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Biomedical subjects

M Uusitupa

Publications and source records attributed to M Uusitupa.

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

Fish diet, fish oil and docosahexaenoic acid rich oil lower fasting and postprandial plasma lipid levels.

OBJECTIVE: The present study was carried out to clarify the effects of fish diet, fish oil and docosahexaenoic acid (DHA) rich oil on fasting and postprandial lipid levels in healthy male students. DESIGN: The study was a randomized single-blind study with a control and three study groups. SETTING: The study was carried out in the Departments of Physiology and Clinical Nutrition of University of Kuopio. SUBJECTS: Healthy male volunteers were recruited for the study from the university student population. Fifty-nine subjects entered and 55 completed the study. INTERVENTIONS: For 15 weeks the subjects in the fish diet group ate 4.3 +/- 0.5 fish containing meals per week and those in the fish oil and DHA-oil groups ate 4 g oil per day. Fish diet provided 0.38 +/- 0.04 g eicosapentaenoic acid (EPA) and 0.67 +/- 0.09 g DHA, fish oil 1.33 g EPA and 0.95 g DHA and DHA-oil (EPA-free) 1.68 g DHA per day. RESULTS: Fasting plasma triglyceride levels decreased in all test groups in 14 weeks when compared to the control group (P < 0.05). Total plasma cholesterol levels did not change but the HDL2/HDL3-cholesterol ratio increased in all test groups by over 50% (P < 0.05). The postprandial total and chylomicron triglyceride responses, measured as areas under the response curve, were lowered in 15 weeks by the fish diet and fish oil (P < 0.05), the same tendency (P < 0.1) being seen in DHA-oil group. CONCLUSIONS: These results show that both fasting and postprandial triglyceride concentrations can be decreased with moderate intakes of long-chain n-3 fatty acids either from a fish diet or fish oil and that also pure DHA has a hypotriglyceridemic effect.

Adult↗
PubMed1995

Natural history of peripheral neuropathy in patients with non-insulin-dependent diabetes mellitus.

BACKGROUND: There is little information on the incidence and natural history of neuropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM). METHODS: We studied patients with newly diagnosed NIDDM and control subjects both at base line and 5 and 10 years later. Polyneuropathy was diagnosed on the basis of clinical criteria (pain and paresthesias) and electrodiagnostic studies (nerve conduction velocity and response-amplitude values). We investigated the relation between metabolic variables (results of oral glucose-tolerance tests, serum lipid and insulin concentrations, and glycosylated hemoglobin values) and the development of polyneuropathy. RESULTS: In 10 years, 36 patients with NIDDM and 8 control subjects died; 86 patients and 121 control subjects completed the study. When the study ended, 18 percent of the patients were being treated only with diet, 59 percent with oral hypoglycemic drugs alone, 12 percent with insulin alone, and 11 percent with both insulin and oral hypoglycemic agents. At base line the prevalence of definite or probable polyneuropathy among the patients with NIDDM was 8.3 percent, as compared with 2.1 percent among the control subjects. These values 10 years later were 41.9 percent and 5.8 percent, respectively. The number of patients with NIDDM who had nerve-conduction abnormalities in the legs and feet increased from 8.3 percent at base line to 16.7 percent after 5 years and to 41.9 percent after 10 years. The decrease in sensory and motor amplitudes, indicating axonal destruction, was more pronounced than the slowing of the nerve conduction velocities, which indicates demyelination. Among the patients with NIDDM, those with polyneuropathy had poorer glycemic control than those without. Low serum insulin concentrations before and after the oral administration of glucose were associated with the development of polyneuropathy, regardless of the degree of glycemia. CONCLUSIONS: The prevalence of polyneuropathy among patients with NIDDM increases with time, and the increase may be greater in patients with hypoinsulinemia.

Blood Glucose↗
PubMed1995

Fatty acid composition of breast adipose tissue in breast cancer patients and in patients with benign breast disease.

