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Biomedical subjects

L Heinemann

Publications and source records attributed to L Heinemann.

At least 109 records · Page 6Linked to original sources
PubMed1990

Comparative data on diet and risk factors from five Eastern European communities.

Starting from large differences in rates and trends of mortality between European countries, an ecological type of comparative study was launched between five population samples in so-called Eastern European countries: Krakow, Warsaw, Novosibirsk, Kaunas, and the German Democratic Republic (GDR). The purpose was to look into dietary data as a possible explanation for varying risk factor and mortality data. It was found that high energy and fat consumption but low carbohydrate intake are common in these populations. The sources of energy and fat however vary markedly. An association was found between diet-related cardiovascular risk factors like the mean total cholesterol value and excess energy or fat intake both in males and in females. It was concluded that changes in diet might be the most important prerequisite for a number of lifestyle changes in these communities, and that those diet changes need to be monitored on a regular basis as part of the national health reports.

Adult↗
PubMed1989

[Action profile of human ultralente insulin compared with human NPH-insulin].

The effect of human NPH insulin (Protaphan HM) and of human ultralente insulin (Ultratard HM) on the profile of blood-glucose concentration was compared, using the glucose clamp technique, in normal subjects after subcutaneous injection of 12 U each. After Protaphan, insulin concentration rose by 11.0 +/- 1.6 microU/ml; maximal glucose infusion rate (GIR) after five hours was 4.7 +/- 0.5 mg/kg.min. But after the same dosage of Ultratard, insulin concentration rose by only 4.7 +/- 1.0 microU/ml (P less than 0.02) on a maximal GIR after ten hours of 3.2 +/- 0.5 mg/kg.min (no significant difference). Ultratard had up to 70% of the maximal Protaphan effect, the infused amount of glucose, up to maximal effect at 9.5 h (72 +/- 9 g), being significantly lower (P less than 0.02) than after Protaphan (130 +/- 18 g). After, respectively, 16 (Protaphan) and 20 (Ultratard) hours, basal insulin levels were again reached. GIR 19 h after Protaphan injection was 1.3 +/- 0.4 mg/kg.min, while 24 h after Ultratard it was 1.5 +/- 0.2 mg/kg.min, which was not significantly different from the basal rate. The difference between Protaphan and Ultratard lies in the marked initial effect of NPH insulin, up to 10 h after injection. In the later phase of the effect profile both insulins were similar at the chosen dose of 12 U.

Adult↗
PubMed1989

Effect of 8 hours of hyperinsulinaemia on haemostatic parameters in healthy man.

The role of variations in plasma insulin concentrations as a factor possibly involved in abnormalities of haemostatic functions, and (or) the development of arterial disease, has been the subject of controversy. This study examines the "in vivo" effect of hyperinsulinaemia on haemostatic parameters in seven healthy men. Two studies were carried out in random order: (a) Hyperinsulinaemia study. Human insulin was infused by a calibrated infusion pump (0.7 mU kg-1 min-1, for 8 h) during a euglycaemic glucose clamp, and (b) Control study 0.15 mmol/l NaCl solution was infused over 8 h. Plasma epinephrine and norepinephrine concentrations remained constant throughout the studies. Mean insulin levels during the hyperinsulinaemia study were 46.2 +/- 1.6 microU/ml, i.e. approximately eightfold higher than those at baseline, whereas plasma glucose levels remained constant at 4.9 +/- 0.1 mmol/l. During the control study, mean insulinaemia was 5.0 +/- 0.9 microU/ml, and plasma glucose 5.2 +/- 0.1 mmol/l. No statistically significant changes were observed during, or after insulin or 0.15 mmol/l NaCl infusions with regard to platelet parameters, blood coagulation, and coagulation inhibitors. These data suggest that abnormalities of the haemostatic function described during insulin-induced hypoglycaemia or in hyperinsulinaemic patients are not due to a direct action of insulin.

Adult↗
PubMed1989

[The Intersalt study: results and perspectives].

The recently published Intersalt Study comprising 10,079 participants from 52 study centers in 32 countries demonstrated that the simple linear relationship so far postulated for the association between electrolytes and hypertension is history. In addition overweight and alcohol consumption make an independent contribution to the level of individual blood pressures. The study results have to be interpreted carefully in the framework of a differentiated epidemiologic analysis.

Adult↗
PubMed1989

Pulsatile insulin infusion and glucose-homeostasis in well-controlled type 1 (insulin-dependent) diabetic patients.

