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Biomedical subjects

J Viikari

Publications and source records attributed to J Viikari.

At least 91 records · Page 5Linked to original sources
PubMed1997

Intake and indicators of iron and zinc status in children consuming diets low in saturated fat and cholesterol: the STRIP baby study. Special Turku Coronary Risk Factor Intervention Project for Babies.

A low-fat diet may predispose children to low meat consumption, low iron intake, and iron deficiency. In the randomized prospective Special Turku Coronary Risk Factor Intervention Project for Babies (STRIP baby study), families of 540 children were counseled to reduce exposure of children > 7 mo of age to known environmental risk factors for coronary heart disease. The control group consisted of 522 children whose families received no specific counseling concerning dietary fat. Iron and zinc intakes of 79 children aged 3-4 y (40 in the intervention group and 39 in the control group) were assessed with 4-d food records. The children in the intervention group consumed less saturated fat than those in the control group and had continuously higher ratios of dietary polyunsaturated to saturated fatty acids. Mean (+/- SD) daily iron intakes in the intervention and control groups were 8.8 +/- 4.2 mg and 8.6 +/- 2.8 mg, respectively. Laboratory findings in the intervention and control groups, respectively, were as follows: hemoglobin, 123 +/- 8 and 122 +/- 7 g/L; mean cell volume, 81.8 +/- 2.9 and 81.7 +/- 3.2 fL; mean corpuscular hemoglobin, 28.1 +/- 1.3 and 27.8 +/- 1.4 pg; ferritin, 21.8 +/- 11.6 and 19.2 +/- 12.4 microg/L; transferrin, 2.90 +/- 0.30 and 2.85 +/- 0.29 g/L; and transferrin receptor, 2.34 +/- 0.46 and 2.29 +/- 0.39 mg/L. There were no significant differences between the groups. Daily zinc intakes were 7.5 +/- 1.2 mg in the intervention group and 7.4 +/- 1.3 mg in the control group; respective serum zinc concentrations were 11.2 +/- 1.9 and 10.5 +/- 1.6 micromol/L (NS). In conclusion, long-term supervised use of a diet low in saturated fat and cholesterol did not influence intake or serum indicators of iron and zinc in children.

C-Reactive Protein↗
PubMed1997

Apolipoprotein A-IFin. Dominantly inherited hypoalphalipoproteinemia due to a single base substitution in the apolipoprotein A-I gene.

We have identified a large kindred with severe serum HDL cholesterol deficiency. The proband, a 65-year-old woman, had greatly diminished concentrations of serum HDL cholesterol (0.19 mmol/L) and apolipoprotein (apo) A-I (21.9 mg/dL). HDL cholesterol and apo A-I levels were similarly reduced in all affected family members, while apo A-II levels were about half of those in the nonaffected family members. Pedigree analysis suggested a dominant inheritance pattern of the phenotype. Sequence analysis of the exons and exon-intron boundaries of the apo A-I gene revealed heterozygosity for a single T-to-G point mutation substituting arginine for leucine at residue 159 of the mature apo A-I protein (apo A-IFin). The T-to-G substitution destroys an Fsp I cleavage site, permitting direct polymerase chain reaction/restriction enzyme analysis of the mutation. All the affected family members were shown to be heterozygous for the apo A-IFin mutation. Isoelectric focusing revealed the presence of the mutant apo A-IFin protein in both serum and HDL of the affected subjects. Functional consequences of the mutation were examined by expressing the mutated and wild-type apo A-I cDNAs in COS-7 cells. The mutant apo A-I mRNA had a size similar to that of the normal mRNA, and both mutant and wild-type apo A-I proteins were secreted into the cell media. In vivo kinetic studies of apo A-I revealed increased catabolism in affected subjects. In conclusion, we describe a novel point mutation of the apo A-I gene, apo A-IFin, causing a dominantly negative phenotype as regards serum HDL levels, possibly due to increased catabolism of apo A-I.

Adolescent↗
PubMed1997

Behavior of 3-year old children in a prospective randomized trial of reduced saturated fat and cholesterol diet since infancy: the STRIP baby project.

