including both waist and hip circumference in risk models for cardiovascular diseases, diabetes and mortality2013In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 14, no 1, p. 86-94Article, review/survey (Refereed)
    Abstract [en]

    Both a larger waist and narrow hips are associated with heightened risk of diabetes, cardiovascular diseases and premature mortality. We review the risk of these outcomes for levels of waist and hip circumferences when terms for both anthropometric measures were included in regression models. MEDLINE and EMBASE were searched (last updated July 2012) for studies reporting the association with the outcomes mentioned earlier for both waist and hip circumferences (unadjusted and with both terms included in the model). Ten studies reported the association between hip circumference and death and/or disease outcomes both unadjusted and adjusted for waist circumference. Five studies reported the risk associated with waist circumference both unadjusted and adjusted for hip circumference. With the exception of one study of venous thromboembolism, the full strength of the association between either waist circumference or hip circumference with morbidity and/or mortality was only apparent when terms for both anthropometric measures were included in regression models. Without accounting for the protective effect of hip circumference, the effect of obesity on risk of death and disease may be seriously underestimated. Considered together (but not as a ratio measure), waist and hip circumference may improve risk prediction models for cardiovascular disease and other outcomes.

  • 15. Cameron, A J
    et al.
    Zimmet, P Z
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Alberti, K G M M
    Sicree, R
    Tuomilehto, J
    Chitson, P
    Shaw, J E
    The metabolic syndrome as a predictor of incident diabetes mellitus in Mauritius.2007In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 24, no 12, p. 1460-1469Article in journal (Refereed)
  • 16. Cameron, Adrian J
    et al.
    Boyko, Edward J
    Sicree, Richard A
    Zimmet, Paul Z
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Alberti, K George M M
    Tuomilehto, Jaakko
    Chitson, Pierrot
    Shaw, Jonathan E
    Central obesity as a precursor to the metabolic syndrome in the AusDiab study and Mauritius.2008In: Obesity (Silver Spring, Md.), ISSN 1930-7381, Vol. 16, no 12, p. 2707-16Article in journal (Refereed)
    Abstract [en]

    Evidence from epidemiologic studies that central obesity precedes future metabolic change and does not occur concurrently with the appearance of the blood pressure, glucose, and lipid abnormalities that characterize the metabolic syndrome (MetS) has been lacking. Longitudinal surveys were conducted in Mauritius in 1987, 1992, and 1998, and in Australia in 2000 and 2005 (AusDiab). This analysis included men and women (aged > or = 25 years) in three cohorts: AusDiab 2000-2005 (n = 5,039), Mauritius 1987-1992 (n = 2,849), and Mauritius 1987-1998 (n = 1,999). MetS components included waist circumference, systolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, and homeostasis model assessment of insulin sensitivity (HOMA-S) (representing insulin sensitivity). Linear regression was used to determine which baseline components predicted deterioration in other MetS components over 5 years in AusDiab and 5 and 11 years in Mauritius, adjusted for age, sex, and ethnic group. Baseline waist circumference predicted deterioration (P < 0.01) in four of the other six MetS variables tested in AusDiab, five of six in Mauritius 1987-1992, and four of six in Mauritius 1987-1998. In contrast, an increase in waist circumference between baseline and follow-up was only predicted by insulin sensitivity (HOMA-S) at baseline, and only in one of the three cohorts. These results suggest that central obesity plays a central role in the development of the MetS and appears to precede the appearance of the other MetS components.

  • 17. Cameron, Adrian J.
    et al.
    Magliano, Dianna J.
    Shaw, Jonathan E.
    Zimmet, Paul Z.
    Carstensen, Bendix
    Alberti, K. George M. M.
    Tuomilehto, Jaakko
    Barr, Elizabeth L. M.
    Pauvaday, Vassen K.
    Kowlessur, Sudhirsen
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    The influence of hip circumference on the relationship between abdominal obesity and mortality2012In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 41, no 2, p. 484-494Article in journal (Refereed)
    Abstract [en]

    Background Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction. Methods In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of > 25% and a decrease of > 20% after waist and hip circumference were added to the model was calculated. Results Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by > 25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by > 20% for 4.5% of those who died and 14.8% of those censored. Conclusions The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models.

  • 18. Cameron, AJ
    et al.
    Soderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Magliano, DJ
    Comment on 'General and abdominal obesity parameters and their combination in relation to mortality: a systematic review and meta-regression analysis'2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 1, p. 140-140Article in journal (Refereed)
  • 19. Cornelis, M. C.
    et al.
    Gustafsson, S.
    Arnlov, J.
    Elmstahl, S.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Sundstrom, J.
    Michaelsson, K.
    Lind, L.
    Ingelsson, E.
    Targeted proteomic analysis of habitual coffee consumption2018In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 283, no 2, p. 200-211Article in journal (Refereed)
    Abstract [en]

    Background: Coffee drinking has been implicated in mortality and a variety of diseases but potential mechanisms underlying these associations are unclear. Large‐scale systems epidemiological approaches may offer novel insights to mechanisms underlying associations of coffee with health.

    Objective: We performed an analysis of known and novel protein markers linked to cardiovascular disease and their association with habitual coffee intake in the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS, n = 816) and followed up top proteins in the Uppsala Longitudinal Study of Adult Men (ULSAM, n = 635) and EpiHealth (n = 2418).

    Methods: In PIVUS and ULSAM, coffee intake was measured by 7‐day dietary records whilst a computer‐based food frequency questionnaire was used in EpiHealth. Levels of up to 80 proteins were assessed in plasma by a proximity extension assay.

    Results: Four protein–coffee associations adjusted for age, sex, smoking and BMI, met statistical significance in PIVUS (FDR < 5%, P < 2.31 × 10−3): leptin (LEP), chitinase‐3‐like protein 1 (CHI3L), tumour necrosis factor (TNF) receptor 6 and TNF‐related apoptosis‐inducing ligand. The inverse association between coffee intake and LEP replicated in ULSAM (β, −0.042 SD per cup of coffee, P = 0.028) and EpiHealth (β, −0.025 SD per time of coffee, P = 0.004). The negative coffee–CHI3L association replicated in EpiHealth (β, −0.07, P = 1.15 × 10−7), but not in ULSAM (β, −0.034, P = 0.16).

    Conclusions: The current study supports an inverse association between coffee intake and plasma LEP and CHI3L1 levels. The coffee–CHI3L1 association is novel and warrants further investigation given links between CHI3L1 and health conditions that are also potentially influenced by coffee.

  • 20. Dalin, Frida
    et al.
    Nordling Eriksson, Gabriel
    Dahlqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Hallgren, Åsa
    Wahlberg, Jeanette
    Ekwall, Olov
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Rönnelid, Johan
    Olcén, Per
    Winqvist, Ola
    Catrina, Sergiu-Bogdan
    Kriström, Berit
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Laudius, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Isaksson, Magnus
    Halldin Stenlid, Maria
    Gustafsson, Jan
    Gebre-Medhin, Gennet
    Björnsdottir, Sigridur
    Janson, Annika
    Åkerman, Anna-Karin
    Åman, Jan
    Duchen, Karel
    Bergthorsdottir, Ragnhildur
    Johannsson, Gudmundur
    Lindskog, Emma
    Landin-Olsson, Mona
    Elfving, Maria
    Waldenström, Erik
    Hulting, Anna-Lena
    Kämpe, Olle
    Bensing, Sophie
    Clinical and immunological characteristics of Autoimmune Addison's disease: a nationwide Swedish multicenter study2017In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 102, no 2, p. 379-389Article in journal (Refereed)
    Abstract [en]

    CONTEXT: Studies on clinical and immunological features of Autoimmune Addison's disease (AAD) are needed to understand the disease burden and increased mortality.

    OBJECTIVE: To provide upgraded data on autoimmune comorbidities, replacement therapy, autoantibody profiles and cardiovascular risk factors.

    DESIGN, SETTING AND PARTICIPANTS: Cross sectional, population-based study. 660 AAD patients were included utilizing the Swedish Addison Registry (SAR) 2008-2014. When analyzing cardiovascular risk factors, 3,594 individuals from the population-based survey in Northern Sweden, MONICA (MONItoring of Trends and Determinants of CArdiovascular Disease), served as controls.

    MAIN OUTCOME MEASURE: Prevalence of autoimmune comorbidities and cardiovascular risk factors. Autoantibodies against 13 autoantigens were determined.

    RESULTS: Sixty percent of the SAR cohort consisted of females. Mean age at diagnosis was significantly higher for females than for males (36.8 vs. 31.1 years). The proportion of 21-hydroxylase autoantibody positive patients was 83% and 62% of patients had one or more associated autoimmune diseases, more frequently coexisting in females (p<0.0001). AAD patients had lower BMI (p<0.0001) and prevalence of hypertension (p=0.027) compared with controls. Conventional hydrocortisone tablets were used by 89% of patients; with the mean dose 28.1±8.5 mg/day. The mean hydrocortisone equivalent dose normalized to body surface was 14.8±4.4 mg/m(2)/day. Higher hydrocortisone equivalent dose was associated with higher incidence of hypertension (p=0.046).

    CONCLUSIONS: Careful monitoring of AAD patients is warranted to detect associated autoimmune diseases. Contemporary Swedish AAD patients do not have increased prevalence of overweight, hypertension, T2DM or hyperlipidemia. However, high glucocorticoid replacement doses may be a risk factor for hypertension.

