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Peter Schnohr

Publications and source records attributed to Peter Schnohr.

30 records · Page 2Linked to original sources
PubMed2004

A solid dietary fat containing fish oil redistributes lipoprotein subclasses without increasing oxidative stress in men.

There is a demand and need for healthy solid dietary fats. However, synthetic fats can be tailored to contain specific physiologic properties. Our goal was to design dietary solid test fats that would be both beneficial to the atherogenic lipid profile and stable against lipid peroxidation. Sixteen men (age 35-75 y) substituted 80 g of their normal dietary fat intake with test fat for two periods of 21 d each in a double-blind, randomized, crossover study. Although solid, both test fats were low in cholesterol-raising SFA. Test fat "F" contained 5 g/100 g long chain (n-3) fatty acids matched by oleic acid in test fat "O." Plasma total triacylglycerol (TAG), VLDL TAG, cholesterol in VLDL, and intermediate density lipoproteins (IDL) were lower (P < 0.05), whereas apolipoprotein (apo) B of the large LDL-2 (d = 1031-1042 g/L) subclass, and cholesterol of HDL(2b) subclass, were higher after intake of F than O fat (P < 0.05). There was no difference in the effect on in vivo oxidation measured as the ratio of plasma isoprostanes F(2) to arachidonic acid and urinary isoprostanes, whereas the vitamin E activity/plasma total lipids ratio was higher after intake of F than O (P = 0.008). In conclusion, a solid dietary fat containing (n-3) PUFA decreased plasma TAG, VLDL, and IDL cholesterol, and redistributed lipoprotein subclasses in LDL and HDL, with a higher concentration of the larger and less atherogenic subfractions. These changes took place without an increase in oxidative stress as measured by in vivo markers.

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PubMed2004

Changes in alcohol intake and mortality: a longitudinal population-based study.

BACKGROUND: Using alcohol intake at one point in time, numerous studies have shown a J- or U-shaped relation with all-cause mortality. Mortality is lowest among the light to moderate drinkers, with the risk of dying from coronary heart disease higher among nondrinkers and the risk of dying from cancer higher among heavy drinkers. We studied whether changes in individual alcohol intake result in corresponding changes in mortality. METHODS: In a longitudinal study of 6644 men and 8010 women, age 25 to 98 years, who had attended at least 2 health surveys with a 5-year interval between them, we addressed the risk of death after combinations of changes in alcohol intake. RESULTS: Mortality after changes in alcohol intake was consistent with the mortality observed among those who reported stable drinking. Stable drinkers showed a U-shaped all-cause mortality, with relative risks of 1.29 (95% confidence interval [CI] = 1.13-1.48) for nondrinkers (< 1 drink per week) and 1.32 (1.15-1.53) for heavy drinkers (> 13 drinks per week) compared with light drinkers (1 to 6 drinks per week). For coronary heart disease mortality, stable nondrinkers had a relative risk of 1.32 (0.97-1.79) compared with stable light drinkers and those who had reduced their drinking from light to none increased their risk (1.40; 1.00-1.95), and those who had increased from nondrinking to light drinking reduced their relative risk ratio (0.71; 0.44-1.14). Cancer mortality was increased in all groups of heavy drinkers. CONCLUSION: Persons with stable patterns of light and moderate alcohol intake had the lowest all-cause mortality. Individual changes in alcohol intake were followed by corresponding changes in mortality.

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PubMed2003

Changes in leisure-time physical activity and risk of death: an observational study of 7,000 men and women.

Associations of regular leisure-time physical activity and changes in leisure-time physical activity with risk of death were studied in 7,023 healthy men and women aged 20-79 years in Copenhagen, Denmark. Physical activity was estimated in both 1976-1978 and 1981-1983. Men consistently engaging in a moderate or high degree of physical activity, respectively reported at both examinations, had significantly lower risks of death than men reporting low activity at both examinations. Adjusted relative risks were 0.71 (95% confidence interval (CI): 0.57, 0.88; p = 0.002) and 0.61 (95% CI: 0.48, 0.76; p < 0.001), respectively. Similar relative risks were found in women: 0.64 (95% CI: 0.52, 0.79; p < 0.001) and 0.66 (95% CI: 0.51, 0.85; p = 0.001), respectively. Men who increased their leisure-time physical activity from low to moderate or high had a significantly lower risk of death than men reporting low physical activity at both examinations (relative risk = 0.64, 95% CI: 0.50, 0.81; p < 0.001). In this study, maintaining or adopting a moderate or high degree of physical activity was associated with lower risk of death across a wide range of ages in both sexes.

