Browsing by Subject "cardiovascular risk"

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  • Mikkola, Ilona; Hagnäs, Maria; Hartsenko, Jelena; Kaila, Minna; Winell, Klas (2020)
    Aims To investigate whether the use of a personalized care plan is associated with clinical outcomes of type 2 diabetes (T2D) treatment in real-world. Methods Quality of treatment was assessed using data from a yearly sample of patients with T2D visiting primary care health centres in 2012–2016. Patients were divided into three groups: 1) patient has a copy of their personalized care plan, 2) care plan exists in the patient record only or 3) patient has no care plan. Data on smoking, laboratory tests, systolic blood pressure (sBP) and statin use were collected. We compared the outcomes between the three groups in terms of proportions of patients achieving the clinical targets recommended by international guidelines. Results Evaluable data were available for 10,403 patients. Of these, 1,711 (16%) had a copy of their personalized care plan, and 3,623 (35%) had no care plan. Those who had a copy of their care plan were significantly more likely than those without to achieve the sBP target (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.29–1.51, p
  • Svedenkrans, Jenny; Ekblom, Örjan; Domellöf, Magnus; Fellman, Vineta; Norman, Mikael; Bohlin, Kajsa (2020)
    Physical activity (PA) can prevent cardiovascular diseases. Because of increased risks of impairments affecting motor activity, PA in children born preterm may differ from that in children born at term. In this prospective cohort study, we compared objectively measured PA in 71 children born extremely preterm (
  • Kraus, W.E.; Yates, T.; Tuomilehto, J.; Sun, J.-L.; Thomas, L.; Mcmurray, J.J.V.; Bethel, M.A.; Holman, R.R. (2018)
    Objective: Physical activity is related to clinical outcomes, even after adjusting for body mass, but is rarely assessed in randomized clinical trials. Research design and methods: We conducted an observational analysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial, in which a total of 9306 people from 40 countries with impaired glucose tolerance and either cardiovascular disease or cardiovascular risk factors were randomized to receive nateglinide or placebo, in a 2-by-2 factorial design with valsartan or placebo. All were asked to also participate in a detailed lifestyle modification programme and followed-up for a median of 6.4 years with progression to diabetes as a co-primary end point. Seven-day ambulatory activity was assessed at baseline using research-grade pedometers. We assessed whether the baseline amount of physical activity was related to subsequent development of diabetes in individuals with impaired glucose tolerance. Results: Pedometer data were obtained on 7118 participants and 35.0% developed diabetes. In an unadjusted analysis each 2000-step increment in the average number of daily steps, up to 10 000, was associated with a 5.5% lower risk of progression to diabetes (HR 0.95, 95%CI 0.92 to 0.97), with >6% relative risk reduction after adjustment. Conclusions: Physical activity should be measured objectively in pharmacologic trials as it is a significant but underappreciated contributor to diabetes outcomes. It should be a regular part of clinical practice as well. © 2018 Author(s) (or their employer(s).
  • Ek, Viktoria (Helsingin yliopisto, 2018)
    Background: The metabolic syndrome predisposes for cardiovascular disease and is characterized by abdominal obesity, dyslipidemia, insulin resistance, hypertension and prothrombotic and proinflammatory states. All obese people do not, however, develop metabolic syndrome. Subcutaneous adipose tissue (SAT) hypertrophy have been linked to metabolic complications in obesity. The aim in this study was to asses if high dietary fructose consumption has an impact on SAT adipocyte size and whether adipocyte size is a metabolic determinant in obese males with metabolic syndrome. Methods: To evaluate the effects of fructose, 34 obese male subjects consumed fructose-sweetened beverages containing 75 g fructose/day for 12 weeks. Subcutaneous abdominal adipose tissue was obtained with needle aspiration technique and adipocyte sizes were measured under a light microscope. Changes in liver fat and cardiometabolic risk parameters were also analyzed. Results: Added dietary fructose intake for 12 weeks did not affect the SAT adipocyte size in subjects with obesity (P=0,417). Subjects showed increased levels of triglycerides (P=0,034) and increased liver fat content (P=0,011) after fructose intervention. Subgroups of subjects with large and small adipocytes (under or over the median value) responded differently to fructose consumption in respect of liver fat gain. Conclusion: SAT adipocyte size was not a major determinant of metabolic health in obese men with features of the metabolic syndrome. Added dietary fructose 75 g per day for 12 weeks did not result in changes in adipocyte size but subgroup of subjects showing decrease in adipocyte size during fructose intervention gained in liver fat. The inability of the SAT adipocytes to expand may play a role in development of the metabolic syndrome in these subjects.