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Biomedical subjects

J Viikari

Publications and source records attributed to J Viikari.

At least 109 records · Page 6Linked to original sources
PubMed1996

Apolipoprotein E polymorphism and serum lipids in a randomized, prospective trial of an infant diet with reduced saturated fat and cholesterol.

BACKGROUND: The inherited apolipoprotein E (apoE) phenotype may determine effectiveness of dietary atherosclerosis prevention. This study analyzes the effects of apoE phenotypes on changes in serum lipid concentrations in a 6-month prospective, randomized trial of a low-saturated-fat, low-cholesterol diet in infancy. PATIENTS AND METHODS: One thousand sixty-two healthy infants were randomized to intervention and control groups at the age of 7 months. Counseling was provided to the intervention families when the children's ages were 7, 8, and 10 months. Dietary goals were the child's intake of energy ad libitum, fat at 30% to 35% of energy, cholesterol at less than 200 mg/d, and saturated, monounsaturated, and polyunsaturated fatty acids at a 1:1:1 ratio. Control families consumed an unrestricted diet. The apoE phenotype of 846 of the infants was determined; serum lipid and lipoprotein concentrations were measured at 7 and 13 months of age; and nutrient intakes were analyzed using 3-day food records at 8 and 13 months of age. RESULTS: At 7 months of age, serum cholesterol concentration was higher in apoE4-positive infants (E2/E4, E3/E4, and homozygous E4) than in apoE4-negative infants (159 +/- 31 mg/dL [4.10 +/- 0.81 mmol/L] vs 150 +/- 29 mg/dL [3.89 +/- 0.74 mmol/L]). The high-density lipoprotein cholesterol concentration was slightly lower in apoE4-positive infants than in apoE4-negative infants (34 +/- 8 mg/dL [0.88 +/- 0.20 mmol/L] vs 35 +/- 7 mg/dL [0.91 +/- 0.19 mmol/L]). Between 7 and 13 months of age, the serum cholesterol concentration in infants in the intervention group was unchanged, apoB concentration increased slightly, and apoA1 concentration decreased. In the control infants, serum cholesterol concentration increased 9 +/- 25 mg/dL (0.24 +/- 0.65 mmol/L), apoB concentration increased markedly, and apoA1 concentration was stable. Changes in serum lipid and apo concentrations that resulted from the dietary intervention were independent of the apoE phenotype. CONCLUSIONS: The apoE phenotype influenced serum cholesterol concentration markedly by 7 months of age. Between the ages of 7 and 13 months, a reduced saturated fat and cholesterol diet effectively prevented the age-associated increases in serum cholesterol and non-high-density cholesterol concentrations that were obvious in the control infants. The effects of the diet occurred in the infants independently of the apoE phenotype.

Analysis of Variance↗
PubMed1995

Prospective randomised trial in 1062 infants of diet low in saturated fat and cholesterol.

Interventions to avoid atherosclerosis might be more successful if launched early in life when eating and life-style patterns are formed, but dietary interventions have been limited by fears of diet-induced growth failure. We investigated the effects of a diet low in saturated fat and cholesterol on serum lipid concentrations and growth in 1062 healthy 7-month-old infants in a randomised study. Every 1-3 months, families in the intervention group received dietary advice aimed at adequate energy supply, with low fat intake (30-35% energy, polyunsaturated/monounsaturated/saturated fatty acid ratio 1/1/1, and cholesterol intake < 200 mg daily). Infants in control families consumed an unrestricted diet. 3-day food records were collected at ages 8 and 13 months. Growth was carefully monitored. Between 7 and 13 months serum cholesterol and non-high-density-lipoprotein cholesterol concentrations did not change significantly in the intervention group (mean change -0.03 [SD 0.72] mmol/L and 0.01 [0.67] mmol/L) but increased substantially in the control group (0.24 [0.64] mmol/L and 0.23 [0.60] mmol/L; p for difference in mean changes between groups < 0.001). Daily intakes of energy and saturated fat were lower in the intervention than in the control group at 13 months (4065 [796] vs 4370 [748] kJ, p = 0.033, and 9.3 [3.5] vs 14.5 [4.8] g, p < 0.001, respectively), and intake of polyunsaturated fat was higher (5.8 [2.2] vs 4.4 [1.4] g, p < 0.001). Growth did not differ between the groups and was as expected for children at this age. Serum cholesterol concentrations fell significantly in parents of intervention-group infants. The increases in serum cholesterol and non-high-density-lipoprotein cholesterol concentration that occur in infants between the ages of 7 and 13 months can be avoided by individualised diets, with no effect on the children's growth.