Interventions aimed at decreased exposure of children to known atherosclerosis risk factors may have untoward behavioral side effects. We examined how children's behavior or parent's perception of the behavior of the children at 3 years of age was influenced by the intervention in a prospective randomized trial that began in infancy and effectively decreased serum cholesterol concentration. This Special Turku coronary Risk factor Intervention Project for babies (STRIP) began when the infant was 7 months old. Half of 1,062 children received individualized dietary counseling at 1 to 3-month intervals during the first 2 years of age and then half-yearly; the other half had an unrestricted diet. At 3 years of age a standardized questionnaire of the child's behavior was sent to 791 families (76% returned the questionnaire). At the onset of the trial the sociodemographic data of the families and serum lipid values of the intervention and control children were similar. Later, mean serum cholesterol values of the intervention children remained constantly at a level 6% to 10% below the values of the control children. At 3 years of age the parental perceptions of the child's behavior suggested minimal differences between the intervention and control children. The intervention children were slightly less jealous and more active and creative but showed slightly more negative signs of behavior (bed-wetting, problems in falling asleep, fears) than the controls. We conclude that long-term, individualized dietary and lifestyle intervention that begins in infancy slightly influences children's behavior or parent's recognition of the behavior of the children at the age of 3 years.

Journal Article↗
PubMed1997

Effect of obesity on the response to insulin therapy in noninsulin-dependent diabetes mellitus.

An initial improvement in glycemic control is often followed by gradual deterioration of glycemia during insulin treatment of patients with noninsulin-dependent diabetes mellitus (NIDDM). We examined the causes of such worsening in a 12-month follow-up analysis of 100 insulin-treated NIDDM patients in the Finnish Multicenter Insulin Therapy Study who were treated with either combination therapy with insulin or insulin alone. In the entire study group, glycemic control averaged 9.7 +/- 0.2% at 0 months and 8.0 +/- 0.1%, 8.0 +/- 0.1%, 8.2 +/- 0.1%, and 8.5 +/- 0.2% at 3, 6, 9, and 12 months (P < 0.001 for each time point vs. 0 months). Glycemic control at 12 months was significantly worse than that at 3 (P < 0.001), 6 (P < 0.001), and 9 months (P < 0.02). Baseline body mass index was the most significant predictor of deterioration in glycemic control. During 1 yr, hemoglobin A1c decreased almost 3-fold more (by 1.7 +/- 0.2%; P < 0.001 vs. 0 months) in patients whose baseline weight was below the mean baseline body mass index of 28.1 kg/m2 (nonobese patients) than in those whose weight exceeded 28.1 kg/m2 (obese patients; 0.5 +/- 0.2%; P = NS vs. 0 months; P < 0.01 vs. obese patients). Glycemic control improved similarly over 1 yr in the nonobese subjects and deteriorated similarly in the obese patients regardless of their treatment regimen. Insulin doses, per body weight, were similar in the nonobese and obese patients. The nonobese patients consistently gained less weight during 12 months of combination therapy with insulin (3.5 +/- 0.6 kg at 12 months) than during insulin therapy alone (5.1 +/- 0.6 kg; P < 0.05). The treatment regimen did not influence weight gain in the obese group, who gained 4.4 +/- 1.0 kg during combination therapy with insulin and 4.5 +/- 1.1 kg during insulin therapy alone. We reached the following conclusions: 1) after an initial good response, glycemic control deteriorates more in obese than in nonobese patients with NIDDM; 2) in obese patients, weight gain per se cannot explain the poor glycemic response to combination or insulin therapy, but it may induce a disproportionately large increase in insulin requirements because of greater insulin resistance in the obese than in the nonobese; 3) in nonobese patients, glycemic control improves equally during 1 yr with combination therapy with insulin and insulin alone, but combination therapy with insulin is associated with less weight gain than treatment with insulin alone; 4) weight gain appears harmful, as it is associated with increases in blood pressure and low density lipoprotein cholesterol.

Adult↗
PubMed1997

Regulation of growth of 7- to 36-month-old children by energy and fat intake in the prospective, randomized STRIP baby trial.