  • 21. Di Cesare, Mariachiara
    et al.
    Bentham, James
    Stevens, Gretchen A.
    Zhou, Bin
    Danaei, Goodarz
    Lu, Yuan
    Bixby, Honor
    Cowan, Melanie J.
    Riley, Leanne M.
    Hajifathalian, Kaveh
    Fortunato, Lea
    Taddei, Cristina
    Bennett, James E.
    Ikeda, Nayu
    Khang, Young-Ho
    Kyobutungi, Catherine
    Laxmaiah, Avula
    Li, Yanping
    Lin, Hsien-Ho
    Miranda, J. Jaime
    Mostafa, Aya
    Turley, Maria L.
    Paciorek, Christopher J.
    Gunter, Marc
    Ezzati, Majid
    Abdeen, Ziad A.
    Hamid, Zargar Abdul
    Abu-Rmeileh, Niveen M.
    Acosta-Cazares, Benjamin
    Adams, Robert
    Aekplakorn, Wichai
    Aguilar-Salinas, Carlos A.
    Ahmadvand, Alireza
    Ahrens, Wolfgang
    Ali, Mohamed M.
    Alkerwi, Ala'a
    Alvarez-Pedrerol, Mar
    Aly, Eman
    Amouyel, Philippe
    Amuzu, Antoinette
    Andersen, Lars Bo
    Anderssen, Sigmund A.
    Andrade, Dolores S.
    Anjana, Ranjit Mohan
    Aounallah-Skhiri, Hajer
    Ariansen, Inger
    Aris, Tahir
    Arlappa, Nimmathota
    Arveiler, Dominique
    Assah, Felix K.
    Avdicova, Maria
    Azizi, Fereidoun
    Babu, Bontha V.
    Balakrishna, Nagalla
    Bandosz, Piotr
    Banegas, Jose R.
    Barbagallo, Carlo M.
    Barcelo, Alberto
    Barkat, Amina
    Barros, Mauro V.
    Bata, Iqbal
    Batieha, Anwar M.
    Batista, Rosangela L.
    Baur, Louise A.
    Beaglehole, Robert
    Ben Romdhane, Habiba
    Benet, Mikhail
    Bernabe-Ortiz, Antonio
    Bernotiene, Gailute
    Bettiol, Heloisa
    Bhagyalaxmi, Aroor
    Bharadwaj, Sumit
    Bhargava, Santosh K.
    Bhatti, Zaid
    Bhutta, Zulfiqar A.
    Bi, HongSheng
    Bi, Yufang
    Bjerregaard, Peter
    Bjertness, Espen
    Bjertness, Marius B.
    Bjorkelund, Cecilia
    Blake, Margaret
    Blokstra, Anneke
    Bo, Simona
    Bobak, Martin
    Boddy, Lynne M.
    Boehm, Bernhard O.
    Boeing, Heiner
    Boissonnet, Carlos P.
    Bongard, Vanina
    Bovet, Pascal
    Braeckman, Lutgart
    Bragt, Marjolijn C. E.
    Brajkovich, Imperia
    Branca, Francesco
    Breckenkamp, Juergen
    Brenner, Hermann
    Brewster, Lizzy M.
    Brian, Garry R.
    Bruno, Graziella
    Bueno-de-Mesquita, H. B(as)
    Bugge, Anna
    Burns, Con
    Cabrera de Leon, Antonio
    Cacciottolo, Joseph
    Cama, Tilema
    Cameron, Christine
    Camolas, Jose
    Can, Gunay
    Candido, Ana Paula C.
    Capuano, Vincenzo
    Cardoso, Viviane C.
    Carvalho, Maria J.
    Casanueva, Felipe F.
    Casas, Juan-Pablo
    Caserta, Carmelo A.
    Castetbon, Katia
    Chamukuttan, Snehalatha
    Chan, Angelique W.
    Chan, Queenie
    Chaturvedi, Himanshu K.
    Chaturvedi, Nishi
    Chen, Chien-Jen
    Chen, Fangfang
    Chen, Huashuai
    Chen, Shuohua
    Chen, Zhengming
    Cheng, Ching-Yu
    Chetrit, Angela
    Chiolero, Arnaud
    Chiou, Shu-Ti
    Chirita-Emandi, Adela
    Cho, Yumi
    Christensen, Kaare
    Chudek, Jerzy
    Cifkova, Renata
    Claessens, Frank
    Clays, Els
    Concin, Hans
    Cooper, Cyrus
    Cooper, Rachel
    Coppinger, Tara C.
    Costanzo, Simona
    Cottel, Dominique
    Cowell, Chris
    Craig, Cora L.
    Crujeiras, Ana B.
    D'Arrigo, Graziella
    d'Orsi, Eleonora
    Dallongeville, Jean
    Damasceno, Albertino
    Damsgaard, Camilla T.
    Dankner, Rachel
    Dauchet, Luc
    De Backer, Guy
    De Bacquer, Dirk
    de Gaetano, Giovanni
    De Henauw, Stefaan
    De Smedt, Delphine
    Deepa, Mohan
    Deev, Alexander D.
    Dehghan, Abbas
    Delisle, Helene
    Delpeuch, Francis
    Dhana, Klodian
    Di Castelnuovo, Augusto F.
    Dias-da-Costa, Juvenal Soares
    Diaz, Alejandro
    Djalalinia, Shirin
    Do, Ha T. P.
    Dobson, Annette J.
    Donfrancesco, Chiara
    Doering, Angela
    Doua, Kouamelan
    Drygas, Wojciech
    Egbagbe, Eruke E.
    Eggertsen, Robert
    Ekelund, Ulf
    El Ati, Jalila
    Elliott, Paul
    Engle-Stone, Reina
    Erasmus, Rajiv T.
    Erem, Cihangir
    Eriksen, Louise
    Escobedo-de la Pena, Jorge
    Evans, Alun
    Faeh, David
    Fall, Caroline H.
    Farzadfar, Farshad
    Felix-Redondo, Francisco J.
    Ferguson, Trevor S.
    Fernandez-Berges, Daniel
    Ferrante, Daniel
    Ferrari, Marika
    Ferreccio, Catterina
    Ferrieres, Jean
    Finn, Joseph D.
    Fischer, Krista
    Monterubio Flores, Eric
    Foeger, Bernhard
    Foo, Leng Huat
    Forslund, Ann-Sofie
    Fortmann, Stephen P.
    Fouad, Heba M.
    Francis, Damian K.
    Franco, Maria do Carmo
    Franco, Oscar H.
    Frontera, Guillermo
    Fuchs, Flavio D.
    Fuchs, Sandra C.
    Fujita, Yuki
    Furusawa, Takuro
    Gaciong, Zbigniew
    Gafencu, Mihai
    Gareta, Dickman
    Garnett, Sarah P.
    Gaspoz, Jean-Michel
    Gasull, Magda
    Gates, Louise
    Geleijnse, Johanna M.
    Ghasemian, Anoosheh
    Giampaoli, Simona
    Gianfagna, Francesco
    Giovannelli, Jonathan
    Giwercman, Aleksander
    Goldsmith, Rebecca A.
    Gonzalez Gross, Marcela
    Gonzalez Rivas, Juan P.
    Bonet Gorbea, Mariano
    Gottrand, Frederic
    -Iversen, Sidsel Graff
    Grafnetter, Dusan
    Grajda, Aneta
    Grammatikopoulou, Maria G.
    Gregor, Ronald D.
    Grodzicki, Tomasz
    Grontved, Anders
    Gruden, Grabriella
    Grujic, Vera
    Gu, Dongfeng
    Guan, Ong Peng
    Gudnason, Vilmundur
    Guerrero, Ramiro
    Guessous, Idris
    Guimaraes, Andre L.
    Gulliford, Martin C.
    Gunnlaugsdottir, Johanna
    Guo, Xiu H.
    Guo, Yin
    Gupta, Prakash C.
    Gureje, Oye
    Gurzkowska, Beata
    Gutierrez, Laura
    Gutzwiller, Felix
    Halkjaer, Jytte
    Hardy, Rebecca
    Kumar, Rachakulla Hari
    Hayes, Alison J.
    He, Jiang
    Hendriks, Marleen Elisabeth
    Hernandez Cadena, Leticia
    Heshmat, Ramin
    Hihtaniemi, Ilpo Tapani
    Ho, Sai Yin
    Ho, Suzanne C.
    Hobbs, Michael
    Hofman, Albert
    Hormiga, Claudia M.
    Horta, Bernardo L.
    Houti, Leila
    Htay, Thein Thein
    Htet, Aung Soe
    Htike, Maung Maung Than
    Hu, Yonghua
    Hussieni, Abdullatif S.
    Huu, Chinh Nguyen
    Huybrechts, Inge
    Hwalla, Nahla
    Iacoviello, Licia
    Iannone, Anna G.
    Ibrahim, M. Mohsen
    Ikram, M. Arfan
    Irazola, Vilma E.
    Islam, Muhammad
    Iwasaki, Masanori
    Jackson, Rod T.
    Jacobs, Jeremy M.
    Jafar, Tazeen
    Jamil, Kazi M.
    Jamrozik, Konrad
    Jasienska, Grazyna
    Jiang, Chao Qiang
    Joffres, Michel
    Johansson, Mattias
    Jonas, Jost B.
    Jorgensen, Torben
    Joshi, Pradeep
    Juolevi, Anne
    Jurak, Gregor
    Juresa, Vesna
    Kaaks, Rudolf
    Kafatos, Anthony
    Kalter-Leibovici, Ofra
    Kapantais, Efthymios
    Kasaeian, Amir
    Katz, Joanne
    Kaur, Prabhdeep
    Kavousi, Maryam
    Keil, Ulrich
    Boker, Lital Keinan
    Kelishadi, Roya
    Kemper, Han H. C. G.
    Kengne, Andre P.
    Kersting, Mathilde
    Key, Timothy
    Khader, Yousef Saleh
    Khalili, Davood
    Khaw, Kay-Tee H.
    Khouw, Ilse M. S. L.
    Kiechl, Stefan
    Killewo, Japhet
    Kim, Jeongseon
    Kiyohara, Yutaka
    Klimont, Jeannette
    Kolle, Elin
    Kolsteren, Patrick
    Korrovits, Paul
    Koskinen, Seppo
    Kouda, Katsuyasu
    Koziel, Slawomir
    Kratzer, Wolfgang
    Krokstad, Steinar
    Kromhout, Daan
    Kruger, Herculina S.
    Kula, Krzysztof
    Kulaga, Zbigniew
    Kumar, R. Krishna
    Kusuma, Yadlapalli S.
    Kuulasmaa, Kari
    Laamiri, Fatima Zahra
    Laatikainen, Tiina
    Lachat, Carl
    Laid, Youcef
    Lam, Tai Hing
    Landrove, Orlando
    Lanska, Vera
    Lappas, Georg
    Laugsand, Lars E.
    Bao, Khanh Le Nguyen
    Le, Tuyen D.
    Leclercq, Catherine
    Lee, Jeannette
    Lee, Jeonghee
    Lehtimaki, Terho
    Lekhraj, Rampal
    Leon-Munoz, Luz M.
    Lim, Wei-Yen
    Fernanda Lima-Costa, M.
    Lin, Xu
    Linneberg, Allan
    Lissner, Lauren
    Litwin, Mieczyslaw
    Liu, Jing
    Lorbeer, Roberto
    Lotufo, Paulo A.
    Eugenio Lozano, Jose
    Luksiene, Dalia
    Lundqvist, Annamari
    Lunet, Nuno
    Lytsy, Per
    Ma, Guansheng
    Machi, Suka
    Maggi, Stefania
    Magliano, Dianna J.
    Makdisse, Marcia
    Malekzadeh, Reza
    Malhotra, Rahul
    Rao, Kodavanti Mallikharjuna
    Manios, Yannis
    Mann, Jim I.
    Manzato, Enzo