Fatty acid composition of triglycerides (TGs) and phospholipids (PLs) in breast adipose tissue was analyzed in 73 female breast cancer patients and 55 patients with benign breast disease. No differences were observed in the dietary intake of the major fatty acids (i.e., palmitic, stearic, oleic, and linoleic acids) or in the proportion of TGs and PLs in breast adipose tissue between the two groups. In postmenopausal women, however, the dietary intake of eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) was significantly lower in the breast cancer patients than in patients with benign breast disease. Accordingly, the percentage of docosahexaenoic acid of PLs in breast adipose tissue was significantly lower in breast cancer patients than in patients with benign breast disease among postmenopausal women. The stage of the breast cancer did not contribute to the observed alterations of fatty acid composition of PLs. Consonant with the previous epidemiologic data, the present results suggest that intake of the long-chain n-3 fatty acids (mainly derived from fish) may have a protective effect against breast cancer, particularly in postmenopausal women.

Adipose Tissue↗
PubMed1995

Mental well-being in people with non-insulin-dependent diabetes.

We assessed the prevalence of minor mental disorder and depression in elderly patients with non-insulin-dependent (Type 2) diabetes mellitus as compared with control subjects and evaluated the associates of impaired mental well-being in diabetic patients. The study consists of a community-based group of patients (n = 82) with a 10 years' known duration of disease and nondiabetic control subjects (n = 115). In addition to clinical and laboratory examinations, self-rating questionnaires assessing minor mental disorder (General Health Questionnaire, GHQ) and depression (Zung Self-rating Depression scale) were completed by the patients and control subjects. The mean scores of GHQ and Zung scores tended to be higher in diabetic than in control subjects, but the frequency of case subjects was not different between the diabetic (GHQ: 40%; Zung: 11%) and nondiabetic groups (GHQ: 36%; Zung: 7%). These findings were explained by more severe symptoms in diabetic case subjects as compared to nondiabetic case-subjects. From the various parameters studied, the presence of symptomatic neuropathy was most strongly associated with depression and minor mental disorder in diabetic subjects. The results suggest that the impact of Type 2 diabetes per se on minor mental disorder or depression in elderly subjects is not overwhelming. However, a subgroup of diabetic patients seems to have markedly impaired mental well-being, and the treatment of its underlying factors may improve overall treatment compliance.

Adaptation, Psychological↗
PubMed1995

Dietary intake and nutritional status of athletic and nonathletic children in early puberty.

Dietary intakes, trace element status, and anthropometric measures were studied in 12- to 13-year-old boys (n = 49) playing ice hockey (AB) and in 11- to 12-year-old girls who were gymnasts, figure skaters, and runners (AG; n = 43). Thirty-five boys (CB) and 53 girls (CG) not involved in supervised sports were controls. After adjustment for sexual maturation, ABs had larger upper arm muscle circumference than CBs. The sum of four skinfolds was smaller in AGs than in CGs. The intake of energy and all micronutrients examined was higher in ABs than in CBs. Micronutrient intakes were not different between AGs and CGs. Compared to CBs, serum ferritin and copper concentrations were lower, but serum zinc concentration was higher in ABs. No differences in trace element status were found between AGs and CGs. Blood investigations did not indicate inadequate trace element status in any of the groups studied.

Adolescent↗
PubMed1995

Short-term and long-term memory in elderly patients with NIDDM.

OBJECTIVE: To determine cognitive and memory dysfunction associated with non-insulin-dependent diabetes mellitus (NIDDM) and its relationship with depression, metabolic control, and serum lipids. RESEARCH DESIGN AND METHODS: We studied a well-characterized group of 20 elderly patients with NIDDM and 22 control subjects with normal glucose tolerance recruited from a larger population-based sample. In addition to clinical and laboratory examinations, self-rating questionnaires that assess minor psychiatric disorder (General Health Questionnaire) and depression (Zung scale) were completed by patients and control subjects. Memory was examined with digit and block-span tests, word-list learning, Heaton Visual Memory Test, and Moss Visual Span Test. Executive functions were examined by Trail-Making A and B test and by Verbal and Category Fluency Tests. Visuoconstructive reasoning was examined with the block design subtest of the Wechsler Adult Intelligence Scale. RESULTS: The NIDDM patients showed preserved memory span, but poor performance in learning tasks compared with control subjects. The patients recalled no fewer words than the control subjects, but the process of of learning seemed to be different in the two groups. The recognition of the learned words was not impaired. Elevated serum total and very-low-density lipoprotein triglyceride levels, measured either before examinations or 5 or 10 years earlier, were associated with effects on retrieval from semantic memory in NIDDM patients. CONCLUSIONS: The NIDDM patients had impaired control of their learning processes. Elevated serum triglyceride levels may be related to control of mental processing in diabetic patients.

