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Renklint, Rebecka
Publications (5 of 5) Show all publications
Östgren, C. J., Otten, J., Festin, K., Angerås, O., Bergström, G., Cederlund, K., . . . Sundström, J. (2023). Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals-a Swedish population-based study. Cardiovascular Diabetology, 22(1), Article ID 261.
Open this publication in new window or tab >>Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals-a Swedish population-based study
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2023 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 22, no 1, article id 261Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with type 2 diabetes have an increased risk of death and cardiovascular events and people with diabetes or prediabetes have been found to have increased atherosclerotic burden in the coronary and carotid arteries. This study will estimate the cross-sectional prevalence of atherosclerosis in the coronary and carotid arteries in individuals with prediabetes and diabetes, compared with normoglycaemic individuals in a large population-based cohort.

METHODS: The 30,154 study participants, 50-64 years, were categorized according to their fasting glycaemic status or self-reported data as normoglycaemic, prediabetes, and previously undetected or known diabetes. Prevalence of affected coronary artery segments, severity of stenosis and coronary artery calcium score (CACS) were determined by coronary computed tomography angiography. Total atherosclerotic burden was assessed in the 11 clinically most relevant segments using the Segment Involvement Score and as the presence of any coronary atherosclerosis. The presence of atherosclerotic plaque in the carotid arteries was determined by ultrasound examination.

RESULTS: Study participants with prediabetes (n = 4804, 16.0%) or diabetes (n = 2282, 7.6%) had greater coronary artery plaque burden, more coronary stenosis and higher CACS than normoglycaemic participants (all, p < 0.01). Among male participants with diabetes 35.3% had CACS ≥ 100 compared to 16.1% among normoglycaemic participants. For women, the corresponding figures were 8.9% vs 6.1%. The prevalence of atherosclerosis in the coronary arteries was higher in participants with previously undetected diabetes than prediabetes, but lower than in patients with known diabetes. The prevalence of any plaque in the carotid arteries was higher in participants with prediabetes or diabetes than in normoglycaemic participants.

CONCLUSIONS: In this large population-based cohort of currently asymptomatic people, the atherosclerotic burden in the coronary and carotid arteries increased with increasing degree of dysglycaemia. The finding that the atherosclerotic burden in the coronary arteries in the undetected diabetes category was midway between the prediabetes category and patients with known diabetes may have implications for screening strategies and tailored prevention interventions for people with dysglycaemia in the future.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Atherosclerosis, Carotid arteries, Coronary arteries, Coronary computed tomography angiography, Diabetes, Prediabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-215075 (URN)10.1186/s12933-023-01982-6 (DOI)37759237 (PubMedID)2-s2.0-85172780903 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 2016-0315Knut and Alice Wallenberg Foundation, 2014-0047Swedish Research Council, 822-2013- 2000Vinnova, 2012-04476University of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala UniversitySwedish Research Council, 2018-02527Swedish Heart Lung Foundation, 2021-03459AFA InsuranceEU, European Research Council, ERC-2018-STG801965Swedish Research Council, 2019-01471Swedish Heart Lung Foundation, 20190505Swedish Heart Lung Foundation, 20210184Swedish Research Council, 2021-06432
Available from: 2023-10-13 Created: 2023-10-13 Last updated: 2023-10-13Bibliographically approved
Prystupa, K., Renklint, R., Chninou, Y., Otten, J., Fritsche, L., Hoerber, S., . . . Wagner, R. (2022). Comprehensive validation of fasting-based and oral glucose tolerance test-based indices of insulin secretion against gold standard measures. BMJ Open Diabetes Research & Care, 10(5), Article ID e002909.
Open this publication in new window or tab >>Comprehensive validation of fasting-based and oral glucose tolerance test-based indices of insulin secretion against gold standard measures
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2022 (English)In: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 10, no 5, article id e002909Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: With pre-diabetes and diabetes increasingly recognized as heterogeneous conditions, assessment of beta-cell function is gaining clinical importance to identify disease subphenotypes. Our study aims to comprehensively validate all types of surrogate indices based on oral glucose tolerance test (OGTT) and fasting measurements in comparison with gold standard methods.

RESEARCH DESIGN AND METHODS: The hyperglycemic clamp extended with glucagon-like peptide 1 (GLP-1) infusion and intravenous glucose tolerance test (IVGTT), as well as OGTT, was performed in two well-phenotyped cohorts. The gold standard-derived indices were compared with surrogate insulin secretion markers, derived from fasting state and OGTT, using both Pearson's and Spearman's correlation coefficients. The insulin-based and C-peptide-based indices were analyzed separately in different groups of glucose tolerance and the entire cohorts.