OBJECTIVE: To study the fat and energy intakes of children between 7 and 36 months of age with different growth patterns. METHODS: In the Special Turku coronary Risk factor Intervention Project for Babies, children were randomized to intervention (n = 540) and control groups (n = 522) at age 7 months. The intervention was aimed at replacing part of the saturated fat intake with monounsaturated and polyunsaturated fat to reduce children's exposure to high serum cholesterol values. The control children consumed a free diet. Children followed for >2 years (n = 848) were included in the analysis. Five groups of children representing different extreme growth patterns during the first 3 years of life were formed, and their energy and fat intakes were analyzed. Relative weight was defined as deviation of weight in percentages from the mean weight of healthy children of same height and sex, and relative height as deviation of height in SD units from the mean height of healthy children of same age and sex. RESULTS: Relative fat intakes (as percent of energy intake) were similar in children showing highly different height gain patterns. The thin (mean relative weight </= 5%) children consumed more fat (mean, 30% energy [ E%] [SD 7] at 13 months and 33 [4] E% at 24 months) than children with normal growth (27 [5] E% at 13 months and 31 [5] E% at 24 months). The energy intake of the tall (mean relative height >/= 95%) and the obese (mean relative weight >/= 95%) were highest, but weight-based energy intake of the tall (at 2 years, 82 [13] kcal/kg) and the obese (79 [17] kcal/kg) were lower than that of children with normal growth (89 [16] kcal/kg). The thin children consumed relatively more energy than the children with normal growth (at 2 years, 94 [13] kcal/kg and 89 [16] kcal/kg, respectively). Parental height and body mass index and the child's absolute and relative energy intakes predicted the best children's growth patterns. Children with consistently low fat intake grew equally to the children with higher fat intake. CONCLUSIONS: Moderate supervised restriction of fat intake to values 25 to 30 E% is compatible with normal growth.

Arteriosclerosis↗
PubMed1997

Growth until 3 years of age in a prospective, randomized trial of a diet with reduced saturated fat and cholesterol.

OBJECTIVE: Modification of fat intake in childhood may decrease children's future risk for atherosclerosis. Excessive changes in fat intake have been linked with possible growth failure. This study evaluates the effects of a low-saturated fat diet on growth during the first 3 years of life. DESIGN: Half of 1062 healthy infants were randomized at 7 months of age to the intervention group (n = 540) to receive at 1- to 6-month intervals individualized dietary counseling aimed at reducing their exposure to atherosclerosis risk factors. Five hundred twenty-two children served as control children. Growth and serum lipids were measured regularly, and nutrient intakes were analyzed using 3- to 4-day food records at 5- to 12-month intervals. RESULTS: The intervention children consistently consumed slightly less energy than did the control children. The mean fat intake of children in both groups was lower than expected, especially during the first 2 years of life (29.0 [SD, 4.7] percentage of energy intake [E%] and 28.8 [4.1] E% in the intervention and control children, respectively, at 8 months, formula-fed children only). At 13, 24, and 36 months, fat intake in the intervention and control children accounted for 26.2 (6.0) and 27.9 (4.9) E%, 29.9 (5.0) and 32.8 (4.8) E%, and 30.8 (4.9) and 33.2 (4.6) E%, respectively. From 13 to 36 months, the baseline adjusted mean serum cholesterol concentration was lower in the intervention children than the control children (95% confidence interval for the difference between means, -0.27 to -0.12 mmol/L). The true mean of the height of the boys in the intervention group during the trial was at most 0.34 cm more or 0.57 cm less (95% confidence interval), and the weight was at most 0.19 kg more or 0.22 kg less than that of the control boys. The respective values for girls were at most 0.77 cm more or 0.16 cm less and at most 0.42 kg more or 0.04 kg less. The numbers of slim children were similar in both groups. CONCLUSIONS: Fat intake by young children is markedly lower than assumed. A supervised low-saturated fat, low-cholesterol diet has no influence on growth during the first 3 years of life.

Body Height↗
PubMed1997

[Diabetic nephropathy--screening, follow-up and treatment. Nephropathy Study Groups of The Finnish Diabetes Organization].

