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Samuelsson J, Bertilsson R, Bülow E, Carlsson S, Åkesson S, Eliasson B, Hanas R, Åkesson K. Autoimmune comorbidity in type 1 diabetes and its association with metabolic control and mortality risk in young people: a population-based study. Diabetologia 2024; 67:679-689. [PMID: 38252314 PMCID: PMC10904419 DOI: 10.1007/s00125-024-06086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
AIMS/HYPOTHESIS This register-based study aimed to describe autoimmune comorbidity in children and young adults from type 1 diabetes onset, and to investigate whether such comorbidity was associated with a difference in HbA1c or mortality risk compared with children/young adults with type 1 diabetes without autoimmune comorbidity. METHODS A total of 15,188 individuals from the Swedish National Diabetes Register, registered with type 1 diabetes before 18 years of age between 2000 and 2019, were included. Five randomly selected control individuals from the Swedish population (Statistics Sweden) were matched to each individual with type 1 diabetes (n=74,210 [346 individuals with type 1 diabetes were not found in the Statistics Sweden register at the date of type 1 diabetes diagnosis, so could not be matched to control individuals]). The National Patient Register was used to attain ICD-10 codes on autoimmune diseases and the Cause of Death Register was used to identify deceased individuals. RESULTS In the total type 1 diabetes cohort, mean±SD age at onset of type 1 diabetes was 9.5±4.4 years and mean disease duration at end of follow-up was 8.8±5.7 years. Of the individuals with type 1 diabetes, 19.2% were diagnosed with at least one autoimmune disease vs 4.0% of the control group. The HRs for comorbidities within 19 years from onset of type 1 diabetes were 11.6 (95% CI 10.6, 12.6) for coeliac disease, 10.6 (95% CI 9.6, 11.8) for thyroid disease, 1.3 (95% CI 1.1, 1.6) for psoriasis, 4.1 (95% CI 3.2, 5.3) for vitiligo, 1.7 (95% CI 1.4, 2.2) for rheumatic joint disease, 1.0 (95% CI 0.8, 1.3) for inflammatory bowel disease, 1.0 (95% CI 0.7, 1.2) for systemic connective tissue disorder, 1.4 (95% CI 1.1, 1.9) for uveitis, 18.3 (95% CI 8.4, 40.0) for Addison's disease, 1.8 (95% CI 0.9, 3.6) for multiple sclerosis, 3.7 (95% CI 1.6, 8.7) for inflammatory liver disease and 19.6 (95% CI 4.2, 92.3) for atrophic gastritis. Autoimmune disease in addition to type 1 diabetes had no statistically significant effect on HbA1c or mortality risk. CONCLUSIONS/INTERPRETATION To our knowledge, this is the first comprehensive study where young individuals with type 1 diabetes were followed regarding development of a wide spectrum of autoimmune diseases, from onset of type 1 diabetes. In this nationwide and population-based study, there was already a high prevalence of autoimmune diseases in childhood, especially coeliac and thyroid disease. The presence of autoimmune comorbidity did not have a statistically significant effect on metabolic control or mortality risk.
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Affiliation(s)
- John Samuelsson
- Department of Paediatrics, Ryhov County Hospital, Jönköping, Sweden.
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | | | - Erik Bülow
- Centre of Registers in Region Västra Götaland, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sanna Carlsson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Sanna Åkesson
- The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Björn Eliasson
- Centre of Registers in Region Västra Götaland, Gothenburg, Sweden
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ragnar Hanas
- The Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics, NU Hospital Group, Uddevalla, Sweden
| | - Karin Åkesson
- Department of Paediatrics, Ryhov County Hospital, Jönköping, Sweden.
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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Göransson J, Sundqvist M, Ghaderi E, Lisby JG, Molin Y, Eriksson E, Carlsson S, Cederlöf A, Ellis L, Melin J. Correction for Göransson et al., "Performance of a System for Rapid Phenotypic Antimicrobial Susceptibility Testing of Gram-Negative Bacteria Directly From Positive Blood Culture Bottles". J Clin Microbiol 2024; 62:e0117323. [PMID: 38054700 DOI: 10.1128/jcm.01173-23] [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] [Received: 10/18/2023] [Accepted: 10/29/2023] [Indexed: 12/07/2023] Open
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Göransson J, Sundqvist M, Ghaderi E, Lisby JG, Molin Y, Eriksson E, Carlsson S, Cederlöf A, Ellis L, Melin J. Performance of a System for Rapid Phenotypic Antimicrobial Susceptibility Testing of Gram-Negative Bacteria Directly from Positive Blood Culture Bottles. J Clin Microbiol 2023; 61:e0152522. [PMID: 36852983 PMCID: PMC10035315 DOI: 10.1128/jcm.01525-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/24/2023] [Indexed: 03/01/2023] Open
Abstract
The rapid administration of optimal antimicrobial treatment is paramount for the treatment of bloodstream infections (BSIs), and rapid antimicrobial susceptibility testing (AST) results are essential. Q-linea has developed the ASTar system, a rapid phenotypic AST device. Here, we report the performance of the ASTar BC G- (Gram-negative) kit when assessed according to the ISO 20776-2:2007 standard for performance evaluation of in vitro diagnostic AST devices. The evaluated ASTar BC G- kit uses a broad panel of 23 antimicrobials for the treatment of BSIs caused by Gram-negative fastidious and nonfastidious bacteria across a range of 6 to 14 2-fold dilutions, including cefoxitin as a screening agent for AmpC-producing Enterobacterales. The ASTar system processes blood culture samples to generate data on MICs and susceptible, intermediate, or resistant (SIR) category. The automated protocol includes concentration determination and concentration adjustment to enable a controlled inoculum, followed by broth microdilution (BMD) and microscopy performed continuously to generate MIC values within approximately 6 h once the test is run on the ASTar system. The performance of the ASTar system was assessed against the ISO 20776-2:2007 standard BMD reference method. Testing was performed across three sites, with results from 412 contrived blood cultures and 74 fresh clinical blood cultures. The ASTar system was also tested for reproducibility, with triplicate testing of 11 strains. The accuracy study comprised 8,650 data points of bacterium-antimicrobial tests. The ASTar system demonstrated an overall essential agreement (EA) of 95.8% (8,283/8,650) and a categorical agreement (CA) of 97.6% (8,433/8,639) compared to the reference BMD method. The overall rate of major discrepancies (MDs) was 0.9% (62/6,845), and that of very major discrepancies (VMDs) was 2.4% (30/1,239). This study shows that the ASTar system delivers reproducible results with overall EA and CA of >95%.
