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Matias I, Lehmann EW, Zizzari P, Byberg S, Cota D, Torekov SS, Quarta C. Endocannabinoid-related molecules predict the metabolic efficacy of GLP-1 receptor agonism in humans with obesity. J Endocrinol Invest 2024; 47:1289-1294. [PMID: 37924474 DOI: 10.1007/s40618-023-02228-8] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/13/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE N-acylethanolamines (NAEs) include endocannabinoid (EC) and EC-related molecules that impact the anti-obesity and anti-diabetic efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RA) in animal studies. However, the clinical relevance of these findings remains to be determined. Here, we tested whether GLP-1RA treatment affects circulating NAE levels and whether NAEs may predict the efficacy of GLP-1RA treatment in humans with obesity undergoing weight loss maintenance. MATERIALS AND METHODS We profiled plasma levels of NAEs in participants with obesity undergoing weight loss maintenance with (n = 23)/or without (n = 20) treatment with the GLP-1RA liraglutide. NAE levels were measured at three different time points: before the start of the study, at the end of the diet-induced weight loss, and after 52-weeks treatment. Linear regression analyses were used to investigate whether pharmacological responses could be predicted by NAEs levels. RESULTS Liraglutide treatment reduced plasma concentrations of the NAE and oleoyl-ethanolamide (OEA), without altering arachidonoyl-ethanolamide (AEA) levels and palmitoyl-ethanolamide (PEA) levels. High pre-treatment levels of OEA were predictive of superior compound-mediated effects on fasting insulin and triglyceride levels. High pre-treatment PEA and AEA levels were also predictive of superior Liraglutide-mediated effects on triglyceride levels. CONCLUSIONS Our data suggests that specific NAEs such as OEA and AEA are promising biomarkers of GLP-1RA metabolic efficacy in humans with obesity during weight loss maintenance. Plasma profiling of EC-related molecules may be a promising strategy to tailor GLP-1R-based therapies to individual needs in obesity and diabetes management.
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Affiliation(s)
- I Matias
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France
| | - E W Lehmann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - P Zizzari
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France
| | - S Byberg
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - D Cota
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France
| | - S S Torekov
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
| | - C Quarta
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France.
- INSERM U1215, Neurocentre Magendie, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France.
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Byberg S, Blond MB, Holm S, Amadid H, Nielsen LB, Clemmensen KKB, Færch K, Holst B. LEAP2 is associated with cardiometabolic markers but is unchanged by antidiabetic treatment in people with prediabetes. Am J Physiol Endocrinol Metab 2023; 325:E244-E251. [PMID: 37436962 DOI: 10.1152/ajpendo.00023.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023]
Abstract
To examine whether fasting plasma liver-expressed antimicrobial peptide 2 (FP-LEAP2) is associated with markers of cardiometabolic disease susceptibility in a cohort with prediabetes and overweight/obesity and whether antidiabetic interventions affect FP-LEAP2 levels. The analysis included 115 individuals with prediabetes [hemoglobin A1c (HbA1c) 39-47 mmol/mol, 5.7%-6.4%] and overweight/obesity [body mass index (BMI) ≥ 25 kg/m2] from a randomized controlled trial. Changes in FP-LEAP2 levels were assessed in relation to treatment with dapagliflozin (10 mg once daily), metformin (1,700 mg daily), or interval-based exercise (5 days/wk, 30 min/session) compared with control (habitual lifestyle) after 6 and 13 wk of treatment. FP-LEAP2 levels were positively associated with [standardized beta coefficient (95% CI)]: BMI 0.22 (0.03:0.41), P = 0.027; body weight 0.27 (0.06:0.48), P = 0.013; fat mass 0.2 (0.00:0.4), P = 0.048; lean mass 0.47 (0.13:0.8), P = 0.008; HbA1c 0.35 (0.17:0.53), P < 0.001; fasting plasma glucose (FPG) 0.32 (0.12:0.51), P = 0.001; fasting serum insulin 0.28 (0.09:0.47), P = 0.005; total cholesterol 0.19 (0.01:0.38), P = 0.043; triglycerides 0.31 (0.13:0.5), P < 0.001; and transaminases and fatty liver index (standardized beta coefficients 0.23-0.32), all P < 0.020. FP-LEAP2 levels were inversely associated with insulin sensitivity [-0.22 (-0.41: -0.03), P = 0.022] and kidney function [estimated glomerular filtration rate (eGFR) -0.34 (-0.56: -0.12), P = 0.003]. FP-LEAP2 levels were not associated with fat distribution or body fat percentage, fasting glucagon, postload glucose, β-cell function, or low-density lipoprotein. The interventions were not associated with changes in FP-LEAP2. FP-LEAP2 is associated with body mass, impaired insulin sensitivity, liver-specific enzymes, and kidney function. The findings highlight the importance of studying LEAP2 in obesity, type 2 diabetes, and nonalcoholic fatty liver disease. FP-LEAP2 was not affected by metformin, dapaglifloxin, or exercise in this population.NEW & NOTEWORTHY LEAP2, primarily secreted by the liver, increases with greater body mass, insulin resistance, and liver-specific enzymes in individuals with prediabetes and overweight or obesity. Fasting glucose, body mass, and alanine aminotransferase independently predict LEAP2 levels. LEAP2 is inversely linked to impaired kidney function. Elevated LEAP2 levels might indicate an increased metabolic risk, warranting further investigation into its potential involvement in glucose and body weight control.