Adult↗
PubMed1995

Intakes of nutrients and nutritional status in coeliac patients.

BACKGROUND: The intake of nutrients and the nutritional status of untreated coeliac patients and coeliac patients in remission were investigated at Kuopio University Hospital. METHODS: Forty untreated and 52 coeliac patients in remission were admitted to the study. The control group included 77 persons. Four-day food records, anthropometric measurements, and blood biochemistry were examined to obtain nutrient intake and nutritional status. RESULTS: Concentrations of serum ferritin, vitamin B12, and erythrocyte folate were lower in patients with untreated coeliac disease than in those in remission. Altogether, 15-38% of the untreated patients but only 0-20% of the patients in remission had levels of haemoglobin, serum ferritin, iron, vitamin B12, or erythrocyte folate below the reference values. No difference in anthropometric measurements was found between the two groups of coeliac patients. CONCLUSIONS: Except for some subclinical abnormal values in biochemical analyses in 20-38% of coeliac patients, nutritional status was quite normal in both groups of coeliac patients.

Adult↗
PubMed1995

Myocardial sympathetic nervous dysfunction detected with iodine-123-MIBG is associated with low heart rate variability after myocardial infarction.

UNLABELLED: The association between myocardial sympathetic innervation and heart rate variability after myocardial infarction was studied in a group of 12 men (aged 30-65 yr) 3 mo after their first myocardial infarction. METHODS: Viable myocardium was imaged using 123I-phenylpentadecanoic acid (pPPA). Functioning myocardial sympathetic nervous tissue was imaged using [123I]-metaiodobenzylguanidine (MIBG). Heart rate variability was measured as the ratio of maximum-to-minimum RR intervals in ECG during deep breathing. RESULTS: The patients were divided into normal (n = 6) and low (n = 6) heart rate variability groups. Myocardial infarction size (pPPA defect) was comparable in the normal and low heart rate variability groups. Even the MIBG defect size was not significantly different in the normal and low groups, the portion of viable myocardium with impaired sympathetic innervation (MIBG defect minus pPPA defect) was significantly greater in the low heart rate variability group than in the normal group. CONCLUSION: The extent of viable myocardium with disturbed sympathetic innervation was greater in patients with low heart rate variability as compared to those with normal heart rate variability 3 mo after myocardial infarction.

3-Iodobenzylguanidine↗
PubMed1994

Screening for mutations in the exon 26 of the apolipoprotein B gene in hypercholesterolemic Finnish families by the single-strand conformation polymorphism method.

To date, the only known apolipoprotein B (apo B) mutation causing hypercholesterolemia is the apo B 3500 Arg-->Gln or the familial defective apo B (FDB) mutation. This mutation has not been detected in the Finnish population. We have set up a systematic single-strand conformation polymorphism (SSCP) analysis-based screening method to search for other mutations in the exon 26 of the apo B gene in 21 Finnish hypercholesterolemic probands. The 7572-bp exon 26 covers half of the coding region of the gene including the DNA sequence coding for the putative low-density lipoprotein (LDL) receptor binding site on the apo B protein. Exon 26 was amplified as six 1190- to 1435-bp fragments, each of which was further split into three smaller 213- to 579-bp segments by restriction enzymes. These digestion products were run on nondenaturing polyacrylamide gels using at least three different electrophoretic conditions and autoradiographed. All previously known genetic variants in the exon 26 were detected by the SSCP method. A C-->T change at nucleotide 7064, in complete association with the XbaI site, was characterized by direct sequencing. This variant did not affect the amino acid sequence of the apo B protein. The SSCP-based procedure appears suitable for systematic screening for DNA sequence changes in large coding regions.

Apolipoproteins B↗
PubMed1994

Therapeutic traditions in type 2 diabetes--are they changing?