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Affiliation(s)
| | - M. Sundqvist
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - E. Ghaderi
- Department of Bacteriology, Uppsala University Hospital, Uppsala, Sweden
| | - J. G. Lisby
- Department of Clinical Microbiology, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark
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Corsini C, Bergengren O, Carlsson S, Lissbrant I, Garmo H, Eriksson Hjelm M, Kindblom J, Westerberg M, Robinson D, Fransson P, Stattin P, Carlsson S. Patient reported outcomes after radical prostatectomy or radiotherapy for prostate cancer – register-based nationwide, population-based study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00304-4] [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: 02/12/2023]
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Nordström T, Discacciati A, Annerstedt M, Mannsikka K, Glaessgen A, Carlsson S, Jäderling F, Grönberg H, Eklund M. Repeat prostate cancer screening using prostate-specific antigen, a multiplex blood-test and magnetic resonance imaging: 2nd screening round outcomes of STHLM3-MRI. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00931-4] [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: 02/12/2023]
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Palmstedt E, Månsson M, Stinesen Kollberg K, Carlsson S, Wallström J, Hellström M, Hugosson J, Arnsrud Godtman R. Men’s estimation of life-time risk of receiving a prostate cancer diagnosis, results from the Göteborg-2 prostate cancer screening trial. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00451-1] [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: 11/28/2022]
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Carlsson S, Bjerner J, Lilja H, Aas K, Fosså S, Müller C, Müller S, Stensvold A, Thomas O, Røe O, Walz J, Bratt O, Oldenburg J. Long-term predictive value of serum PSA values obtained in clinical practice – Results from the Norwegian Prostate Cancer Consortium (NPCC). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01366-x] [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: 11/16/2022]
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Nordström T, Discacciati A, Bergman M, Aly M, Annerstedt M, Glaessgen A, Carlsson S, Jäderling F, Eklund M, Grönberg H. Prostate cancer screening using prostate-specific antigen, a multiplex blood-test, magnetic resonance imaging and targeted prostate biopsies: The STHLM3MRI trial. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01387-7] [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: 10/20/2022]
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Bernie H, Nascimento B, Miranda E, Tin A, Benfante N, Carlsson S, Mulhal J. 125 The Relationship Between PSA and Total Testosterone Levels in Men with Low, Intermediate and High Grade Prostate Cancer. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.134] [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: 10/27/2022]
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Bernie H, Nascimento B, Katz D, Tin A, Benfante N, Sjoberg D, Carlsson S, Vickers A, Mulhall J. 160 Predictors of Worsening Erectile Function in Men With Functional Erections Early After Radical Prostatectomy. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.169] [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: 11/27/2022]
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Rasouli B, Ahlqvist E, Alfredsson L, Andersson T, Carlsson PO, Groop L, Löfvenborg J, Martinell M, Rosengren A, Tuomi T, Wolk A, Carlsson S. Coffee consumption, genetic susceptibility and risk of latent autoimmune diabetes in adults: A population-based case-control study. Diabetes & Metabolism 2018; 44:354-360. [DOI: 10.1016/j.diabet.2018.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/23/2018] [Accepted: 05/06/2018] [Indexed: 01/25/2023]
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Affiliation(s)
- P M Mannucci
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University of Milano, Italy
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Eriksson BI, Carlsson S, Halvarsson M, Risberg B, Mattsson C. Antithrombotic Effect of Two Low Molecular Weight Thrombin Inhibitors and a Low-Molecular Weight Heparin in a Caval Vein Thrombosis Model in the Rat. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1665419] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryA sensitive thrombosis model with a high reproducibility was developed in the rat, utilizing stasis of the caval vein and a standardized surgical trauma as the only thrombogenic stimuli. Since no procoagulant substances were used, the results of the present study might be relevant in a clinical situation. The antithrombotic effect of two recently synthesized low-molecular-weight thrombin inhibitors have been compared to dalteparin, (Fragmin) a low-molecular-weight heparin fragment. Each compound was studied at 8 different doses with 10 rats in each group. On a gravimetric basis, the thrombin inhibitor melagatran was twice as potent as dalteparin (ED50 16 and 33 µ/kg per h, respectively). The second thrombin inhibitor, inogatran, had an intermediate effect, with an ED50 of 24 µLg/kg per h. No differences in antithrombotic effect were, however, found when the compounds were compared at anticoagulant equivalent doses (same APTT prolongation). A 50% reduction in the mean thrombus weight was obtained when APTT was prolonged to 1.2 to 1.3 times the pretreatment value.
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Affiliation(s)
- B I Eriksson
- The Department of Orthopaedics, Sahlgrenska University Hospital, Astra Hässle AB
| | - S Carlsson
- Preclinical Research and Development, University of Göteborg, Astra Hässle AB
| | - M Halvarsson
- The Department of Surgery, Sahlgrenska University Hospital, Astra Hässle AB
| | - B Risberg
- The Department of Surgery, Sahlgrenska University Hospital, Astra Hässle AB
| | - C Mattsson
- Preclinical Research and Development, University of Göteborg, Astra Hässle AB
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Carlsson S, Lilja B, Mattsson S, Pettersson C, Dahlström J. Cardiac Blood Pool Imaging — A Clinical Comparison between Red Blood Cells Labeled with 99mTc in vivo and in vitro and 99mTc-Labeled Human Serum Albumin. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1620913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryIn 25 patients undergoing radiocardiographic determination of ventricular function, three methods for blood pool imaging were compared. 99mTc was used to label human serum albumin (HSA) and red blood cells (RBC) in vivo or in vitro. The activity concentration of 99mTc in blood was measured during 2 hrs after injection and a significantly higher concentration was found with RBC compared to HSA already after 15 min. The left ventricular to background count rate ratio was significantly lower for HSA after 90 min compared to RBC. There was no statistical difference in 99mTc activity concentration in blood or in left ventricular to background count rate ratio during the two hrs when the two RBC-labeling procedures were compared. 99mTc-labeled RBC are superior to 99mTc-labeled HSA for gated blood pool studies and especially for repeated determinations of ventricular function. Because the in vivo labeling is the most convenient method it has been adopted as the clinical routine at our hospital.
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Rasouli B, Andersson T, Carlsson PO, Hjort R, Löfvenborg JE, Martinell M, Groop L, Tuomi T, Carlsson S. Serious life events and the risk of latent autoimmune diabetes in adults (LADA) and Type 2 diabetes. Diabet Med 2017. [PMID: 28632336 DOI: 10.1111/dme.13410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIM It has been suggested that experiencing serious life events may promote Type 1 diabetes in children. Studies in adults are lacking, as are studies on the interaction of life events with genetic factors. We aimed to investigate life events and the risk of latent autoimmune diabetes in adults (LADA) and Type 2 diabetes while taking into account HLA genotype. METHODS Analysis was based on 425 incident cases of LADA, 1417 incident cases of Type 2 diabetes and 1702 population-based controls recruited in Sweden between 2010 and 2016. Self-reported information on life events including conflicts, divorce, illness/accidents, death and financial problems experienced during the 5 years preceding diagnosis/index year was used. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated by logistic regression and adjusted for age, sex, BMI, family history of diabetes, smoking, physical activity and education. RESULTS Overall there was no association between experience of any life event and either LADA (OR 0.86, 95% CI 0.68-1.08) or Type 2 diabetes (OR 1.00, 95% CI 0.83-1.21). The results were similar for individual events as well as in separate analysis of men and women. Similar results were seen in more autoimmune LADA (glutamic acid decarboxylase antibodies > median) [OR (any life event) 0.88, 95% CI 0.64-1.21] and in LADA carriers of the high-risk HLADR4-DQ8 genotype (OR 0.89, 95% CI 0.61-1.29). CONCLUSIONS Our findings indicate that experience of a serious life event, including the death of a family member, divorce or financial problems, is not associated with an increased risk of LADA, overall or in genetically susceptible individuals.
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Affiliation(s)
- B Rasouli
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - P-O Carlsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - R Hjort
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - J E Löfvenborg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Martinell
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - L Groop
- Department of Clinical Sciences in Malmö, Clinical Research Centre, Lund University, Malmö, Sweden
- Finnish Institute of Molecular Medicine, Helsinki University, Helsinki, Finland
| | - T Tuomi
- Division of Endocrinology, Abdominal Center, Helsinki University Hospital, Research Program for Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - S Carlsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Hjort R, Alfredsson L, Andersson T, Carlsson PO, Grill V, Groop L, Martinell M, Rasouli B, Storm P, Tuomi T, Carlsson S. Family history of type 1 and type 2 diabetes and risk of latent autoimmune diabetes in adults (LADA). Diabetes Metab 2017; 43:536-542. [PMID: 28669512 DOI: 10.1016/j.diabet.2017.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/11/2017] [Accepted: 05/23/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND A family history of diabetes (FHD) is a strong predictor of diabetes risk, yet has rarely been investigated in latent autoimmune diabetes in adults (LADA). This study therefore investigated the risk of LADA and type 2 diabetes (T2D) in relation to FHD, taking into account the type of diabetes in relatives. METHODS Data from a population-based study were used, including incident cases of LADA [glutamic acid decarboxylase antibody (GADA)-positive, n=378] and T2D (GADA-negative, n=1199), and their matched controls (n=1484). First-degree relatives with disease onset at age<40 years and taking insulin treatment were classified as type 1 diabetes (T1D) or, if otherwise, as T2D. Odds ratios (ORs) were adjusted for age, gender, BMI, education and smoking. Cases were genotyped for high- and low-risk HLA genotypes. RESULTS Both FHD-T1D (OR: 5.8; 95% CI: 3.2-10.3) and FHD-T2D (OR: 1.9; 95% CI: 1.5-2.5) were associated with an increased risk of LADA, whereas the risk of T2D was associated with FHD-T2D (OR: 2.7; 95% CI: 2.2-3.3), but not FHD-T1D. In LADA patients, FHD-T1D vs FHD-T2D was associated with higher GADA but lower C-peptide levels, lower prevalence of low-risk HLA genotypes (5.0% vs 28.6%, respectively; P=0.038) and a tendency for higher prevalence of high-risk genotypes (90.0% vs 69.1%, respectively; P=0.0576). CONCLUSION The risk of LADA is substantially increased with FHD-T1D but also, albeit significantly less so, with FHD-T2D. This supports the idea of LADA as a mix of both T1D and T2D, but suggests that the genes related to T1D have greater impact. LADA patients with FHD-T1D had more T1D-like features, emphasizing the heterogeneity of LADA.