Cholesterol↗
PubMed1995

Magnetic resonance imaging of Achilles tendon xanthomas using a fat-water discrimination technique at 0.1 T.

RATIONALE AND OBJECTIVES: Tendon xanthomas are atherosclerotic plaque like collections of lipids that develop with age in the Achilles tendons of patients having familial hypercholesterolemia (FH). We tested a fat-water discrimination technique for imaging Achilles tendon xanthomatosis. METHODS: We used the spin-warp imaging technique optimized for low-field magnetic resonance (MR) imaging to obtain separate fat and water images of the Achilles tendon. Seven patients with FH, two patients with normal tendons, and three patients with other tendon pathology were studied. RESULTS: Normal tendons showed an intensity near or equal to that of the noisy background in all images. Compared with the background, the intensity of the FH tendons was approximately fivefold greater in magnitude images, fourfold in fat images, and 10-fold in water images. CONCLUSION: The method sensitively detected even subtle xanthomatosis in young patients, but differentiation of xanthomas from other pathologic lesions was possible with this method only when the tendons were significantly thickened.

Achilles Tendon↗
PubMed1995

Third generation time-resolved immunofluorometric TSH assay for automatic immunoassay system evaluated.

We evaluated a new, third generation assay for serum thyrotropin (TSH) based on time-resolved fluorescence (AutoDelfia hTSH Ultra) for the 1235 AutoDelfia automatic immunoassay system. The functional sensitivity of the TSH assay was 0.007 mIU l-1 (between-assay CV, 20%). The between-assay imprecision was CV 4.1-7.7%, between TSH concentrations of 0.026 and 23.8 mIU l-1. The within-assay imprecision was CV 1.2-1.5% between TSH concentrations of 0.5 and 12 mIU l-1. The degree of agreement between the AutoDelfia hTSH Ultra assay and a second generation TSH-IRMA was studied. The mean difference was -0.04 (SD 0.28) mIU l-1 at concentrations between 0.22 and 52 mIU l-1. Serum TSH concentrations of euthyroid subjects, hypothyroid and hyperthyroid patients as well as those of patients with non-thyroidal illness, and thyroid carcinoma patients with TSH suppressive thyroxine treatment were analysed. The AutoDelfia automatic immunoassay system offers many benefits in sensitivity, precision, speed, output rate, time and convenience. Overnight runs are possible, and the system is easy to operate.

Fluorescence Polarization Immunoassay↗
PubMed1995

Nocturnal breathing abnormalities in acromegaly after adenomectomy.

OBJECTIVE: The incidence of sleep apnoea is increased in acromegaly. The aim of the study was to determine the occurrence of nocturnal breathing abnormalities and upper airway morphology in acromegalic patients some years after adenomectomy. DESIGN: A case-control study. PATIENTS: Eleven patients with treated acromegaly and two control groups: (1) sleep studies: 197 subjects randomly selected from the population, (2) cephalometry: 27 healthy subjects and 17 patients with obstructive sleep apnoea. MEASUREMENTS: Nocturnal breathing was monitored with a static charge-sensitive bed. The upper airway soft tissues and bone morphology were assessed by cephalometric X-ray photography. The upper airway collapsibility was investigated with dynamic nasopharyngoscopy. Endocrinological investigations were also performed. RESULTS: Nocturnal breathing abnormalities were present in all but one acromegalic patient (91%), which was far more frequent than in the general population (29.4%, P < 0.0001). Treated acromegaly was the most powerful predictor of breathing abnormalities, independent of the other significant predictors, age and body mass index. The predominant breathing abnormality was periodic breathing with symmetrically waxing and waning respiratory effort without a major body movement component. Episodes of complete obstruction with repetitive arousals were rare. Except for the longer soft palate, the cephalometric findings were similar to normal. In comparison to obstructive sleep apnoea, the treated acromegalic patients had rather prognathic than retrognathic mandibles. Fibreoptic endoscopy in the acromegalic patients revealed collapsible upper airways at the level of the soft palate, whereas at the base of the tongue little, if any, dynamic narrowing was observed. CONCLUSION: Our study confirms that nocturnal breathing abnormalities are common in treated acromegaly, and may persist years after the removal of the GH secreting tumour. The breathing abnormalities and the upper airway morphology in acromegalic patients after adenomectomy are different from those observed in primary obstructive sleep apnoea, suggesting a different pathophysiology of the airway obstruction.

