1
|
Kindler C, Elfwing S, Öhrvik J, Nikberg M. A Deep Neural Network-Based Decision Support Tool for the Detection of Lymph Node Metastases in Colorectal Cancer Specimens. Mod Pathol 2023; 36:100015. [PMID: 36853787 DOI: 10.1016/j.modpat.2022.100015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 01/11/2023]
Abstract
The identification of lymph node metastases in colorectal cancer (CRC) specimens is crucial for the planning of postoperative treatment and can be a time-consuming task for pathologists. In this study, we developed a deep neural network (DNN) algorithm for the detection of metastatic CRC in digitized histologic sections of lymph nodes and evaluated its performance as a diagnostic support tool. First, the DNN algorithm was trained using pixel-level annotations of cancerous areas on 758 whole slide images (360 with cancerous areas). The algorithm's performance was evaluated on 74 whole slide images (43 with cancerous areas). Second, the algorithm was evaluated as a decision support tool on 288 whole slide images covering 1517 lymph node sections, randomized in 16 batches. Two senior pathologists (C.K. and C.O.) assessed each batch with and without the help of the algorithm in a 2 × 2 crossover design, with a washout period of 1 month in between. The time needed for the evaluation of each node section was recorded. The DNN algorithm achieved a median pixel-level accuracy of 0.952 on slides with cancerous areas and 0.996 on slides with benign samples. N+ disease (metastases, micrometastases, or tumor deposits) was present in 103 of the 1517 sections. The algorithm highlighted cancerous areas in 102 of these sections, with a sensitivity of 0.990. Assisted by the algorithm, the median time needed for evaluation was significantly shortened for both pathologists (median time for pathologist 1, 26 vs 14 seconds; P < .001; 95% CI, 11.0-12.0; median time for pathologist 2, 25 vs 23 seconds; P < .001; 95% CI, 2.0-4.0). Our DNN showed high accuracy for detecting metastatic CRC in digitized histologic sections of lymph nodes. This decision support tool has the potential to improve the diagnostic workflow by shortening the time needed for the evaluation of lymph nodes in CRC specimens without impairing diagnostic accuracy.
Collapse
Affiliation(s)
- Csaba Kindler
- Department of Pathology, Laboratory Medicine, Västmanlands Hospital, Västerås, Sweden; Centre for Clinical Research, Uppsala University, Västerås, Sweden.
| | | | - John Öhrvik
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
| | - Maziar Nikberg
- Centre for Clinical Research, Uppsala University, Västerås, Sweden; Department of Surgery, Västmanlands Hospital, Västerås, Sweden
| |
Collapse
|
2
|
Kindler C, Elfwing S, Öhrvik J, Nikberg M. DEEP NEURAL NETWORK AS A DECISION SUPPORT TOOL FOR THE DETECTION OF LYMPH NODE METASTASES OF COLORECTAL CANCER. J Pathol Inform 2022. [DOI: 10.1016/j.jpi.2022.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
|
3
|
Hedenstierna G, Tokics L, Reinius H, Rothen HU, Östberg E, Öhrvik J. Higher age and obesity limit atelectasis formation during anaesthesia: an analysis of computed tomography data in 243 subjects. Br J Anaesth 2020; 124:336-344. [DOI: 10.1016/j.bja.2019.11.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/29/2019] [Accepted: 11/23/2019] [Indexed: 11/30/2022] Open
|
4
|
Nohlert E, Öhrvik J, Helgason ÁR. Self-perceived ability to cope with stress and depressive mood without smoking predicts successful smoking cessation 12 months later in a quitline setting: a secondary analysis of a randomized trial. BMC Public Health 2018; 18:1066. [PMID: 30153814 PMCID: PMC6114486 DOI: 10.1186/s12889-018-5973-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background Telephone-based smoking cessation services (‘quitlines’) are both effective and cost-effective. Knowledge of modifiable baseline factors in real-life settings with heterogeneous participants is essential for the development and improvement of treatment protocols to assist in telephone-based smoking cessation. The aim was to assess if self-perceived abilities to cope measured at baseline, would predict abstinence at the 12-month follow-up at the Swedish National Tobacco Quitline (SNTQ). Methods The data were retrieved from a previous randomized controlled trial comparing the effectiveness of proactive and reactive service at the SNTQ. Included were 612 clients calling the SNTQ between February 2009 and September 2010. Outcome measures were self-reported point prevalence and 6-month continuous abstinence at the 12-month follow-up. Plausible predictors of smoking cessation were assessed at the first call and in a baseline questionnaire. Self-perceived abilities at baseline were measured by two questions: (1) How likely is it that you will be smoke-free in one year? and (2) How likely are you to be able to handle stress and depressive mood without smoking? The associations between potential predictors and outcome (smoke-free at 12-month follow-up) were assessed by logistic regression analysis. Results Of the two potential predictors for abstinence at 12-month follow-up, only the perceived ability to handle stress and depressive mood without smoking remained significant in the adjusted analyses (Odds Ratio, OR 1.13, 95% CI 1.00–1.27 for point prevalence and OR 1.16, 95% CI 1.01–1.33 for 6-month continuous abstinence according to intention-to-treat). The overall strongest predictor in the adjusted analyses was smoking status in the week before baseline (OR 3.30, 95% CI 1.79–6.09 for point prevalence and OR 3.97, 95% CI 2.01–7.83 for 6-month continuous abstinence). Conclusions The perceived ability to handle stress and depressive mood without smoking at baseline predicted the subjects’ abstinence at the 12-month follow-up. An assessment of/adjustment for stress and depressive mood coping skills may be appropriate in future smoking cessation treatment and research. The treatment protocol can be tailored to individual differences and needs for optimal support. Trial registration ClinicalTrials.gov: NCT02085616. Registered March 10, 2014, ‘retrospectively registered’.
Collapse
Affiliation(s)
- Eva Nohlert
- Centre for Clinical Research, Uppsala University, Hospital of Vastmanland Vasteras, 721 89, Vasteras, Sweden.
| | - John Öhrvik
- Centre for Clinical Research, Uppsala University, Hospital of Vastmanland Vasteras, 721 89, Vasteras, Sweden
| | - Ásgeir R Helgason
- Department of Public Health Sciences, Social Medicine, Karolinska Institutet, Stockholm, Sweden.,Reykjavik University and Icelandic Cancer Society, Reykjavik, Iceland
| |
Collapse
|
5
|
Abstract
BACKGROUND Despite the growing body of evidence on growth differentiation factor 15 (GDF-15) reference values for patients with existing cardiovascular disease, limited investigation has been dedicated to characterizing the distribution and prognostic impact of GDF-15 in predominantly healthy populations. Furthermore, current cutoff values for GDF-15 fail to account for the well-documented age-dependence of circulating GDF-15. METHODS From 810 community-dwelling older adults, we selected a group of apparently healthy participants (n = 268). From this sample, circulating GDF-15 was modeled using the generalized additive models for location scale and shape (GAMLSS) to develop age-dependent centile values. Unadjusted and adjusted Cox proportional hazards models were used to assess the association between the derived GDF-15 reference values (expressed as centiles) and all-cause mortality. RESULTS Smoothed centile curves showed increasing GDF-15 with age in the apparently healthy participants. An approximately three-fold difference was observed between the 95th and 5th GDF-15 centiles across ages. In a median 8.0 years of follow-up, 97 all-cause deaths were observed in 806 participants with eligible values. In unadjusted Cox regression analyses, the hazard ratio (95% CI) for all-cause mortality per 25-unit increase in GDF-15 centile was 1.80 (1.48-2.20) and dichotomized at the 95th centile, ≥95th versus <95th, was 3.04 (1.99-4.65). Age-dependent GDF-15 centiles remained a significant predictor of all-cause mortality in all subsequent adjusted models. CONCLUSIONS Age-dependent GDF-15 centile values developed from a population of apparently healthy older adults are independently predictive of all-cause mortality. Therefore, GDF-15 reference values could be a useful tool for risk-stratification in a clinical setting. ClinicalTrials.gov Identifier: NCT01452178.