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Affiliation(s)
- R Hjort
- Unit of epidemiology, institute of environmental medicine, Karolinska Institutet, Stockholm, Sweden.
| | - L Alfredsson
- Unit of cardiovascular epidemiology, institute of environmental medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Andersson
- Unit of epidemiology, institute of environmental medicine, Karolinska Institutet, Stockholm, Sweden; Centre for occupational and environmental medicine, Stockholm County Council, Sweden
| | - P-O Carlsson
- Department of medical sciences, Uppsala university, Uppsala, Sweden
| | - V Grill
- NTNU institute of cancer research and molecular medicine, Norwegian university of science and technology, Trondheim, Norway; Department of endocrinology, Trondheim university hospital, Trondheim, Norway
| | - L Groop
- Department of clinical sciences in Malmö, clinical research centre, Lund university, Malmö, Sweden
| | - M Martinell
- Department of public health and caring sciences, Uppsala university, Uppsala, Sweden
| | - B Rasouli
- Unit of epidemiology, institute of environmental medicine, Karolinska Institutet, Stockholm, Sweden
| | - P Storm
- Department of clinical sciences in Malmö, clinical research centre, Lund university, Malmö, Sweden
| | - T Tuomi
- Division of endocrinology, abdominal centre, Finnish institute for molecular medicine and research program for diabetes and obesity, university of Helsinki and Folkhälsan research centre, Helsinki university hospital, Helsinki, Finland
| | - S Carlsson
- Unit of epidemiology, institute of environmental medicine, Karolinska Institutet, Stockholm, Sweden
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Carlsson S, Andersson T, Araghi M, Galanti R, Lager A, Lundberg M, Nilsson P, Norberg M, Pedersen NL, Trolle-Lagerros Y, Magnusson C. Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes: results from five pooled cohorts. J Intern Med 2017; 281:398-406. [PMID: 28164394 DOI: 10.1111/joim.12592] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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] [Indexed: 01/01/2023]
Abstract
BACKGROUND Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk. OBJECTIVE To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts. METHODS Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity. RESULTS Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00-1.32) in current users of snus. In individuals consuming 5-6 boxes per week, the HR was 1.42 (95% CI: 1.07-1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17-2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01-1.16). CONCLUSION Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.
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Affiliation(s)
- S Carlsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - M Araghi
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - R Galanti
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - A Lager
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - M Lundberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - P Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - M Norberg
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - C Magnusson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
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Rasouli B, Andersson T, Carlsson PO, Grill V, Groop L, Martinell M, Midthjell K, Storm P, Tuomi T, Carlsson S. Use of Swedish smokeless tobacco (snus) and the risk of Type 2 diabetes and latent autoimmune diabetes of adulthood (LADA). Diabet Med 2017; 34:514-521. [PMID: 27353226 DOI: 10.1111/dme.13179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 12/13/2022]
Abstract
AIMS It has been suggested that moist snuff (snus), a smokeless tobacco product that is high in nicotine and widespread in Scandinavia, increases the risk of Type 2 diabetes. Previous studies are however few, contradictory and, with regard to autoimmune diabetes, lacking. Our aim was to study the association between snus use and the risk of Type 2 diabetes and latent autoimmune diabetes of adulthood (LADA). METHOD Analyses were based on incident cases (Type 2 diabetes, n = 724; LADA, n = 200) and population-based controls (n = 699) from a Swedish case-control study. Additional analyses were performed on cross-sectional data from the Norwegian HUNT study (n = 21 473) with 829 prevalent cases of Type 2 diabetes. Odds ratios (OR) were estimated adjusted for age, BMI family history of diabetes and smoking. Only men were included. RESULTS No association between snus use and Type 2 diabetes or LADA was seen in the Swedish data. For Type 2 diabetes, the OR for > 10 box-years was 1.00 [95% confidence interval (CI), 0.47 to 2.11] and for LADA 1.01 (95% CI, 0.45 to 2.29). Similarly, in HUNT, the OR for Type 2 diabetes in ever-users was estimated at 0.91 (95% CI, 0.75 to 1.10) and in heavy users at 0.92 (95% CI, 0.46 to 1.83). CONCLUSION The risk of Type 2 diabetes and LADA is unrelated to the use of snus, despite its high nicotine content. This opens the possibility of the increased risk of Type 2 diabetes seen in smokers may not be attributed to nicotine, but to other substances in tobacco smoke.
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Affiliation(s)
- B Rasouli
- Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Andersson
- Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - P-O Carlsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - V Grill
- NTNU Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Trondheim University Hospital, Trondheim, Norway
| | - L Groop
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - M Martinell
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - K Midthjell
- HUNT Research Centre, Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - P Storm
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - T Tuomi
- Department of Medicine, Helsinki University Central Hospital and Research Program for Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - S Carlsson
- Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Laugsand LE, Janszky I, Vatten LJ, Dalen H, Midthjell K, Grill V, Carlsson S. Autoimmune diabetes in adults and risk of myocardial infarction: the HUNT study in Norway. J Intern Med 2016; 280:518-531. [PMID: 27445256 DOI: 10.1111/joim.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 01/14/2023]
Abstract
BACKGROUND The long-term consequences of autoimmune diabetes in adults (AIDA) are largely unexplored. OBJECTIVE To investigate the risk of myocardial infarction (MI) in AIDA compared to type 2 diabetes, taking into consideration the effects of socio-economic and lifestyle factors, the metabolic syndrome and glycaemic control. METHODS A total of 62 995 participants including 207 individuals with AIDA (onset ≥35 years and anti-GAD positive) and 2322 individuals with type 2 diabetes (onset ≥35 years and anti-GAD negative), from the population-based Norwegian HUNT study, were followed for a first MI during the period 1995-2008. We identified 2614 MIs by hospital records or the National Cause of Death Registry. Cox proportional hazard models were used to estimate the risk of MI by diabetes subgroups after adjustment for age and socio-economic and lifestyle factors. RESULTS AIDA amongst women was associated with a nearly fourfold increased risk of MI [hazard ratio (HR) 3.63, 95% confidence interval (CI) 2.21-5.96) compared to nondiabetic participants, whereas no excess risk was found in men with AIDA (HR 1.30, 95% CI 0.70-2.52). By contrast, type 2 diabetes was associated with an increased MI risk in both men (HR 1.92, 95% CI 1.62-2.26) and women (HR 2.39, 95% CI 1.98-2.89). The metabolic profile was more favourable in patients with AIDA than in those with type 2 diabetes, but glycaemic control was worse. Multivariable models and sensitivity analyses suggest that these results were robust. CONCLUSIONS Women with AIDA were more likely to develop MI, compared to men with AIDA and both men and women with type 2 diabetes. Further investigations are warranted to confirm this gender difference.
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Affiliation(s)
- L E Laugsand
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Cardiology, St. Olavs Hospital, Trondheim, Norway.
| | - I Janszky
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - L J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - H Dalen
- Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - K Midthjell
- HUNT Research Centre, Department of Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway
| | - V Grill
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - S Carlsson
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Carlsson S, Andersson T, Ahlbom A. Prevalence and incidence of diabetes mellitus: a nationwide population-based pharmaco-epidemiological study in Sweden. Diabet Med 2016; 33:1149-50. [PMID: 27429054 DOI: 10.1111/dme.12984] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/04/2015] [Accepted: 09/30/2015] [Indexed: 11/30/2022]
Affiliation(s)
- S Carlsson
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Andersson
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm County Council, Sweden
| | - A Ahlbom
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm County Council, Sweden
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Mattsson S, Johansson L, Leide Svegborn S, Liniecki J, Noßke D, Riklund KÅ, Stabin M, Taylor D, Bolch W, Carlsson S, Eckerman K, Giussani A, Söderberg L, Valind S. Radiation Dose to Patients from Radiopharmaceuticals: a Compendium of Current Information Related to Frequently Used Substances. Ann ICRP 2015; 44:7-321. [PMID: 26069086 DOI: 10.1177/0146645314558019] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This report provides a compendium of current information relating to radiation dose to patients, including biokinetic models, biokinetic data, dose coefficients for organ and tissue absorbed doses, and effective dose for major radiopharmaceuticals based on the radiation protection guidance given in Publication 60(ICRP, 1991). These data were mainly compiled from Publications 53, 80, and 106(ICRP, 1987, 1998, 2008), and related amendments and corrections. This report also includes new information for 82Rb-chloride, iodide (123I, 124I, 125I, and 131I) and 123I labeled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FPCIT).The coefficients tabulated in this publication will be superseded in due course by values calculated using new International Commission on Radiation Units and Measurements/International Commission on Radiological Protection adult and paediatric reference phantoms and Publication 103 methodology (ICRP,2007). The data presented in this report are intended for diagnostic nuclear medicine and not for therapeutic applications.