The utilisation of antidiabetic drugs reflects both the prevalence of diabetes and the different therapeutic traditions of physicians. A questionnaire survey to study attitudes to the use of oral antidiabetic drugs amongst physicians and possible changes in treatment habits was carried out in a representative sample of Finnish physicians (n = 454) in 1992 and the results were compared with those of a similar survey carried out in 1985, and with drug utilisation statistics. The mean fasting blood glucose level at which a physician would start pharmacological treatment was 8.7 mmol.l-1, which was significantly lower than in the 1985 survey. The responses to various case histories suggested a more active approach to pharmacological treatment compared to the 1985 survey. Insulin treatment especially seems to have gained in popularity. This change in attitude was paralled by an increase in the consumption of antidiabetic drugs in Finland during the observation period. The increase in use of oral drugs was steeper in Finland than in Norway and Sweden. Whether this active approach will improve the metabolic control and prognosis of patients with Type 2 diabetes, remains to be demonstrated.

Adult↗
PubMed1994

Regular eye examinations of diabetic patients in the Finnish health care system.

A questionnaire about regular eye examinations of diabetic patients was sent to 1,776 physicians in eastern, western and southern provinces of Finland. The study was a part of a larger questionnaire about the medical care of high blood pressure and diabetes. Of the 1,706 doctors working actively, 950 (56%) completed the questionnaire, and 398 (42%) of them treated diabetic patients and gave their opinions of the ophthalmological care in diabetic patients. Regular eye examinations in type I diabetes were carried out annually by 79% of the physicians. In type II diabetic patients, the figure was 55%. In different provinces, these percentages varied from 61% to 81% in type I and from 38% to 74% in type II diabetes. The eye examination was performed in 54% by the physician who also treated diabetes, otherwise the examinations were performed by an ophthalmologist in a hospital, health centre or in private practice. In southern provinces of Finland, regular eye examinations were performed primarily by ophthalmologists in private practice, in western and eastern provinces they were performed by the doctors who also treated diabetes. Most of the regular annual eye examinations were reported by specialists in general practice and physicians working in health centres. The reported current practice in the regular eye examinations of type I diabetic patients is near the current European and American recommendations, but in type II diabetic patients these recommendations are not met adequately.

Adult↗
PubMed1994

Effects of two high-fat diets with different fatty acid compositions on glucose and lipid metabolism in healthy young women.

Effects of two experimental diets with a relatively high fat content--one enriched with saturated fatty acids (SAFA-diet) and the other with a low content of erucic acid rapeseed oil and rich in monounsaturated fatty acids (MUFA-diet)--on glucose and lipid metabolism were examined in healthy young women. The study was carried out with a randomized, crossover study design with each diet lasting 3 wk and a 2-wk washout period between the experimental diets. Glucose area under the curve during the intravenous glucose tolerance test (glucose dose 300 mg/kg, plasma samples before glucose dose and at 10-min intervals for 90 min) was significantly lower and the glucose disappearance rate after a glucose injection tended to be steeper after the MUFA-diet than after the SAFA-diet. After the MUFA-diet serum total cholesterol was 21.6% lower and serum low-density-lipoprotein cholesterol 29.5% lower than after the SAFA-diet, but high-density-lipoprotein cholesterol did not differ between the diets. The results give suggestive evidence that the dietary fatty acid composition affects glucose tolerance of healthy subjects.

Adult↗
PubMed1994

Metabolic evolution of type 2 diabetes: a 10-year follow-up from the time of diagnosis.

OBJECTIVES: To investigate fasting and post-load plasma glucose, insulin and C-peptide levels during oral glucose tolerance tests in patients with type 2 diabetes and in control subjects, and the metabolic evolution of the diabetes. DESIGN, SETTING AND SUBJECTS: A 10-year prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed type 2 diabetic patients diagnosed at health centres between 1979 and 1981 and 144 (62 men, 82 women) nondiabetic control subjects recruited from the population register. At baseline, diabetic subjects were treated with diet only. The subjects were studied at baseline and after 5 and 10 years. MAIN OUTCOME MEASURES: The changes in plasma glucose, insulin and C-peptide levels in diabetic and control subjects at baseline and after 5 and 10 years follow-up. Factors associated with the decline in insulin and C-peptide levels in diabetic patients (e.g. metabolic control, islet cell antibodies). RESULTS: A slight increase in glucose levels was seen during the follow-up in both diabetic with diet and/or oral drug treated patients, but post-glucose insulin (and C-peptide and 5- and 10-year examination) levels declined in diabetic patients; this was opposite to the controls, in whom the levels tended to increase. The decline in insulin levels (area under the curve) during the follow-up was greatest in those diabetic patients with poor metabolic control during the follow-up. The cumulative incidence of requirement for insulin based on various cut-off levels for post-glucagon C-peptide nearly doubled between the 5- and 10-year examinations. Islet cell antibodies were predictive of insulin deficiency. CONCLUSIONS: Type 2 diabetes was characterized by progressive impairment of insulin response to glucose and this decline was associated with poor metabolic control of diabetes.