Collapse
Affiliation(s)
- Steven Doerstling
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- CONTACT Steven Doerstling Center for Clinical Research, Uppsala University, Västmanland Hospital, SE–72189, Västerås, Sweden
| | - Pär Hedberg
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden
| | - John Öhrvik
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Jerzy Leppert
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Egil Henriksen
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden
| |
Collapse
|
6
|
Nohlert E, Öhrvik J, Helgason ÁR. Self-perceived ability to cope with stress without smoking predicts successful smoking cessation 12 months later in a quitline setting: a randomized trial. Tob Induc Dis 2018. [DOI: 10.18332/tid/83845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
7
|
Pettersson K, Bjerke KM, Jahnsen R, Öhrvik J, Rodby-Bousquet E. Psychometric evaluation of the Scandinavian version of the caregiver priorities and child health index of life with disabilities. Disabil Rehabil 2017; 41:212-218. [PMID: 28927310 DOI: 10.1080/09638288.2017.1378930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine test-retest reliability and construct validity of the Scandinavian version of the caregiver priorities and child health index of life with disabilities (CPCHILD) questionnaire for children with cerebral palsy (CP). METHODS Families were recruited in Sweden and Norway and stratified according to the gross motor function classification system levels I-V for children born 2000-2011, mean age 7.9 (SD 3.2). Construct validity based on the first questionnaire (n = 106) was evaluated for known groups, using linear regression analysis. Intraclass correlation coefficient was used to estimate test-retest reliability (n = 64), and Cronbach's alpha was calculated as an indicator of internal consistency. RESULTS The questionnaire showed construct validity and the ability to discriminate between levels of gross motor function for the total score and all domain scores (p < 0.05). Test-retest reliability was high with intraclass correlation coefficient of 0.92 for the total score and of 0.72-0.92 for the domain scores. Cronbach's alpha was 0.96 for the total score and 0.83-0.96 for the domain scores. CONCLUSIONS The Scandinavian version of the CPCHILD for children with CP seems to be a valid and reliable proxy measure for health related quality of life. Implications for rehabilitation Valid and reliable outcome measures are needed to evaluate whether follow-up programs enhance health related quality of life in different countries. The Scandinavian version of the caregiver priorities and child health index of life with disabilities (CPCHILD) was evaluated for known-groups validity and test-retest reliability. The Scandinavian version of the CPCHILD is a sound and valid measurement for evaluation and comparison of health related quality of life of children with cerebral palsy in different countries.
Collapse
Affiliation(s)
- Katina Pettersson
- a Department of Clinical Sciences Lund, Orthopaedics , Lund University , Lund , Sweden.,b Centre for Clinical Research Västerås , Uppsala University , Västerås , Sweden
| | - Kari Marte Bjerke
- c Department of Clinical Neurosciences for Children , Oslo University Hospital , Oslo , Norway.,d Oslo Municipality , Oslo , Norway
| | - Reidun Jahnsen
- e Department of Clinical Neurosciences for Children , The Cerebral Palsy Follow-Up Program (CPOP), Oslo University Hospital , Oslo , Norway
| | - John Öhrvik
- b Centre for Clinical Research Västerås , Uppsala University , Västerås , Sweden.,f Department of Medicine , Karolinska Institutet , Solna , Sweden
| | - Elisabet Rodby-Bousquet
- a Department of Clinical Sciences Lund, Orthopaedics , Lund University , Lund , Sweden.,b Centre for Clinical Research Västerås , Uppsala University , Västerås , Sweden
| |
Collapse
|
8
|
Bäcklund A, Gertow K, Jin H, Olsson L, Gonzalez-Diez M, Sabater-Lleal M, Strawbridge RJ, Sennblad B, Öhrvik J, Zabaneh D, Shah S, Veglia F, Folkersen L, Gigante B, Leander K, Vikström M, Silveira A, Colombo GI, Gabrielsen A, Hedin U, Franco-Cereceda A, Paulsson-Berne G, Nyyssönen K, Tuomainen TP, Savonen K, Rauramaa R, Smit AJ, Giral P, Mannarino E, van der Laan SW, Pasterkamp G, Hansson GK, Eriksson P, Baldassarre D, Tremoli E, de Faire U, Humphries SE, Hamsten A, Holmdahl R, Maegdefessel L. Abstract 23: Identification of NCF4 as a Novel Regulator in Arterial Remodeling and Advanced Atherosclerosis. Arterioscler Thromb Vasc Biol 2017. [DOI: 10.1161/atvb.37.suppl_1.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Arterial wall remodeling is a central multifactorial process in the development and progression of cardiovascular diseases. We employed an approach aimed at observing genetic variants associated with the progression of carotid intima-media thickness (cIMT) in order to identify novel pathways effecting vessel remodeling. This was achieved by conducting gene-centric analysis of 400,000 variants in 3,042 subjects with repeated cIMT measurements.
Rs16997464 on chr22 intergenic between neutrophil cytosolic factor-4 (
NCF4)
and colony stimulating factor 2 receptor beta (
CSF2RB
) was associated with cIMT progression
at array-wide significance (p <4.5x10
-7
). The potential causative genes within this locus were investigated using a human vascular and non-vascular tissue biobank. Expression of 9 genes near rs16997464, were analyzed with the most significant association being with
NCF4
in aortic adventitia. The effect of the variant on the function of the
NCF4
gene product was further analyzed by comparing the oxidative burst capacity of neutrophils from subjects with different rs16997464 genotypes. We observed that neutrophils homozygous for the minor T allele, associated with slower cIMT progression, produced more extracellular ROS than neutrophils homozygous for the G allele, indicating a functional effect of rs16997464 on the
NCF4
gene product p40
phox
, a component of the NADPH oxidase 2 complex (NOX2).
In parallel, we investigated if the chr22 locus also influenced the cellular composition of the atherosclerotic plaque, by utilizing data from the Athero-Express Biobank. Here we found that the minor T allele associated with a higher smooth muscle cell (SMC) content in the plaque. Finally, using a partial ligation model in mice where
ncf4
is mutated, resulting in a reduced but not absent NOX2-associated ROS formation, we observed a reduced neointima formation in the
ncf4
-mutated strain compared with wild-type littermates.
Thus, this study identified rs16997464 in the
NCF4-CSF2RB
locus as a novel genetic determinant of cIMT progression, and provides evidence suggesting that
NCF4
is involved in SMC proliferation and alteration of vessel wall pathophysiology.
Collapse
Affiliation(s)
| | | | - Hong Jin
- Karolinska Institute, Stockholm, Sweden
| | | | | | | | | | | | | | | | - Sonia Shah
- Cntr Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | | | | | | | | | | | | | - Ulf Hedin
- Karolinska Institute, Stockholm, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Gustafsson JT, Herlitz Lindberg M, Gunnarsson I, Pettersson S, Elvin K, Öhrvik J, Larsson A, Jensen-Urstad K, Svenungsson E. Excess atherosclerosis in systemic lupus erythematosus,-A matter of renal involvement: Case control study of 281 SLE patients and 281 individually matched population controls. PLoS One 2017; 12:e0174572. [PMID: 28414714 PMCID: PMC5393555 DOI: 10.1371/journal.pone.0174572] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/11/2017] [Indexed: 01/08/2023] Open
Abstract
Background Systemic lupus erythematosus (SLE), is a heterogeneous disease which predominantly affects young females (90%). SLE is associated with a shorter life expectancy than in the general population. Standardized mortality ratios (SMR) of 2.4 have been reported, which is comparable to diabetes. In modern societies cardiovascular disease (CVD) is the major cause of premature mortality. Accelerated atherosclerosis is generally assumed to be the underlying cause for SLE related CVD. However, previous studies diverge regarding whether atherosclerosis is more common in SLE than in controls. With this in mind and based on own clinical experience we hypothesized that accelerated atherosclerosis is not a general feature of SLE, but prevails in SLE subgroups. Methods 281 SLE patients and 281 individually age and sex matched population controls, were investigated clinically. Fasting blood samples and risk factor data were collected. All participants were subject to B-mode ultrasonography of the carotid arteries. Carotid plaque occurrence and mean intima media thickness (mIMT) were recorded. Two SLE subgroups previously described to be at high CVD risk; 1) patients with nephritis and 2) patients with anti-phospholipid antibodies (aPL), and one subgroup reported to be at comparatively lower CVD risk; patients positive for Sjögren´s syndrome antigens A/B (SSA/SSB) antibodies were analyzed separately in comparison with their respective matched controls. Results Median age was 49 (IQR 36–59) years, 93% were females. Manifest CVD; ischemic heart, cerebro- and peripheral vascular disease, prevailed in patients (12% vs. 1%, p<0.0001). Overall plaque prevalence did not differ (20% vs. 16%), but patients had slightly higher mIMT than controls (0.56 vs. 0.53 mm, p<0.0033). After age adjustment plaques, but not mIMT, remained associated with previous CVD events. Therefore we focused further analyses on plaques, a more robust measure of atherosclerosis. Patients with nephritis (40%), but neither aPL (25%) nor SSA/SSB (40%) positive patients, had more plaques than their respective controls (23% vs. 11%, p = 0.008). Notably, patients with nephritis were younger than other SLE patients (45 vs.49 years, p = 0.02). To overcome the confounding effect of age we performed an age-matched nested case-control analysis, which demonstrated that patients with nephritis had twice as often plaques (23%) as both non-nephritis patients (11%, p = 0.038) and controls (12%, p = 0.035). Conclusions In SLE excess carotid plaques are essentially confined to the SLE subgroup with nephritis. This subgroup had plaques twice as often as age-matched non-nephritis SLE patients and population controls. Non-nephritis SLE patients, including the aPL positive subgroup, which has a high CVD risk, had similar prevalence of plaques as controls. To prevent later CVD events, this novel observation calls for risk factor screening and initiation of anti-atherosclerotic treatment selectively in SLE nephritis patients. Preferably at nephritis onset, which is often at a young age. In a general perspective this study demonstrates the importance to perform careful clinical subgroup analyses when investigating heterogeneous, hitherto not clearly defined, conditions like SLE.