    Margozzini, Paula
    Markey, Oonagh
    Marques-Vidal, Pedro
    Marrugat, Jaume
    Martin-Prevel, Yves
    Martorell, Reynaldo
    Masoodi, Shariq R.
    Matsha, Tandi E.
    Mazur, Artur
    Mbanya, Jean Claude N.
    McFarlane, Shelly R.
    McGarvey, Stephen T.
    McKee, Martin
    McLachlan, Stela
    McLean, Rachael M.
    McNulty, Breige A.
    Yusof, Safiah Md
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    Meisinger, Christa
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    Mensink, Gert B. M.
    Meshram, Indrapal I.
    Metspalu, Andres
    Mi, Jie
    Michaelsen, Kim F.
    Mikkel, Kairit
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    Francisco Miquel, Juan
    Jaime Miranda, J.
    Misigoj-Durakovic, Marjeta
    Mohamed, Mostafa K.
    Mohammad, Kazem
    Mohammadifard, Noushin
    Mohan, Viswanathan
    Yusoff, Muhammad Fadhli Mohd
    Molbo, Drude
    Moller, Niels C.
    Molnar, Denes
    Mondo, Charles K.
    Monterrubio, Eric A.
    Monyeki, Kotsedi Daniel K.
    Moreira, Leila B.
    Morejon, Alain
    Moreno, Luis A.
    Morgan, Karen
    Mortensen, Erik Lykke
    Moschonis, George
    Mossakowska, Malgorzata
    Mota, Jorge
    Motlagh, Mohammad Esmaeel
    Motta, Jorge
    Mu, Thet Thet
    Muiesan, Maria Lorenza
    Mueller-Nurasyid, Martina
    Murphy, Neil
    Mursu, Jaakko
    Murtagh, Elaine M.
    Musa, Kamarul Imran
    Musil, Vera
    Nagel, Gabriele
    Nakamura, Harunobu
    Namesna, Jana
    Nang, Ei Ei K.
    Nangia, Vinay B.
    Nankap, Martin
    Narake, Sameer
    Maria Navarrete-Munoz, Eva
    Nenko, Ilona
    Neovius, Martin
    Nervi, Flavio
    Neuhauser, Hannelore K.
    Nguyen, Nguyen D.
    Nguyen, Quang Ngoc
    Nieto-Martinez, Ramfis E.
    Ning, Guang
    Ninomiya, Toshiharu
    Nishtar, Sania
    Noale, Marianna
    Norat, Teresa
    Noto, Davide
    Al Nsour, Mohannad
    O'Reilly, Dermot
    Ochoa-Aviles, Angelica M.
    Oh, Kyungwon
    Olayan, Iman H.
    Anselmo Olinto, Maria Teresa
    Oltarzewski, Maciej
    Omar, Mohd A.
    Ordunez, Pedro
    Ortiz, Ana P.
    Osler, Merete
    Osmond, Clive
    Ostojic, Sergej M.
    Otero, Johanna A.
    Overvad, Kim
    Paccaud, Fred Michel
    Padez, Cristina
    Pajak, Andrzej
    Palli, Domenico
    Palloni, Alberto
    Palmieri, Luigi
    Panda-Jonas, Songhomitra
    Panza, Francesco
    Parnell, Winsome R.
    Parsaeian, Mahboubeh
    Pednekar, Mangesh S.
    Peeters, Petra H.
    Peixoto, Sergio Viana
    Pereira, Alexandre C.
    Perez, Cynthia M.
    Peters, Annette
    Peykari, Niloofar
    Pham, Son Thai
    Pigeot, Iris
    Pikhart, Hynek
    Pilav, Aida
    Pilotto, Lorenza
    Pistelli, Francesco
    Pitakaka, Freda
    Piwonska, Aleksandra
    Piwonski, Jerzy
    Plans-Rubio, Pedro
    Poh, Bee Koon
    Porta, Miquel
    Portegies, Marileen L. P.
    Poulimeneas, Dimitrios
    Pradeepa, Rajendra
    Prashant, Mathur
    Price, Jacqueline F.
    Puiu, Maria
    Punab, Margus
    Qasrawi, Radwan F.
    Qorbani, Mostafa
    Bao, Tran Quoc
    Radic, Ivana
    Radisauskas, Ricardas
    Rahman, Mahmudur
    Raitakari, Olli
    Raj, Manu
    Rao, Sudha Ramachandra
    Ramachandran, Ambady
    Ramke, Jacqueline
    Ramos, Rafel
    Rampal, Sanjay
    Rasmussen, Finn
    Redon, Josep
    Reganit, Paul Ferdinand M.
    Ribeiro, Robespierre
    Riboli, Elio
    Rigo, Fernando
    de Wit, Tobias Floris Rinke
    Ritti-Dias, Raphael M.
    Rivera, Juan A.
    Robinson, Sian M.
    Robitaille, Cynthia
    Rodriguez-Artalejo, Fernando
    del Cristo Rodriguez-Perez, Maria
    Rodriguez-Villamizar, Laura A.
    Rojas-Martinez, Rosalba
    Rojroongwasinkul, Nipa
    Romaguera, Dora
    Ronkainen, Kimmo
    Rosengren, Annika
    Rouse, Ian
    Rubinstein, Adolfo
    Ruehli, Frank J.
    Rui, Ornelas
    Sandra Ruiz-Betancourt, Blanca
    Russo Horimoto, Andrea R. V.
    Rutkowski, Marcin
    Sabanayagam, Charumathi
    Sachdev, Harshpal S.
    Saidi, Olfa
    Salanave, Benoit
    Salazar Martinez, Eduardo
    Salomaa, Veikko
    Salonen, Jukka T.
    Salvetti, Massimo
    Sanchez-Abanto, Jose
    Sandjaja,
    Sans, Susana
    Santos, Diana A.
    Santos, Osvaldo
    dos Santos, Renata Nunes
    Santos, Rute
    Sardinha, Luis B.
    Sarrafzadegan, Nizal
    Saum, Kai-Uwe
    Savva, Savvas C.
    Scazufca, Marcia
    Rosario, Angelika Schaffrath
    Schargrodsky, Herman
    Schienkiewitz, Anja
    Schmidt, Ida Maria
    Schneider, Ione J.
    Schultsz, Constance
    Schutte, Aletta E.
    Sein, Aye Aye
    Senbanjo, Idowu O.
    Sepanlou, Sadaf G.
    Shalnova, Svetlana A.
    Shaw, Jonathan E.
    Shibuya, Kenji
    Shin, Youchan
    Shiri, Rahman
    Siantar, Rosalynn
    Sibai, Abla M.
    Silva, Antonio M.
    Santos Silva, Diego Augusto
    Simon, Mary
    Simons, Judith
    Simons, Leon A.
    Sjostrom, Michael
    Slowikowska-Hilczer, Jolanta
    Slusarczyk, Przemyslaw
    Smeeth, Liam
    Smith, Margaret C.
    Snijder, Marieke B.
    So, Hung-Kwan
    Sobngwi, Eugene
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Soekatri, Moesijanti Y. E.
    Solfrizzi, Vincenzo
    Sonestedt, Emily
    Sorensen, Thorkild I. A.
    Soric, Maroje
    Jerome, Charles Sossa
    Soumare, Aicha
    Staessen, Jan A.
    Starc, Gregor
    Stathopoulou, Maria G.
    Staub, Kaspar
    Stavreski, Bill
    Steene-Johannessen, Jostein
    Stehle, Peter
    Stein, Aryeh D.
    Stergiou, George S.
    Stessman, Jochanan
    Stieber, Jutta
    Stoeckl, Doris
    Stocks, Tanja
    Stokwiszewski, Jakub
    Stratton, Gareth
    Strufaldi, Maria Wany
    Sun, Chien-An
    Sundstrom, Johan
    Sung, Yn-Tz
    Sunyer, Jordi
    Suriyawongpaisal, Paibul
    Swinburn, Boyd A.
    Sy, Rody G.
    Szponar, Lucjan
    Tai, E. Shyong
    Tammesoo, Mari-Liis
    Tamosiunas, Abdonas
    Tang, Line
    Tang, Xun
    Tanser, Frank
    Tao, Yong
    Tarp, Jakob
    Tarqui-Mamani, Carolina B.
    Taylor, Anne
    Tchibindat, Felicite
    Thijs, Lutgarde
    Thuesen, Betina H.
    Tjonneland, Anne
    Tolonen, Hanna K.
    Tolstrup, Janne S.
    Topbas, Murat
    Topor-Madry, Roman
    Torrent, Maties
    Traissac, Pierre
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Trinh, Oanh T. H.
    Trivedi, Atul
    Tshepo, Lechaba
    Tulloch-Reid, Marshall K.
    Tuomainen, Tomi-Pekka
    Tuomilehto, Jaakko
    Tynelius, Per
    Tzotzas, Themistoklis
    Tzourio, Christophe
    Ueda, Peter
    Ukoli, Flora A. M.
    Ulmer, Hanno
    Unal, Belgin
    Valdivia, Gonzalo
    Vale, Susana
    Valvi, Damaskini
    van der Schouw, Yvonne T.
    Van Herck, Koen
    Minh, Hoang Van
    van Valkengoed, Irene G. M.
    Vanderschueren, Dirk
    Vanuzzo, Diego
    Vatten, Lars
    Vega, Tomas
    Velasquez-Melendez, Gustavo
    Veronesi, Giovanni
    Verschuren, W. M. Monique
    Viegi, Giovanni
    Viet, Lucie
    Viikari-Juntura, Eira
    Vineis, Paolo
    Vioque, Jesus
    Virtanen, Jyrki K.
    Visvikis-Siest, Sophie
    Viswanathan, Bharathi
    Vollenweider, Peter
    Voutilainen, Sari
    Vrijheid, Martine
    Wade, Alisha N.
    Wagner, Aline
    Walton, Janette
    Mohamud, Wan Nazaimoon Wan
    Wang, Ming-Dong
    Wang, Qian
    Wang, Ya Xing
    Wannamethee, S. Goya
    Wareham, Nicholas
    Weerasekera, Deepa
    Whincup, Peter H.
    Widhalm, Kurt
    Widyahening, Indah S.
    Wiecek, Andrzej
    Wilks, Rainford J.
    Willeit, Johann
    Wojtyniak, Bogdan
    Wong, Jyh Eiin
    Wong, Tien Yin
    Woo, Jean
    Woodward, Mark
    Wu, Frederick C.
    Wu, JianFeng
    Wu, Shou Ling
    Xu, Haiquan
    Xu, Liang
    Yamborisut, Uruwan
    Yan, Weili
    Yang, Xiaoguang
    Yardim, Nazan
    Ye, Xingwang
    Yiallouros, Panayiotis K.
    Yoshihara, Akihiro
    You, Qi Sheng
    Younger-Coleman, Novie O.
    Yusoff, Ahmad F.
    Zainuddin, Ahmad A.
    Zambon, Sabina
    Zdrojewski, Tomasz
    Zeng, Yi
    Zhao, Dong
    Zhao, Wenhua
    Zheng, Yingfeng
    Zhou, Maigeng
    Zhu, Dan
    Zimmermann, Esther
    Zuniga Cisneros, Julio
    Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants2016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 387, no 10026, p. 1377-1396Article in journal (Refereed)
    Abstract [en]

    Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.

    Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18.5 kg/m(2) [underweight], 18.5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), = 40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.

    Findings We used 1698 population-based data sources, with more than 19.2 million adult participants (9.9 million men and 9.3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21.7 kg/m(2) (95% credible interval 21.3-22.1) in 1975 to 24.2 kg/m(2) (24.0-24.4) in 2014 in men, and from 22.1 kg/m(2) (21.7-22.5) in 1975 to 24.4 kg/m(2) (24.2-24.6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21.4 kg/m(2) in central Africa and south Asia to 29.2 kg/m(2) (28.6-29.8) in Polynesia and Micronesia; for women the range was from 21.8 kg/m(2) (21.4-22.3) in south Asia to 32.2 kg/m(2) (31.5-32.8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13.8% (10.5-17.4) to 8.8% (7.4-10.3) in men and from 14.6% (11.6-17.9) to 9.7% (8.3-11.1) in women. South Asia had the highest prevalence of underweight in 2014, 23.4% (17.8-29.2) in men and 24.0% (18.9-29.3) in women. Age-standardised prevalence of obesity increased from 3.2% (2.4-4.1) in 1975 to 10.8% (9.7-12.0) in 2014 in men, and from 6.4% (5.1-7.8) to 14.9% (13.6-16.1) in women. 2.3% (2.0-2.7) of the world's men and 5.0% (4.4-5.6) of women were severely obese (ie, have BMI = 35 kg/m(2)). Globally, prevalence of morbid obesity was 0.64% (0.46-0.86) in men and 1.6% (1.3-1.9) in women.

    Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. 

  • 22. Ekblom, Örjan
    et al.
    Ekblom-Bak, Elin
    Bolam, Kate A.
    Ekblom, Björn
    Schmidt, Caroline
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Bergström, Göran
    Börjesson, Mats
    Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings– data from SCAPIS pilot study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 978Article in journal (Refereed)
    Abstract [en]

    Background: As the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions.

    Methods: A sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders.

    Results: Concurrent validity was low-to-moderate (r <0.35 and ROC AUC <0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration.

    Discussion: In this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations.

    Conclusion: Assessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.

  • 23. Ekström, Mattias
    et al.
    Söderberg, Stefan
    Tornvall, Per
    Acute Systemic Inflammation is Unlikely to Affect Adiponectin and Leptin Synthesis in Humans2015In: Frontiers in cardiovascular medicine, ISSN 2297-055X, Vol. 2Article in journal (Refereed)
    Abstract [en]

    Adipose tissue (AT), classically thought to be merely an energy store, has been shown to produce inflammatory and metabolically active cytokines. Recently, adiponectin and leptin, adipokines primarily synthesized by adipocytes, have attracted considerable attention because inflammation has been suggested to modulate adipokine levels. However, the regulation of adiponectin and leptin is complex and the knowledge about their synthesis within the early onset of inflammation is poorly understood. The aim of this study was to investigate if the synthesis of adiponectin and leptin is affected during the early phase of an acute systemic inflammation. Eighteen healthy subjects were allocated to vaccination against Salmonella typhi or to a control group, and adiponectin and leptin concentrations measured in plasma during 24 h. Nine patients, without markers of inflammation, undergoing open heart surgery were investigated before and after the operation by analysis of plasma levels and AT gene expression of adiponectin and leptin. Plasma interleukin (IL)-6 concentrations were measured in both cohorts. Plasma levels of IL-6 were doubled after vaccination and increased 30-fold after open heart surgery. Plasma levels of adiponectin and leptin were unchanged after vaccination whereas adiponectin and leptin tended to decrease after surgery. The gene expression of adiponectin and leptin was unaltered in omental and subcutaneous AT after surgery. Despite the use of two models of stimulated in vivo systemic inflammation, we found no evidence of an early regulation of adiponectin and leptin synthesis, indicating that these two adipokines are not key elements in an acute systemic inflammation in humans.

  • 24.
    Eriksson, Maria A
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Rask, Eva
    Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Johnson, Owe
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Carlström, Kjell
    Unit of Obstetrics and Gynecology, Department of Clinical Science, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
    Ahrén, Bo
    Department of Medicine, Lund University, Lund, Sweden.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Sex-related differences in the associations between hyperleptinemia, insulin resistance and dysfibrinolysis2008In: Blood Coagulation and Fibrinolysis, ISSN 0957-5235, E-ISSN 1473-5733, Vol. 19, no 7, p. 625-632Article in journal (Refereed)
    Abstract [en]

    The adipocyte-derived hormone leptin is associated with insulin resistance and reduced fibrinolytic status--or dysfibrinolysis--in humans. As leptin associates differentially to the development of cardiovascular disease and diabetes in men and women, we hypothesized that leptin and insulin sensitivity are related to dysfibrinolysis in a sex-dependent manner. Thirty-two men and 40 women were recruited from the Monitoring of trends and determinants in Cardiovascular disease (MONICA) population sample, representing the highest and lowest quartiles of fasting insulin levels. Lipids, fibrinolytic status [plasminogen activator inhibitor 1 (PAI-1) activity, tissue plasminogen activator (tPA) mass and activity, and tPA-PAI complex], leptin, testosterone and sex-hormone-binding globulin were measured. Insulin sensitivity was estimated using the euglycaemic clamp technique. Body composition was determined by bioimpedance. Determinants for circulating levels of fibrinolytic factors were explored in a multivariate linear regression analysis. Levels of fibrinolytic variables and estimated insulin sensitivity did not differ between men and women. Leptin was independently associated with reduced fibrinolytic status (high PAI-1 activity, low tPA activity, high tPA mass, and high tPA-PAI complex) in men (P < 0.001-0.002). In women, fat mass and/or insulin sensitivity were related to these factors (P < 0.001-0.03), and leptin only to reduced tPA activity (P = 0.002). Hyperleptinemia, dysfibrinolysis, insulin sensitivity and androgenicity associate differentially in men and women.