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Affiliation(s)
- Sarah Byberg
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Bæk Blond
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Stephanie Holm
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hanan Amadid
- Department of Data Science, Novo Nordisk, Herlev, Denmark
| | | | | | - Kristine Færch
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Birgitte Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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3
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Gradel AKJ, Holm SK, Byberg S, Merkestein M, Hogendorf WFJ, Lund ML, Buijink JA, Damgaard J, Lykkesfeldt J, Holst B. The dietary regulation of LEAP2 depends on meal composition in mice. FASEB J 2023; 37:e22923. [PMID: 37104087 DOI: 10.1096/fj.202201828r] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/03/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023]
Abstract
Ghrelin represents a key hormone regulating energy balance. Upon activation of the growth hormone secretagogue receptor (GHSR), ghrelin increases blood glucose levels, food intake, and promotes weight gain. The liver-expressed antimicrobial peptide 2 (LEAP2) acts as an endogenous antagonist of the GHSR. While the regulation of LEAP2 and its effect on the GHSR likely occur in an opposite pattern to that of ghrelin, the dietary regulation of LEAP2 remains to be described. We, therefore, examined the regulation of LEAP2 by different acute meal challenges (glucose, mixed meal, olive, lard, and fish oil) and diets (chow vs. high-fat) in C57BL/6 male mice. In addition, the effect of specific fatty acids (oleic, docosahexaenoic, and linoleic acid) on LEAP2 was assessed in murine intestinal organoids. While only mixed meal increased liver Leap2 expression, all meal challenges except fish oil increased jejunal Leap2 expression compared to water. Leap2 expression correlated with levels of hepatic glycogen and jejunal lipids. Lipid versus water dosing increased LEAP2 levels in the systemic circulation and portal vein where fish oil was associated with the smallest increase. In line with this, oleic acid, but not docosahexaenoic acid increased Leap2 expression in intestinal organoids. Feeding mice with high-fat versus chow diet not only increased plasma LEAP2 levels, but also the increment in plasma LEAP2 upon dosing with olive oil versus water. Taken together, these results show that LEAP2 is regulated by meal ingestion in both the small intestine and the liver according to the meal/diet of interest and local energy stores.
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Affiliation(s)
- Anna Katrina Jógvansdóttir Gradel
- Department of Biomedical Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Section for Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Global Drug Discovery, Novo Nordisk A/S, Måløv, Denmark
| | - Stephanie K Holm
- Department of Biomedical Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sarah Byberg
- Department of Biomedical Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Mari Lilith Lund
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesse Arnold Buijink
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Jens Lykkesfeldt
- Section for Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Holst
- Department of Biomedical Sciences, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Holm SK, Vestergaard ET, Zubanovic NB, Byberg S, Clemmensen C, Holst B, Thomsen HH. Ketone monoester increases circulating levels of LEAP2 and decreases appetite in healthy men. Diabetes Obes Metab 2023. [PMID: 36867127 DOI: 10.1111/dom.15044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/18/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Stephanie Kjaerulff Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Sarah Byberg
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christoffer Clemmensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Klose M, Huynh K, Krogsgaard K, Drejer J, Pharm D, Byberg S, Madsbad S, Magkos F, Researcher S, Aharaz A, Edsberg B, Tfelt J, Astrup A, Feldt-Rasmussen U. ODP350 Safety and Efficacy of Tesomet over 48 Weeks of Treatment: Results From a 24-Week Phase 2, Randomized, Double-Blind Study With 24 Week Open-Label Extension in Adults With Hypothalamic Obesity. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Objective
To assess the safety and efficacy of Tesomet (tesofensine plus metoprolol) in adults with hypothalamic obesity, a rare disease with no approved therapy.
Research Design and Methods
Twenty-one adults with hypothalamic obesity (16 females, 5 males) were randomized to Tesomet (0.5 mg tesofensine/50 mg metoprolol) (n=14) or placebo (n=8) during a 24-week double-blind period. On completion of the double-blind period, 17 (81%) subjects (11 Tesomet; 6 placebo) entered in to a 24-week open-label extension period and were treated with Tesomet. The primary endpoint was safety while secondary endpoints included measures of body weight, waist circumference, and body composition. Trial NCT03845075.
Results
The most common adverse events following the 24-week double-blind period and the 24-week open-label extension period were sleep disorder, dizziness, dry mouth, and headache; the majority of these adverse events were mild to moderate in severity. No significant nor clinically meaningful changes in heart rate or blood pressure were observed during the study. On completion of the double-blind period mean change in body weight (kg) was -7.84 for the Tesomet group versus -0.34 kg for the placebo group (P=0. 03). At the end of the open-label extension period mean change in body weight (kg) from baseline was -6.34 for the Tesomet-Tesomet group and -6. 03 for the placebo-Tesomet group. On completion of the double-blind period mean change in waist circumference (cm) was -7. 09 cm for the Tesomet group versus -1.16 for the placebo group (P=NS). At the end of the open-label extension period mean change in waist circumference (cm) from baseline was -5.73 for the Tesomet-Tesomet group and -3. 04 for the placebo-Tesomet group. On completion of the double-blind period mean change in fat mass (kg) was -5.28 for the Tesomet group versus -1.11 for the placebo group (P=NS). At the end of the open-label extension period mean change in fat mass (kg) from baseline was -4.84 for the Tesomet-Tesomet group and -3.85 for the placebo-Tesomet group. On completion of the double-blind period mean change in lean tissue mass (kg) was -2.76 for the Tesomet group versus 0.36 for the placebo group (P<0. 01). At the end of the open-label extension period mean change in lean mass (kg) from baseline was -1.64 for the Tesomet-Tesomet group and -2.22 for the placebo-Tesomet group.