Collapse
Affiliation(s)
- Johanna T. Gustafsson
- Unit of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Marie Herlitz Lindberg
- Department of Clinical Physiology, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Iva Gunnarsson
- Unit of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Susanne Pettersson
- Unit of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Kerstin Elvin
- Unit of Clinical Immunology, Department of Clinical Immunology and Transfusion Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Öhrvik
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Kerstin Jensen-Urstad
- Department of Clinical Physiology, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Elisabet Svenungsson
- Unit of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- * E-mail:
| |
Collapse
|
10
|
McLeod O, Silveira A, Valdes-Marquez E, Björkbacka H, Almgren P, Gertow K, Gådin JR, Bäcklund A, Sennblad B, Baldassarre D, Veglia F, Humphries SE, Tremoli E, de Faire U, Nilsson J, Melander O, Hopewell JC, Clarke R, Björck HM, Hamsten A, Öhrvik J, Strawbridge RJ. Genetic loci on chromosome 5 are associated with circulating levels of interleukin-5 and eosinophil count in a European population with high risk for cardiovascular disease. Cytokine 2016; 81:1-9. [PMID: 26821299 PMCID: PMC4837217 DOI: 10.1016/j.cyto.2016.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/18/2015] [Accepted: 01/18/2016] [Indexed: 12/30/2022]
Abstract
IL-5 is a Th2 cytokine which activates eosinophils and is suggested to have an atheroprotective role. Genetic variants in the IL5 locus have been associated with increased risk of CAD and ischemic stroke. In this study we aimed to identify genetic variants associated with IL-5 concentrations and apply a Mendelian randomisation approach to assess IL-5 levels for causal effect on intima-media thickness in a European population at high risk of coronary artery disease. We analysed SNPs within robustly associated candidate loci for immune, inflammatory, metabolic and cardiovascular traits. We identified 2 genetic loci for IL-5 levels (chromosome 5, rs56183820, BETA=0.11, P=6.73E(-5) and chromosome 14, rs4902762, BETA=0.12, P=5.76E(-6)) and one for eosinophil count (rs72797327, BETA=-0.10, P=1.41E(-6)). Both chromosome 5 loci were in the vicinity of the IL5 gene, however the association with IL-5 levels failed to replicate in a meta-analysis of 2 independent cohorts (rs56183820, BETA=0.04, P=0.2763, I(2)=24, I(2)-P=0.2516). No significant associations were observed between SNPs associated with IL-5 levels or eosinophil count and IMT measures. Expression quantitative trait analyses indicate effects of the IL-5 and eosinophil-associated SNPs on RAD50 mRNA expression levels (rs12652920 (r2=0.93 with rs56183820) BETA=-0.10, P=8.64E(-6) and rs11739623 (r2=0.96 with rs72797327) BETA=-0.23, P=1.74E(-29), respectively). Our data do not support a role for IL-5 levels and eosinophil count in intima-media thickness, however SNPs associated with IL-5 and eosinophils might influence stability of the atherosclerotic plaque via modulation of RAD50 levels.
Collapse
Affiliation(s)
- Olga McLeod
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Angela Silveira
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Elsa Valdes-Marquez
- CTSU - Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Harry Björkbacka
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Peter Almgren
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Karl Gertow
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jesper R Gådin
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Alexandra Bäcklund
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Sennblad
- Cardiovascular Medicine Unit, Department of Medicine, Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden
| | - Damiano Baldassarre
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | - Elena Tremoli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Jemma C Hopewell
- CTSU - Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robert Clarke
- CTSU - Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Hanna M Björck
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hamsten
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - John Öhrvik
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Västerås, Uppsala University, SE-72189 Västerås, Sweden
| | - Rona J Strawbridge
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
11
|
Leander K, Mälarstig A, Van't Hooft FM, Hyde C, Hellénius ML, Troutt JS, Konrad RJ, Öhrvik J, Hamsten A, de Faire U. Circulating Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Predicts Future Risk of Cardiovascular Events Independently of Established Risk Factors. Circulation 2016; 133:1230-9. [PMID: 26896437 DOI: 10.1161/circulationaha.115.018531] [Citation(s) in RCA: 153] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 02/12/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The secreted protein proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular disease (CVD). The relationship between circulating PCSK9 and incident CVD in the general population is unknown. We investigated whether serum PCSK9 concentration is associated with incident CVD in a prospective cohort study of 4232 men and women 60 years of age at the time of recruitment. METHODS AND RESULTS Incident CVD was recorded by matching to national registries. After 15 years of follow-up, a total of 491 incident events (fatal and nonfatal myocardial infarctions, unstable angina, deaths from coronary heart disease, fatal and nonfatal ischemic strokes) were recorded. Cox proportional hazards model was used to calculate hazard ratios with 95% confidence intervals. Baseline serum PCSK9 concentration predicted incident CVD; concentration in quartile 4 compared with quartile 1 was associated with a hazard ratio of 1.69 (95% confidence interval, 1.30-2.19) after adjustment for sex. Further adjustment for low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, lipoprotein(a), triglycerides, hypertension, diabetes mellitus, smoking, overweight, obesity, physical inactivity, and statin use resulted in a decrease in the hazard ratio to 1.48 (95% confidence interval, 1.12-1.95). CONCLUSIONS Serum PCSK9 concentration is associated with future risk of CVD even after adjustments for established CVD risk factors. Further studies are needed to confirm this observation.
Collapse
Affiliation(s)
- Karin Leander
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.).
| | - Anders Mälarstig
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Ferdinand M Van't Hooft
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Craig Hyde
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Mai-Lis Hellénius
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Jason S Troutt
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Robert J Konrad
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - John Öhrvik
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Anders Hamsten
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| | - Ulf de Faire
- From the Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Stockholm, Sweden (K.L., U.d.F.); Cardiovascular Genetics and Genomics Group, Cardiovascular Medicine Unit, Department of Medicine (A.M., F.M.v.H., J.Ö., A.H.) and Department of Medicine (M.-L.H.), Solna, Karolinska Institutet, Stockholm, Sweden; Pharmatherapeutics Clinical Research, Pfizer Worldwide R&D, Sollentuna, Sweden (A.M.); Research Statistics, Pfizer Worldwide R&D, Cambridge, MA (C.H.); Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN (J.S.T., R.J.K.); and Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden (U.d.F.)
| |
Collapse
|
12
|
Nohlert E, Öhrvik J, Helgason ÁR. Non-responders in a quitline evaluation are more likely to be smokers - a drop-out and long-term follow-up study of the Swedish National Tobacco Quitline. Tob Induc Dis 2016; 14:5. [PMID: 26843854 PMCID: PMC4739394 DOI: 10.1186/s12971-016-0070-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 01/26/2016] [Indexed: 11/25/2022] Open
Abstract
Background A previous randomized controlled trial (RCT) of the Swedish National Tobacco Quitline detected no significant differences in smoking cessation outcomes between proactive and reactive services at 12-month follow-up. However, the response rate was only 59 % and non-responders were over-represented in the proactive service. We performed a drop-out analysis to assess the smoking status of initial responders and non-responders. Methods At 29–48 months after the first call, a postal questionnaire with six questions was sent to 150 random clients from the RCT database, with equal numbers from the proactive and reactive services as well as responders and non-responders at 12-month follow-up. Clients who did not return the questionnaire were contacted by telephone. The outcome measures were point prevalence (PP) and 6-month continuous abstinence (CA), and their associations with response status at 12 months were assessed by logistic regression. Results The response rate was 74 % (111/150). Abstinence was significantly higher among initial responders than non-responders (PP 54 % vs. 32 %, p = .023 and CA 49 % vs. 21 %, p = .003). The odds ratios for initial responders vs. initial non-responders were, for PP = 2.5 (95 % CI 1.1–5.6, p = .024), and for CA = 3.7 (95 % CI 1.5–8.9, p = .004), after adjusting for proactive/reactive service. Conclusions Non-responders to a 12-month follow-up smoking cessation questionnaire in a quitline setting were more likely to be smokers 1.5–3 years later. We propose a conservative correction factor of 0.8 for self-reported abstinence in telephone-based cessation studies if the response rate is approximately 55–65 %.