Aged↗
PubMed1994

Physical activity and fibrinogen concentration in newly diagnosed NIDDM.

OBJECTIVE: To evaluate whether plasma fibrinogen concentration is correlated with the level of physical activity and aerobic power in patients with newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: We studied 78 middle-aged (54 +/- 6 years, mean +/- SD), obese (body mass index [BMI] 32+/- 5 kg/m2) patients (45 men and 33 women) before and after a 12-month treatment period consisting of either conventional treatment given by community health centers or intensified dietary and exercise education given by a university outpatient clinic. Plasma fibrinogen concentration was measured by using a coagulometer. Physical activity was assessed by a questionnaire, and the patients were classified into a sedentary group or moderately or intensively exercising groups. Aerobic power (maximum oxygen uptake [VO2max], anaerobic threshold [VO2at]) was measured by direct breath-by-breath technique. RESULTS: At baseline, the sedentary patients had higher fibrinogen concentration than those with moderate or high physical activities (3.8 +/- 0.8 vs. 3.3 +/- 0.7 g/l, P < 0.01). Both VO2max and VO2at (ml.min-1.kg-1) showed an inverse linear correlation with fibrinogen (r = -0.38, P < or = 0.001, and r = -0.29, P < 0.01, respectively). In the stepwise multiple regression analysis, BMI, VO2 (ml/min), and smoking were the only significant independent factors explaining 23% of the variance in fibrinogen concentration. In sedentary patients, poor glycemic control was related with high fibrinogen concentration. During the follow-up period, patients maintained, on the average, good to moderate glycemic control. The originally sedentary group showed a decrease in fibrinogen concentration (to 3.3 +/- 0.7 g/l, P < or = 0.001) that reached the same level that the physically more active groups had at baseline. This change was associated with improved glycemic control, but not with any of the other assessed factors, including fatty acid composition of serum lipids reflecting dietary intake of fats. CONCLUSIONS: In addition to BMI and smoking, low reported physical activity and low aerobic power are independently associated with high plasma fibrinogen concentration in newly diagnosed NIDDM.

Adult↗
PubMed1994

Metabolic and dietary determinants of serum lipids in obese patients with recently diagnosed non-insulin-dependent diabetes.

The aim of the study was to ascertain the metabolic and dietary determinants of changes in serum lipids during a 15-month diet therapy of obese patients (n = 71, 41 males, 30 females) with recently diagnosed Type 2 (non-insulin-dependent) diabetes. The subjects lost weight and improvement in glycaemic control was observed, but due to variation in individual responses the mean serum total cholesterol or non-HDL cholesterol did not change significantly. The proportion of palmitic acid decreased and that of linoleic acid increased in serum lipids during the study, and serum triglycerides decreased and HDL-cholesterol increased. In univariate analyses, decreased serum triglyceride level was associated with serum triglycerides at baseline, decreases in body mass index, fasting blood glucose and palmitic acid proportion of serum triglycerides, and the intake of saturated fats and dietary fibre, but in multiple regression analyses the determinants for decreased serum triglycerides were high serum triglycerides at baseline and a decreased proportion of palmitic acid in serum triglycerides. In univariate analysis, increased HDL-cholesterol was associated with the baseline HDL-cholesterol, decrease in the triceps/subscapularis ratio and the intake of saturated and mono-unsaturated fatty acids, but none of these variables had an independent contribution to the increase in serum HDL-cholesterol in multiple regression analysis. In conclusion, a reduction of palmitic acid in the serum lipids, which was probably due to reduction of dietary saturated fatty acids, had beneficial effects on serum lipids in obese patients with Type 2 diabetes, independently of weight loss and improvement in glycaemic control.

Adult↗