Owing to advances in the diagnosis and treatment of diabetic nephropathy, its management has become more active and is now initiated earlier after the presence of microalbuminuria has been established. In 1996 the Finnish Diabetic Association's nephropathy group issued recommendations concerning screening for diabetic nephropathy, and treatment and follow-up of patients with the disease.

Adolescent↗
PubMed1996

Elaidic and trans-vaccenic acids in plasma phospholipids as indicators of dietary intake of 18:1 trans-fatty acids.

Octadecenoic (18:1) trans-fatty acid fractions from margarine, butter and plasma phospholipids (PL) were isolated by silver ion TLC, and nine positional isomers (n-11-n-3) were identified by GC-MS based on their ozonolysis products. The GC analysis of the isolated fractions gave similar peak profiles and separated seven trans-isomers (n-11-n-6 and n-3). Without a preceding isolation step, the reproducibility of the GC method for plasma PL elaidic (18:1 n 9 trans) and trans-vaccenic acids (n-7) was 3.4 and 2.7% (R.S.D.), respectively. These trans-isomers were rapidly incorporated and cleared in plasma PL and they closely reflected both increased and decreased intake of 18:1 trans-fatty acids during moderate fat substitutions. Significant associations between high-density lipoprotein cholesterol (HDL-C) and PL elaidic and trans-vaccenic acids appeared in habitual margarine users only.

Adult↗
PubMed1996

Prospective randomized trial of low-saturated-fat, low-cholesterol diet during the first 3 years of life. The STRIP baby project.

BACKGROUND: The long-term consequences of modified fat intake in early childhood are poorly known. The randomized prospective STRIP baby project evaluates the effects of repeated dietary counseling on nutrient intakes and serum lipid values in children 7 months to 3 years old. METHODS AND RESULTS: One thousand sixty-two infants were randomized to intervention and control groups at 7 months of age. The families of the 540 intervention children were counseled to reduce the child's intake of saturated fat and cholesterol but to ensure adequate energy intake. Five hundred twenty-two control children consumed an unrestricted diet. Food records were kept, and serum lipids were measured at 5- to 12-month intervals. Intakes of saturated fat, fat as proportion of energy (E%), and cholesterol were lower in the intervention children than in control children at 13, 24, and 36 months of age. Fat intake by the intervention children decreased from 29 +/- 5 E% at 8 months of age to 26 +/- 6 E% at 13 months and then increased to 30 +/- 5 E% at 24 months and to 31 +/- 5 E% at 36 months. The control children consumed 29 +/- 4 E%, 28 +/- 5 E%, 33 +/- 5 E%, and 33 +/- 5 E% of fat at 8, 13, 24, and 36 months, respectively. The ratio of dietary poly-unsaturated to saturated fats of the intervention children was consistently higher than that of the control children (P < .0001). Baseline adjusted mean serum cholesterol concentration was lower in the intervention children than control children between 13 and 36 months (P < .0001; 95% confidence interval of the difference between the group means, -0.27 to -0.12 mmol/L). The effect was significant only in boys (95% confidence interval, -0.39 to -0.20 mmol/L in boys; -0.21 to 0.01 mmol/L in girls). CONCLUSIONS: Repeated individualized dietary counseling markedly reduces the increase in serum cholesterol concentration that occurs in control children during the first years of life.

Aging↗
PubMed1996

Common polymorphism of the vitamin D receptor gene is associated with variation of peak bone mass in young finns.

Previous studies suggested a relation between polymorphism of the vitamin D receptor (VDR) gene and bone mineral density (BMD) at perimenopausal age. To enlighten the possible association of the VDR gene polymorphism and BMD, we studied young (20-29 years) adults whose BMD provides a measure of their maximal bone mass. After sequencing the DNA regions flanking the polymorphic BsmI site, we set up a specific solid-phase minisequencing technique to assay this allelic variation. BMD values were adjusted for age, sex, weight, physical activity, smoking, and calcium intake. Young subjects homozygous for the b allele (BsmI site present) had a significantly higher BMD in lumbar spine and femoral neck than those homozygous for the B allele (BsmI site absent). This data shows that the BsmI polymorphism of the VDR gene is associated with peak bone mass. The implication of this result regarding the prevention of osteoporosis deserves further attention.