Collapse
Affiliation(s)
- Eva Nohlert
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, 721 89 Västerås, Sweden
| | - John Öhrvik
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, 721 89 Västerås, Sweden ; Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ásgeir R Helgason
- Department of Public Health Sciences, Social Medicine, Karolinska Institutet and Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden ; Reykjavik University, Reykjavik, Iceland
| |
Collapse
|
13
|
Kerstis B, Aarts C, Tillman C, Persson H, Engström G, Edlund B, Öhrvik J, Sylvén S, Skalkidou A. Association between parental depressive symptoms and impaired bonding with the infant. Arch Womens Ment Health 2016; 19:87-94. [PMID: 25854998 DOI: 10.1007/s00737-015-0522-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
Impaired bonding with the infant is associated with maternal postpartum depression but has not been investigated extensively in fathers. The primary study aim was to evaluate associations between maternal and paternal depressive symptoms and impaired bonding with their infant. A secondary aim was to determine the associations between parents' marital problems and impaired bonding with the infant. The study is part of a population-based cohort project (UPPSAT) in Uppsala, Sweden. The Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks and 6 months postpartum and the Postpartum Bonding Questionnaire at 6 months postpartum were completed by 727 couples. The prevalence of impaired bonding was highest among couples in which both spouses had depressive symptoms. Impaired bonding was associated with higher EPDS scores in both mothers and fathers, as well as with experiencing a deteriorated marital relationship. The association between maternal and paternal impaired bonding and the mothers' and fathers' EPDS scores remained significant even after adjustment for relevant confounding factors. Depressive symptoms at 6 weeks postpartum are associated with impaired bonding with the infant at 6 months postpartum for both mothers and fathers. It is critical to screen for and prevent depressive symptoms in both parents during early parenthood.
Collapse
Affiliation(s)
- Birgitta Kerstis
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, S-721 89, Västerås, Sweden. .,Departments of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Clara Aarts
- Departments of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Carin Tillman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Hanna Persson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gabriella Engström
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Birgitta Edlund
- Departments of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - John Öhrvik
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, S-721 89, Västerås, Sweden.,Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sara Sylvén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| |
Collapse
|
14
|
Abstract
Aim To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden. Methods In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers. Results The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area 'Role restriction'. The mothers had the lowest level of stress in the sub-area 'Social isolation' and the fathers in the sub-area 'Incompetence'. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for 'Social isolation', where the fathers perceived higher stress. There was an association between the parents' depressive symptoms and parental stress. The parents' own depressive symptoms at 3 months and sense of coherence and the partners' parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses. Conclusions Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents.
Collapse
Affiliation(s)
- Birgitta Kerstis
- a School of Health, Care and Social Welfare , Mälardalen University , Västerås , Sweden
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
| | - Eva Nohlert
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
| | - John Öhrvik
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
- c Department of Medicine , Karolinska Institutet , Stockholm , Sweden
| | - Margareta Widarsson
- b Centre for Clinical Research , Uppsala University Västmanland County Hospital , Västerås , Sweden
| |
Collapse
|
15
|
Persson J, Strawbridge RJ, McLeod O, Gertow K, Silveira A, Baldassarre D, Van Zuydam N, Shah S, Fava C, Gustafsson S, Veglia F, Sennblad B, Larsson M, Sabater-Lleal M, Leander K, Gigante B, Tabak A, Kivimaki M, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Humphries SE, Tremoli E, de Faire U, Lind L, Ingelsson E, Hedblad B, Melander O, Kumari M, Hingorani A, Morris AD, Palmer CNA, Lundman P, Öhrvik J, Söderberg S, Hamsten A. Sex-Specific Effects of Adiponectin on Carotid Intima-Media Thickness and Incident Cardiovascular Disease. J Am Heart Assoc 2015; 4:e001853. [PMID: 26276317 PMCID: PMC4599454 DOI: 10.1161/jaha.115.001853] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Plasma adiponectin levels have previously been inversely associated with carotid intima-media thickness (IMT), a marker of subclinical atherosclerosis. In this study, we used a sex-stratified Mendelian randomization approach to investigate whether adiponectin has a causal protective influence on IMT. METHODS AND RESULTS Baseline plasma adiponectin concentration was tested for association with baseline IMT, IMT progression over 30 months, and occurrence of cardiovascular events within 3 years in 3430 participants (women, n=1777; men, n=1653) with high cardiovascular risk but no prevalent disease. Plasma adiponectin levels were inversely associated with baseline mean bifurcation IMT after adjustment for established risk factors (β=-0.018, P<0.001) in men but not in women (β=-0.006, P=0.185; P for interaction=0.061). Adiponectin levels were inversely associated with progression of mean common carotid IMT in men (β=-0.0022, P=0.047), whereas no association was seen in women (0.0007, P=0.475; P for interaction=0.018). Moreover, we observed that adiponectin levels were inversely associated with coronary events in women (hazard ratio 0.57, 95% CI 0.37 to 0.87) but not in men (hazard ratio 0.82, 95% CI 0.54 to 1.25). A gene score of adiponectin-raising alleles in 6 loci, reported recently in a large multi-ethnic meta-analysis, was inversely associated with baseline mean bifurcation IMT in men (β=-0.0008, P=0.004) but not in women (β=-0.0003, P=0.522; P for interaction=0.007). CONCLUSIONS This report provides some evidence for adiponectin protecting against atherosclerosis, with effects being confined to men; however, compared with established cardiovascular risk factors, the effect of plasma adiponectin was modest. Further investigation involving mechanistic studies is warranted.
Collapse
Affiliation(s)
- Jonas Persson
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden (J.P., B.G., P.L.)
| | - Rona J Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Olga McLeod
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Karl Gertow
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Angela Silveira
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Damiano Baldassarre
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (D.B., E.T.) Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.)
| | - Natalie Van Zuydam
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (N.V.Z., A.D.M., C.A.P.)
| | - Sonia Shah
- University College London Genetics Institute, University College London, London, United Kingdom (S.S.) Diamantina Institute and Queensland Brain Institute, University of Queensland, Australia (S.S.)
| | - Cristiano Fava
- Division of Internal Medicine C, Department of Medicine, Hospital "Policlinico G.B Rossi", University of Verona, Italy (C.F.) Clinical Research Center, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden (C.F., B.H., O.M.)
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden (S.G., E.I.)
| | - Fabrizio Veglia
- Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.)
| | - Bengt Sennblad
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.) Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (B.S.)
| | - Malin Larsson
- IFM Bioinformatics, Linköping University, Linköping, Sweden (M.L.)
| | - Maria Sabater-Lleal
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Karin Leander
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., B.G., U.F.)
| | - Bruna Gigante
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden (J.P., B.G., P.L.) Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., B.G., U.F.)
| | - Adam Tabak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom (A.T., M.K.) 1st Department of Medicine, Semmelweis University Faculty of Medicine, Semmelweis University, Budapest, Hungary (A.T.)
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom (A.T., M.K.)
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (J.K.)
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland (R.R.) Department of Clinical Physiology and Nuclear Medicine, University Hospital of Kuopio, Kuopio, Finland (R.R.)
| | - Andries J Smit
- Department of Medicine, University Medical Center Groningen, University of Groningen, The Netherlands (A.J.S.)
| | - Elmo Mannarino
- Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Italy (E.M.)
| | - Philippe Giral
- Assistance Publique - Hopitaux de Paris, Service Endocrinologie-Metabolisme, Groupe Hôpitalier Pitie-Salpetriere, Unités de Prévention Cardiovasculaire, Paris, France (P.G.)
