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Biomedical subjects

M Uusitupa

Publications and source records attributed to M Uusitupa.

At least 127 records · Page 7Linked to original sources
PubMed1994

Relation of habitual diet and cardiorespiratory fitness to blood coagulation and fibrinolytic factors.

The relation of habitual diet and cardiorespiratory fitness to plasma fibrinogen concentration, Factor VII activity (F VIIc), Factor X activity (F X), tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1) concentrations, anti-thrombin III (AT III) and apolipoprotein(a) (Apo[a]) was analyzed in 111 normolipidemic men aged 51-53 years. Diet was evaluated by seven day food records. Maximal oxygen consumption and aerobic threshold were determined in maximal bicycle ergospirometry test based on breath-by-breath analysis of expired respiratory gas. Plasma fibrinogen was measured by thrombin method, F VIIc by one-stage coagulation method, AT III and F X colorimetrically, t-PA and PAI-1 antigens by ELISA and Apo(a) concentration radioimmunologically. Carbohydrate intake was negatively (r = -0.31, p < 0.001; r = -0.24, p < 0.01; r = -0.36, p < 0.001) and fat intake positively (r = 0.24, p < 0.01; r = 0.29, p < 0.001; r = 0.32, p < 0.001) related to F X, PAI-1, and t-PA, respectively. Aerobic threshold correlated negatively with fibrinogen (r = -0.33, p < 0.001) and F X (r = -0.30, p < 0.001). Fasting insulin was the strongest determinant for PAI-1 (r = 0.55, p < 0.001) and a significant positive correlate to F VIIc (r = 0.30, p < 0.001), F X (r = 0.28, p < 0.01) and t-PA (r = 0.47, p < 0.001). These data emphasize the importance that carbohydrate rich diet and cardiorespiratory fitness may have against thrombogenesis.

Aerobiosis↗
PubMed1993

Nerve function and its determinants in patients with newly-diagnosed type 2 (non-insulin-dependent) diabetes mellitus and in control subjects--a 5-year follow-up.

In order to assess the changes in nerve function 5 years after the diagnosis of diabetes mellitus and the determinants of progression of neuropathy, we studied 113 Type 2 (non-insulin-dependent) diabetic patients and 127 non-diabetic control subjects. Motor and sensory nerve conduction velocities were measured at the time of diagnosis of diabetes and 5 years later. At both examinations conduction velocities and response amplitudes were lower in diabetic patients than in control subjects. During the follow-up sural nerve conduction was impaired in both diabetic and control subjects, but, in general, changes in neurophysiological parameters were slight and inconsistent. In 12 diabetic patients nerve function deteriorated significantly during the follow-up. These patients had higher glycaemic indices at both examinations and lower baseline blood pressure levels as compared to the rest of the diabetic patients. No differences between these patient groups were found in other baseline risk factors (age, obesity, use of alcohol, smoking, serum insulin levels, albuminuria, lipids). In conclusion, Type 2 diabetic patients have disturbed nerve function at the time of diagnosis, but neurophysiological impairment during the next 5 years is on the average slight. Poor glycaemic control seems to be the most important risk factor in the deterioration of nerve function in these patients.

Aged↗
PubMed1993

The maintenance of improved metabolic control after intensified diet therapy in recent type 2 diabetes.