Adult↗
PubMed1996

Life changes, locus of control and metabolic syndrome precursors in adolescents and young adults: a three-year follow-up.

The relations between life changes, locus of control and changes in the parameters of the metabolic syndrome were examined. A three-year follow-up study of 671 randomly selected, healthy adolescents and young adults was used. Somatic parameters measured both at the baseline and the follow-up were serum insulin, serum HDL chol, serum triglyceride, SBP and BMI. Locus of control was measured with the Nowicki-Strickland locus of control scale and subjects were asked about life changes that they had faced during the follow-up period. Results showed that, in women, there were significant main effects for life changes in predicting (high) somatic risk level, whereas, in men, an opposite association was found. In addition, locus of control had a moderating effect on the life change-metabolic parameters relation, i.e. most of the life changes predicted a lower level of somatic risk in subjects with an external rather than internal locus of control. Results question the universal applicability of beneficial health effects of internal locus of control. It was suggested that accumulation of life changes might contribute, in interaction with locus of control, to the early development of the metabolic syndrome.

Adolescent↗
PubMed1996

Type A behavior and metabolic syndrome precursors in young adults.

The association between type A behavior and a cluster of parameters of the metabolic syndrome was studied in 919 randomly selected healthy young adults. Type A behavior was measured using the Type A Behavior Questionnaire for the Finnish Multicenter Study and the Hunter Wolf A-B Rating Scale. The results showed that type A men scored higher on the "Metabolic Syndrome Precursors Factor," representing a metabolic entity, than did non-type A men. In addition, type A behavior had a moderating effect on the relationship between parameters of the metabolic syndrome, that is, interdependence of these somatic factors was stronger in type A men than in non-type A men. These findings were not true of women. It is discussed whether type A behavior might affect bodily functions through increased activity along the pituitary-adrenal system resulting in insulin resistance, compensatory hyperinsulinemia, and other characteristics of the metabolic syndrome.

Adolescent↗
PubMed1996

Coronary flow reserve is impaired in young men with familial hypercholesterolemia.

OBJECTIVES: We sought to investigate whether functional abnormalities in coronary vasomotion exist in young adults by studying 15 men (age 31 +/- 8 years [mean +/- SD]) with familial hypercholesterolemia (FH) and a matched group of 20 healthy control subjects. BACKGROUND: Precursors of morphologic coronary artery disease are known to be present in adolescents and young adults with a high risk factor profile. METHODS: Myocardial blood flow was measured at the basal state and during dipyridamole-induced hyperemia using positron emission tomography and oxygen-15-labeled water. RESULTS: Serum total and low density lipoprotein cholesterol concentrations were higher in the patients than in the control subjects (mean +/- SD): 7.7 +/- 1.9 versus 5.3 +/- 1.5 mmol/liter (298 +/- 73 vs. 205 +/- 58 mg/dl) and 6.1 +/- 1.8 versus 3.5 +/- 1.4 mmol/liter (236 +/- 70 vs. 135 +/- 54 mg/dl), respectively (both p < 0.001). The baseline myocardial blood flow was similar in the patients and control subjects: 0.92 +/- 0.24 versus 0.83 +/- 0.13 ml/g per min, respectively (p = 0.21). A significant increase in flow was observed in both groups after dipyridamole infusion, but the flow at maximal vasodilation was 29% lower in the patients: 3.19 +/- 1.59 versus 4.49 +/- 1.27 ml/g per min (p = 0.011). Consequently, coronary flow reserve (the ratio of hyperemia flow to basal flow) was 35% lower in the patients than in the control subjects: 3.5 +/- 1.6 versus 5.4 +/- 1.5 (p = 0.0008). Total coronary resistance during hyperemia was higher in the patients than in the control subjects: 36 +/- 25 versus 21 +/- 10 mm Hg/min per g per ml (p = 0.045). Coronary flow reserve was inversely associated with serum total cholesterol concentration: r = -0.43 (p = 0.009). CONCLUSIONS: Coronary flow reserve is reduced in young men with FH, and, consequently, coronary resistance during hyperemia is increased. The results demonstrate very early impairment of coronary vasomotion in hypercholesterolemic patients.