Pulsatile, intravenous insulin infusion designed to mimic the portal insulin concentrations that emerge physiologically after a meal, has been postulated to improve glucose tolerance in Type 1 (insulin-dependent) diabetic patients. We studied the effects of insulin pulsing (10 i.v. pulses of human insulin of 0.035 U kg-1 idealised body weight were given, each of 20 s duration, with intervals of 6 min, three times per day covered with adequate administration of glucose) on 2 successive days on glucose-tolerance in nine well-controlled Type 1 diabetic patients on continuous subcutaneous insulin infusion therapy (age 26 (7) years, mean (SD); duration of diabetes 10 (7) years; body mass index 23.4 (2.3) kg m-2; HbA1c 6.0 (0.6)%). On the days before and after the insulin pulsing, the patients were subjected to metabolic assessments by an oral glucose tolerance test (1 g glucose kg-1 body weight) 30 min after the subcutaneous injection of 0.15 U kg-1 body weight regular human insulin and a subsequent bicycle-ergometer test. During these metabolic assessments, plasma free insulin concentrations, plasma glucagon and the non-protein respiratory quotient remained unaffected by the insulin pulsing. However, glucose tolerance deteriorated significantly (maximal glucose concentration 120 min after glucose load was 10.0 mmol l-1 before and 13.9 mmol l-1 after insulin pulsing, P less than 0.01). In conclusion, the pattern of insulin pulsing used in this study did not ameliorate oral glucose homeostasis in well-controlled Type 1 (insulin dependent) diabetic patients.

Adult↗
PubMed1989

The action profiles of human NPH insulin preparations.

The complete time-action profiles of four subcutaneously injected human NPH insulin preparations (Protaphane HM/Novo; Insulatard Human/Nordisk; Huminsulin Basal/Eli Lilly; Basal H-Insulin/Hoechst) have been investigated by means of the euglycaemic clamp technique (blood glucose 5.0 mmol l-1). Six normal male subjects were connected to a Biostator on five occasions in randomized order including a control study without insulin injection. A stable basal insulin level of about 10 mU l-1 was established by means of a low dose insulin infusion (0.1 mU kg-1 min-1) which subsequently suppressed C-peptide by 35 +/- 19% (mean +/- SD) to levels of around 0.3 nmol l-1. Twelve units of NPH insulin were injected subcutaneously into the abdominal wall and glucose infusion rates were monitored for 19 h. In the control study, the mean glucose infusion rate was 1.11 +/- 0.60 (range 0.32-1.95) mg kg-1 min-1. Maximal glucose infusion rates, reached 5-7 h after injection, were comparable (4.3-4.9 mg kg-1 min-1) for the four different preparations used. Glucose infusion rates returned to basal rates within the 19 h study period. Mean plasma free insulin levels peaked at 17.5-18.6 mU l-1 3-4.5 h after injection and returned to basal levels within 16 h. The time ranges of greater than 90, greater than 75, greater than 50, and greater than 25% of maximal insulin action (as estimated from glucose infusion rates) revealed no significant differences between the four insulin preparations tested. No significant insulin action was observed beyond 17 h after insulin injection of any preparation.

Adult↗
PubMed1989

Comparison of methods for determination of microalbuminuria in diabetic patients.

Microalbuminuria is an early marker of prognostic significance in diabetic renal disease. The aim of the present study was to compare methods which do not require radioactive markers for estimating microalbuminuria (20-300 mg l-1) with a radioimmunoassay for albumin estimation. Albumin concentrations of 329 diabetic patients were measured using two laser turbidimetric methods for albuminuria and proteinuria, two semiquantitative tests (Albusure and Albustix), and a routine albumin radioimmunoassay. The four methods in the order laser immunoturbidimetric for albuminuria, laser turbidimetric for proteinuria, Albusure and Albustix gave the following results: sensitivity 0.97, 0.93, 0.97 and 0.81; specificity 0.92, 0.88, 0.94 and 0.55; positive predictive value for microalbuminuria 0.83, 0.75, 0.85 and 0.42; negative predictive value for microalbuminuria 0.99, 0.97, 0.99 and 0.88. We suggest that both laser turbidimetric methods are reliable and can replace methods with radioactive markers, the same being true for the Albusure test.

Albuminuria↗
PubMed1989

Results from a comparative dietary assessment in Europe: I. Comparison of dietary information derived from concurrently applied frequency questionnaires and quantitative measurement instruments.