Altogether 86 patients with recently diagnosed NIDDM, aged 40-64 years were randomised after 3 months of basic education to intensified diet (Int. group, 21 men, 19 women) or conventional treatment groups (Conv. group, 28 men, 18 women). The aim was to examine whether an intensified diet education would result in a better metabolic control and greater reduction in cardiovascular risk factors than conventional treatment for obese patients with recently diagnosed type 2 diabetes mellitus. Furthermore, both groups were re-examined after a second year of observation period to find out the maintenance of the results after intervention. After basic education, Int. group participated in 12-months diet education, while Conv. group was treated in local health centres. During the intervention period, only Int. group showed further weight reduction. Only 20% of patients in Int. and 6% of patients in Conv. group had BMI < 27 kg/m2 at the end of the intervention, while 75% of patients in Int. and 52% of patients in Conv. group had achieved a good metabolic control (fasting blood glucose < 6.7 mmol/l; P = 0.005 between groups). Serum total cholesterol did not change significantly, but the changes in HDL-cholesterol, triglycerides and apolipoprotein B level were significant in Int. group only. The proposed acceptable values for serum lipids were achieved by 52 to 88% of patients without major differences between the two groups. During the second year of observation, weight gained in both groups and a deterioration was seen in metabolic control. Despite that a greater proportion of patients in the Int. group still was in good metabolic control (55.3% vs. 31.8%, P = 0.016), furthermore Int. group was receiving less frequently oral drugs for hyperglycaemia than Conv. group. No differences in serum lipids were observed between the groups after the observation period. HDL-cholesterol showed a persistent improvement in both groups.

Adult↗
PubMed1993

Resting energy expenditure in relation to energy intake in patients with Alzheimer's disease, multi-infarct dementia and in control women.

Energy intake and resting energy expenditure in relation to body composition were studied in female patients with Alzheimer's disease, multi-infarct dementia and in home-living non-demented elderly women. Patients with Alzheimer's disease tended to have lower body weight and higher energy intake (p = NS) than control subjects or patients with multi-infarct dementia. Resting energy expenditure did not differ significantly between the groups (1089 +/- 129 kcal/day for patients with Alzheimer's disease, 1078 +/- 102 kcal/day for patients with multi-infarct dementia and 1188 +/- 143 kcal/day for control women; mean +/- SD). Energy expenditure did not differ between the groups when calculated in relation to body weight or lean body mass. In institutionalized female patients with long-standing Alzheimer's disease the resting energy expenditure was not increased, but they tended to have low body weight despite a high energy intake.

Aged↗
PubMed1993

A prospective study of clinical and metabolic associates of proteinuria in patients with type 2 diabetes mellitus.

Urinary protein excretion rate and clinical and metabolic associates were investigated in a group of 108 patients with Type 2 diabetes mellitus at the time of diagnosis and after 5 years, and also 121 control subjects. The presence of coronary heart disease, neuropathy and retinopathy, cardiovascular risk factors and 24-h urinary excretion rate of albumin, beta-2-microglobulin, and IgG were examined. At the 5-year examination, urinary excretion rate of albumin was higher in diabetic patients than in control subjects (39 +/- 75 vs 16 +/- 28 mg 24 h-1 for men, p < 0.05; 38 +/- 57 vs 22 +/- 42 mg 24(-1) h for women, p < 0.01). Furthermore, increased beta-2-microglobulin excretion rate, a marker of tubular impairment, was observed in diabetic men as compared to control men (0.17 +/- 0.15 vs 0.14 +/- 0.21 mg 24 h-1, p < 0.05). Diabetic patients with increased albumin excretion rate (> 30 mg 24 h-1) showed poorer metabolic control than those with normal albumin excretion rate, but no significant differences in body mass index or in the frequencies of smoking, hypertension, coronary heart disease or retinopathy and neuropathy were observed between the groups. Baseline hyperinsulinaemia was closely associated with increasing albuminuria at the 5-year examination.

Adult↗
PubMed1993

Increased urinary polyamine excretion after starting a very low calorie diet.