Discussion
Tesomet was generally well tolerated after 48 weeks treatment and resulted in clinically meaningful improvements in body weight and body composition measures in adults with hypothalamic obesity. In contrast to previous studies of tesofensine monotherapy in general obesity, no significant nor clinically meaningful changes in cardiovascular measures were observed during the study.
Conclusion
Tesomet is a promising new experimental treatment for hypothalamic obesity. A randomized, placebo controlled, multi-center, dose-finding, Phase 2b study has now been initiated.
Presentation: No date and time listed
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Huynh K, Klose M, Krogsgaard K, Drejer J, Byberg S, Madsbad S, Magkos F, Aharaz A, Edsberg B, Tfelt-Hansen J, Astrup AV, Feldt-Rasmussen U. Randomized controlled trial of Tesomet for weight loss in hypothalamic obesity. Eur J Endocrinol 2022; 186:687-700. [PMID: 35294397 PMCID: PMC9175551 DOI: 10.1530/eje-21-0972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/16/2022] [Indexed: 11/21/2022]
Abstract
CONTEXT Hypothalamic injury often leads to rapid, intractable weight gain causing hypothalamic obesity, which is associated with increased risk of cardiovascular and metabolic morbidity and mortality. There are no approved or effective pharmacological treatments for hypothalamic obesity, and conventional lifestyle management remains ineffective. OBJECTIVE To investigate the safety and efficacy of Tesomet (0.5 mg tesofensine/50 mg metoprolol) in adults with hypothalamic obesity. METHODS Twenty-one adults with hypothalamic obesity (16 females) were randomized to Tesomet (0.5 mg/50 mg) or placebo for 24 weeks. Patients also received diet/lifestyle counselling. The primary endpoint was safety; secondary endpoints included measures of body weight, appetite scores, quality of life, and metabolic profile. RESULTS Eighteen patients completed 24 weeks. Consent withdrawal, eligibility, and serious adverse events (SAE) unrelated to treatment resulted in dropouts. One patient experienced a Tesomet-related SAE of exacerbated pre-existing anxiety leading to treatment discontinuation. Tesomet-related adverse events were otherwise mostly mild and included sleep disturbances (Tesomet 50%, placebo 13%), dry mouth (Tesomet 43%, placebo 0%), and headache (Tesomet 36%, placebo 0%). No significant differences in heart rate or blood pressure were observed between groups. Compared to placebo, Tesomet resulted in additional mean (95% CI) weight change of -6.3% ((-11.3; -1.3); P = 0.017), increased the number of patients achieving ≥5% weight loss (Tesomet 8/13, placebo 1/8; P = 0.046), and tended to augment the reduction in waist circumference by 5.7 cm ((-0.1; 11.5); P = 0.054). CONCLUSION Tesomet was welltolerated, did not affect heart rate or blood pressure, and resulted in significant reductions in body weight compared to placebo in adults with hypothalamic obesity.
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Affiliation(s)
- Kim Huynh
- Department of Medical Endocrinology and Metabolism PE 2131/2, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Marianne Klose
- Department of Medical Endocrinology and Metabolism PE 2131/2, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | | | | | - Sarah Byberg
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre University Hospital, University of Copenhagen, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen, Copenhagen N, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Frederiksberg C, Denmark
| | | | | | - Jacob Tfelt-Hansen
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Arne Vernon Astrup
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Frederiksberg C, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism PE 2131/2, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen, Copenhagen N, Denmark
- Correspondence should be addressed to U Feldt-Rasmussen;
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Hagemann CA, Jensen MS, Holm S, Gasbjerg LS, Byberg S, Skov-Jeppesen K, Hartmann B, Holst JJ, Dela F, Vilsbøll T, Christensen MB, Holst B, Knop FK. LEAP2 reduces postprandial glucose excursions and ad libitum food intake in healthy men. Cell Rep Med 2022; 3:100582. [PMID: 35492241 PMCID: PMC9043997 DOI: 10.1016/j.xcrm.2022.100582] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/24/2022] [Accepted: 02/28/2022] [Indexed: 12/12/2022]
Abstract
The gastric hormone ghrelin stimulates food intake and increases plasma glucose through activation of the growth hormone secretagogue receptor (GHSR). Liver-expressed antimicrobial peptide 2 (LEAP2) has been proposed to inhibit actions of ghrelin through inverse effects on GHSR activity. Here, we investigate the effects of exogenous LEAP2 on postprandial glucose metabolism and ad libitum food intake in a randomized, double-blind, placebo-controlled, crossover trial of 20 healthy men. We report that LEAP2 infusion lowers postprandial plasma glucose and growth hormone concentrations and decreases food intake during an ad libitum meal test. In wild-type mice, plasma glucose and food intake are reduced by LEAP2 dosing, but not in GHSR-null mice, pointing to GHSR as a potential mediator of LEAP2’s glucoregulatory and appetite-suppressing effects in mice. Exogenous LEAP2 lowers postprandial plasma glucose excursions Exogenous LEAP2 suppresses ad libitum food intake During fasting, exogenous LEAP2 increases insulin secretion and suppresses lipolysis The GHSR is required for eliciting LEAP2 effects in mice
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Affiliation(s)
- Christoffer A Hagemann
- Center for Clinical Metabolic Research, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Gubra, Hørsholm, Denmark
| | - Malene S Jensen
- Center for Clinical Metabolic Research, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - Stephanie Holm
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lærke S Gasbjerg
- Center for Clinical Metabolic Research, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sarah Byberg
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kirsa Skov-Jeppesen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bolette Hartmann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Dela
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Vilsbøll
- Center for Clinical Metabolic Research, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Mikkel B Christensen
- Center for Clinical Metabolic Research, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Birgitte Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Filip K Knop
- Center for Clinical Metabolic Research, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Steno Diabetes Center Copenhagen, Gentofte, Denmark.