RESULTS: The highest correlation coefficients were found for area under curve (AUC) (I0-30)/AUC (G0-30), I30/G30, first-phase Stumvoll and Kadowaki model. These indices have high correlation coefficients with measures obtained from both insulin and C-peptide levels from IVGTT and hyperglycemic clamp. AUC (I0-120)/AUC (G0-120), BIGTT-AIR0-60-120, I30/G30, first-phase Stumvoll and AUC (I0-30)/AUC (G0-30) demonstrated the strongest association with incretin-stimulated insulin response.

CONCLUSIONS: We have identified glucose-stimulated and GLP-1-stimulated insulin secretion indices, derived from OGTT and fasting state, that have the strongest correlation with gold standard measures and could be potentially used in future researches and clinical practice.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2022
Keywords
C-peptide, insulin, insulin secretion
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-199675 (URN)10.1136/bmjdrc-2022-002909 (DOI)000853814700001 ()36100292 (PubMedID)2-s2.0-85137782270 (Scopus ID)
Available from: 2022-10-05 Created: 2022-10-05 Last updated: 2023-05-23Bibliographically approved
Bergman, F., Edin, K., Renklint, R., Olsson, T. & Sörlin, A. (2020). The ability to benefit from an intervention to encourage use of treadmill workstations: Experiences of office workers with overweight or obesity. PLOS ONE, 15(1), Article ID e0228194.
Open this publication in new window or tab >>The ability to benefit from an intervention to encourage use of treadmill workstations: Experiences of office workers with overweight or obesity
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2020 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 1, article id e0228194Article in journal (Refereed) Published
Abstract [en]

One way to increase physical activity in offices is to install treadmill workstations, whereoffice workers can walk on a treadmill while performing their normal tasks. However, theexperiences of people using these treadmill workstations over a long period of time is notknown. In this 13-month study, we explored the experiences of office workers with treadmillworkstations available in their offices. After completing a larger randomized controlled trialwith 80 office workers ages 40 to 67 years with overweight or obesity, we interviewed 20 participantsfrom the intervention group, using a semi-structured interview guide. Data wereanalyzed using a grounded theory approach with constant comparison of emerging codes,subcategories, and categories, followed by connecting the categories to create a core category.The core category is described as the “Ability to benefit.” Although all participants hada rather high motivational level and pre-existing knowledge about the health benefits ofincreasing physical activity at work, they had different capacities for benefiting from the intervention.The categories are described as ideal types: the Convinced, the Competitive, theResponsible, and the Vacillating. These ideal types do not represent any single participantbut suggest generalized abstractions of experiences and strategies emerging from the codingof the interviews. One participant could easily have more than one ideal type. Becauseof differences in ideal type strategies and paths used throughout the course of the study,participants had different abilities to benefit from the intervention. Knowledge regarding theideal types may be applied to facilitate the use of the treadmill workstations. Because differentideal types might require different prompts for behavior change, tailored interventionstrategies directed towards specific ideal types could be necessary.

Place, publisher, year, edition, pages
PLOS, 2020
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-167746 (URN)10.1371/journal.pone.0228194 (DOI)000534605400047 ()31990954 (PubMedID)2-s2.0-85078687693 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2023-03-24Bibliographically approved
Bergman, F., Wahlström, V., Stomby, A., Otten, J., Lanthén, E., Renklint, R., . . . Olsson, T. (2018). Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial. The Lancet Public Health, 3(11), Article ID e523-e535.
Open this publication in new window or tab >>Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial
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2018 (English)In: The Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, article id e523-e535Article in journal (Refereed) Published
Abstract [en]

Background: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time.

Methods: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants.

Findings: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon.

Interpretation: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity.

Place, publisher, year, edition, pages
The Lancet Publishing Group, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-152709 (URN)10.1016/S2468-2667(18)30163-4 (DOI)000451514600013 ()30322782 (PubMedID)2-s2.0-85055089034 (Scopus ID)
Available from: 2018-10-19 Created: 2018-10-19 Last updated: 2023-03-24Bibliographically approved
Sörlin, A., Bergman, F., Renklint, R., Olsson, T. & Edin, K.Challenges and benefits during long-term use of treadmill workstations to decrease sedentary behavior at work.
Open this publication in new window or tab >>Challenges and benefits during long-term use of treadmill workstations to decrease sedentary behavior at work
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(English)Manuscript (preprint) (Other academic)
Keywords
Treadmill workstations, barriers, facilitators, sedentary behavior, physical activity
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-152801 (URN)
Available from: 2018-10-24 Created: 2018-10-24 Last updated: 2023-03-07
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