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PubMed2003

Platelet glycoprotein IIb/IIIa Pl(A2)/Pl(A2) homozygosity associated with risk of ischemic cardiovascular disease and myocardial infarction in young men: the Copenhagen City Heart Study.

OBJECTIVES: We tested the hypothesis that platelet glycoprotein (GP) IIb/IIIa Pl(A2)/Pl(A2) homozygotes or Pl(A1)/Pl(A2) heterozygotes versus Pl(A1)/Pl(A1) noncarriers have increased risk of ischemic cardiovascular disease and myocardial infarction (MI), stratified for age and gender. BACKGROUND: The GP IIb/IIIa Pl(A1)/Pl(A2) polymorphism influences aggregation of platelets; however, an association between ischemic cardiovascular disease and heterozygosity remains controversial, and association with homozygosity is largely unexplored. METHODS: We genotyped the participants of the Copenhagen City Heart Study, a prospective cardiovascular investigation of the Danish general population (n = 9,149, 22-year follow-up) and assessed the risk of ischemic cardiovascular disease in heterozygotes or homozygotes versus noncarriers. RESULTS: Of the participants, 70.0%, 27.3%, and 2.7% were noncarriers, heterozygotes, or homozygotes, respectively. Incidence of ischemic cardiovascular disease was 167 and 103 per 10,000 person-years in homozygous and noncarrier men (log-rank: p = 0.006), whereas this difference was not observed in women (p = 0.33) (genotype.gender interaction: p = 0.03). In homozygous versus noncarrier men <40 years of age, 40 to 50 years, and >50 years at entry, age-adjusted relative risks (RRs) of ischemic cardiovascular disease were 3.6 (1.4 to 9.0), 2.4 (1.3 to 4.6), and 1.0 (0.6 to 1.8), respectively (age.genotype interaction in men: p = 0.04); equivalent multifactorially adjusted RRs were 3.0 (1.1 to 8.0), 2.0 (1.0 to 3.9), and 1.0 (0.6 to 1.8), respectively. The corresponding age-adjusted RR values of MI in men were 5.2 (1.5 to 18), 3.5 (1.6 to 7.5), and 0.5 (0.1 to 1.5), respectively (age.genotype interaction in men: p = 0.002); equivalent multifactorially adjusted RRs were 3.8 (1.0 to 15), 3.1 (1.4 to 6.9), and 0.5 (0.2 to 1.5), respectively. CONCLUSIONS: Pl(A2)/Pl(A2) homozygosity is associated with a three-fold and four-fold risk of ischemic cardiovascular disease and MI in young men.

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PubMed2003

Hepatic lipase mutations,elevated high-density lipoprotein cholesterol, and increased risk of ischemic heart disease: the Copenhagen City Heart Study.