  • 25.
    Eriksson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johnson, Owe
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Hellsten, Gideon
    Norsjö District Health Centre, Norsjö; Sweden.
    Nilsson, Torbjörn K
    Department of Clinical Chemistry, Örebro University Hospital, Örebro, Sweden.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Improved fibrinolytic activity during exercise may be an effect of the adipocyte-derived hormones leptin and adiponectin2008In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 122, no 5, p. 701-708Article in journal (Refereed)
    Abstract [en]
    Introduction

    Physical activity is associated with improved fibrinolytic activity and reduced risk for cardiovascular disease. High levels of leptin and low levels of adiponectin, both adipocyte-derived hormones, or adipokines, are related to dysfibrinolysis and risk for cardiovascular disease. In this study, we explored if improved fibrinolytic activity during exercise could be linked to changes in leptin and adiponectin levels.

    Materials and methods

    Twenty healthy men (mean age 36 years) participated in a 14-day long skiing expedition in the Swedish mountains. They were randomly assigned to either a 40% or a 30% fat-based diet. Anthropometry, lipids, fibrinolytic activity (PAI-1 activity, tPA activity and mass) and adipokines (leptin and adiponectin) were measured before, during and six weeks after the expedition.

    Results

    PAI-1 activity and circulating levels of leptin decreased whereas levels of adiponectin increased during exercise. The fall in PAI-1 activity showed a strong linear association with changes in leptin and adiponectin levels (p = 0.001 and p < 0.001, respectively). Changes in leptin and adiponectin levels were independent of decreasing waist circumference. However, the association between anthropometric measures and adipokines changed considerably during the expedition. Adiponectin was weakly and negatively associated with BMI at baseline. In contrast, there was a strong positive association between adiponectin and BMI after two weeks of exercise, whereas the association between leptin and BMI became less pronounced. In addition, increasing leptin and decreasing adiponectin levels were associated with increasing PAI-1 activity during the six weeks following the expedition. After six weeks of normal activity, fibrinolytic activity and hormone levels returned towards baseline levels.

    Conclusion

    Heavy exercise induced improved fibrinolytic activity, which was associated independently with changes in circulating levels of the adipocyte-derived hormones leptin and adiponectin. Improved fibrinolytic activity (and reduced risk for cardiovascular disease) related to physical activity could possibly be mediated by leptin and adiponectin.

  • 26.
    Eriksson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, Torbjörn K
    Eriksson, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Jansson, Jan-Håkan
    Leptin levels are not associated with enalapril treatment after an uncomplicated myocardial infarction, but associate strongly with changes in fibrinolytic variables in menManuscript (preprint) (Other academic)
  • 27.
    Eriksson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Jansson, Jan-Håkan
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Leptin and adiponectin predict independently a first-ever myocardial infarction with a sex difference: data from a large prospective Swedish nested case-referent studyManuscript (preprint) (Other academic)
  • 28.
    Eriksson, Marie
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Carlberg, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Pennlert, Johanna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Time trends and socioeconomic differences in blood pressure levels: the Northern Sweden MONICA study 1994-20142017In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 24, no 14, p. 1473-1481Article in journal (Refereed)
    Abstract [en]

    Background: People with low socioeconomic status have higher blood pressure (BP), increasing their risk of myocardial infarction and stroke. We hypothesized that the gap in systolic (SBP) and diastolic (DBP) BP, according to educational level, has decreased over time but, that economical vulnerability would confer higher BP.

    Methods: A total of 4564 women and 4363 men aged 25-74 years participated in five population-based surveys in the Northern Sweden MONICA study between 1994 and 2014 (participation rate 76.8-62.5%).

    Results: SBP decreased by 10 mmHg in women and 4 mmHg in men, while DBP was unchanged. Treatment with antihypertensives increased in all but the youngest men. The prevalence of BP control in the population (<140/90 mmHg) increased and in 2014 reached 75% among women and 70% among men. The decrease in SBP was more pronounced in people without university education than in people with university education and DBP showed the same pattern, regardless of education. After adjustment for confounding factors, age, male sex, higher body mass index, and being born in a Nordic country were related to higher SBP and DBP. University education was related to lower SBP, while variables mirroring economic vulnerability were not associated with BP levels.

    Conclusions: BP levels as well as the socioeconomic gap in BP has decreased in Sweden but people with a lower level of education still have higher SBP. Lacking economic resources is not associated with high BP.

  • 29.
    Eriksson, Marie
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Forslund, Ann-Sofi
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Greater decreases in cholesterol levels among individuals with high cardiovascular risk than among the general population: the northern Sweden MONICA study 1994 to 20142016In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 37, no 25, p. 1985-1992Article in journal (Refereed)
    Abstract [en]

    AIM: Decreasing cholesterol levels in Western populations is the main reason for decreasing mortality due to coronary heart disease. Our aim was to analyze trends in cholesterol levels in the population during a period of 20 years in relation to previous cardiovascular disease (CVD), other cardiovascular risk factors, and socioeconomic status.

    METHODS AND RESULTS: A total of 4546 women and 4349 men aged 25-74 years participated in five population-based surveys in the Northern Sweden MONICA Study between 1994 and 2014 (participation rate 76.8-62.5%). Total cholesterol levels decreased from 6.2 mmol/L (95% confidence interval, CI, 6.1-6.2) in 1994 to 5.5 mmol/L (CI 5.4-5.5) in 2014. The decrease was more pronounced in elderly vs. younger participants (1.0 vs. 0.5 mmol/L). In 2014, participants with previous CVD, diabetes, or hypertension had lower cholesterol levels than the general population, whereas their levels were higher or similar to the general population in 1994. The use of lipid-lowering drugs increased markedly and was used by 14.3% in 2014. Previously described differences in cholesterol levels between participants with obesity and normal weight, and between those with and without university education, diminished, or vanished over time.

    CONCLUSION: Cholesterol levels decreased by 0.7 mmol/L over 20 years with no sign of abating. The improvement occurred in all age and gender groups but more prominently among those at high risk of ischaemic heart disease.

  • 30.
    Eriksson, Marie
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Holmgren, L
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lundblad, Dan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Large improvements in major cardiovascular risk factors in the population of northern Sweden: the MONICA study 1986-20092011In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 269, no 2, p. 219-231Article in journal (Refereed)
    Abstract [en]

    Abstract.  Eriksson M, Holmgren L, Janlert U, Jansson J-H, Lundblad D, Stegmayr B, Söderberg S, Eliasson M (Department of Public Health and Clinical Medicine, Umeå University, Umeå; Research Department, Norrbotten County Council, Luleå; Department of Medicine, Skellefteå Hospital, Skellefteå; Department of Medicine, Sunderby Hospital, Luleå; and National Board of Health and Welfare, Stockholm, Sweden). Large improvements in major cardiovascular risk factors in the population of northern Sweden: the MONICA study 1986–2009. J Intern Med 2011; 269: 219–231.

    Objectives.  The incidence of cardiovascular disease has declined rapidly in Sweden since the 1980s. We explored changes in major cardiovascular risk factors in northern Sweden between 1986 and 2009.

    Design.  Since 1986, six population surveys have been carried out in northern Sweden using procedures of the World Health Organization MONICA project. The population age range was 25–64 years in 1986 and 1990, and 25–74 years from 1994. Trends were analysed using generalized linear models.

    Results.  A total of 10 586 subjects were included in the surveys. Blood pressure decreased by 4.9/3.9 mmHg in women and 1.8/1.5 mmHg in men aged 25–64 years between 1986 and 2009. In men and women aged 65–74 years, the decrease was 12.6/6.1 mmHg between 1994 and 2009. From 1994, the use of blood pressure-lowering drugs increased, particularly among the older subgroup. The prevalence of smoking halved between 1986 and 2009; 11% of women and 9% of men were smokers in 2009. Cholesterol levels decreased by 0.9 mmol L−1 in the younger age group (25–64 years), and the use of lipid-lowering agents increased from 1994. Among subjects aged 25–64 years, one in five was obese in 2009, which was twice as many as in 1986, and body mass index (BMI) increased by 1.5 kg m−2, corresponding to an increase in weight of 4 kg. There was no further increase in BMI from 2004. The prevalence of diabetes did not change between 1986 and 2009. The proportion that received a university education increased markedly in all age groups, especially in women, during the study period.

    Conclusions.  Significant improvements were observed in major cardiovascular risk factors in northern Sweden between 1986 and 2009.

  • 31. Ferrario, Marco M
    et al.
    Veronesi, Giovanni
    Chambless, Lloyd E
    Tunstall-Pedoe, Hugh
    Kuulasmaa, Kari
    Salomaa, Veikko
    Borglykke, Anders
    Hart, Nigel
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Cesana, Giancarlo
    The contribution of educational class in improving accuracy of cardiovascular risk prediction across European regions: the MORGAM Project Cohort Component2014In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 100, no 15, p. 1179-1187Article in journal (Refereed)
    Abstract [en]

    Objective To assess whether educational class, an index of socioeconomic position, improves the accuracy of the SCORE cardiovascular disease (CVD) risk prediction equation.