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Grenabo BA, Carlsson S, Damber JE, Frånlund M, Geterud K, Khatami A, Socratous A, Stranne J, Hellström M, Hugosson J. 760 Role of magnetic resonance imaging in prostate cancer screening; results from a pilot study within the Gothenburg randomized screening trial. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)60751-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Carlsson S, Assel M, Vickers A. Letter to the editor concerning 'Do prostate cancer risk models improve the predictive accuracy of PSA screening? A meta-analysis'. Ann Oncol 2015; 26:1031. [PMID: 25646367 DOI: 10.1093/annonc/mdv038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Carlsson
- Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;; Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;.
| | - M Assel
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering, New York, USA
| | - A Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering, New York, USA
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Löfvenborg JE, Andersson T, Carlsson PO, Dorkhan M, Groop L, Martinell M, Tuomi T, Wolk A, Carlsson S. Fatty fish consumption and risk of latent autoimmune diabetes in adults. Nutr Diabetes 2014; 4:e139. [PMID: 25329601 PMCID: PMC4216999 DOI: 10.1038/nutd.2014.36] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/18/2014] [Accepted: 09/02/2014] [Indexed: 12/18/2022] Open
Abstract
Objective: It has been suggested that intake of fatty fish may protect against both type 1 and type 2 diabetes. Hypotheses rest on the high marine omega-3 fatty acid eicosapentaenoic acid+docosahexaenoic acid (EPA+DHA) and vitamin D contents, with possible beneficial effects on immune function and glucose metabolism. Our aim was to investigate, for the first time, fatty fish consumption in relation to the risk of latent autoimmune diabetes in adults (LADA). Methods: Analyses were based on data from a Swedish case–control study with incident cases of LADA (n=89) and type 2 diabetes (n=462) and randomly selected diabetes-free controls (n=1007). Diabetes classification was based on the onset of age (⩾35), glutamic acid decarboxylase autoantibodies, and C-peptide. A validated food frequency questionnaire was used to derive information on previous intake of fish, polyunsaturated long-chain omega-3 fatty acids (n-3 PUFA) and supplementation of fish oil and vitamin D. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression, adjusted for age, gender, body mass index (BMI), family history of diabetes, physical activity, smoking, education, and consumption of alcohol, fruit, vegetables and red meat. Results: Weekly fatty fish consumption (⩾1 vs <1 serving per week), was associated with a reduced risk of LADA but not type 2 diabetes (OR 0.51, 95% CI 0.30–0.87, and 1.01, 95% CI 0.74–1.39, respectively). Similar associations were seen for estimated intake of n-3 PUFA (⩾0.3 g per day; LADA: OR 0.60, 95% CI 0.35–1.03, type 2 diabetes: OR 1.14, 95% CI 0.79–1.58) and fish oil supplementation (LADA: OR 0.47, 95% CI 0.19–1.12, type 2 diabetes: OR 1.58, 95% CI 1.08–2.31). Conclusions: Our findings suggest that fatty fish consumption may reduce the risk of LADA, possibly through effects of marine-originated omega-3 fatty acids.
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Affiliation(s)
- J E Löfvenborg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Andersson
- 1] Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden [2] Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - P-O Carlsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - M Dorkhan
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - L Groop
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - M Martinell
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - T Tuomi
- Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital; Research Program for Diabetes and Obesity, University of Helsinki and Folkhalsan Research Center, Helsinki, Finland
| | - A Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - S Carlsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Blomqvist L, Carlsson S, Gjertsson P, Heintz E, Hultcrantz M, Mejare I, Andrén O. Limited evidence for the use of imaging to detect prostate cancer: a systematic review. Eur J Radiol 2014; 83:1601-6. [PMID: 25059597 DOI: 10.1016/j.ejrad.2014.06.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 06/29/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the diagnostic accuracy of imaging technologies for detecting prostate cancer in patients with elevated PSA-values or suspected findings on clinical examination. METHODS The databases Medline, EMBASE, Cochrane, CRD HTA/DARE/NHS EED and EconLit were searched until June 2013. Pre-determined inclusion criteria were used to select full text articles. Risk of bias in individual studies was rated according to QUADAS or AMSTAR. Abstracts and full text articles were assessed independently by two reviewers. The performance of diagnostic imaging was compared with systematic biopsies (reference standard) and sensitivity and specificity were calculated. RESULTS The literature search yielded 5141 abstracts, which were reviewed by two independent reviewers. Of these 4852 were excluded since they did not meet the inclusion criteria. 288 articles were reviewed in full text for quality assessment. Six studies, three using MRI and three using transrectal ultrasound were included. All were rated as high risk of bias. Relevant studies on PET/CT were not identified. CONCLUSION Despite clinical use, there is insufficient evidence regarding the accuracy of imaging technologies for detecting cancer in patients with suspected prostate cancer using TRUS guided systematic biopsies as reference standard.
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Affiliation(s)
- L Blomqvist
- Department of Diagnostic Radiology, Karolinska University Hospital, Solna, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - S Carlsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Urology, Karolinska University Hospital, Solna, Sweden
| | - P Gjertsson
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - E Heintz
- The Swedish Council on Health Technology Assessment, Stockholm, Sweden
| | - M Hultcrantz
- The Swedish Council on Health Technology Assessment, Stockholm, Sweden
| | - I Mejare
- The Swedish Council on Health Technology Assessment, Stockholm, Sweden
| | - O Andrén
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Urology, Örebro University Hospital, Örebro, Sweden
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Löfvenborg JE, Andersson T, Carlsson PO, Dorkhan M, Groop L, Martinell M, Rasouli B, Storm P, Tuomi T, Carlsson S. Coffee consumption and the risk of latent autoimmune diabetes in adults--results from a Swedish case-control study. Diabet Med 2014; 31:799-805. [PMID: 24750356 DOI: 10.1111/dme.12469] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 01/22/2014] [Accepted: 04/10/2014] [Indexed: 11/28/2022]
Abstract
AIMS Coffee consumption is associated with a reduced risk of Type 2 diabetes. Our aim was to investigate if coffee intake may also reduce the risk of latent autoimmune diabetes in adults, an autoimmune form of diabetes with features of Type 2 diabetes. METHODS We used data from a population-based case-control study with incident cases of adult onset (≥ 35 years) diabetes, including 245 cases of latent autoimmune diabetes in adults (glutamic acid decarboxylase antibody positive), 759 cases of Type 2 diabetes (glutamic acid decarboxylase antibody negative), together with 990 control subjects without diabetes, randomly selected from the population. Using questionnaire information on coffee consumption, we estimated the odds ratio of latent autoimmune diabetes in adults and Type 2 diabetes adjusted for age, sex, BMI, smoking, physical activity, alcohol, education and family history of diabetes. RESULTS Coffee intake was inversely associated with Type 2 diabetes (odds ratio 0.92, 95% CI 0.87-0.98 per cup/day). With regard to latent autoimmune diabetes in adults, the general trend was weak (odds ratio 1.04, 95% CI 0.96-1.13), but stratification by degree of autoimmunity (median glutamic acid decarboxylase antibody levels) suggested that coffee intake may be associated with an increased risk of high glutamic acid decarboxylase antibody latent autoimmune diabetes in adults (odds ratio 1.11, 95% CI 1.00-1.23 per cup/day). Furthermore, for every additional cup of coffee consumed per day, there was a 15.2% (P = 0.0268) increase in glutamic acid decarboxylase antibody levels. CONCLUSIONS Our findings confirm that coffee consumption is associated with a reduced risk of Type 2 diabetes. Interestingly, the findings suggest that coffee may be associated with development of autoimmunity and possibly an increased risk of more Type 1-like latent autoimmune diabetes in adults.