OBJECTIVES: We investigated associations between single nucleotide polymorphisms (SNPs) in the hepatic lipase promoter, levels of high-density lipoprotein (HDL), and risk of ischemic heart disease (IHD). Our primary hypothesis was that these SNPs associate with IHD after adjustment for HDL levels. BACKGROUND: Hepatic lipase influences HDL metabolism, and may thus affect reverse cholesterol transport and consequently risk of IHD. METHODS: We genotyped 9,121 white subjects aged 20 to 93 years from the Copenhagen City Heart Study, 456 of whom had incident IHD, as well as 921 Danish patients with IHD for the -216, -480, and -729 SNPs in the hepatic lipase promoter. RESULTS: Frequencies of wild-type, triple heterozygotes, and triple mutation homozygotes in the general population were 61%, 33%, and 5%, respectively. Compared with wild-type, HDL cholesterol levels were 4% (0.06 mmol/l) and 10% (0.15 mmol/l) higher in heterozygotes and mutation homozygotes; the equivalent values for apolipoprotein A1 were 3% and 7% higher. In prospective and case-control studies, mutation homozygotes versus wild-type had relative risk (RR) and odds ratio (OR) for IHD of 1.5 (95% confidence interval [CI]: 1.0 to 2.2) and 1.4 (CI: 1.1 to 1.9) when adjusted for age, gender, and HDL cholesterol. In individuals with the epsilon43 apolipoprotein E genotype, RR and OR for IHD in mutation homozygotes versus wild-type was 2.9 (CI: 1.5 to 5.6) and 2.0 (CI: 1.2 to 3.2). CONCLUSIONS: Hepatic lipase promoter SNPs are associated with increased HDL cholesterol and, paradoxically, an increased risk of IHD after adjustment for HDL cholesterol, and particularly in individuals with apolipoprotein E epsilon43 genotype. Implications are that increased HDL levels may in certain situations be not protective, but rather associated with increased IHD risk.

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PubMed2003

[Individual and population based risk factors of ischemic heart diseases. A 21-year follow-up of 12,000 men and women from the Osterbro study].

INTRODUCTION: The importance of coronary heart disease risk factors may differ between individuals and community and by sex and age. METHOD: The Copenhagen City Heart Study followed for 21 years a random sample of 5599 men and 6478 women aged 30 to 79 years at baseline. The importance of risk factors in individuals and the community were evaluated as relative and population attributable risks. RESULTS: We traced 2180 coronary events. In Cox regression analysis with ten risk factors entered simultaneously, relative risks for coronary heart disease in men ranged from 1.69 to 1.20 with the highest risks for diabetes, hypertension, smoking, and physical inactivity. In women, relative risks ranged from 2.74 to 1.19 with the highest risks for diabetes, smoking, hypertension, and physical inactivity. Population attributable risks in men ranged from 22 to 3% with the highest risks for smoking, hypertension, and no daily alcohol intake. In women, attributable risks ranged from 37 to 3% with the highest risks for smoking, hypertension, and hypercholesterolemia. Several of these rankings differed by age. DISCUSSION: The importance of coronary heart disease risk factors may differ for individuals, the community, and by sex and age. Consequently, prevention strategies should be tailored accordingly.

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PubMed2003

Vital exhaustion as a risk factor for ischaemic heart disease and all-cause mortality in a community sample. A prospective study of 4084 men and 5479 women in the Copenhagen City Heart Study.

BACKGROUND: Vital exhaustion, a psychological measure characterized by fatigue and depressive symptoms, has been suggested to be an independent risk factor for ischaemic heart disease (IHD) but the generality of the phenomenon remains in question. The aim of this study is to describe prevalence of these symptoms in a community sample and determine whether they prospectively predict increased risk of IHD and all-cause mortality in men and women. METHODS: The study base was 4084 men and 5479 women aged 20-98 free of IHD examined in 1991-1993 in the Copenhagen City Heart Study. Events were ascertained through record linkage until 1998 for IHD and September 2000 for all-cause mortality. There were 483 first hospital admissions and deaths caused by IHD and 1559 deaths from all causes during follow-up. RESULTS: The 17 items on the vital exhaustion questionnaire were frequently endorsed with prevalence ranging from 6 to 47 per cent, higher in women. All but 4 of the 17 items were significantly associated with IHD with significant relative risks (RR) ranging between 1.36 (95% CI: 1.08, 1.72) and 2.10 (95% CI: 1.63, 2.71). Associations with all-cause mortality were also observed, but were weaker. RR of both IHD and all-cause mortality increased with increasing item sum score and were similar in men and women. For IHD, RR reached a maximum of 2.57 (95% CI: 1.65, 4.00) for subjects endorsing >9 items. The similar RR for all-cause mortality was 2.50 (95% CI: 2.09, 2.99). Multivariate adjustment for biological, behavioural, and socioeconomic risk factors did not substantially affect the association for IHD but attenuated the association with all-cause mortality. CONCLUSIONS: Measures of fatigue and depression were common symptoms in this population sample and convey increased risk of IHD and of all-cause mortality. We propose this knowledge begin to be implemented in risk assessment in clinical practice.