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, University College London, London, United Kingdom (S.E.H.)
| | - Elena Tremoli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (D.B., E.T.) Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.)
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., B.G., U.F.)
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden (L.L.)
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden (S.G., E.I.)
| | - Bo Hedblad
- Clinical Research Center, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden (C.F., B.H., O.M.)
| | - Olle Melander
- Clinical Research Center, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden (C.F., B.H., O.M.)
| | - Meena Kumari
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London, United Kingdom (M.K., A.H.)
| | - Aroon Hingorani
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London, United Kingdom (M.K., A.H.)
| | - Andrew D Morris
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (N.V.Z., A.D.M., C.A.P.)
| | - Colin N A Palmer
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (N.V.Z., A.D.M., C.A.P.)
| | - Pia Lundman
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden (J.P., B.G., P.L.)
| | - John Öhrvik
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Stefan Söderberg
- Division of Medicine, Department of Public Health and Clinical Medicine, University of Umeå, Sweden (S.)
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | | |
Collapse
|
16
|
Johansson AC, Öhrvik J, Söderlund A. Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery. Eur Spine J 2015; 25:296-303. [DOI: 10.1007/s00586-015-3820-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 10/23/2022]
|
17
|
Silveira A, McLeod O, Strawbridge RJ, Gertow K, Sennblad B, Baldassarre D, Veglia F, Deleskog A, Persson J, Leander K, Gigante B, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Gustafsson S, Söderberg S, Öhrvik J, Humphries SE, Tremoli E, de Faire U, Hamsten A. Plasma IL-5 concentration and subclinical carotid atherosclerosis. Atherosclerosis 2014; 239:125-30. [PMID: 25587992 PMCID: PMC4340644 DOI: 10.1016/j.atherosclerosis.2014.12.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 11/17/2014] [Accepted: 12/10/2014] [Indexed: 11/30/2022]
Abstract
Objective Genetic variants robustly associated with coronary artery disease were reported in the vicinity of the interleukin (IL)-5 locus, and animal studies suggested a protective role for IL-5 in atherosclerosis. Therefore, we set this work to explore IL-5 as a plasma biomarker for early subclinical atherosclerosis, as determined by measures of baseline severity and change over time of carotid intima-media thickness (cIMT). Methods We used biobank and databases of IMPROVE, a large European prospective cohort study of high-risk individuals (n = 3534) free of clinically overt cardiovascular disease at enrollment, in whom composite and segment-specific measures of cIMT were recorded at baseline and after 15 and 30 months. IL-5 was measured with an immunoassay in plasma samples taken at baseline. Results IL-5 levels were lower in women than in men, lower in the South than in North of Europe, and showed positive correlations with most established risk factors. IL-5 showed significant inverse relationships with cIMT change over time in the common carotid segment in women, but no significant relationships to baseline cIMT in either men or women. Conclusions Our results suggest that IL-5 may be part of protective mechanisms operating in early atherosclerosis, at least in women. However, the relationships are weak and whereas IL-5 has been proposed as a potential molecular target to treat allergies, it is difficult to envisage such a scenario in coronary artery disease. Genetic and animal studies suggested a protective role for IL-5 in atherosclerosis. We studied plasma IL-5 relationships to baseline and change over time in carotid IMT. Significant relationships of IL-5 and cIMT were time, segment and gender specific. High plasma IL-5 was related to slow progression of IMT in common carotid in women. In general, IL-5 does not seem useful as biomarker for coronary artery disease.
Collapse
Affiliation(s)
- Angela Silveira
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
| | - Olga McLeod
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Rona J Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Karl Gertow
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Sennblad
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden
| | - Damiano Baldassarre
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | - Anna Deleskog
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Persson
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
| | - Karin Leander
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bruna Gigante
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Rainer Rauramaa
- Foundation for Research in Health, Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Andries J Smit
- Department of Medicine, University Medical Center Groningen and University of Groningen, The Netherlands
| | - Elmo Mannarino
- Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
| | - Philippe Giral
- Assistance Publique - Hopitaux de Paris, Service Endocrinologie-Metabolisme, Groupe Hôpitalier Pitie-Salpetriere, Unités de Prévention Cardiovasculaire, Paris, France
| | - Sven Gustafsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Söderberg
- Division of Medicine, Department of Public Health and Clinical Medicine, University of Umeå, Sweden
| | - John Öhrvik
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, University College London, United Kingdom
| | - Elena Tremoli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
18
|
Strawbridge RJ, Deleskog A, McLeod O, Folkersen L, Kavousi M, Gertow K, Baldassarre D, Veglia F, Leander K, Gigante B, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Dehghan A, Hofman A, Franco OH, Humphries SE, Tremoli E, de Faire U, Gustafsson S, Östensson CG, Eriksson P, Öhrvik J, Hamsten A. A serum 25-hydroxyvitamin D concentration-associated genetic variant in DHCR7 interacts with type 2 diabetes status to influence subclinical atherosclerosis (measured by carotid intima-media thickness). Diabetologia 2014; 57:1159-72. [PMID: 24663808 DOI: 10.1007/s00125-014-3215-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/25/2014] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The findings of studies investigating whether or not low serum 25-hydroxyvitamin D [25(OH)D] concentration promotes development of atherosclerosis have been contradictory. The present study employed a Mendelian randomisation approach and carotid artery intima-media thickness (cIMT), a surrogate marker of coronary artery disease, to address this question. METHODS The multicentre, longitudinal Carotid Intima-Media Thickness and IMT-Progression as Predictors of Vascular Events in a High-Risk European Population (IMPROVE) cohort study, which enrolled individuals with at least three cardiovascular risk factors and no history or symptoms of cardiovascular disease, was used for the present investigation. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30. Six single nucleotide polymorphisms (SNPs) associated with serum 25(OH)D concentration in genome-wide association studies were identified and genotyped in 3,418 individuals, of whom 929 had type 2 diabetes. RESULTS SNPs in the genes encoding vitamin D binding protein (GC; rs2282679 and rs7041) and 7-dehydrocholesterol reductase/NAD synthetase-1 (DHCR7; rs12785878 and rs3829251) were negatively associated with 25(OH)D levels. Effect sizes and significance of associations between SNPs and 25(OH)D levels differed between individuals with and without type 2 diabetes, although no significant interactions were observed. A SNP in DHCR7 interacted with type 2 diabetes to significantly influence progression of cIMT measures independent of 25(OH)D levels and established risk factors. Expression analysis demonstrated that this SNP modulates DHCR7 mRNA levels in aortic adventitia. CONCLUSIONS/INTERPRETATION SNPs in GC and DHCR7 were associated with serum levels of 25(OH)D, but only rs3829251 (DHCR7) influenced progression of subclinical atherosclerosis, as measured by cIMT, in a manner dependent on type 2 diabetes status but independent of 25(OH)D levels.
Collapse
Affiliation(s)
- Rona J Strawbridge
- Atherosclerosis Research Unit, Centre for Molecular Medicine, Building L8:03, Karolinska University Hospital Solna, 17176, Stockholm, Sweden,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
McLeod O, Silveira A, Fredrikson GN, Gertow K, Baldassarre D, Veglia F, Sennblad B, Strawbridge RJ, Larsson M, Leander K, Gigante B, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Humphries SE, Tremoli E, de Faire U, Öhrvik J, Nilsson J, Hamsten A. Plasma autoantibodies against apolipoprotein B-100 peptide 210 in subclinical atherosclerosis. Atherosclerosis 2014; 232:242-8. [DOI: 10.1016/j.atherosclerosis.2013.11.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 11/05/2013] [Accepted: 11/12/2013] [Indexed: 01/17/2023]
|
20
|
Deleskog A, Piksasova O, Silveira A, Gertow K, Baldassarre D, Veglia F, Sennblad B, Strawbridge RJ, Larsson M, Leander K, Gigante B, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Gustafsson S, Östenson CG, Humphries SE, Tremoli E, de Faire U, Öhrvik J, Hamsten A. Serum 25-Hydroxyvitamin D Concentration in Subclinical Carotid Atherosclerosis. Arterioscler Thromb Vasc Biol 2013; 33:2633-8. [DOI: 10.1161/atvbaha.113.301593] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Vitamin D deficiency has been implicated in cardiovascular disease and is associated with multiple cardiovascular risk factors. We investigated the serum 25-hydroxyvitamin D (25(OH)D) concentration in relation to latitude, baseline carotid intima-media thickness (IMT), and IMT progression, the carotid IMT measures being surrogate markers of subclinical atherosclerosis and cardiovascular disease risk.