Acromegaly↗
PubMed1995

Effect of insulin treatment on serum lipoprotein(a) in non-insulin-dependent diabetes.

In order to evaluate whether Lp(a), a lipoprotein that is potentially thrombogenic and atherogenic, is a potential risk factor for CAD in non-insulin-dependent diabetes (NIDDM), we compared the Lp(a) and its distribution in 145 NIDDM patients with that in 94 healthy control subjects. Furthermore, we studied the effect of insulin treatment on serum Lp(a) in 108 patients with NIDDM. Male and female NIDDM patients had similar Lp(a) concentrations to healthy controls (median value 167 mg L-1, range 15-1550 mg L-1 vs. 157 mg L-1, range 15-919 mg L-1, NS and 92, range 15-1190 mg L-1 vs. 103 mg L-1, range 15-842 mg L-1, NS). Also, the cumulative distribution of Lp(a) did not differ between the NIDDM patients and healthy subjects. Insulin treatment increased Lp(a) in diabetics with a Lp(a) concentration of less than 300 mg L-1, but this effect was not related to the concomitant improvement in metabolic control (mean change (+/- SEM) of HbA1c from 9.80 +/- 0.15 to 8.00 +/- 0.12; P < 0.001). In subjects with elevated Lp(a) concentrations (> 300 mg L-1) the Lp(a) concentration was unaffected by insulin, despite a similar improvement in glycaemic control. These results suggest that insulin may modulate the concentration of Lp(a).

Adult↗
PubMed1995

Diet of Finnish children in relation to the family's socio-economic status.

The differences between higher and lower socio-economic groups in food consumption, energy intake and nutrient density of the diet of Finnish 9- to 15-year-old children were examined in a study performed within the project entitled Cardiovascular Risk in Young Finns. Data on food consumption were collected using the 48-hour recall method. Family's socio-economic status was defined according to the father's educational level, his occupation, and family income. Children of families with higher socio-economic status used more fruit, low-fat milk, soft vegetable margarine and less high-fat milk, butter, rye products and coffee than did the children of families with lower socioeconomic status. Consequently, the main differences appeared in the fat, vitamin D, vitamin C and fatty acid content of the diet. Differences in energy intake and in mineral density of the diet were minor. If these childhood dietary differences remain in adulthood, it is possible that the present disparity between socio-economic groups in mortality from coronary heart disease will not disappear.

Adolescent↗
PubMed1995

Effect of weaning on serum lipoprotein(a) concentration: the STRIP baby study.

Risk for coronary heart disease is increased in adult Caucasians with high serum lipoprotein(a) [Lp(a)] concentration. In adults the concentration is mainly regulated by genetic factors. Our previous study suggests that breast milk has a beneficial effect on serum Lp(a) concentration in infants. Now we analyzed the influence of weaning by measuring serum Lp(a) and cholesterol in 414 infants at 7, 13, 24, and 36 mo of age. At 7 mo the infants received, in addition to solid food, only breast milk (n = 148), breast milk and formula (n = 74), or formula only (n = 191). Median (range) serum Lp(a) concentrations were then 25 (< or = 12-743) mg/L, 35 (< or = 12-1188) mg/L, and 45 (< or = 12-577) mg/L in the three feeding groups, respectively (p = 0.0013). Breast milk and formula were changed to cow's milk in all infants before 12 mo of age. At 13 mo serum Lp(a) concentration had increased more in infants who were weaned from breast milk than in those who had been fed both breast milk and formula, or formula only (median increases 37, 26, and 20 mg/L, respectively; p = 0.0062). Thus the serum Lp(a) concentration was similar in all feeding groups at 13 mo. This finding was also observed at 24 and 36 mo. The increase in serum Lp(a) concentration was independent of the baseline Lp(a) level, apolipoprotein E phenotype, gender, and weight gain of the infants between 7 and 13 mo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Helicobacter pylori infection in Finnish children and adolescents. A serologic cross-sectional and follow-up study.