Adult↗
PubMed1996

Effects of prospective, randomized cholesterol-lowering dietary intervention and apolipoprotein E phenotype on serum lipoprotein(a) concentrations of infants aged 7-24 mo.

A high serum lipoprotein(a) [Lp(a)] concentration is associated with increased risk of coronary artery disease. Few external factors are able to markedly modify serum Lp(a) concentrations. The aim of this study was to evaluate how serum Lp(a) concentrations of infants between 7 and 24 mo of age change in a cholesterol-lowering dietary intervention, and to assess the influence of apolipoprotein (apo) E phenotypes on serum Lp(a) concentrations. The intervention children (n=394) had serum cholesterol, non-high-density-lipoprotein cholesterol, and cholesterol corrected for Lp(a)-cholesterol values (P for all <0.001) lower than those of the control children (n=390), but median serum Lp(a) concentrations at the age of 24 mo were not different from those of control children. Serum Lp(a) values differed according to the apo E phenotype as the median Lp(a) values increased from E2/2 to E3/2, E4/2, E3/3, E4/3, and to E4/4 (P for the difference=0.023, Mann-Whitney U test). Our results suggest that apo E phenotype influences serum Lp(a) concentrations noticeably, but the effect of the cholesterol-lowering dietary intervention was not significant in subjects aged 24 mo.

Apolipoproteins E↗
PubMed1996

Correlation of toddlers' serum lipoprotein(a) concentration with parental values and grandparents' coronary heart disease: the STRIP baby study.

The correlation between lipoprotein(a) (Lp(a)) concentrations in children aged 7-24 months and their family members was determined and the association between the Lp(a) values of the children and a family history of coronary heart disease (CHD) was assessed. The Lp(a) values of the children correlated strongly with midparent Lp(a) values as early as at 7 months of age (r = 0.54 to 0.59, p < 0.0001). This correlation was stronger than the correlation of serum total cholesterol and total cholesterol corrected for Lp(a)-cholesterol between children and parents. None of the parents had CHD. The median Lp(a) concentration of the parents with a family history of CHD was significantly higher than that of parents with no such history (111 vs 87 mg/1, p = 0.024). However, the children's Lp(a) levels were not associated with CHD in their grandparents. The genetic dependence of the Lp(a) concentration is already evident in infancy. The Lp(a) concentration in young parents, but not in their 24-month-old children, is associated with CHD in grandparents. This may be explained by a dilution of the genetic influence on Lp(a) over two generations.

Adult↗
PubMed1996

Age-dependent variation in the serum concentration of mannan-binding protein.

Mannan-binding protein (MBP) is an acute phase reactant, and its deficiency is associated with the common opsonic defect and suspectibility to infections and atopic constitution. The aim of this study was to investigate the changes occurring in the serum level of MBP in infancy and during later childhood. We studied the serum concentration of MBP in 611 Finnish children of different ages and 110 adults by using an enzyme immunoassay. In an analysis of successive serum samples from infants at the day of birth and at the ages of 1 and 5 months, and at 1 and 2 years, the serum concentration of MBP increased significantly after birth, and was at its highest (the mean and median were 8.13 and 8.49 mgl-1, respectively) at the age of 1 month. After that, it declined to the initial level until the age of 5 months. The MBP concentration continued to decrease during childhood, and after the age of 12 years the MBP values reached the adult level. In Finnish adults the mean and median concentrations of MBP were 4.48 and 4.02 mgl-1, respectively, which seem to be higher than those reported previously in other populations. The high concentration of MBP in infants may best be explained by exposure to novel environmental antigens in early childhood, which suggests a protective role for MBP during the period of immaturity of the immunosystem. In older children the high level of MBP can probably be explained by childhood infections and the ensuing need of MBP.

Acute-Phase Proteins↗