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8
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Huynh KD, Klose MC, Krogsgaard K, Drejer J, Byberg S, Madsbad S, Magkos F, Aharaz A, Edsberg B, Tfelt-Hansen J, Astrup A, Feldt-Rasmussen U. Weight Loss, Improved Body Composition and Fat Distribution by Tesomet in Acquired Hypothalamic Obesity. J Endocr Soc 2021. [PMCID: PMC8089137 DOI: 10.1210/jendso/bvab048.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background: Structural damage to the hypothalamus often results in hypothalamic obesity characterized by rapid and severe weight-gain with increased risk of cardiovascular and metabolic morbidity and mortality. Currently, there are no approved or effective pharmacological treatments and conventional weight management remains largely ineffective. Objective: This RCT investigated safety and efficacy of Tesomet (co-administration of 0.5mg tesofensine and 50mg metoprolol) in hypopituitary patients with acquired hypothalamic obesity. Methods: Twenty-one (16 females) hypopituitary adults with hypothalamic obesity were randomized to Tesomet or placebo (2:1) for 24 weeks (NCT03845075). Subjects also received diet and lifestyle counselling. Primary endpoint was safety evaluated by change in heart rate, blood pressure and adverse events. Secondary endpoints included changes in anthropometric measures, body composition, corrected QT-interval and arrythmias. Results: Subjects had a median (range) age of 50 (25; 70) years and 90% had a BMI ≥30 kg/m2. Almost half (48%) had a history of craniopharyngioma, 86% had undergone pituitary/hypothalamic surgery, and 52% had irradiation therapy. All received one or more anterior pituitary hormone replacements; 52% had diabetes insipidus. In total, 18/21 subjects completed the study, one without investigational treatment. Three serious adverse events (SAE) were recorded in 2 subjects randomized to Tesomet. Adverse events were otherwise mostly mild (58%), frequently reported were sleep disturbances (62%), dry mouth (46%) and dizziness (46%), known side effects of tesofensine or metoprolol. Four subjects, two in each group, discontinued treatment. Tesomet discontinuation was secondary to anxiety (n=1) or dry mouth (n=1). No significant differences in heart rate or blood pressure were observed between the two groups. At week 24, compared to placebo (weight-loss: -0.3%), Tesomet treatment resulted in additional mean weight-loss of -6.3% (95CI [-11.3%; -1.3%], p=0.017); increase in the proportion of patients achieving >5% reduction in body weight (Tesomet 8; Placebo 1, OR 11.2 [1.0; 120.4], p=0.046); and reduction in waist circumference of -5.7cm ([-11.5; 0.1], p=0.054). Tesomet-induced weight loss was primarily correlated to a reduction in mean (SD) fat mass -5.3kg (5.3) (r2=0.9, P=0001) and to lesser extent a reduction in lean tissue mass -2.9kg (1.9) (r2=0.4, P=0.03). Treatment did not affect corrected QT-interval; mean change from placebo was -1.1ms (95CI [-16.0; 13.9], p=0.882), nor were arrythmias registered during the trial period. Conclusions: Tesomet was generally well-tolerated, did not affect heart rate, blood pressure or QTc-interval, and resulted in significant reductions in body weight compared to placebo in this cohort of hypopituitary patients with acquired hypothalamic obesity.
The study was sponsored by Saniona A/S
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Affiliation(s)
- Kim D Huynh
- University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Sarah Byberg
- Department of Biomedical Sciences, University of Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen,, Frederiksberg, Denmark
| | | | | | - Jacob Tfelt-Hansen
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Frederiksberg, Denmark
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Byberg S, Futtrup J, Andreassen M, Krogh J. Metabolic effects of dopamine agonists in patients with prolactinomas: a systematic review and meta-analysis. Endocr Connect 2019; 8:1395-1404. [PMID: 31518995 PMCID: PMC6826167 DOI: 10.1530/ec-19-0286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 09/13/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Recent large cohort studies suggest an association between high plasma prolactin and cardiovascular mortality. The objective of this systematic review was to systematically assess the effect of reducing prolactin with dopamine agonist on established cardiovascular risk factors in patients with prolactinomas. DESIGN Bibliographical search was done until February 2019 searching the following databases: PubMed, EMBASE, WHO and LILAC. Eligible studies had to include participants with verified prolactinomas where metabolic variables were assessed before and after at least 2 weeks treatment with dopamine agonists. METHODS Baseline data and outcomes were independently collected by two investigators. The study was registered with PROSPERO (registration number CRD42016046525). RESULTS Fourteen observational studies enrolling 387 participants were included. The pooled standardized mean difference of the primary outcome revealed a reduction of BMI and weight of -0.21 (95% CI -0.37 to -0.05; P = 0.01; I2 = 71%), after treatment. Subgroup analysis suggested that the reduction of weight was primarily driven by studies with high prolactin levels at baseline (P = 0.04). Secondary outcomes suggested a small decrease in waist circumference, a small-to-moderate decrease in triglycerides, fasting glucose levels, HOMA-IR, HbA1c and hsCRP, and a moderate decrease in LDL, total cholesterol and insulin. CONCLUSION This systematic review suggests a reduction of weight as well as an improved lipid profile and glucose tolerance after treatment with dopamine agonist in patients with prolactinomas. These data are based on low-quality evidence.