    Methods In a pooled analysis of 68 455 40-64-year-old men and women, free from coronary heart disease at baseline, from 47 prospective population-based cohorts from Nordic countries (Finland, Denmark, Sweden), the UK (Northern Ireland, Scotland), Central Europe (France, Germany, Italy) and Eastern Europe (Lithuania, Poland) and Russia, we assessed improvements in discrimination and in risk classification (net reclassification improvement (NRI)) when education was added to models including the SCORE risk equation.

    Results The lowest educational class was associated with higher CVD mortality in men (pooled age-adjusted HR=1.64, 95% CI 1.42 to 1.90) and women (HR=1.31, 1.02 to 1.68). In men, the HRs ranged from 1.3 (Central Europe) to 2.1 (Eastern Europe and Russia). After adjustment for the SCORE risk, the association remained statistically significant overall, in the UK and Eastern Europe and Russia. Education significantly improved discrimination in all European regions and classification in Nordic countries (clinical NRI=5.3%) and in Eastern Europe and Russia (NRI=24.7%). In women, after SCORE risk adjustment, the association was not statistically significant, but the reduced number of deaths plays a major role, and the addition of education led to improvements in discrimination and classification in the Nordic countries only.

    Conclusions We recommend the inclusion of education in SCORE CVD risk equation in men, particularly in Nordic and East European countries, to improve social equity in primary prevention. Weaker evidence for women warrants the need for further investigations.

  • 32. Ferrario, Marco M.
    et al.
    Veronesi, Giovanni
    Kee, Frank
    Chambless, Lloyd E.
    Kuulasmaa, Kari
    Jorgensen, Torben
    Amouyel, Philippe
    Arveiler, Dominique
    Bobak, Martin
    Cesana, Giancarlo
    Drygas, Wojciech
    Ferrieres, Jean
    Giampaoli, Simona
    Iacoviello, Licia
    Nikitin, Yuri
    Pajak, Andrzej
    Peters, Annette
    Salomaa, Veikko
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Tamosiunas, Abdonas
    Wilsgaard, Tom
    Tunstall-Pedoe, Hugh
    Determinants of social inequalities in stroke incidence across Europe: a collaborative analysis of 126 635 individuals from 48 cohort studies2017In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 71, no 12, p. 1210-1216Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge on the origins of the social gradient in stroke incidence in different populations is limited. This study aims to estimate the burden of educational class inequalities in stroke incidence and to assess the contribution of risk factors in determining these inequalities across Europe.

    Materials and methods: The MORGAM (MOnica Risk, Genetics, Archiving and Monograph) Study comprises 48 cohorts recruited mostly in the 1980s and 1990s in four European regions using standardised procedures for baseline risk factor assessment and fatal and non-fatal stroke ascertainment and adjudication during follow-up. Among the 126 635 middle-aged participants, initially free of cardiovascular diseases, generating 3788 first stroke events during a median follow-up of 10 years, we estimated differences in stroke rates and HRs for the least versus the most educated individuals.

    Results: Compared with their most educated counterparts, the overall age-adjusted excess hazard for stroke was 1.54 (95% CI 1.25 to 1.91) and 1.41 (95% CI 1.16 to 1.71) in least educated men and women, respectively, with little heterogeneity across populations. Educational class inequalities accounted for 86–413 and 78–156 additional stroke events per 100 000 person-years in the least compared with most educated men and women, respectively. The additional events were equivalent to 47%–130% and 40%–89% of the average incidence rates. Inequalities in risk factors accounted for 45%–70% of the social gap in incidence in the Nordic countries, the UK and Lithuania-Kaunas (men), but for no more than 17% in Central and South Europe. The major contributors were cigarette smoking, alcohol intake and body mass index.

    Conclusions: Social inequalities in stroke incidence contribute substantially to the disease rates in Europe. Healthier lifestyles in the most disadvantaged individuals should have a prominent impact in reducing both inequalities and the stroke burden.

  • 33. Gao, W G
    et al.
    Qiao, Q
    Pitkäniemi, J
    Wild, S
    Magliano, D
    Shaw, J
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Zimmet, P
    Chitson, P
    Knowlessur, S
    Alberti, G
    Tuomilehto, J
    Risk prediction models for the development of diabetes in Mauritian Indians2009In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 26, no 10, p. 996-1002Article in journal (Refereed)
    Abstract [en]

    AIMS: To develop risk prediction models of future diabetes in Mauritian Indians. METHODS: Three thousand and ninety-four Mauritian Indians (1141 men, aged 20-65 years) without diabetes in 1987 or 1992 were followed up to 1992 or 1998. Subjects underwent repeated oral glucose tolerance tests and diabetes was diagnosed according to 2006 World Health Organization/International Diabetes Federation criteria. Cox regression models for interval censored data were performed using data from 1544 randomly selected participants. Predicted probabilities for diabetes were calculated and validated in the remaining 1550 subjects. RESULTS: Over 11 years of follow-up, there were 511 cases of diabetes. Among variables tested, family history of diabetes, obesity (body mass index, waist circumference) and glucose were significant predictors of diabetes. Predicted probabilities derived from a simple model fitted with sex, family history of diabetes and obesity ranged from 0.05 to 0.64 in men and 0.03 to 0.49 in women. To predict the onset of diabetes, area under the receiver operating characteristic (ROC) curve (AROC) of predicted probabilities was 0.62 (95% confidence interval, 0.56-0.68) in men and 0.64 (0.59-0.69) in women. At a cut-off point of 0.12, the sensitivity and specificity were 0.72 (0.71-0.74) and 0.47 (0.45-0.49) in men and 0.77 (0.75-0.78) and 0.50 (0.48-0.52) in women, respectively. Addition of fasting plasma glucose (FPG) to the model improved the prediction slightly [AROC curve 0.70 (0.65-0.76) in men, 0.71 (0.67-0.76) in women]. CONCLUSIONS: A diabetes prediction model based on obesity and family history yielded moderate discrimination in Mauritian Indians, which was slightly inferior to the model with the FPG but may be useful in low-income countries to promote identification of people at high risk of diabetes.

  • 34. Glader, C A
    et al.
    Birgander, L S
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Ildgruben, H P
    Saikku, P
    Waldenström, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Dahlén, G H
    Lipoprotein(a), Chlamydia pneumoniae, leptin and tissue plasminogen activator as risk markers for valvular aortic stenosis.2003In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 24, no 2, p. 198-208Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of the present study was to identify risk markers for the development of valvular aortic stenosis (AS). Lipoprotein(a) (Lp(a)) and Chlamydia pneumoniae IgG antibody titres in plasma and in circulating immune complexes as well as leptin and tissue plasminogen activator (t-PA) in plasma were studied.

    METHODS AND RESULTS: One hundred and one patients (41 women and 60 men, mean age 71+/-8 years) with significant AS and 101 age- and sex-matched controls were included in this study. All patients underwent aortic valve replacement at the University Hospital in Umeå, Sweden. The controls had no symptoms of cardiovascular disease and they were examined echocardiographically. An Lp(a) level >or=480 mg x l(-1), a C. pneumoniae-specific IgG titre >or=1/128, a high leptin level and a high t-PA mass concentration in plasma were identified as risk markers for AS. A strong synergism between Lp(a) and C. pneumoniae IgG antibodies in circulating immune complexes was found.

    CONCLUSION: Our data indicate that a chronic C. pneumoniae infection and a high plasma Lp(a) level might influence and aggravate aortic heart valve sclerosis via the formation of circulating immune complexes. The present study also strongly suggests an association between high plasma leptin, t-PA mass concentration and AS.

  • 35.
    Gonzalez, Manuel Cruz
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Robinson, Simon
    Mills, Nicholas L
    Eriksson, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Sandström, Thomas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Newby, David E
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Hyperleptinemia is associated with altered endothelial functionManuscript (preprint) (Other academic)
    Abstract [en]

    Introduction The adipocyte-derived hormone leptin has been associated with increased risk of cardiovascular disease but the underlying mechanisms are unclear. Leptin effects on vascular endothelium may be a key mediator although contradictory results have been presented. We aimed to explore the effects of leptin on endothelial vasomotor and fibrinolytic function in healthy volunteers and patients with coronary heart disease.

    Methods and Results The vascular effects of leptin were assessed using venous occlusion plethysmography in healthy volunteers (n=17) and in patients with stable coronary heart disease (CHD) (n=83). In healthy male volunteers, intra-arterial infusion of recombinant human leptin (80, 800 and 8,000 ng/min; n=10) did not affect forearm blood flow or plasma tissue plasminogen activator (tPA) or plasminogen activator inhibitor type 1 (PAI-1) concentrations (all P>0.05).  However, during concomitant co-infusion with leptin (800 ng/min; n=10), induced vasodilatation was reduced (P=0.001), and tPA activity increased (P=0.002). In line with this, patients with coronary heart disease included in the highest tertile of plasma leptin concentrations had reduced substance P-induced vasodilatation (P<0.001), and increased tPA antigen and activity release (p<0.001 and p=0.03 respectively) compared to those in the lowest tertile.

    Conclusions Although leptin does not directly affect basal vascular function, acute local and chronic systemic hyperleptinemia are associated with altered endothelial function in healthy volunteers and patients with coronary heart disease respectively. These results support hyperleptinemia as a link between obesity and cardiovascular disease.

  • 36.
    Gonzalez, Manuel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Lind, Lars
    Uppsala Univ, Dept Med, Uppsala, Sweden.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Leptin and endothelial function in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study2013In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 228, no 2, p. 485-490Article in journal (Refereed)
    Abstract [en]

    Background: Leptin levels are elevated in obese humans. Several studies have shown an association between hyperleptinemia and development of atherosclerosis and cardiovascular disease (CVD), but the relationship between leptin and vascular function remains unclear.