BACKGROUND: The purpose was to examine the epidemiology of Helicobacter pylori infection in Finnish children and adolescents. METHODS: Blood samples taken from healthy subjects (n = 461) 3-18 years old were studied cross-sectionally for the presence of H. pylori antibodies. Additionally, blood samples drawn in 1980, 1983, 1986, and 1989 from 74 children born in 1977 were tested. Serum IgG-class antibodies to H. pylori were determined by an enzyme immunoassay. RESULTS: In the cross-sectional series the mean antibody levels and the percentage of seropositive children increased with age. The overall seroprevalence was 10.2%. During the follow-up period from 3 to 12 years of age the seropositivity increased from 4.6% to 5.7%. On the basis of the seroconversions between 3 and 12 years of age the annual incidence of H. pylori infection was calculated to be only 0.3%. CONCLUSIONS: In children seropositivity for H. pylori of the IgG class is often a sign of an infection acquired in early childhood. It seems likely that the age-dependent increase in the seropositivity reflects cumulation of a chronic infection.

Adolescent↗
PubMed1995

Association between serum lipids and apolipoprotein E phenotype is influenced by diet in a population-based sample of free-living children and young adults: the Cardiovascular Risk in Young Finns Study.

Apolipoprotein E (apoE) is a genetic determinant of coronary heart disease and lipid levels in several populations. We studied whether the association of apoE alleles with serum lipids varies with diet in a population of free-living young Finns. One thousand twelve subjects, aged 9-24 years, were studied as a part of the Cardiovascular Risk in Young Finns Study in 1986. Serum lipid concentrations and apoE phenotypes were determined, and the composition of the diet was assessed by the 48-h recall method. The subjects were divided into three groups according to the intake of dietary saturated fatty acids (SAFA, g/1000 kcal) and cholesterol (mg/1000 kcal). Group one (high SAFA-cholesterol group) was formed from subjects belonging to the highest tertiles of both cholesterol and SAFA intakes (n = 175); group two (middle SAFA-cholesterol group) consisted of subjects belonging to the middle respective tertiles (n = 119); and group three (low SAFA-cholesterol group) consisted of subjects belonging to the lowest respective tertiles (n = 192). The statistical significance of the association of serum total cholesterol and low density lipoprotein (LDL) concentration with apoE phenotype increased from the low SAFA-cholesterol group (P = 0.024 for total cholesterol and P = 0.015 for LDL-cholesterol, respectively) to the high SAFA-cholesterol group (P = 0.0022 and P = 0.00073, respectively). The middle SAFA-cholesterol group fell between these two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Height loss rate as a marker of osteoporosis in postmenopausal women with rheumatoid arthritis.

The relation between the loss of height and bone mineral density (BMD) at the lumbar spine and proximal femur was determined in 61 women aged 56-70 years suffering from rheumatoid arthritis. Statistically highly significant negative correlations were found between the loss of height and the spinal and femoral BMD. A loss of 4 cm or more in height over 10 years seems to be associated with a significant decrease of BMD, and it can be recommended as a clinical marker of osteoporosis.

Aged↗
PubMed1994

Upper airway obstruction in hypothyroidism.

OBJECTIVES: To determine the occurrence and frequency of nocturnal upper airway obstruction in hypothyroidism. DESIGN: A case-control study of patients with newly diagnosed hypothyreosis and euthyroid subjects who had been selected from the population register. The subjects underwent sleep recordings with a static-charge-sensitive bed (SCSB). SETTING: Turku University Hospital and Research and Development Unit, Social Insurance Institution, Turku, Finland. SUBJECTS: Twenty six consecutive patients underwent sleep recordings with SCSB and a pulse oximeter. One hundred and eighty-eight euthyroid subjects who were previously studied with the SCSB were used as controls. MAIN OUTCOME MEASURES: In a multivariate analysis, hypothyroidism, gender, age, and body mass index (BMI) were considered as predictors for the occurrence of nocturnal breathing abnormalities. RESULTS: Nocturnal breathing abnormalities were frequent in both groups. Fifty per cent of the hypothyroid patients and 29.3% of the control subjects had at least some episodes of partial or complete upper airway obstruction (P = 0.04). Severe obstruction with episodes of repetitive apnoea was present in 7.7% of the patients and in 1.5% of the controls. The multivariate analysis revealed that the presence of hypothyroidism did not significantly (P = 0.06), and independently of age, BMI or gender, predict nocturnal breathing abnormalities, whereas obesity (P < 0.0001) and male gender (P = 0.0001) were independent and significant predictors. CONCLUSIONS: The incidence of nocturnal upper airway obstruction is increased in hypothyroidism, but is related to obesity and male gender rather than to hypothyroidism per se.