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Affiliation(s)
- Sarah Byberg
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
- Correspondence should be addressed to S Byberg:
| | - Jesper Futtrup
- Panum Institute, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Andreassen
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jesper Krogh
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
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10
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Hovmand N, Byberg S, Larsen MB, Podlekareva D, Buck DL, Hansen BR. Necrotizing fasciitis and meningitis due to Streptococcus pneumoniae serotype 9 N: a case report. BMC Infect Dis 2019; 19:358. [PMID: 31035964 PMCID: PMC6489194 DOI: 10.1186/s12879-019-3969-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022] Open
Abstract
Background Necrotizing fasciitis is a deep infection of the fascia and subcutaneous tissue with a high mortality rate. Meningitis is an infection of the membranes surrounding the brain with a likewise high mortality rate. Streptococcus pneumoniae is the most frequent cause of bacterial meningitis and it is an extremely rare cause of necrotizing fasciitis. Different subcapsular serotypes of S. pneumoniae are known to have diverse virulence. The serotype 9 N is associated with a high risk of death. Case presentation We report a case of a previously healthy 68-year-old female who presented at our clinic with complaints of pain in her left calf since having experienced a very painful leg cramp 3 weeks prior. Within a few hours after admission, she developed fever, neck stiffness and an altered mental state. Concurrently, the pain in her leg worsened. Upon further examination it was found that she suffered from both meningitis and necrotizing fasciitis due to S. pneumoniae, serotype 9 N. The patient survived and avoided leg amputation. Conclusions The patient suffered from two very lethal infections simultaneously. Both of them were caused by S. pneumoniae. We believe that her favorable outcome was, a result of prompt surgical intervention and appropriate antibiotic treatment. Our case underlines the importance of continuous reevaluation of the symptoms and clinical findings in patients with unclear causes of severe illness, especially if the patient’s condition changes.
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Affiliation(s)
- Nichlas Hovmand
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Sarah Byberg
- Department of Endocrinology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Morten Bo Larsen
- Department of Orthopedics, Copenhagen University Hospital, Hvidovre, Denmark
| | - Daria Podlekareva
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - David Levarett Buck
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Birgitte Rønde Hansen
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
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11
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Byberg S, Abrahamsen B, Kassem M, Ralston S, Schwarz P. Clinical improvement in a patient with monostotic melorheostosis after treatment with denosumab: a case report. J Med Case Rep 2018; 12:278. [PMID: 30257703 PMCID: PMC6158818 DOI: 10.1186/s13256-018-1820-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022] Open
Abstract
Background A 20-year-old Danish woman with melorheostosis in her right femoral shaft and disabling pain in the affected area, whose symptoms did not in the long term respond to zoledronic acid, experienced continuous remission of pain after treatment with denosumab. To the best of our knowledge, this is the first case report on denosumab treatment for melorheostosis. Case presentation Radiologic findings and bone biopsy showed irregular cortical hyperostosis in the right femoral shaft with increased tracer uptake on Tc99-bone scan. The diagnosis of melorheostosis was made based on the radiological findings. There was a good initial response to zoledronic acid administration, but after relapse of pain, the second and third administrations had a poor effect. As a second line of treatment denosumab was administered at 8-week intervals, the frequency was based on our patient’s symptoms and on biochemical markers of bone turnover. Conclusion This is the first report indicating that denosumab has a place in the treatment of melorheostosis when the effect of bisphosphonate treatment is insufficient.
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Affiliation(s)
- Sarah Byberg
- Department of Endocrinology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Bo Abrahamsen
- Department of Medicine, Holbæk Hospital, Denmark and OPEN, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Moustapha Kassem
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Stuart Ralston
- Rheumatology and Bone Diseases Unit, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - Peter Schwarz
- Department of Endocrinology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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Patsche CB, Rudolf F, Mogensen SW, Sifna A, Gomes VF, Byberg S, Wejse C. Low prevalence of malnourishment among household contacts of patients with tuberculosis in Guinea-Bissau. Int J Tuberc Lung Dis 2018; 21:664-669. [PMID: 28482961 DOI: 10.5588/ijtld.16.0673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING An urban demographic surveillance site in Bissau, the capital of Guinea-Bissau, West Africa.BACKGROUND We hypothesised that if previous malnutrition plays a part in acquiring active tuberculosis (TB) disease, households of TB cases would have a higher prevalence of malnutrition than those of healthy controls. DESIGN A cross-sectional study comparing nutritional and socio-economic status of all newly diagnosed patients with TB in 2014 with household contacts (persons residing in the household of TB cases) and random controls. Exclusion criteria were extra-pulmonary TB, age <15 years and pregnancy. RESULTS Prevalence of malnutrition was 5% in household contacts and healthy controls, and 51% in patients with TB. Patients with TB had 22% (95%CI 19-25) lower body weight, 22% (95%CI 20-25) lower body mass index and 22% (95%CI 19-24) lower mid-upper arm circumference than healthy controls (P < 0.001); household contacts and healthy controls were comparable for all measures. The socio-economic status of households with TB cases was lower. CONCLUSIONS We did not find a higher prevalence of malnourishment in households with TB cases. This finding did not support the hypothesis that malnourishment was an important causative factor for the development of active TB among patients in this study.