    Aim: To evaluate associations between circulating plasma leptin and measures of vascular function in a large sample of elderly individuals from the community.

    Methods: This cross-sectional study included 1016 subjects aged 70 (50% women) from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). The invasive technique forearm plethysmography with intra-arterial infusions of acetylcholine and sodium nitroprusside was used for estimation of endothelial dependent vasodilatation (EDV) and endothelial independent vasodilatation (EIDV), respectively, in resistance arteries, and the non-invasive technique ultrasound assessed flow mediated vasodilation (FMD) in conduit arteries. The aortic augmentation index (AoAI), a surrogate measure of arterial stiffness, was evaluated by pulse wave analysis. Associations of vascular function, arterial stiffness and blood pressure with leptin were explored.

    Results: In sex-adjusted models, high levels of leptin were inversely associated with EDV and EIDV. These associations remained after stratification for sex, traditional risk factors of CVD and insulin resistance, but were attenuated after taking a measure of obesity (body mass index) into account. In addition, leptin associated with arterial stiffness and systolic and diastolic blood pressure.

    Conclusion: Hyperleptinemia associated inversely with vasodilatation in resistance arteries. Furthermore, hyperleptinemia associated with arterial stiffness and hypertension. These associations were attenuated after adjusting for body mass index suggesting that leptin may be the mediator between obesity and impaired vascular function. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

  • 37. Grantham, N. M.
    et al.
    Magliano, D. J.
    Tanamas, S. K.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Schlaich, M. P.
    Shaw, J. E.
    Higher heart rate increases risk of diabetes among men: the Australian Diabetes Obesity and Lifestyle (AusDiab) Study2013In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 30, no 4, p. 421-427Article in journal (Refereed)
    Abstract [en]

    Aims A very limited number of prospective studies have reported conflicting data on the relation between heart rate and diabetes risk. Our aim therefore was to determine in a large, national, population-based cohort if heart rate predicts the development of diabetes. Methods The Australian Diabetes Obesity and Lifestyle study followed up 6537 people over 5years. Baseline measurements included questionnaires, anthropometrics and blood and urine collection. Heart rate was recorded in beats per min (Dinamap). An oral glucose tolerance test was performed at baseline and follow-up, and diabetes was defined using World Health Organization criteria. Results A total of 5817 participants were eligible for analysis, 221 of whom developed diabetes. Compared with participants with a heart rate <60bmin1, those with a heart rate 80bmin1 were more likely to develop diabetes (odds ratio1.89, 95%CI 1.073.35) over 5years, independent of traditional risk factors. This relationship was highly significant, particularly in non-obese men (odds ratio5.61, 95%CI 1.7517.98), but not in their obese counterparts or in women. Conclusions Resting heart rate is associated with an increased risk of diabetes over a 5-year period, particularly among non-obese men. This suggests that sympathetic overactivity may be a contributing factor to the development of diabetes, and that resting heart rate may be useful in predicting risk of Type2 diabetes in non-obese men.

  • 38. Gustafsson, Stefan
    et al.
    Lind, Lars
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ingelsson, Erik
    Associations of circulating adiponectin with measures of vascular function and morphology2010In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 95, no 6, p. 2927-2934Article in journal (Refereed)
    Abstract [en]

    Serum levels of adiponectin were positively associated with IM-GSM and plaque GSM (indicating lower fat content in the IM and plaques) and CCA distensibility (indicating higher wall elasticity), independent of potential confounders. Our results imply that adiponectin is associated with less arterial pathology.

  • 39. Gustafsson, Stefan
    et al.
    Lind, Lars
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Zilmer, Mihkel
    Hulthe, Johannes
    Ingelsson, Erik
    Oxidative Stress and Inflammatory Markers in Relation to Circulating Levels of Adiponectin2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, no 7, p. 1467-1473Article in journal (Refereed)
    Abstract [en]

    Objective: Previous epidemiological studies together with animal studies have suggested an association between adiponectin and oxidative stress and inflammation, but community-based studies are lacking. Our objective was to investigate the relative importance of oxidative stress and inflammatory markers, representing different pathways in relation to adiponectin. Design and Methods: In a cross-sectional sample of 929 70-year-old individuals (50% women) of the Prospective Investigation of the Vasculature in Uppsala Seniors study, relations between serum adiponectin and oxidative stress [conjugated dienes (CD), homocysteine, total antioxidant capacity, oxidized low-density lipoprotein (OxLDL), OxLDL antibodies, baseline CD of LDL, glutathione (GSH), total glutathione (TGSH), glutathione disulfide], circulation interleukins (IL-6, IL-8), other cytokines [tumor necrosis factor alpha, monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF), vascular endothelial growth factor], cell adhesion molecules (vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin, P-selectin, L-selectin), and systemic inflammatory markers [C-reactive protein (CRP), leukocyte count] in separate models were investigated. Results: In age- and sex-adjusted, as well as multivariable-adjusted models, adiponectin was significantly and positively associated with GSH, log TGSH, whereas an inverse association was observed for CD and log EGF. An inverse association between adiponectin and MCP-1, log E-selectin, and log CRP was significant in age- and sex-adjusted models, but not in multivariable-adjusted models. Conclusions: Our results imply that higher levels of adiponectin are associated with a more beneficial oxidative stress profile, with higher levels of principal anti-oxidative GSH and total GSH together with lower levels of lipid peroxidation, possibly through shared pathways. Further studies are needed to investigate whether changes in the oxidative stress profile may be a mechanism linking adiponectin with type 2 diabetes and/or cardiovascular disease.

  • 40. Gustafsson, Stefan
    et al.
    Lind, Lars
    Zethelius, Björn
    Venge, Per
    Flyvbjerg, Allan
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ingelsson, Erik
    Adiponectin and cardiac geometry and function in elderly: results from two community-based cohort studies2010In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 162, no 3, p. 543-550Article in journal (Refereed)
    Abstract [en]

    Serum adiponectin concentrations were associated with ejection fraction in men, and these associations were partially attenuated by NT-proBNP. Our results imply that adiponectin may be associated with systolic function through pathways that involve natriuretic peptides.

  • 41.
    Hallmans, Göran
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Agren, A
    Johansson, G
    Johansson, Anders
    Umeå University, Faculty of Medicine, Department of Odontology, Periodontology.
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Jansson, JH
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindahl, B
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Nilsson, M
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort: evaluation of risk factors and their interactions.2003In: Scandinavian Journal of Public Health. Supplement Links, ISSN 1403-4956, Vol. 61, p. 18-24Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is, first, to describe the organization, sampling procedures, availability of samples/database, ethical considerations, and quality control program of the Northern Sweden Health and Disease Study Cohort. Secondly, some examples are given of studies on cardiovascular disease and diabetes with a focus on the biomarker programme. The cohort has been positioned as a national and international resource for scientific research.

  • 42. Hansen, T
    et al.
    Ahlström, H
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Hulthe, J
    Wikström, J
    Lind, L
    Johansson, L
    Visceral adipose tissue, adiponectin levels and insulin resistance are related to atherosclerosis as assessed by whole-body magnetic resonance angiography in an elderly population2009In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 205, no 1, p. 163-167Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The principal aim of this study was to determine whether the amount of visceral adipose tissue (VAT) is more related than subcutaneous adipose tissue (SAT) to atherosclerosis assessed by whole-body MRA (WBMRA). A further objective was to investigate whether traditional risk factors, inflammation, or adipokines could explain the hypothesized relationship between VAT and atherosclerosis. METHODS: Men and women aged 70 were recruited from the general population into the Prospective Investigation of The Vasculature in Uppsala Seniors (PIVUS) and 306 of them underwent WBMRA in a clinical 1.5-T scanner. The arterial tree was assessed for degree of stenosis or occlusion and a total atherosclerotic score (TAS) was established. Information on risk factors and BMI and on SAT and VAT, segmented on an axial MR scan was collected. Adiponectin, leptin, and high sensitive C-reactive protein (hsCRP) were measured in serum. HOMA index was used as a marker of insulin resistance. RESULTS: VAT was related to TAS independently of gender, total obesity (BMI), amount of SAT, hsCRP and also to the traditional risk factors included in the Framingham risk score (FRS) in an elderly population. Adiponectin or the HOMA insulin resistance, but not leptin or VAT, together with FRS was significantly related to TAS in a multiple censored regression model. CONCLUSION: Adiponectin attenuated the relationship between VAT and TAS, suggesting that adiponectin and insulin resistance is an important link between visceral adiposity and atherosclerosis.