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Affiliation(s)
- J E Löfvenborg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Carlsson S, Ahlbom A, Lichtenstein P, Andersson T. Shared genetic influence of BMI, physical activity and type 2 diabetes: a twin study. Diabetologia 2013; 56:1031-5. [PMID: 23404445 DOI: 10.1007/s00125-013-2859-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/24/2013] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to examine the long-term associations of BMI and physical activity with type 2 diabetes, and to estimate shared genetic components of these traits. METHODS We used data from the Swedish Twin Registry on 23,539 twins born 1886-1958 who answered questionnaires between 1967 and 1972 and were followed up until 1998. The risk of type 2 diabetes in relation to BMI and physical activity was assessed by Cox regression. Structural equation models were used to estimate genetic and environmental variance components and genetic correlations. RESULTS The risk of type 2 diabetes increased with BMI (HR 1.32 [95% CI 1.29, 1.35] per kg/m²) and decreased with physical activity (HR 0.56 [95% CI 0.39, 0.80] for high vs low). Heritability was estimated to be 77% (95% CI 54%, 83%) for type 2 diabetes, 65% (95% CI 58%, 73%) for BMI, and 57% (95% CI 47%, 67%) for physical activity. The genetic correlation with type 2 diabetes was 0.43 (95% CI 0.31, 0.58) for BMI and -0.23 (95% CI -0.46, 0.02) for physical activity, implying that 18% (95% CI 9%, 34%) of the genetic influence on type 2 diabetes is shared with BMI and 5% (95% CI 0%, 20%) with physical activity. CONCLUSIONS/INTERPRETATION Indications of shared genetic effects are found for BMI and type 2 diabetes, which suggests that these traits are partly influenced by the same genetic factors. In contrast, our findings suggest that the genes related to physical activity are essentially different from those associated with type 2 diabetes.
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Affiliation(s)
- S Carlsson
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
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Carlsson S, Geijerstam J. Management of mild traumatic brain injuries in emergency departments in Sweden: Evidence of a change in clinical practice. J Rehabil Med 2013; 45:718-20. [DOI: 10.2340/16501977-1202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rasouli B, Ahlbom A, Andersson T, Grill V, Midthjell K, Olsson L, Carlsson S. Alcohol consumption is associated with reduced risk of Type 2 diabetes and autoimmune diabetes in adults: results from the Nord-Trøndelag health study. Diabet Med 2013; 30:56-64. [PMID: 22612671 DOI: 10.1111/j.1464-5491.2012.03713.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS We investigated the influence of different aspects of alcohol consumption on the risk of Type 2 diabetes and autoimmune diabetes in adults. METHODS We used data from the Nord-Trøndelag Health Survey (HUNT) study, in which all adults aged ≥ 20 years from Nord-Trondelag County were invited to participate in three surveys in 1984-1986, 1995-1997 and 2006-2008. Patients with diabetes were identified using self-reports, and participants with onset age ≥ 35 years were classified as having Type 2 diabetes if they were negative for anti-glutamic acid decarboxylase (n = 1841) and as having autoimmune diabetes if they were positive for anti-glutamic acid decarboxylase (n = 140). Hazard ratios of amount and frequency of alcohol use, alcoholic beverage choice, and binge drinking and alcohol use disorders were estimated. RESULTS Moderate alcohol consumption (adjusted for confounders) was associated with a reduced risk of Type 2 diabetes in men, but not in women (hazard ratio for men 10-15 g/day 0.48, 95% CI 0.28-0.77; hazard ratio for women ≥ 10 g/day 0.81, 95% CI 0.33-1.96). The reduced risk was primarily linked to consumption of wine [hazard ratio 0.93, 95% CI 0.87-0.99 (per g/day)]. No increased risk was seen in participants reporting binge drinking or in problem drinkers. The results were also compatible with a reduced risk of autoimmune diabetes associated with alcohol consumption [hazard ratio 0.70, 95% CI 0.45-1.08 (frequent consumption) and hazard ratio 0.36, 95% CI 0.13-0.97 (2-7 g/day)]. CONCLUSIONS Moderate alcohol consumption associates with reduced risk of both Type 2 diabetes and autoimmune diabetes. A protective effect of alcohol intake may be limited to men. High alcohol consumption does not seem to carry an increased risk of diabetes.
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Affiliation(s)
- B Rasouli
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Olsson L, Pettersen E, Ahlbom A, Carlsson S, Midthjell K, Grill V. No effect by the common gene variant rs10830963 of the melatonin receptor 1B on the association between sleep disturbances and type 2 diabetes: results from the Nord-Trøndelag Health Study. Diabetologia 2011; 54:1375-8. [PMID: 21380592 DOI: 10.1007/s00125-011-2106-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 02/11/2011] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS Genetic variation in the melatonin receptor 1B (MTNR1B) is associated with type 2 diabetes. Melatonin contributes to the regulation of sleep, and sleep problems are a documented risk factor for type 2 diabetes. The aim of this study was to investigate whether the MTNR1B gene variant rs10830963 is associated with sleep problems and whether this variant contributes to the association between sleep disturbances and type 2 diabetes. METHODS This was a case-control study nested within the population-based Nord-Trøndelag Health Study, including 1,322 prevalent cases of type 2 diabetes and 1,447 controls. In addition, prospective data were available for 838 incident cases and 1,133 controls. Genotyping was done by TaqMan single-nucleotide polymorphism allelic discrimination analysis. ORs and 95% CIs were calculated using logistic regression models. RESULTS Our findings confirm an association between sleep disturbances and type 2 diabetes (OR 1.69, 95% CI 1.22-2.33, p = 0.0016) and between the risk allele of rs10830963 and type 2 diabetes (OR 1.12, 95% CI 1.00-1.27, p = 0.0579). There was a tendency for an association between the risk allele and prevalence of sleep problems (specifically early awakening). However, the risk allele did not influence the association of sleep problems with diabetes, which was unaltered after adjustment for the MTNR1B risk allele (OR 1.69, 95% CI 1.23-2.34, p = 0.0014). Results based on prospective data were similar, although non-significant. CONCLUSIONS/INTERPRETATION Our findings do not support participation of the MTNR1B gene variant rs10830963 in the well documented association between sleep disturbances and type 2 diabetes.
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Affiliation(s)
- L Olsson
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
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Roobol MJ, Carlsson S, Hugosson J. Meta-analysis finds screening for prostate cancer with PSA does not reduce prostate cancer-related or all-cause mortality but results likely due to heterogeneity - the two highest quality studies identified do find prostate cancer-related mortality reductions. ACTA ACUST UNITED AC 2011; 16:20-1. [DOI: 10.1136/ebm1165] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Carlsson S, El-Rarbary AA, Lawesson SO. Enamine chemistry XX. synthesis of furan derivatives by reductive cyclisation of enamines. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bscb.19800890807] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kindmark A, Jawaid A, Harbron CG, Barratt BJ, Bengtsson OF, Andersson TB, Carlsson S, Cederbrant KE, Gibson NJ, Armstrong M, Lagerström-Fermér ME, Dellsén A, Brown EM, Thornton M, Dukes C, Jenkins SC, Firth MA, Harrod GO, Pinel TH, Billing-Clason SME, Cardon LR, March RE. Genome-wide pharmacogenetic investigation of a hepatic adverse event without clinical signs of immunopathology suggests an underlying immune pathogenesis. Pharmacogenomics J 2007; 8:186-95. [PMID: 17505501 DOI: 10.1038/sj.tpj.6500458] [Citation(s) in RCA: 241] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
One of the major goals of pharmacogenetics is to elucidate mechanisms and identify patients at increased risk of adverse events (AEs). To date, however, there have been only a few successful examples of this type of approach. In this paper, we describe a retrospective case-control pharmacogenetic study of an AE of unknown mechanism, characterized by elevated levels of serum alanine aminotransferase (ALAT) during long-term treatment with the oral direct thrombin inhibitor ximelagatran. The study was based on 74 cases and 130 treated controls and included both a genome-wide tag single nucleotide polymorphism and large-scale candidate gene analysis. A strong genetic association between elevated ALAT and the MHC alleles DRB1(*)07 and DQA1(*)02 was discovered and replicated, suggesting a possible immune pathogenesis. Consistent with this hypothesis, immunological studies suggest that ximelagatran may have the ability to act as a contact sensitizer, and hence be able to stimulate an adaptive immune response.