Urinary polyamine excretion has been suggested to reflect hypermetabolism or catabolism in different illnesses. In the present study, the excretion of urinary polyamines was examined in 12 obese subjects (3 men, 9 women aged 32-55 y, body mass index 33.3-64.7 kg m-2) before and during a very low calorie diet (the total calorie intake 2100-3350 kJ). In addition, nitrogen balance, basal energy expenditure (BEE) and serum thyroid hormone levels were examined. During the first week on a very low calorie diet (VLCD) the mean body weight declined from 121.8 +/- 27.3 to 117.4 +/- 26.2 kg (mean +/- SD, p < 0.001), and after 12 weeks of treatment body weight was 106.6 +/- 24.6 kg. Immediate reduction of BEE from 1.44 +/- 0.24 to 1.34 +/- 0.24 kcal min-1 (p < 0.001) was found within the first week of therapy and BEE measured on weight-maintaining diet remained lower at 12 weeks (1.25 +/- 0.27 kcal min-1, p < 0.01). Serum free T3 decreased and reverse T3 increased significantly after starting VLCD. Nitrogen balance remained negative during the first 2 weeks on VLCD. A significant increase in total (38%), and in N1-acetyl- and N8-acetylspermidine excretions in the urine (40% and 27%, respectively, p < 0.05) was found during the first week, but later on the levels were not significantly different from the baseline levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Endocrine and metabolic effects of guar gum in menopausal women.

The effect of a gel-forming dietary fiber, guar gum (15 g/day) on blood pressure, climacteric symptoms, serum hormones (estrone, estradiol, testosterone, androstenedione, follicle-stimulating hormone and luteinizing hormone) and on blood glucose and serum lipids (cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides) was studied in a double-blind, placebo-controlled, parallel-group trial involving 30 menopausal women. A total of 15 women (Group A) were treated with guar gum and 15 (Group B) with placebo, for 6 months. Patients visited the doctor at the beginning of the study and after 3 and 6 months of treatment. Climacteric symptoms decreased significantly (p < 0.001) in both groups. Serum total cholesterol decreased by 5% in the guar gum group but this was not statistically significant. No changes in serum hormone levels or in other lipid and blood glucose levels were observed in either group. Body weight and blood pressure also did not change.

Blood Glucose↗
PubMed1993

Validation of a short dietary questionnaire and a qualitative fat index for the assessment of fat intake.

In connection with a population-based study on familial and non-familial determinants of serum total cholesterol an interviewer-administered short questionnaire, including 21 food items, and a qualitative fat index based on four questions were developed. Subjects for the validation study, 51 women and 31 men, aged 16-71 years, were selected from the population-based study (n = 892). The short questionnaire and the qualitative fat index were validated with a 3 day food record as the reference method. The short questionnaire captured 90-97% of the mean intakes of total fat, saturated, monounsaturated and polyunsaturated fatty acids and cholesterol. The Pearson correlation coefficients between the fat intakes based on the questionnaire and the diet records were strongest for the intake of total fat (r = 0.80). The qualitative fat index was based on four questions concerning type of fat: the higher the scores the higher the intakes of polyunsaturated fatty acids. The Spearman correlation coefficients between the qualitative fat index and the intakes based on the diet records were -0.55 for saturated, 0.34 for monounsaturated and 0.52 for polyunsaturated fatty acids. The respective correlation for the P/S ratio (total amounts of polyunsaturated fatty acids/saturated fatty acids) and the PM/S ratio (total amounts of polyunsaturated and monounsaturated fatty acids/saturated fatty acids) were 0.50 and 0.53. An inverse association between serum total cholesterol and the qualitative fat index was found in the whole study population, suggesting the impact of dietary fat on serum cholesterol in this study population. In conclusion, the short questionnaire proved to be accurate in measuring the intake of different fatty acids at the group level, whereas the simpler fat index measured the quality of fat quite well.

Adolescent↗
PubMed1992

Left ventricular function and dimensions in newly diagnosed non-insulin-dependent diabetes mellitus.