Adult↗
PubMed1994

Nutritional and genetic contributions to serum cholesterol concentration in a children's follow-up study.

In the Finnish multicentre study of cardiovascular risk in young Finns in 1980, 1983 and 1986, 2429, 2052 and 1841 9 to 18-year-old children and adolescents participated. In 1980, subjects of eastern origin living in the west had, despite their western diet, higher serum cholesterol concentrations than subjects both residing in and originating from the west. In males, eastern origin increased the east/west difference in serum cholesterol concentrations. Between 1980 and 1986 the mean serum total cholesterol of the study cohorts decreased by 5.5% and simultaneously the east/west differences in serum cholesterol concentrations disappeared in boys. The study suggests that genetic background is a separate factor determining serum total cholesterol level, but with declining serum cholesterol concentrations the effect of the genetic factor does not become manifest.

Adolescent↗
PubMed1994

Individualized dietary counselling of families: serum cholesterol concentration and growth of children aged 7-13 months.

We studied the effect of a change in dietary fat composition on serum total and high-density lipoprotein cholesterol and growth in healthy infants between 7 and 13 months of age. The intervention families (n = 22) received individualized dietary counselling when the infant was 7, 8 and 10 months of age. The intervention diet was designed to have a fat content of 35-45 E% of total energy intake in infants aged 7-12 months and 30-35 E% after 12 months of age. The ratio of saturated to monounsaturated to polyunsaturated fatty acids was designed to be 1:1:1. The children in the control group (n = 23) were given no specific advice on the fat composition of the diet. Intake of polyunsaturated fatty acids was significantly higher in the intervention group than in the controls (5.9 E% versus 3.6 E%, p < 0.05). Serum total cholesterol concentration decreased significantly in the intervention group during the study from 4.16 +/- 0.41 mmol/l to 3.86 +/- 0.48 mmol/l (p < 0.05). The infants of both groups grew like average Finnish children. Modification of dietary fat composition, as widely recommended for adults and older children to prevent coronary heart disease, decreases cholesterol values in infants without affecting their normal growth.

Cholesterol↗
PubMed1994

Sonography in the detection of achilles tendon xanthomata in children with familial hypercholesterolaemia.

Patients with heterozygous familial hypercholesterolaemia (FH) are at high risk for the development of coronary artery disease. Achilles tendon xanthomata are often the first clinical manifestation of FH, but are seldom palpable earlier than during the third decade. Twenty-one FH children aged 3-18 years underwent high-frequency ultrasound examination of the achilles tendon. Hypoechoic infiltration of the normal tendon structure was demonstrated in 8 of 21 (38%) of the FH children. The findings were similar in boys and girls. Control subjects (n = 68) aged 1-25 years had no sonographically detectable tendon abnormalities. The thickness of the achilles tendon of the FH children was (mean +/- SD) 7.1 +/- 1.5 mm (range 5-10 mm). The respective values for the controls were 5.8 +/- 1.0 mm (3-7 mm. We conclude that ultrasound examination sensitively detects cholesterol accumulation in the achilles tendon of FH children before tendon xanthomata are clinically evident.

Achilles Tendon↗
PubMed1994

Cholesterol measurement by reflotron dry chemistry in infants, children and adults.

Cholesterol values measured with the Reflotron dry chemistry (Boehringer Mannheim, Mannheim, Germany) and enzymatic (CHOD-PAP) routine method in 4150 venous blood samples from 580 infants aged 7 months, 1778 children aged 13 months to 19 years, and 1792 adults aged 18-63 years showed good correlation between the two assay systems (r > 0.92). However, the mean cholesterol concentrations were 4.5%, 3.7% and 2.3% lower in infants, children and adults, respectively, if measured with the Reflotron analyser as compared with values obtained with the CHOD-PAP method. These differences in the values were greater when cholesterol values were low (significance for the slope of regression line, p < 0.001). Values were below the detection limit of the Reflotron assay (2.59 mmol l-1) in 104 (4.4%) and 4 (0.2%) of all paediatric and adult samples, respectively. When measured with the CHOD-PAP method, 75 (72%) and 3 (75%) of these same samples showed values which exceeded the 2.59 mmol l-1 detection limit. We conclude that Reflotron dry chemistry analyser is precise in fast measurement of serum cholesterol both in all paediatric subjects and adults. A particular problem in paediatric age groups is that about 4% of children have values below the detection limit of the Reflotron analyser.

Adolescent↗