Data from four central European dietary investigations carried out between 1982 and 1984 in the German Democratic Republic, Poland and the Federal Republic of Germany applying both a food frequency questionnaire (FFQ) and a quantitative recording instrument (24-h recall, 3-d record or 10- to 14-d record) were analysed to compare frequency of food consumption as reported by the FFQ with the corresponding information as derived from the quantitative instrument. The actual intake was found to be overestimated by the FFQ for categories of frequent consumption and underestimated for categories of rare consumption. Categories for which both instruments yielded similar estimates of frequency were found to vary between food items and to depend on the overall frequency of consumption of an item. This indicates that when using unvalidated FFQs and taking their FFQ-categories literally artificial differences of food consumption within the population(s) under study can be introduced. This implies also the tendency that the average food intake estimated through FFQs can yield unrealistically high values for items consumed frequently.

Adult↗
PubMed1989

Results from a comparative dietary assessment in Europe: II. Feasibility of pooling individual-based dietary data between countries.

Dietary investigations in four central European survey populations carried out in the German Democratic Republic, Poland and Denmark between 1982 and 1984 using different methodologies were analysed in order to assess the possibilities of characterizing the dietary habits of individual survey participants in a comparable fashion. This was done with the view of assessing the feasibility of a pooled cancer cohort study. For this purpose a method has been devised to combine dietary information derived by food frequency questionnaires and quantitative recording methods into a quantitative characterization of individuals' habits. A comparable characterization between different cultural settings could be demonstrated for a selected list of food items. The selection was determined by the food items considered in common in the different food frequency questionnaires and yielding sufficient and comparable variation as well as absolute amounts of intake. This was more clearly found for food items such as 'fruit' which experience a concise role in dietary habits. However, the observed discrepancies of the different dietary methods within the countries, and, most importantly, between the countries, result in distributions of average daily consumption values which are not deemed to be comparable.

Adult↗
PubMed1988

[Status and perspectives of prevention in coronary heart disease].

The outstanding objective prerequisites for the protection of life and health of the whole population, which are at our disposal, have quite significantly widened the possibilities for individual decisions and actions concerning the influence on health and functional capacity as well as responsibility and cooperation of every citizen. Comprehensively, also in our country the readiness of all citizens must be stimulated to form the personal way of life according to the scientific knowledge fully using the abundantly given possibilities. In this respect we too have to solve still great problems.

Coronary Disease↗
PubMed1988

Risk factors in the population of the GDR-MONICA Study (1983/84).

The GDR-MONICA project comprises 25 administratively defined areas with a population of nearly two million people aged 25-64. Data from the first random sample survey are reported here. The survey gathered information regarding risk factors, dietary behaviour, physical activity and psychosocial factors from 11,281 persons aged 25-64. The average risk factor levels were high in the population: The mean casual blood pressure was 140/88 mmHg and 138/86 mmHg for men and women respectively. In both sexes the mean total cholesterol level exceeded 6.1 mmol/L, and the mean body mass index (BMI) was just over 26.0. The study population consumed, on average, excessive amounts of energy, fat, alcohol, and sodium, and too few carbohydrates. Preliminary conclusions regarding unfavourable trends in risk factor levels have been drawn by comparing the present data with other recent reliable epidemiological studies.

Adult↗
PubMed1988

[Atrial natriuretic factor in patients with type 1 diabetes mellitus in various stages of diabetic nephropathy].

In this study we investigated circulating atrial natriuretic factor (ANF) concentrations in patients with different stages of diabetic nephropathy. Type 1 diabetic patients with incipient or overt nephropathy had elevated plasma ANF concentrations when compared with nonnephropathic diabetics and normals. Patients having a hyperfiltration only, which might be a risk factor for the development of diabetic nephropathy, had also elevated ANF concentrations. No correlation could be found between ANF concentrations and blood pressure, diabetes duration, age, or parameters of metabolic control. These findings may indicate a role of ANF in the development of diabetic nephropathy. Long-term follow-up studies should be performed to assess the prognostic and diagnostic importance of plasma ANF determinations in diabetic patients.

Adult↗
PubMed1988

[Hormonal contraceptives and cardiovascular risk. Results of an East German multicenter case control study].

Case control studies of oral contraceptives in the literature proved an increasing risk of cardiovascular diseases ranged from 2 to 6. In the presented GDR-case-control-study 425 women with cardiovascular diseases and 1,275 controls without cardiovascular diseases have been entered. Cases and controls were examined in ten centers. We found no elevated risk for ischemic heart disease, cerebrovascular disease, and hypertonic heart disease in oral contraceptive users. The risk did not depend on age, type of oral hormonal contraceptive, and duration of use. There was only a statistical significant increase in the estimated relative risk of 2.05 in venous thrombosis and thrombophlebitis. Of course, prudent medical practice requires that a possible risk of certain cardiovascular events during hormonal contraceptive use must be taken into account when weighting the risks and benefits of each patient's contraceptive choices. Further studies are needed.

Adult↗