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Affiliation(s)
- C B Patsche
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark, The Bandim Health Project, Bissau, Guinea-Bissau
| | - F Rudolf
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark, The Bandim Health Project, Bissau, Guinea-Bissau
| | - S W Mogensen
- The Bandim Health Project, Bissau, Guinea-Bissau
| | - A Sifna
- The Bandim Health Project, Bissau, Guinea-Bissau
| | - V F Gomes
- The Bandim Health Project, Bissau, Guinea-Bissau
| | - S Byberg
- The Bandim Health Project, Bissau, Guinea-Bissau, Research Center for Vitamins and Vaccines, The Bandim Health Project, Statens Serum Institut, Copenhagen, Odense Patient Data Explorative Network, Institute of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense
| | - C Wejse
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark, The Bandim Health Project, Bissau, Guinea-Bissau, Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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13
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Rasmussen SM, Biering-Sørensen S, Byberg S, Andersen A, Bjerregaard-Andersen M, Rodrigues A, Benn CS, Martins CL, Aaby P. The effect of early measles vaccination at 4.5 months of age on growth at 9 and 24 months of age in a randomized trial in Guinea-Bissau. BMC Pediatr 2016; 16:199. [PMID: 27912735 PMCID: PMC5135799 DOI: 10.1186/s12887-016-0738-z] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/26/2016] [Indexed: 11/23/2022] Open
Abstract
Background Providing an early, additional measles vaccine (MV) at 4.5 months of age has been shown to reduce child mortality in low-income countries. We studied the effects on growth at 9 and 24 months of age. Methods A randomized controlled trial was conducted in Guinea-Bissau from 2003–2007 including 6,648 children. Children were randomized 1:1:1 to receive Edmonston-Zagreb measles vaccine at 4.5 and 9 months of age (group A), no vaccine at 4.5 months and Edmonston-Zagreb measles vaccine at 9 months (group B), or no vaccine at 4.5 months and Schwarz measles vaccine at 9 months (group C) Data on anthropometrics were obtained at enrolment at 4.5 months of age and again at 9 and 24 months of age. Analyses were stratified by sex, season of enrolment, and neonatal vitamin A supplementation (NVAS) status, as all these factors have been shown to modify the effect of early MV on mortality. Results Overall there was no effect of early MV on anthropometry at 9 months. At 24 months children who had received early MV had a significantly larger mid-upper-arm-circumference (MUAC/in cm) (Difference = 0.08; 95% CI (0.02;0.14)) compared with children in the control group; this effect was most pronounced among girls (0.12 (0.03;0.20)). The effect of early MV on MUAC remained significant in the dry season and in girls who received placebo rather than NVAS. Conclusion Early MV was associated with a larger MUAC particularly in girls. These results indicate that a two-dose measles vaccination schedule might not only reduce child mortality but also improve growth. Trial registration ClinicalTrials.gov NCT00168558. Registered September 9, 2005, retrospectively registered Electronic supplementary material The online version of this article (doi:10.1186/s12887-016-0738-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S M Rasmussen
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - S Biering-Sørensen
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - S Byberg
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark.,OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A Andersen
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - M Bjerregaard-Andersen
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark.,Department of Endocrinology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A Rodrigues
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau
| | - C S Benn
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau. .,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark. .,OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - C L Martins
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau
| | - P Aaby
- Bandim Health Project, Indepth Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.,Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
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14
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Byberg S, Thysen SM, Rodrigues A, Martins C, Cabral C, Careme M, Aaby P, Benn CS, Fisker AB. A general measles vaccination campaign in urban Guinea-Bissau: Comparing child mortality among participants and non-participants. Vaccine 2016; 35:33-39. [PMID: 27890397 DOI: 10.1016/j.vaccine.2016.11.049] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 08/09/2016] [Revised: 11/11/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Measles vaccination campaigns targeting children aged 9-59months are conducted every three years in Guinea-Bissau. Studies have demonstrated beneficial non-specific effects of measles vaccine. We compared mortality one year after the December 2012 measles vaccination campaign in Bissau city for children who received campaign measles vaccine with children who did not receive campaign measles vaccine. METHODS Field workers from Bandim Health Project registered all children living in the Bandim Health Project's study area who received measles vaccination at the campaign posts. Children not seen during the campaign were visited at home and campaign participation status was assessed. We compared mortality rates of participants vs. non-participants in Cox regression models. RESULTS 5633 children aged 9-59months (85%) received campaign measles vaccination and 1006 (15%) did not. During the subsequent year 16 children died. Adjusted for background factors, the hazard ratio (HR) comparing measles vaccinated versus unvaccinated was 0.28 (95% CI: 0.10-0.77). The benefit was larger for girls (HR: 0.17 (0.05-0.59)) and for children who had received routine measles vaccine before the campaign (HR: 0.15 (0.04-0.63)). CONCLUSIONS We found indications of strong beneficial non-specific effects of receiving measles vaccine during the 2012 campaign, especially for girls and children with previous routine measles vaccination. Measles vaccination campaigns may be an effective way of improving child survival.