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Santos HA, Carlsson S, Murtomäki L, Kontturi K. Cover Picture: Effect of Gramicidin on Phospholipid-Modified Monolayers and on Ion Transfer at a Liquid–Liquid Interface (ChemPhysChem 6/2007). Chemphyschem 2007. [DOI: 10.1002/cphc.200790013] [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: 11/09/2022]
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Santos HA, Carlsson S, Murtomäki L, Kontturi K. Effect of Gramicidin on Phospholipid-Modified Monolayers and on Ion Transfer at a Liquid–Liquid Interface. Chemphyschem 2007; 8:913-20. [PMID: 17366646 DOI: 10.1002/cphc.200600767] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The interaction of hybrid lipid/gramicidin A (gA) monolayers with dextran sulfate (DS) and the effect of this interaction on ion transfer at a liquid-liquid interface is reported. The interfacial and physicochemical properties are studied with Langmuir-Blodgett (LB) and electrochemical techniques. The results obtained from compression isotherms demonstrate that the interactions between the different species in the hybrid monolayer vary according to the chemical nature of the lipid (hydrocarbon region and charge of the head group). Interfacial capacitance measured with AC voltammetry indicates that the DS chains form a rather flat and compact layer when adsorbed to either zwitterionic or negatively charged phospholipid monolayers, and that calcium, even at low concentrations, interacts with the monolayers. These results are successfully described by a model based on the solution of the Poisson-Boltzmann equation in the interfacial region. Ion transfer and interactions with the lipid/gA/DS-modified monolayers were also studied with electrochemical techniques. Admittance data show that although the studied ions are not using gA channels for the transfer through the lipid membranes, the incorporation of gA in the lipid domain and the adsorption of DS at the interface have a significant effect on ion transfer across the monolayers. This effect can be explained as a consequence of the modified surface charge and of the compactness of the lipid domain due to its interaction with gA and to calcium and DS adsorption at the interface. The ion-transfer rate, therefore, depends on the composition of the monolayer and the chemical nature of the ion.
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Affiliation(s)
- Hélder A Santos
- Department of Chemical Technology, Laboratory of Physical Chemistry and Electrochemistry, Helsinki University of Technology, P.O. Box 6100, Kemistintie 1, 02015 TKK Espoo, Finland.
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Carlsson S, Nilsson A, Jonsson M, Wiklund N. 409 LEARNING CURVE CONCERNING POSITIVE SURGICAL MARGINS FOR DA VINCI ROBOTIC ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1569-9056(07)60407-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carlsson S, Midthjell K, Tesfamarian MY, Grill V. Age, overweight and physical inactivity increase the risk of latent autoimmune diabetes in adults: results from the Nord-Trøndelag health study. Diabetologia 2007; 50:55-8. [PMID: 17096113 DOI: 10.1007/s00125-006-0518-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Accepted: 10/10/2006] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS Latent autoimmune diabetes (LADA) is a common form of diabetes, yet the risk factors are poorly characterised. The aim of this study was to investigate the influence of age, overweight and physical activity on the risk of LADA. METHODS We analysed age, overweight and physical inactivity and the incidence of LADA in 38,800 men and women, observed between 1984 and 1986 and 1995 and 1997 as part of the Nord-Trøndelag Health Survey. We also compared such factors with incident cases of type 2 (n = 738) and 'classic' type 1 diabetes (n = 18). Patients classified as LADA (n = 81) had antibodies against GAD and were insulin independent at diagnosis. RESULTS The proportion of those who were older, overweight and inactive before diagnosis was almost identical in LADA and type 2 diabetes patients. BMI >or=30 kg/m(2) was strongly associated with LADA incidence (relative risk [RR] = 15.0, 95% CI 7.51-29.97). The association was similar for type 2 diabetes (RR = 15.37, 95% CI 12.07-19.57) but not for type 1 diabetes. Similarly, age (>or=60 years) was an important risk factor for LADA (RR = 5.62, 95% CI 2.36-13.4) as well as for type 2 diabetes (RR = 6.78, 95% CI 5.07-9.06) in contrast to type 1 diabetes. Physical inactivity was associated with an increased risk of both LADA and type 2 diabetes. CONCLUSIONS/INTERPRETATION This study suggests that increased age, overweight and physical inactivity are as strong risk factors for LADA as for type 2 diabetes. These findings suggest a role for insulin resistance in the pathogenesis of LADA.
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Affiliation(s)
- S Carlsson
- Division of Epidemiology, Stockholm Centre of Public Health, Stockholm, Sweden.
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Carlsson S, Kontturi AK, Kontturi K. Improving membrane activity of oligonucleotides by cetylpyridinium chloride: an electrochemical study. Eur J Pharm Sci 2006; 29:451-9. [PMID: 17011756 DOI: 10.1016/j.ejps.2006.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2006] [Revised: 08/02/2006] [Accepted: 08/20/2006] [Indexed: 10/24/2022]
Abstract
The interaction of phospholipid membranes and oligonucleotides complexed with a positively charged surfactant is reported. Phospholipid membranes were assembled at the interface between an immobilized organic phase and an aqueous phase using the Langmuir-Blodgett (L-B) technique. The interaction and adsorption of the naked oligonucleotides and oligonucleotides complexed with cetylpyridinium chloride (CP) was studied electrochemically using cyclic voltammetry (CV) and ac-voltammetry. Interfacial capacitance, obtained indirectly from ac-voltammetry as a function of interfacial potential, was fitted to the theory based on the solution of the Poisson-Boltzmann equation. It was shown that both types of naked oligonucleotides (phosphoromonothioates and phosphodiesters) adsorb on the lipid monolayers poorly. The introduction of CP to the system increases the adsorption efficiency significantly. However, one phosphoromonothioate appeared to form a compact globule with CP instead of adsorbing to the lipid membrane. These results demonstrate that electrochemical methods are a powerful tool for probing the behavior of drugs in the vicinity of model cell membranes.
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Affiliation(s)
- Sanna Carlsson
- Laboratory of Physical Chemistry and Electrochemistry, Helsinki University of Technology, PO Box 6100, FIN-02015 Hut, Finland
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Woods M, Carlsson S, Hong Q, Patole SN, Lie LH, Houlton A, Horrocks BR. A Kinetic Model of the Formation of Organic Monolayers on Hydrogen-Terminated Silicon by Hydrosilation of Alkenes. J Phys Chem B 2005; 109:24035-45. [PMID: 16375395 DOI: 10.1021/jp052542e] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have analyzed a kinetic model for the formation of organic monolayers based on a previously suggested free radical chain mechanism for the reaction of unsaturated molecules with hydrogen-terminated silicon surfaces (Linford, M. R.; Fenter, P. M.; Chidsey, C. E. D. J. Am. Chem. Soc 1995, 117, 3145). A direct consequence of this mechanism is the nonexponential growth of the monolayer, and this has been observed spectroscopically. In the model, the initiation of silyl radicals on the surface is pseudo first order with rate constant, ki, and the rate of propagation is determined by the concentration of radicals and unreacted Si-H nearest neighbor sites with a rate constant, kp. This propagation step determines the rate at which the monolayer forms by addition of alkene molecules to form a track of molecules that constitute a self-avoiding random walk on the surface. The initiation step describes how frequently new random walks commence. A termination step by which the radicals are destroyed is also included. The solution of the kinetic equations yields the fraction of alkylated surface sites and the mean length of the random walks as a function of time. In mean-field approximation we show that (1) the average length of the random walk is proportional to (kp/ki)1/2, (2) the monolayer surface coverage grows exponentially only after an induction period, (3) the effective first-order rate constant describing the growth of the monolayer and the induction period (kt) is k = (2ki kp)1/2, (4) at long times the effective first-order rate constant drops to ki, and (5) the overall activation energy for the growth kinetics is the mean of the activation energies for the initiation and propagation steps. Monte Carlo simulations of the mechanism produce qualitatively similar kinetic plots, but the mean random walk length (and effective rate constant) is overestimated by the mean field approximation and when kp >> ki, we find k approximately ki0.7kp0.3 and Ea = (0.7Ei+ 0.3Ep). However the most striking prediction of the Monte Carlo simulations is that at long times, t >> 1/k, the effective first-order rate constant decreases to ki even in the absence of a chemical termination step. Experimental kinetic data for the reaction of undec-1-ene with hydrogen-terminated porous silicon under thermal reflux in toluene and ethylbenzene gave a value of k = 0.06 min(-1) and an activation energy of 107 kJ mol(-1). The activation energy is in reasonable agreement with density functional calculations of the transition state energies for the initiation and propagation steps.