Approach and Results—
Serum 25(OH)D concentration was related to high-resolution carotid IMT measures in 3430 middle-aged and elderly subjects with high cardiovascular risk but no prevalent disease, who were recruited at 7 centers in Finland, Sweden, The Netherlands, France, and Italy. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30 after entry into the study, whereas blood samples, clinical data, and information about lifestyle were collected at baseline. Serum 25(OH)D levels were positively associated with latitude (Jonckheere–Terpstra χ=166.643;
P
<0.001) and, as previously reported, associated with a range of cardiovascular risk factors. There were no independent relationships between 25(OH)D and segment-specific or composite IMT measures in the entire cohort. In analyses stratified by sex, diabetes mellitus, and statin treatment, weak associations with some baseline and progression measures of carotid IMT were observed in males, diabetics, and nonstatin-treated individuals.
Conclusions—
Levels of 25(OH)D differed across Europe, were highest in the North, showed multiple associations with established and emerging cardiovascular risk factors but were not consistently, independently related to measures of carotid IMT. This argues against a protective role of vitamin D against subclinical atherosclerosis in high-risk individuals.
Collapse
Affiliation(s)
- Anna Deleskog
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Olga Piksasova
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Angela Silveira
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Karl Gertow
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Damiano Baldassarre
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Fabrizio Veglia
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Bengt Sennblad
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Rona J. Strawbridge
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Malin Larsson
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Karin Leander
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Bruna Gigante
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Jussi Kauhanen
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Rainer Rauramaa
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Andries J. Smit
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Elmo Mannarino
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Philippe Giral
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Sven Gustafsson
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Claes-Göran Östenson
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Steve E. Humphries
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Elena Tremoli
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Ulf de Faire
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - John Öhrvik
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Anders Hamsten
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| |
Collapse
|
21
|
Venskutonyte L, Brismar K, Öhrvik J, Rydén L, Kjellström B. Self-rated health predicts outcome in patients with type 2 diabetes and myocardial infarction: a DIGAMI 2 quality of life sub-study. Diab Vasc Dis Res 2013; 10:361-7. [PMID: 23673377 DOI: 10.1177/1479164113482694] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Diabetes mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) 2 Quality of Life (QoL) sub-study included 465 patients with type 2 diabetes and acute myocardial infarction (AMI) followed for 2 years. Self-rated health was reported by the rating scale (RS), graded 0 = death to 100 = perfect health. Prospective associations between RS and all-cause mortality, cardiovascular (CV) death and cardiovascular events (CVEs = CV death, non-fatal AMI, stroke) were assessed. Median age was 68 years (range 59-74), 68% male. Patients experiencing CVE (n = 132) or death (n = 71) had lower RS compared with patients free from events: 60 (50-79) versus 70 (55-81) (p < 0.001) and 60 (50-75) versus 70 (51-80) (p = 0.008). The RS score predicted CVE [hazard ratio (HR); 95% confidence interval (CI): 0.87; 0.80-0.95] and all-cause mortality (0.86; 0.76-0.97), and corresponding HRs after adjustment were 0.90; 0.83-0.99 and 0.90; 0.79-1.02, respectively. A low self-rated health is of prognostic importance in patients with type 2 diabetes and AMI and may serve as an easily obtainable indicator of high risk for CVEs supplementing traditional risk factors.
Collapse
Affiliation(s)
- Laura Venskutonyte
- Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
22
|
Nohlert E, Öhrvik J, Tegelberg Å, Tillgren P, Helgason ÁR. Long-term follow-up of a high- and a low-intensity smoking cessation intervention in a dental setting--a randomized trial. BMC Public Health 2013; 13:592. [PMID: 23777201 PMCID: PMC3693879 DOI: 10.1186/1471-2458-13-592] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 06/11/2013] [Indexed: 11/16/2022] Open
Abstract
Background Achieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. Also, intervention intensity is an important issue for development of efficient and cost-effective cessation treatment protocols. The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence. Methods 300 smokers attending dental or general health care were randomly assigned to HIT or LIT at the public dental clinic. Main outcome measures were self-reported point prevalence, continuous abstinence (≥6 months), and sustained abstinence. The study was a follow-up after 5–8 years of a previously performed 12-month follow-up, both by postal questionnaires. Results Response rate was 85% (n=241) of those still alive and living in Sweden. Abstinence rates were 8% higher in both programs at the long-term than at the 12-month follow-up. The difference of 7% between HIT and LIT had not change, being 31% vs. 24% for point prevalence and 26% vs. 19% for 6-month continuous abstinence, respectively. Significantly more participants in HIT (12%) than in LIT (5%) had been sustained abstinent (p=0.03). Logistic regression analyses showed that abstinence at 12-month follow-up was a strong predictor for abstinence at long-term follow-up. Conclusions Abstinence at 12-month follow-up is a good predictor for long-term abstinence. The difference in outcome between HIT and LIT for smoking cessation remains at least 5–8 years after the intervention. Trial registration number NCT00670514
Collapse
Affiliation(s)
- Eva Nohlert
- Centre for Clinical Research, Uppsala University, Västerås, Sweden.
| | | | | | | | | |
Collapse
|
23
|
Nilsson G, Hedberg P, Öhrvik J. Inflammation and the Metabolic Syndrome: Clustering and Impact on Survival in a Swedish Community-Based Cohort of 75 Year Olds. Metab Syndr Relat Disord 2013; 11:92-101. [DOI: 10.1089/met.2012.0100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Göran Nilsson
- Department of Medicine, Central Hospital, Västerås, Sweden
- Department of Clinical Research, Uppsala University, Uppsala, Sweden
| | - Pär Hedberg
- Department of Physiology, Central Hospital, Västerås, Sweden
| | - John Öhrvik
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
24
|
Huang J, Sabater-Lleal M, Asselbergs FW, Tregouet D, Shin SY, Ding J, Baumert J, Oudot-Mellakh T, Folkersen L, Johnson AD, Smith NL, Williams SM, Ikram MA, Kleber ME, Becker DM, Truong V, Mychaleckyj JC, Tang W, Yang Q, Sennblad B, Moore JH, Williams FMK, Dehghan A, Silbernagel G, Schrijvers EMC, Smith S, Karakas M, Tofler GH, Silveira A, Navis GJ, Lohman K, Chen MH, Peters A, Goel A, Hopewell JC, Chambers JC, Saleheen D, Lundmark P, Psaty BM, Strawbridge RJ, Boehm BO, Carter AM, Meisinger C, Peden JF, Bis JC, McKnight B, Öhrvik J, Taylor K, Franzosi MG, Seedorf U, Collins R, Franco-Cereceda A, Syvänen AC, Goodall AH, Yanek LR, Cushman M, Müller-Nurasyid M, Folsom AR, Basu S, Matijevic N, van Gilst WH, Kooner JS, Hofman A, Danesh J, Clarke R, Meigs JB, Kathiresan S, Reilly MP, Klopp N, Harris TB, Winkelmann BR, Grant PJ, Hillege HL, Watkins H, Spector TD, Becker LC, Tracy RP, März W, Uitterlinden AG, Eriksson P, Cambien F, Morange PE, Koenig W, Soranzo N, van der Harst P, Liu Y, O'Donnell CJ, Hamsten A. Genome-wide association study for circulating levels of PAI-1 provides novel insights into its regulation. Blood 2012; 120:4873-81. [PMID: 22990020 PMCID: PMC3520624 DOI: 10.1182/blood-2012-06-436188] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 08/14/2012] [Indexed: 11/20/2022] Open
Abstract
We conducted a genome-wide association study to identify novel associations between genetic variants and circulating plasminogen activator inhibitor-1 (PAI-1) concentration, and examined functional implications of variants and genes that were discovered. A discovery meta-analysis was performed in 19 599 subjects, followed by replication analysis of genome-wide significant (P < 5 × 10(-8)) single nucleotide polymorphisms (SNPs) in 10 796 independent samples. We further examined associations with type 2 diabetes and coronary artery disease, assessed the functional significance of the SNPs for gene expression in human tissues, and conducted RNA-silencing experiments for one novel association. We confirmed the association of the 4G/5G proxy SNP rs2227631 in the promoter region of SERPINE1 (7q22.1) and discovered genome-wide significant associations at 3 additional loci: chromosome 7q22.1 close to SERPINE1 (rs6976053, discovery P = 3.4 × 10(-10)); chromosome 11p15.2 within ARNTL (rs6486122, discovery P = 3.0 × 10(-8)); and chromosome 3p25.2 within PPARG (rs11128603, discovery P = 2.9 × 10(-8)). Replication was achieved for the 7q22.1 and 11p15.2 loci. There was nominal association with type 2 diabetes and coronary artery disease at ARNTL (P < .05). Functional studies identified MUC3 as a candidate gene for the second association signal on 7q22.1. In summary, SNPs in SERPINE1 and ARNTL and an SNP associated with the expression of MUC3 were robustly associated with circulating levels of PAI-1.