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Affiliation(s)
- S Byberg
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.
| | - S M Thysen
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; Department of Public Health, Centre for Global Health, Aarhus University, 8000 Aarhus C, Denmark
| | - A Rodrigues
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau
| | - C Martins
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau
| | - C Cabral
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau
| | - M Careme
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau
| | - P Aaby
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark
| | - C S Benn
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - A B Fisker
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Bandim Health Project, Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
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15
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Kristiansen M, Byberg S, Agyemang C, Norredam M. Dementia burden among migrants in Denmark compared with Danish-born: a register-based cohort study. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.032] [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: 11/14/2022] Open
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Byberg S, Fisker AB, Rodrigues A, Balde I, Enemark U, Aaby P, Benn CS, Griffiths UK. Household experience and costs of seeking measles vaccination in rural Guinea-Bissau. Trop Med Int Health 2016; 22:12-20. [DOI: 10.1111/tmi.12793] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S. Byberg
- Bandim Health Project; Indepth Network; Bissau Guinea-Bissau
- Bandim Health Project; Research Center for Vitamins and Vaccines; Statens Serum Institut; Copenhagen S Denmark
- Odense Patient data Explorative Network; University of Southern Denmark; Odense Denmark
| | - A. B. Fisker
- Bandim Health Project; Indepth Network; Bissau Guinea-Bissau
- Bandim Health Project; Research Center for Vitamins and Vaccines; Statens Serum Institut; Copenhagen S Denmark
- Odense Patient data Explorative Network; University of Southern Denmark; Odense Denmark
| | - A. Rodrigues
- Bandim Health Project; Indepth Network; Bissau Guinea-Bissau
| | - I. Balde
- Bandim Health Project; Indepth Network; Bissau Guinea-Bissau
| | - U. Enemark
- Centre for Global Health; Department of Public Health; Aarhus University; Aarhus Denmark
| | - P. Aaby
- Bandim Health Project; Indepth Network; Bissau Guinea-Bissau
- Bandim Health Project; Research Center for Vitamins and Vaccines; Statens Serum Institut; Copenhagen S Denmark
| | - C. S. Benn
- Bandim Health Project; Indepth Network; Bissau Guinea-Bissau
- Bandim Health Project; Research Center for Vitamins and Vaccines; Statens Serum Institut; Copenhagen S Denmark
- Odense Patient data Explorative Network; University of Southern Denmark; Odense Denmark
| | - U. K. Griffiths
- Department of Global Health and Development; London School of Hygiene and Tropical Medicine; London UK
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Frankel H, Byberg S, Bjerregaard-Andersen M, Martins CL, Aaby P, Benn CS, Fisker AB. Different effects of BCG strains - A natural experiment evaluating the impact of the Danish and the Russian BCG strains on morbidity and scar formation in Guinea-Bissau. Vaccine 2016; 34:4586-4593. [PMID: 27491688 DOI: 10.1016/j.vaccine.2016.07.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 04/09/2016] [Revised: 07/04/2016] [Accepted: 07/15/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Different Bacillus Calmette-Guerin (BCG) vaccine strains may have different non-specific effects. We assessed the effect of two BCG strains (Danish and Russian) on childhood morbidity and BCG scarification in Guinea-Bissau. METHODS During 2011-2013, infants in the Bandim Health Project's urban study area received the Danish or Russian BCG in a natural experiment. Health center consultations were registered at point of care and scar status and size at age 4½ months. We assessed the effect of strain on consultation rates between vaccination and age 45days in Cox proportional hazards models. Scar prevalence and size were compared using binomial regression and ranksum tests. RESULTS Among 1206 children, 18% received Danish BCG (n=215) and 82% Russian BCG (n=991). The adjusted hazard ratio (aHR) for consultations was 0.94 (95% CI 0.60-1.46) for Danish BCG compared with Russian BCG. Girls vaccinated with Danish BCG tended to have lower consultation rates compared with girls vaccinated with Russian BCG (aHR 0.56 (0.25-1.24)), whereas the effect was opposite for boys (aHR 1.24 (0.74-2.11)), p=0.09. Children vaccinated with Danish BCG were more likely to develop a scar (97%) than children vaccinated with Russian BCG (87%), the relative risk (RR) being 1.11 (1.06-1.16). The effect was stronger in girls, and BCG scar size was larger among infants vaccinated with the Danish strain. CONCLUSION BCG strain influences scar prevalence and scar size, and may have sex differential effects on morbidity. BCG strains are currently used interchangeably, but BCG scarring has been linked to subsequent survival. Hence, more research into the health effects of different BCG strains is warranted. Small adjustments of BCG production could potentially lower childhood morbidity and mortality at low cost.