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Affiliation(s)
- M Woods
- School of Natural Sciences: Chemistry, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU, UK
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Abstract
A novel channel flow configuration was developed and utilized for studying the poly(styrenesulfonate)-cetylpyridinium ion interaction kinetics. The surfactant solution was continuously injected into a flow of polyelectrolyte solution, and the extent of the association reaction was probed at an ion-selective detector electrode. The system was modeled within an analytical approximation, which was tested by a finite-element simulation of the full convective mass transport problem including the homogeneous complexation reaction. The results show that association kinetics can be resolved and that the initial steps of the reaction are not influenced by intermolecular interactions between the bound surfactants. The presented methodology is general, and further development should enable the study of complex cooperative kinetics of surfactant-polyelectrolyte systems.
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Affiliation(s)
- Sanna Carlsson
- Laboratory of Physical Chemistry and Electrochemistry, Helsinki University of Technology, P.O. Box 6100, Fin-02015 HUT, Helsinki, Finland
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Carlsson S, Hammar N, Grill V. Alcohol consumption and type 2 diabetes Meta-analysis of epidemiological studies indicates a U-shaped relationship. Diabetologia 2005; 48:1051-4. [PMID: 15864527 DOI: 10.1007/s00125-005-1768-5] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Accepted: 02/28/2005] [Indexed: 10/25/2022]
Abstract
To clarify the relationship between alcohol consumption and type 2 diabetes we conducted a meta-analysis of published epidemiological studies. Data from 13 cohorts were included in the analysis. The results of these studies are consistent with regard to moderate alcohol consumption, indicating a protective effect in the order of 30% (relative risk [RR]meta = 0.72, 95% CI = 0.67-0.77). The reduced risk is seen in men as well as in women, although few studies investigated women. No protective effect of high alcohol consumption was seen and one cannot rule out that large intakes of alcohol may increase the risk of type 2 diabetes. Results from published studies suggest a U-shaped relationship between alcohol and type 2 diabetes, but this is based on rather few studies with heterogeneous design and definitions. It seems important to further investigate if, and to what extent, high alcohol consumption increases the risk of type 2 diabetes. Aspects of moderate alcohol consumption also need further investigation; these include type of drink, frequency of drinking, sex and ethnic differences.
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Affiliation(s)
- S Carlsson
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Carlsson S, Persson Brobert GP, Grill V. Influence of smoking and snus on the prevalence and incidence of type 2 diabetes amongst men: the northern Sweden MONICA study. J Intern Med 2005; 257:481-2; author reply 483. [PMID: 15836667 DOI: 10.1111/j.1365-2796.2005.01481.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Carlsson S, Midthjell K, Grill V. Smoking is associated with an increased risk of type 2 diabetes but a decreased risk of autoimmune diabetes in adults: an 11-year follow-up of incidence of diabetes in the Nord-Trøndelag study. Diabetologia 2004; 47:1953-6. [PMID: 15558231 DOI: 10.1007/s00125-004-1554-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2004] [Accepted: 07/28/2004] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS We compared the association between smoking habits and later occurrence of type 2 diabetes on the one hand and between smoking and diabetes with autoimmunity on the other hand. METHODS We used data from a prospective study of 11-year cumulative incidence of diabetes in the Nord-Trøndelag Health Survey. RESULTS Confirming previous reports, heavy smoking (>/=20 cigarettes per day) carried an increased relative risk (RR) of type 2 diabetes (n=738, RR=1.64, 95% CI: 1.12-2.39). In contrast, smoking reduced the risk of latent autoimmune diabetes in adults (LADA) and of traditional type 1 diabetes (LADA n= 81, RR=0.25, 95% CI: 0.11-0.60; type 1 diabetes, n=18, RR=0.17, 95% CI: 0.04-0.73). CONCLUSIONS/INTERPRETATIONS The results indicate that nicotine influences autoimmune processes in human diabetes.
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Affiliation(s)
- S Carlsson
- Division of Epidemiology, Stockholm Centre of Public Health and Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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Agardh EE, Carlsson S, Ahlbom A, Efendic S, Grill V, Hammar N, Hilding A, Ostenson CG. Coffee consumption, type 2 diabetes and impaired glucose tolerance in Swedish men and women. J Intern Med 2004; 255:645-52. [PMID: 15147528 DOI: 10.1111/j.1365-2796.2004.01331.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The association between coffee consumption, type 2 diabetes and impaired glucose tolerance was examined. In addition, indicators of insulin sensitivity and beta-cell function according to homeostasis model assessment were studied in relation to coffee consumption. DESIGN Population-based cross-sectional study. SETTING AND SUBJECTS The study comprised 7949 healthy Swedish subjects aged 35-56 years residing within five municipalities of Stockholm. An oral glucose tolerance test identified 55 men and 52 women with previously undiagnosed type 2 diabetes and 172 men and 167 women with impaired glucose tolerance. Information about coffee consumption and other factors was obtained by questionnaire. RESULTS The relative risks (adjusted for potential confounders) of type 2 diabetes and impaired glucose tolerance when drinking >/=5 cups of coffee per day compared with </=2 cups per day in men were 0.45 [95% confidence intervals (CI) 0.22-0.92] and 0.63 (CI: 0.41-0.97), respectively, and in women 0.27 (CI: 0.11-0.66) and 0.47 (CI: 0.29-0.76) respectively. In subjects with type 2 diabetes and impaired glucose tolerance, high coffee consumption (>/=5 cups day(-1)) was inversely associated with insulin resistance. In addition, in those with type 2 diabetes and in women (not in men) with impaired glucose tolerance high coffee consumption was inversely associated with low beta-cell function. In women, but not obviously in men, with normal glucose tolerance, coffee consumption was associated with a reduced risk of insulin resistance. CONCLUSIONS The results of this study indicated that high consumers of coffee have a reduced risk of type 2 diabetes and impaired glucose tolerance. The beneficial effects may involve both improved insulin sensitivity and enhanced insulin response.
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Affiliation(s)
- E E Agardh
- Department of Molecular Medicine, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden.
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Carlsson S, Govoni M, Wiklund NP, Weitzberg E, Lundberg JO. In vitro evaluation of a new treatment for urinary tract infections caused by nitrate-reducing bacteria. Antimicrob Agents Chemother 2003; 47:3713-8. [PMID: 14638471 PMCID: PMC296218 DOI: 10.1128/aac.47.12.3713-3718.2003] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2003] [Revised: 08/19/2003] [Accepted: 09/09/2003] [Indexed: 11/20/2022] Open
Abstract
Dietary and endogenous nitrates are excreted in urine, and during infection with nitrate-reducing bacteria they are reduced to nitrite. At a low pH nitrite is converted to a variety of nitrogen oxides that are toxic to bacteria. We hypothesized that acidification of nitrite-rich infected urine would result in the killing of the nitrate-reducing bacteria. An Escherichia coli control strain and a mutant lacking nitrate reductase activity were preincubated in urine supplemented with sodium nitrate (0 to 10 mM) at pH 7.0. Then, the nitrite-containing bacterial culture was transferred (and diluted 1/10) to slightly acidic urine (pH 5 and 5.5) containing ascorbic acid (10 mM) and growth was monitored. The control strain produced nitrite in amounts related to the amount of nitrate added. This strain was killed when the culture was transferred to acidic urine. In contrast, the mutant that did not produce nitrite retained full viability. When control bacteria were grown in acidic urine with nitrate and ascorbic acid present from the start of the experiment, no inhibition of growth was noted. The MICs and minimal bactericidal concentrations of sodium nitrite-ascorbic acid in acidic urine were comparable to those of conventional antibiotics. Preincubation of nitrate-reducing E. coli in nitrate-rich urine leads to the accumulation of nitrite. Subsequent acidification of the urine results in generation of nitrogen oxides that are bactericidal. Killing, however, requires a sequential procedure in which the bacteria are first allowed to grow in a nitrate-rich neutral environment, later followed by acidification. We speculate that ingestion of nitrate followed some hours later by acidification of urine could be a new therapeutic strategy for the treatment of urinary tract infections.