  • 43. Harding, Jessica L.
    et al.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Shaw, Jonathan E.
    Zimmet, Paul Z.
    Pauvaday, Vassen
    Kowlessur, Sudhir
    Tuomilehto, Jaakko
    Alberti, K. George M. M.
    Magliano, Dianna J.
    All-cause cancer mortality over 15 years in multi-ethnic Mauritius: The impact of diabetes and intermediate forms of glucose tolerance2012In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 131, no 10, p. 2385-2393Article in journal (Refereed)
    Abstract [en]

    There are accumulating data describing the association between diabetes and cancer mortality from Westernised populations. There are no data describing the relationship between diabetes and cancer mortality in African or South Asian populations from developing countries. We explored the relationship of abnormal glucose tolerance and diabetes on cancer mortality risk in a large, multi-ethnic cohort from the developing nation of Mauritius. Population-based surveys were undertaken in 1987, 1992 and 1998. The 9559 participants comprised 66% of South Asian (Indian), 27% of African (Creole), and 7% of Chinese descent. Cox's proportional hazards model with time varying covariates was used to obtain hazard ratios (HRs) and 95% confidence intervals (95% CI) for risk of cancer mortality, after adjustment for confounding factors. In men, but not women, cancer mortality risk increased with rising 2h-PG levels with HR for the top versus bottom quintile of 2.77 (95%CI: 1.28 to 5.98). South Asian men with known diabetes had a significantly greater risk of cancer mortality than those with normal glucose tolerance (NGT) HR: 2.74 (95%CI: 1.00-7.56). Overall, impaired glucose tolerance was associated with an elevated risk of cancer mortality compared to NGT (HR: 1.47, 95% CI: 0.982.19), though this was not significant. We have shown that the association between abnormal glucose tolerance and cancer extends to those of African and South Asian descent. These results highlight the importance of understanding this relationship in a global context to direct future health policy given the rapid increase in type 2 diabetes, especially in developing nations.

  • 44. Hare, Matthew JL
    et al.
    Magliano, Dianna J
    Zimmet, Paul Z
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Joonas, Noorjehan
    Pauvaday, Vassen
    Larhubarbe, Jose
    Tuomilehto, Jaakko
    Kowlessur, Sudhir
    Alberti, K George MM
    Shaw, Jonathan E
    Glucose-independent ethnic differences in HbA(1c), in people without known diabetes2013In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 36, no 6, p. 1534-1540Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To determine whether glucose-independent differences in HbA(1c) exist between people of African, South Asian, and Chinese ethnicities.

    RESEARCH DESIGN AND METHODS Data from 6,701 people aged 19-78 years, without known diabetes, from Mauritius, and participating in the population-based Non-Communicable Disease Surveys of the main island and the island of Rodrigues were included. Participants were African (n = 1,219 from main island, n = 1,505 from Rodrigues), South Asian (n = 3,820), and Chinese (n = 157). Survey data included HbA(1c), plasma glucose during oral glucose tolerance testing (OGTT), anthropometry, demographics, and medical and lifestyle history.

    RESULTS Mean HbA(1c), after adjustment for fasting and 2-h plasma glucose and other factors known to influence HbA(1c), was higher in Africans from Rodrigues (6.1%) than in South Asians (5.7%, P < 0.001), Chinese (5.7%, P < 0.001), or Africans from the main island of Mauritius (5.7%, P < 0.001). The age-standardized prevalence of diabetes among Africans from Rodrigues differed substantially depending on the diagnostic criteria used [OGTT 7.9% (95% CI 5.8-10.0); HbA(1c) 17.3% (15.3-19.2)]. Changing diagnostic criteria resulted in no significant change in the prevalence of diabetes within the other ethnic groups.

    CONCLUSIONS People of African ethnicity from Rodrigues have higher HbA(1c) than those of South Asian or African ethnicity from the main island of Mauritius for reasons not explained by plasma glucose during an OGTT or traditional factors known to affect glycemia. Further research should be directed at determining the mechanism behind this disparity and its relevance to clinical outcomes.

  • 45. He, L
    et al.
    Tuomilehto, J
    Qiao, Q
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Daimon, M
    Chambers, J
    Pitkaniemi, J
    Impact of classical risk factors of type 2 diabetes among Asian Indian, Chinese and Japanese populations2015In: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 41, no 5, p. 401-409Article in journal (Refereed)
    Abstract [en]

    Aims. This review investigated the population impact of major modifiable type 2 diabetes (T2D) risk factors, with special focus on native Asian Indians, to estimate population attributable risks (PARs) and compare them with estimates from Chinese and Japanese populations. Methods. Information was obtained on risk factors in 21,041 Asian Indian, 17,774 Chinese and 17,986 Japanese populations from multiple, large, cross-sectional studies (the DECODA project) of T2D. Crude and adjusted PARs were estimated for the major T2D risk factors. Results. Age had the highest crude and adjusted PARs among Asian Indians and Chinese in contrast to waist hip ratio among Japanese. After adjusting for age, the PAR for body mass index (BMI) in Asian Indians (41.4% [95% CI: 37.2%; 45.4%]) was second only to triglycerides (46.4% [95% CI: 39.5%; 52.8%]) compared with 35.8% [95% CI: 29.9%; 41.4%] in Japanese and 38.4% [95% CI: 33.5%; 43.2%] in Chinese people. The PAR for BMI adjusted for age, LDL and triglycerides (39.7% [95% CI: 31.6%; 47.2%]) was higher than for any other factor in Asian Indians, and was much higher than in the Chinese (16.8% [95% CI: 3.0%; 30.9%]) and Japanese (30.4% [95% CI: 17.5%; 42.2%]) populations. Conclusion. This review provides estimates of the association between major risk factors and prevalences of T2D among Asian populations by examining their PARs from large population-based samples. From a public-health point of view, the importance of BMI in Asian Indians is especially highlighted in comparison to the other Asian populations. Given these results and other recent findings on the causality link between BMI and T2D, it can be postulated that obesity may be involved in the aetiology of T2D through interaction with ethnic-specific genetic factors, although ethnicity itself is not a direct risk factor for T2D as people of all ethnic backgrounds develop diabetes.

  • 46.
    Henein, Mark
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Bajraktari, Gani
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Left atrial function in idiopathic pulmonary hypertensionArticle in journal (Other academic)
  • 47.
    Henein, Mark
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Gonzalez, Manuel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Tossavainen, Erik
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Left atrial strain rate using speckle tracking echocardiography during atrial systole in estimation of pulmonary capillary wedge pressure: a simultaneous echocardiography and cardiac catheterization studyArticle in journal (Other academic)
  • 48.
    Henein, Mark
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Tossavainen, Erik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Grönlund, Christer
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Gonzalez, Manuel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Left atrial strain rate estimates PCWP2013In: International cardiovascular forum, ISSN 2409-3424, no 1, p. 25-30Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Raised left atrial (LA) pressure is a common pathway for many pathologies and is known for its complications. It has a direct effect on LA cavity size and potentially also its function. We hypothesized that raised LA pressure, as shown by pulmonary capillary wedge pressure (PCWP), correlates with severity of global LA deformation abnormalities during atrial systole (LASRa). DESIGN AND PATIENTS: We prospectively studied 46 consecutive patients, mean age 61 ±13 years, 17 males, of various etiologies who underwent right heart catheterization and simultaneous Doppler echocardiography using spectral, tissue Doppler and speckle tracking echocardiography techniques for assessing LA structure and function. RESULTS: PCWP correlated with direct measurements of LA structure and function: LA volume (r= 0.43, p<0.01) and LASRa (r=0.79, p<0.001). PCWP correlated also with other indirect measures of LA pressure such as E/A (r=0.65, p<0.001), E wave deceleration time (r=0.54, p<0.001), E/e’ (r=0.49, p<0.001) and LA systolic filling fraction (r=0.52, p<0.001). However, LASRa together with LA systolic filling fraction, had the highest areas under the curve (0.83 and 0.87, respectively) for identifying patients with PCWP > 15 mmHg. CONCLUSION: PCWP correlates with LA deformation rate during atrial systole and to a higher extent than conventional Doppler measures of raised LA pressures. These findings should have significant clinical implications in correctly identifying breathless patients due to raised LA pressure.

  • 49.
    Henein, Michael Y
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Grönlund, Christer
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Tossavainen, Erik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Gonzalez, Manuel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Right and left heart dysfunction predict mortality in pulmonary hypertension2017In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 45-51Article in journal (Refereed)
    Abstract [en]

    In pulmonary hypertension (PH), the right heart dysfunction is a strong predictor of adverse clinical outcome, while the role of the left heart is not fully determined. The aim of this study was to identify predictors of mortality in precapillary PH including measures of both right and left heart function. We studied 34 patients (mean age 64 ± 13, range 31-82 years, 24 females) with precapillary PH, all of whom underwent detailed Doppler echocardiographic examination of the right and left heart function using conventional and speckle-tracking echocardiography. Patients were followed up for up to 8 years (mean 4·2 ± 1·9 years). At follow-up, 16 patients survived. Left ventricular (LV) filling time (P = 0·007), pulmonary artery acceleration time (P = 0·009), right atrial pressure (RAP) (P<0·001) and tricuspid regurgitation (TR) severity (P = 0·007) were worse in the deceased group. RV global longitudinal strain (GLS) (P = 0·001), RAP (P≤0·001), LV filling time (P<0·001) and TR severity (P<0·001) were the most accurate predictors, having the largest AUC (>0·65) and carried the highest risk for mortality (P<0·001 for all). The strongest predictors of mortality in precapillary PH indirectly reflect both left and right heart dysfunction including atrial structure and function disturbances. While an interaction pattern is observed, it needs to be confirmed in a larger cohort.

  • 50. Hyvärinen, Marjukka
    et al.
    Qiao, Qing
    Tuomilehto, Jaakko
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Stehouwer, Coen D A
    The difference between acute coronary heart disease and ischaemic stroke risk with regard to gender and age in Finnish and Swedish populations2010In: International journal of stroke : official journal of the International Stroke Society, ISSN 1747-4949, Vol. 5, no 3, p. 152-156Article in journal (Refereed)
    Abstract [en]

    Acute coronary heart disease and ischaemic stroke events appeared approximately 10 years earlier in men than in women, and these rates remained higher in men than in women in all age groups. The gender difference was more marked for coronary heart disease than for ischaemic stroke. This may be taken into account when developing interventions and treatment strategies.

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