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Affiliation(s)
- H Frankel
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - S Byberg
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - M Bjerregaard-Andersen
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; Department of Endocrinology, Odense University Hospital, Odense, Denmark.
| | - C L Martins
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau.
| | - P Aaby
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - C S Benn
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - A B Fisker
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Aage S, Kiraly N, Da Costa K, Byberg S, Bjerregaard-Andersen M, Fisker AB, Aaby P, Benn CS. Neonatal vitamin A supplementation associated with increased atopy in girls. Allergy 2015; 70:985-94. [PMID: 25939706 DOI: 10.1111/all.12641] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neonatal vitamin A supplementation (NVAS) is currently being considered as policy in countries at risk of deficiency. A previous study suggested that NVAS may be associated with increased atopy. We examined the effect of NVAS on atopy by conducting long-term follow-up of a previous randomized controlled trial in Guinea-Bissau. METHODS In 2002-2004, we randomized 4345 normal birthweight neonates to NVAS (50 000 IU retinyl palmitate) or placebo together with their Bacillus Calmette-Guérin vaccination. In 2013, we visited the 1692 (39%) children now aged 8-10 years who were still living in the study area, and 1478 (87%) were found at home. Provided consent, a skin prick test was performed, and history of allergic symptoms was recorded. Associations of NVAS and atopy (defined as skin prick test reaction of ≥3 mm) were analysed using binomial regression. RESULTS Of the 1430 children with a valid skin prick test, 228 (16%) were positive (more boys (20%) than girls (12%), P-value < 0.0001). NVAS did not increase the overall risk of atopy (RR 1.10 [95% CI 0.87-1.40]). However, NVAS was associated with significantly increased risk among females (RR 1.78 [1.17-2.72]) but not among males (0.86 [0.64-1.15], P-value for interaction between NVAS and gender = 0.005). Furthermore, NVAS was associated with increased risk of wheezing among females (RR 1.80 [1.03-3.17], but not among males, P-value for interaction = 0.05). CONCLUSION The study corroborated previous observations; NVAS was associated with increased risk of atopy and wheezing, in this study only among females. Further studies on NVAS and atopy are warranted.
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Affiliation(s)
- S. Aage
- Bandim Health Project; Bissau Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA); Statens Serum Institut; Copenhagen S Denmark
| | - N. Kiraly
- Gastro and Food Allergy Research Group; Murdoch Children's Research Institute; Parkville Vic. Australia
| | | | - S. Byberg
- Bandim Health Project; Bissau Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA); Statens Serum Institut; Copenhagen S Denmark
- OPEN, Institute of Clinical Research; University of Southern Denmark/Odense University Hospital; Odense C Denmark
| | - M. Bjerregaard-Andersen
- Bandim Health Project; Bissau Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA); Statens Serum Institut; Copenhagen S Denmark
| | - A. B. Fisker
- Bandim Health Project; Bissau Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA); Statens Serum Institut; Copenhagen S Denmark
| | - P. Aaby
- Bandim Health Project; Bissau Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA); Statens Serum Institut; Copenhagen S Denmark
| | - C. S. Benn
- Bandim Health Project; Bissau Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA); Statens Serum Institut; Copenhagen S Denmark
- OPEN, Institute of Clinical Research; University of Southern Denmark/Odense University Hospital; Odense C Denmark
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Byberg S, Krasnik A, Norredam M. Disease burden among refugees and immigrants in Denmark compared with Danish-born. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.315] [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: 11/12/2022] Open
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Norredam M, Hoejbjerg Hansen O, Holm Pedersen J, Byberg S, Krasnik A, Agyemang C, Kunst AE. Exploring disease trajectories according to migrant status – does the ‘healthy migrant effect’ last? Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.211] [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: 11/14/2022] Open
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Byberg S, Hansen ALS, Christensen DL, Vistisen D, Aadahl M, Linneberg A, Witte DR. Sleep duration and sleep quality are associated differently with alterations of glucose homeostasis. Diabet Med 2012; 29:e354-60. [PMID: 22587629 DOI: 10.1111/j.1464-5491.2012.03711.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [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: 12/17/2022]
Abstract
AIMS Studies suggest that inadequate sleep duration and poor sleep quality increase the risk of impaired glucose regulation and diabetes. However, associations with specific markers of glucose homeostasis are less well explained. The objective of this study was to explore possible associations of sleep duration and sleep quality with markers of glucose homeostasis and glucose tolerance status in a healthy population-based study sample. METHODS The study comprised 771 participants from the Danish, population-based cross-sectional 'Health2008' study. Sleep duration and sleep quality were measured by self-report. Markers of glucose homeostasis were derived from a 3-point oral glucose tolerance test and included fasting plasma glucose, 2-h plasma glucose, HbA(1c), two measures of insulin sensitivity (the insulin sensitivity index(0,120) and homeostasis model assessment of insulin sensitivity), the homeostasis model assessment of β-cell function and glucose tolerance status. Associations of sleep duration and sleep quality with markers of glucose homeostasis and tolerance were analysed by multiple linear and logistic regression. RESULTS A 1-h increment in sleep duration was associated with a 0.3 mmol/mol (0.3%) decrement in HbA(1c) and a 25% reduction in the risk of having impaired glucose regulation. Further, a 1-point increment in sleep quality was associated with a 2% increase in both the insulin sensitivity index(0,120) and homeostasis model assessment of insulin sensitivity, as well as a 1% decrease in homeostasis model assessment of β-cell function. CONCLUSIONS In the present study, shorter sleep duration was mainly associated with later alterations in glucose homeostasis, whereas poorer sleep quality was mainly associated with earlier alterations in glucose homeostasis. Thus, adopting healthy sleep habits may benefit glucose metabolism in healthy populations.
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Affiliation(s)
- S Byberg
- Steno Diabetes Center A/S, Gentofte.
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