Collapse
Affiliation(s)
- Jie Huang
- National Heart, Lung, and Blood Institute (NHBLI) Framingham Heart Study, Framingham, MA 01702, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Deleskog A, Piksasova O, Silveira A, Samnegård A, Tornvall P, Eriksson P, Gustafsson S, Östenson CG, Öhrvik J, Hamsten A. Serum 25-hydroxyvitamin D concentration, established and emerging cardiovascular risk factors and risk of myocardial infarction before the age of 60 years. Atherosclerosis 2012; 223:223-9. [DOI: 10.1016/j.atherosclerosis.2012.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 03/14/2012] [Accepted: 04/17/2012] [Indexed: 12/31/2022]
|
26
|
Westman A, Linton S, Öhrvik J, Wahlén P, Leppert J. Do psychosocial factors predict disability and health at a 3-year follow-up for patients with non-acute musculoskeletal pain? A validation of the Örebro Musculoskeletal Pain Screening Questionnaire. Eur J Pain 2012; 12:641-9. [DOI: 10.1016/j.ejpain.2007.10.007] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2006] [Revised: 10/05/2007] [Accepted: 10/21/2007] [Indexed: 11/17/2022]
|
27
|
Strawbridge RJ, Dupuis J, Prokopenko I, Barker A, Ahlqvist E, Rybin D, Petrie JR, Travers ME, Bouatia-Naji N, Dimas AS, Nica A, Wheeler E, Chen H, Voight BF, Taneera J, Kanoni S, Peden JF, Turrini F, Gustafsson S, Zabena C, Almgren P, Barker DJ, Barnes D, Dennison EM, Eriksson JG, Eriksson P, Eury E, Folkersen L, Fox CS, Frayling TM, Goel A, Gu HF, Horikoshi M, Isomaa B, Jackson AU, Jameson KA, Kajantie E, Kerr-Conte J, Kuulasmaa T, Kuusisto J, Loos RJ, Luan J, Makrilakis K, Manning AK, Martínez-Larrad MT, Narisu N, Nastase Mannila M, Öhrvik J, Osmond C, Pascoe L, Payne F, Sayer AA, Sennblad B, Silveira A, Stančáková A, Stirrups K, Swift AJ, Syvänen AC, Tuomi T, van 't Hooft FM, Walker M, Weedon MN, Xie W, Zethelius B, Ongen H, Mälarstig A, Hopewell JC, Saleheen D, Chambers J, Parish S, Danesh J, Kooner J, Östenson CG, Lind L, Cooper CC, Serrano-Ríos M, Ferrannini E, Forsen TJ, Clarke R, Franzosi MG, Seedorf U, Watkins H, Froguel P, Johnson P, Deloukas P, Collins FS, Laakso M, Dermitzakis ET, Boehnke M, McCarthy MI, Wareham NJ, Groop L, Pattou F, Gloyn AL, Dedoussis GV, Lyssenko V, Meigs JB, Barroso I, Watanabe RM, Ingelsson E, Langenberg C, Hamsten A, Florez JC. Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes. Diabetes 2011; 60:2624-34. [PMID: 21873549 PMCID: PMC3178302 DOI: 10.2337/db11-0415] [Citation(s) in RCA: 257] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/29/2011] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis.
Collapse
Affiliation(s)
- Rona J. Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts
| | - Inga Prokopenko
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, U.K
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
| | - Adam Barker
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Emma Ahlqvist
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital and Malmö, Lund University, Malmö, Sweden
| | - Denis Rybin
- Boston University Data Coordinating Center, Boston, Massachusetts
| | - John R. Petrie
- BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, U.K
| | - Mary E. Travers
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, U.K
| | - Nabila Bouatia-Naji
- Université Lille-Nord de France, Lille, France
- CNRS UMR 8199, Institut Pasteur de Lille, Lille, France
| | - Antigone S. Dimas
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Alexandra Nica
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, U.K
| | - Eleanor Wheeler
- Metabolic Disease Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, U.K
| | - Han Chen
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Benjamin F. Voight
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
- Center for Human Genetic Research and Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston, Massachusetts
| | - Jalal Taneera
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital and Malmö, Lund University, Malmö, Sweden
| | - Stavroula Kanoni
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, U.K
- Department of Dietetics-Nutrition, Harokopio University, Athens, Greece
| | - John F. Peden
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
- Department of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Fabiola Turrini
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital and Malmö, Lund University, Malmö, Sweden
- Department of Medicine, University of Verona, Verona, Italy
| | - Stefan Gustafsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Carina Zabena
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Fundación Investigación Biomédica del Hospital Clínico San Carlos, Madrid, Spain
| | - Peter Almgren
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital and Malmö, Lund University, Malmö, Sweden
| | - David J.P. Barker
- Heart Research Center, Oregon Health and Science University, Portland, Oregon
| | - Daniel Barnes
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, U.K
| | - Johan G. Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Per Eriksson
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Elodie Eury
- Université Lille-Nord de France, Lille, France
- CNRS UMR 8199, Institut Pasteur de Lille, Lille, France
| | - Lasse Folkersen
- Experimental Cardiovascular Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Caroline S. Fox
- National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Timothy M. Frayling
- Institute of Biomedical and Clinical Sciences, Peninsula Medical School, University of Exeter, Exeter, U.K
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
- Department of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Harvest F. Gu
- Endocrinology and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Momoko Horikoshi
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, U.K
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
| | - Bo Isomaa
- Folkhälsan Research Centre, Helsinki, Finland
- Malmska Municipal Health Care Center and Hospital, Jakobstad, Finland
| | - Anne U. Jackson
- Center for Statistical Genetics, Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Karen A. Jameson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, U.K
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Julie Kerr-Conte
- Université Lille-Nord de France, Lille, France
- INSERM UMR 859, Lille, France
| | - Teemu Kuulasmaa
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Johanna Kuusisto
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Ruth J.F. Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Jian'an Luan
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, Laiko General Hospital, Athens University Medical School, Athens, Greece
| | - Alisa K. Manning
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - María Teresa Martínez-Larrad
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Fundación Investigación Biomédica del Hospital Clínico San Carlos, Madrid, Spain
| | - Narisu Narisu
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Maria Nastase Mannila
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - John Öhrvik
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, U.K
| | - Laura Pascoe
- Institute of Cell and Molecular Biosciences, Newcastle University, Newcastle, U.K
| | - Felicity Payne
- Metabolic Disease Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, U.K
| | - Avan A. Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, U.K
| | - Bengt Sennblad
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Angela Silveira
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Alena Stančáková
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Kathy Stirrups
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, U.K
| | - Amy J. Swift
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Ann-Christine Syvänen
- Department of Medical Sciences, Molecular Medicine, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Tiinamaija Tuomi
- Folkhälsan Research Centre, Helsinki, Finland
- Department of Medicine, Helsinki University Central Hospital, and Research Program of Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Ferdinand M. van 't Hooft
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Mark Walker
- Institute of Cellular Medicine, Newcastle University, Newcastle, U.K
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Sciences, Peninsula Medical School, University of Exeter, Exeter, U.K
| | - Weijia Xie
- Institute of Biomedical and Clinical Sciences, Peninsula Medical School, University of Exeter, Exeter, U.K
| | - Björn Zethelius
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | | | | | | | | | | | - Halit Ongen
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
- Department of Cardiovascular Medicine, University of Oxford, Oxford, U.K
- Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford, U.K
| | - Anders Mälarstig
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | | | - Danish Saleheen
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K
- Center for Non-Communicable Diseases Pakistan, Karachi, Pakistan
| | - John Chambers
- Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London, U.K
- Cardiology, Ealing Hospital NHS Trust, Middlesex, U.K
| | - Sarah Parish
- Clinical Trial Service Unit, University of Oxford, Oxford, U.K
| | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K
| | - Jaspal Kooner
- Cardiology, Ealing Hospital NHS Trust, Middlesex, U.K
- National Heart and Lung Institute, Imperial College London, London, U.K
| | - Claes-Göran Östenson