Left ventricular (LV) function and dimensions were assessed with Doppler and M-mode echocardiography in 26 men and 17 women with newly diagnosed non-insulin-dependent diabetes mellitus, and in 13 healthy control men and 13 women. The diabetic men had lower peak filling rate normalized to mitral stroke volume than the control men (mean +/- standard error of the mean, 4.2 +/- 0.1 vs 4.9 +/- 0.3 stroke volume/s, p less than 0.01). The diabetic women had increased LV mass (102 +/- 12 vs 86 +/- 8 g/m2, p less than 0.01) and decreased fractional shortening (34 +/- 1 vs 38 +/- 1%, p less than 0.05) when compared with control women. At 3 and 15 months, 23 diabetic men and 15 women were reexamined. Concomitantly with decreasing blood glucose levels, fractional shortening improved mainly during the first 3 months and was significantly higher in both diabetic men (36 +/- 2 vs 30 +/- 2%, p less than 0.05) and women (38 +/- 1 vs 34 +/- 1%, p less than 0.05) at 15 months than at baseline. In the diabetic men, peak filling rate increased from 4.3 +/- 0.1 stroke volume/s at baseline to 4.8 +/- 0.2 stroke volume/s at 15 months (p less than 0.05). At 15 months, peak filling rate was correlated (r = 0.61, p less than or equal to 0.001) with autonomic nervous function assessed as heart rate variability during deep breathing test in diabetic men who also showed an inverse correlation between LV hypertrophy and heart rate variability throughout the follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Habitual physical activity, aerobic capacity and metabolic control in patients with newly-diagnosed type 2 (non-insulin-dependent) diabetes mellitus: effect of 1-year diet and exercise intervention.

The aim of this study was to assess the effects of a 1-year intensified diet and exercise education regimen on habitual physical activity and aerobic capacity in middle-aged, obese patients with newly-diagnosed Type 2 (non-insulin-dependent) diabetes mellitus. In addition, we analysed whether the level and the changes in physical activity and aerobic capacity are related to the metabolic control of diabetes. After a 3-month basic education programme, 78 patients (45 men, 33 women) were randomly placed in an intervention or conventionally treated group. The intervention group received intensified diet education and continuous encouragement to increase physical activity which was monitored using exercise records and questionnaires. Aerobic capacity was assessed by measuring oxygen uptake at anaerobic threshold and at peak exercise. The proportion of patients with regular recreational exercise increased from 24% to 38% in the intervention men (0.10 less than p less than 0.20), remained at 54% in the conventionally treated men, increased from 53% to 70% in the intervention women (0.10 less than p less than 0.20) and from 31% to 50% (0.10 less than p less than 0.20) in the conventionally treated women. No measurable improvement was found in oxygen uptake in any of the groups. When the groups were combined, HbA1c showed an inverse correlation with oxygen uptake at anaerobic threshold (r = 0.27, p less than 0.01) and maximum oxygen uptake (r = 0.28, p less than 0.01) at 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerobiosis↗
PubMed1992

Morning or bed-time insulin with or without glibenclamide in elderly type 2 diabetic patients unresponsive to oral antidiabetic agents.

We studied in a group of elderly (mean age 77 yr) non-obese Type 2 diabetic patients (n = 9) in a randomised, placebo-controlled prospective cross-over study of 8 months duration, the effects of substituting maximal sulfonylurea medication with a single injection of human zinc insulin taken either at bedtime (BTI) or morning (MI). All patients were poorly controlled with oral antidiabetic agents. After a 2-month regimen with either BTI or MI, a glibenclamide (GL, 3.5 mg/day) was given for an additional 2 months. Both insulin regimens decreased mean diurnal blood glucose and glycosylated HbA1c values to a similar extent (2.6-2.7%; p < 0.01-0.05), but with a lower daily insulin dose with BTI (0.30 +/- 0.03 IU/kg) as compared with MI (0.39 +/- 0.05 IU/kg; p < 0.01). A further improvement in metabolic control was observed in both groups after the introduction of GL; the mean reduction in glycosylated HbA1c was 1.4% for BTI and 0.7% for MI (p < 0.01 and 0.05, respectively), In conclusion, a subgroup of poorly controlled elderly Type 2 diabetic patients showed an improvement in metabolic control after a single injection of insulin despite discontinuation of maximal doses of oral antidiabetic agents. After 2 months of insulin treatment, a further improvement was achieved by a low dose of sulfonylurea in these patients who were formerly considered unresponsive to oral antidiabetic agents.

Aged↗