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Affiliation(s)
- S Carlsson
- Department of Surgery, Section of Urology, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
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Abstract
A selection of commonly used reconstruction and filter techniques in the processing of 99mTc oxidronate (i.e., 99mTc hydroxymethane diphosphonate) single photon emission computed tomography (SPECT) of the spine was compared. The possible additional value of scatter correction on image contrast was also evaluated. Twenty-eight bone SPECT examinations of consecutive patients were studied retrospectively. The reconstruction techniques used were filtered back-projection and iterative reconstruction with the use of ordered subsets estimation maximization. Three-dimensional post-filtering with a Metz filter and a Butterworth filter was used. Each combination was evaluated with or without scatter correction. Each study was also processed with the department's standard technique of two-dimensional pre-filtering with a Metz filter followed by filtered back-projection (without scatter correction). Five observers evaluated the image quality of reconstructed coronal and sagittal slices, with special reference to the resolution of vertebrae, vertebral processes, the spinal canal and suspected abnormal uptakes. A grading scale from -2 to +2 was used with the standard technique as the reference. The best image quality was found with iterative reconstruction in combination with a contrast enhancing Metz filter or a noise reducing Butterworth filter. Scatter correction did not improve image quality.
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Affiliation(s)
- S-A Starck
- Department of Hospital Physics, County Hospital Ryhov, Jönköping, Sweden.
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Sarich TC, Osende JI, Eriksson UG, Fager GB, Eriksson-Lepkowska M, Ohlsson L, Carlsson S, Wåhlander K, Gustafsson D, Badimon JJ. Acute antithrombotic effects of ximelagatran, an oral direct thrombin inhibitor, and r-hirudin in a human ex vivo model of arterial thrombosis. J Thromb Haemost 2003; 1:999-1004. [PMID: 12871368 DOI: 10.1046/j.1538-7836.2003.00201.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Thrombin plays a major role in thrombus formation through activation of platelets and conversion of fibrinogen to fibrin. OBJECTIVES To investigate the antithrombotic effects of the oral direct thrombin inhibitor (DTI) ximelagatran and the parenteral DTI r-hirudin in humans. SUBJECTS AND METHODS Healthy male volunteers randomized into four parallel groups each with 15 subjects received either ximelagatran (20, 40 or 80 mg orally) or r-hirudin (0.4 mg kg-1 intravenous bolus + infusion of 0.15 mg kg-1 h-1 for 2 h and 0.075 mg kg-1 h-1 for 3 h). Antithrombotic effects were assessed as changes in total thrombus area (TTA) and total fibrin area (TFA) from baseline, using the Badimon perfusion chamber model at baseline and 2 h and 5 h after drug administration. RESULTS Two hours postdosing, ximelagatran showed antithrombotic effects at both high and low shear rates (TTA% of mean baseline value +/- SEM was 76 +/- 13% and 71 +/- 17% [both P < 0.05] for the 20-mg dose, 85 +/- 11% [P > 0.05] and 62 +/- 15% [P < 0.05] for the 40-mg dose and 60 +/- 11% and 26 +/- 7% [both P < 0.05] for the 80-mg dose, respectively). r-Hirudin also showed a significant antithrombotic effect at high and low shear rates (76 +/- 11% [P = 0.05] and 57 +/- 17% [P < 0.05] of baseline values, 2 h postdosing, respectively). The inhibitory effects on TFA were similar to those on TTA. CONCLUSIONS The oral DTI ximelagatran shows antithrombotic effects under both high and low shear conditions. The antithrombotic effect of 40-80 mg ximelagatran appeared comparable to that of parenterally administered r-hirudin, which has been previously demonstrated to be clinically effective in acute coronary syndromes.
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Affiliation(s)
- T C Sarich
- Experimental Medicine, AstraZeneca LP, Wilmington, DE 19850, USA.
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Klement P, Carlsson S, Rak J, Liao P, Vlasin M, Stafford A, Johnston M, Weitz JI. The benefit-to-risk profile of melagatran is superior to that of hirudin in a rabbit arterial thrombosis prevention and bleeding model. J Thromb Haemost 2003; 1:587-94. [PMID: 12871470 DOI: 10.1046/j.1538-7836.2003.00060.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although hirudin is better than heparin at preventing recurrent ischemia in patients with unstable angina, hirudin produces more bleeding. The purpose of this study was to use a rabbit arterial thrombosis prevention and ear bleeding model to determine whether for equivalent efficacy, melagatran, a synthetic direct thrombin inhibitor, is safer than hirudin. A combination of balloon injury and stasis was used to induce thrombosis in the distal aorta, and patency and blood flow were continuously monitored with ultrasonic flow probes. Rabbits were randomized to melagatran (in total doses of 78-313 nmol kg(-1)), hirudin (in total doses of 18-107 nmol kg(-1)), or saline over 90 min. To assess safety, blood loss from standardized ear incisions was measured. Both melagatran and hirudin produced dose-dependent increases in patency and blood flow. At doses that maintained the highest levels of patency, however, melagatran produced 2-3-fold less bleeding than hirudin. Thus, at maximally effective doses, melagatran causes less bleeding than hirudin in this model. These findings raise the possibility that some direct thrombin inhibitors are safer than others.
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Affiliation(s)
- P Klement
- McMaster University and Henderson Research Center, Hamilton, Ontario, Canada
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Grill V, Dinesen B, Carlsson S, Efendic S, Pedersen O, Ostenson CG. Hyperproinsulinemia and proinsulin-to-insulin ratios in Swedish middle-aged men: association with glycemia and insulin resistance but not with family history of diabetes. Am J Epidemiol 2002; 155:834-41. [PMID: 11978587 DOI: 10.1093/aje/155.9.834] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Elevated proinsulin and proinsulin/insulin ratios are features of abnormal beta-cell function in type 2 diabetes. The participation of genetic factors is disputed. The authors wished to investigate relations between family history of diabetes on one hand and proinsulin as well as proinsulin/immunoreactive insulin ratios on the other. A large, population-based sample of Swedish men aged 35-54 years in 1992 was studied. Subjects without known diabetes were selected either to have a strong family history of diabetes (n = 1,619) or no history of the disease (n = 1,495). An oral glucose tolerance test detected 172 subjects with impaired glucose tolerance and 55 subjects with previously unknown diabetes according to World Health Organization 1985 criteria. In multiple regression analysis, fasting levels of proinsulin and proinsulin/insulin ratios were positively associated both with the 2-hour glucose level (as a continuous variable) and with obesity, whereas a negative association was found with birth weight. No association was found with family history of diabetes or with chronologic age. These findings indicate that elevated proinsulin and proinsulin/insulin ratios are secondary to increased demands on beta-cell secretion induced by hyperglycemia and insulin resistance with no discernible influence of family history of diabetes.
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Affiliation(s)
- V Grill
- Department of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
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Manjer J, Carlsson S, Elmståhl S, Gullberg B, Janzon L, Lindström M, Mattisson I, Berglund G. The Malmö Diet and Cancer Study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev 2001; 10:489-99. [PMID: 11916347 DOI: 10.1097/00008469-200112000-00003] [Citation(s) in RCA: 396] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In order to investigate potential selection bias in population-based cohort studies, participants (n = 28098) and non-participants (n = 40807) in the Malmö Diet and Cancer Study (MDCS) were compared with regard to cancer incidence and mortality. MDCS participants were also compared with participants in a mailed health survey with regard to subjective health, socio-demographic characteristics and lifestyle. Cancer incidence prior to recruitment was lower in non-participants, Cox proportional hazards analysis yielded a relative risk (RR) with a 95% confidence interval of 0.95 (0.90-1.00), compared with participants. During recruitment, cancer incidence was higher in non-participants, RR: 1.08 (1.01-1.17). Mortality was higher in non-participants both during, 3.55 (3.13-4.03), and following the recruitment period, 2.21 (2.03-2.41). The proportion reporting good health was higher in the MDCS than in the mailed health survey (where 74.6% participated), but the socio-demographic structure was similar. We conclude that mortality is higher in non-participants than in participants during recruitment and follow-up. It is also suggested that non-participants may have a lower cancer incidence prior to recruitment but a higher incidence during the recruitment period.
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Affiliation(s)
- J Manjer
- Department of Community Medicine, Lund University, Malmö University Hospital, Sweden
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