- Endocrinology and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Lars Lind
- Department of Medical Sciences, Molecular Medicine, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Cyrus C. Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, U.K
| | - Manuel Serrano-Ríos
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Fundación Investigación Biomédica del Hospital Clínico San Carlos, Madrid, Spain
| | - Ele Ferrannini
- Department of Internal Medicine and CNR Institute of Clinical Physiology, University of Pisa School of Medicine, Pisa, Italy
| | - Tom J. Forsen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Vaasa Health Care Center, Vaasa, Finland
| | - Robert Clarke
- Clinical Trial Service Unit, University of Oxford, Oxford, U.K
| | - Maria Grazia Franzosi
- Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Udo Seedorf
- Leibniz Institute for Arteriosclerosis Research, University of Münster, Münster, Germany
| | - Hugh Watkins
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
- Department of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Philippe Froguel
- Université Lille-Nord de France, Lille, France
- CNRS UMR 8199, Institut Pasteur de Lille, Lille, France
- Department of Genomics of Common Disease, School of Public Health, Imperial College London, Hammersmith Hospital, London, U.K
| | - Paul Johnson
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, U.K
- DRWF Human Islet Isolation Facility and Oxford Islet Transplant Programme, University of Oxford, Oxford, U.K
| | - Panos Deloukas
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, U.K
| | | | - Markku Laakso
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Emmanouil T. Dermitzakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Michael Boehnke
- Center for Statistical Genetics, Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Mark I. McCarthy
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, U.K
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, U.K
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital and Malmö, Lund University, Malmö, Sweden
| | - François Pattou
- Université Lille-Nord de France, Lille, France
- INSERM UMR 859, Lille, France
| | - Anna L. Gloyn
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, U.K
| | | | - Valeriya Lyssenko
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital and Malmö, Lund University, Malmö, Sweden
| | - James B. Meigs
- General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Inês Barroso
- Metabolic Disease Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, U.K
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Richard M. Watanabe
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, U.K
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Jose C. Florez
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
- Center for Human Genetic Research and Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
28
|
Mälarstig A, Silveira A, Wågsäter D, Öhrvik J, Bäcklund A, Samnegård A, Khademi M, Hellenius ML, Leander K, Olsson T, Uhlén M, de Faire U, Eriksson P, Hamsten A. Plasma CD93 concentration is a potential novel biomarker for coronary artery disease. J Intern Med 2011; 270:229-36. [PMID: 21332844 DOI: 10.1111/j.1365-2796.2011.02364.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES A common nonsynonymous single nucleotide polymorphism (SNP) in the CD93 gene (rs3746731, Pro541Ser) has been associated with risk of coronary artery disease (CAD). CD93 is a transmembrane glycoprotein, which is detectable in soluble form in human plasma. We investigated whether the concentration of soluble CD93 in plasma is related to risk of myocardial infarction (MI) and CAD, using a case-control study of premature MI (n = 764) and a nested case-control analysis of a longitudinal cohort study of 60-year-old subjects (analysis comprising 844 of 4232 subjects enrolled at baseline). In addition, SNPs in the CD93 gene were studied in relation to plasma CD93 concentration and CD93 mRNA expression. METHODS AND RESULTS A sensitive and specific enzyme-linked immunosorbent assay was established for determination of the plasma CD93 concentration. Subjects were divided into three groups according to tertiles of the distribution of CD93 concentration. Lower odds ratios for risk of MI and incidence of CAD were observed in the middle CD93 tertile (142-173 μg L(-1) ): odds ratio (95% confidence interval), 0.69 (0.49-0.97) and 0.61 (0.40-0.94), respectively. These associations were independent of traditional CAD risk factors. The minor allele of a SNP in the 3' untranslated region of CD93 (rs2749812) was associated with increased plasma CD93 concentrations (P = 0.03) and increased CD93 mRNA expression levels (P = 0.02). CONCLUSION The results of the present study suggest that the concentration of soluble CD93 in plasma is a potential novel biomarker for CAD, including MI.
Collapse
Affiliation(s)
- A Mälarstig
- Atherosclerosis Research Unit, Karolinska University Hospital, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Nilsson G, Hedberg P, Öhrvik J. Survival of the fattest: unexpected findings about hyperglycaemia and obesity in a population based study of 75-year-olds. BMJ Open 2011; 1:e000012. [PMID: 22021724 PMCID: PMC3191391 DOI: 10.1136/bmjopen-2010-000012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 03/08/2011] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To study the relationship between body mass index (BMI) and mortality among 75-year-olds with and without diabetes mellitus type 2 (DM) or impaired fasting glucose (IFG). DESIGN Prospective population-based cohort study with a 10-year follow-up. PARTICIPANTS A random sample of 618 of the 1100 inhabitants born in 1922 and living in the city of Västerås in 1997 were invited to participate in a cardiovascular health survey; 70% of those invited agreed to participate (432 individuals: 210 men, 222 women). OUTCOME MEASURES All-cause and cardiovascular mortality. RESULTS 163 of 432 (38%) participants died during the 10-year follow-up period. The prevalence of DM or IFG was 41% (35% among survivors, 48% among non-survivors). The prevalence of obesity/overweight/normal weight/underweight according to WHO definitions was 12/45/42/1% (14/43/42/1% among survivors, 9/47/42/2% among non-survivors). The hazard rate for death decreased by 10% for every kg/m(2) increase in BMI in individuals with DM/IFG (HR 0.91, 95% CI 0.86 to 0.97; p=0.003). After adjustment for sex, current smoking, diagnosed hypertension, diagnosed angina pectoris, previous myocardial infarction and previous stroke/transient ischaemic attack, the corresponding decrease in mortality was 9% (HR 0.92, 95% CI 0.86 to 0.99; p=0.017). These findings remained after exclusion of individuals with BMI<20 or those who died within 2-year follow-up. In individuals without DM/IFG, BMI had no effect on mortality (HR 1.01, 95% CI 0.95 to 1.07; p=0.811). The HR for BMI differed significantly between individuals with and without DM/IFG (p interaction=0.025). The increased all-cause mortality in individuals with DM/IFG in combination with lower BMI was driven by cardiovascular death. CONCLUSION High all-cause and cardiovascular mortality was associated with lower BMI in 75-year-olds with DM/IFG but not in those without DM/IFG. Further studies on the combined effect of obesity/overweight and DM/IFG are needed in order to assess the appropriateness of current guideline recommendations for weight reduction in older people with DM/IFG.
Collapse
Affiliation(s)
- Göran Nilsson
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
| | - Pär Hedberg
- Department of Clinical Physiology, Central Hospital, Västerås, Sweden
| | - John Öhrvik
- Department of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
30
|
Westman A, Linton SJ, Öhrvik J, Wahlén P, Theorell T, Leppert J. Controlled 3-year follow-up of a multidisciplinary pain rehabilitation program in primary health care. Disabil Rehabil 2009; 32:307-16. [DOI: 10.3109/09638280903095924] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
31
|
Hagelberg A, Ivert T, Efendić S, Öhrvik J, Anderson RE. Insulin glargine improves glycaemic control after coronary surgery in patients with diabetes or pre-diabetes. SCAND CARDIOVASC J 2009; 42:71-6. [DOI: 10.1080/14017430701721756] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
32
|
Öhrvik J, Hedberg P, Jonason T, Lönnberg I, Nilsson G. Factor Analysis of the Individual Components of the Metabolic Syndrome Among Elderly Identifies Two Factors With Different Survival Patterns—A Population-Based Study. Metab Syndr Relat Disord 2009; 7:171-7. [DOI: 10.1089/met.2008.0028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- John Öhrvik
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pär Hedberg
- Departments of Physiology, Central Hospital, Västerås, Sweden
| | - Tommy Jonason
- Departments of Physiology, Central Hospital, Västerås, Sweden
| | | | - Göran Nilsson
- Medicine, Central Hospital, Västerås, Sweden
- Department of Clinical Research, Uppsala University, Uppsala, Sweden
| |
Collapse
|
33
|
Olofsson PS, Söderström LÅ, Jern C, Sirsjö A, Ria M, Sundler E, de Faire U, Wiklund PG, Öhrvik J, Hedin U, Paulsson-Berne G, Hamsten A, Eriksson P, Hansson GK. Genetic variants of TNFSF4 and risk for carotid artery disease and stroke. J Mol Med (Berl) 2008; 87:337-46. [DOI: 10.1007/s00109-008-0412-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 09/19/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
|
34
|
|