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PubMed2003

Nonlinear relation between alcohol intake and high-density lipoprotein cholesterol level: results from the Copenhagen City Heart Study.

BACKGROUND: It has been suggested that the level of high-density lipoprotein cholesterol (HDL-C) in the blood can be used as a marker of recent alcohol intake. However, before using HDL-C as a predictor of alcoholism, the relation between alcohol intake and HDL-C in the entire range of consumption must be explored. Most studies model the relation between alcohol intake and HDL-C linearly, although a threshold effect is expected. The objective of this study was to evaluate the shape of the relation between intake of alcohol and HDL-C and to determine whether there are differential effects of beer, wine, and spirits on HDL-C and whether they remain after adjusting for total alcohol. METHOD: The relation between alcohol intake and HDL-C was investigated by means of generalized additive models using data from the Copenhagen City Heart Study. RESULTS: A nonlinear effect of alcohol improved the model fit significantly, and the nonlinearity of alcohol was highly significant in both men and women. The relation was concave: HDL-C was stable in men and women who drank more than approximately 35 and 20 drinks per week, respectively. We found a significant nonlinear term of wine on HDL-C in men after adjustment for total alcohol intake. CONCLUSIONS: There was a concave relation between alcohol intake and HDL-C, indicating a threshold effect of alcohol on HDL-C. The association between wine and HDL-C in men after adjusting for total alcohol intake may be due to residual lifestyle confounding.

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PubMed2002

[Mortality associated with physical activity in leisure time, at work, in sports and cycling to work].

INTRODUCTION: Previous studies have shown that high levels of physical activity are associated with lower mortality in middle-aged men. Few studies have investigated this association in women and the independent effects of cycling to work and participation in sports. MATERIAL AND METHODS: The participants were 13,445 women and 17,441 men aged 20 to 93 years. Self-reported physical activity included general questions about leisure time physical activity and physical activity at work, sports participation, and cycling to work. Adjustment was made for blood pressure, total cholesterol, triglyceride, body mass index, smoking, and educational level. RESULTS: During 433,000 person-years of observation, 2738 women and 4672 men died. Physical inactivity during leisure time predicted mortality in both men and women in all age groups. In women and men, the most physically active in leisure time experienced only half the mortality of the sedentary. Even in the moderately and highly active persons, sports participants experienced only half the mortality of non-participants. Physical activity at work predicted mortality in women only. The men and women who rode a bicycle to work had a 39% lower risk of mortality after multivariate adjustment including leisure time physical activity. DISCUSSION: Leisure time physical activity was inversely associated with all-cause mortality in both men and women in all age groups. Benefit was found from moderate leisure time physical activity with further benefit from sports activity and bicycling as transportation. Benefit from physical activity at work was found in women only.

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PubMedDate not supplied

Energy adjustment methods applied to alcohol analyses.

When alcohol consumption is related to outcome, associations between alcohol type and health outcomes may occur simply because of the ethanol in the beverage type. When one analyzes the consequences of consumption of beer, wine, and spirits, the total alcohol intake must therefore be taken into account. However, owing to the linear dependency between total alcohol intake and the alcohol content of each beverage type, the effects cannot be separated from each other or from the effect of ethanol. In nutritional epidemiology, similar problems regarding intake of macronutrients and total energy intake have been addressed, and four methods have been proposed to solve the problem: energy partition, standard, density, and residual. The aim of this study was to evaluate the usefulness of the energy adjustment methods in alcohol analyses by using coronary heart disease as an example. Data obtained from the Copenhagen City Heart Study were used. The standard and energy partition methods yielded similar results for continuous, and almost similar results for categorical, alcohol variables. The results from the density method differed, but nevertheless were concordant with these. Beer and wine drinkers, in comparison with findings for nondrinkers, had lower risk of coronary heart disease. Except for the case of men drinking beer, the effect seemed to be associated with drinking one drink per week. The standard method derives influence of substituting alcohol types at constant total alcohol intake and complements the estimates of adding consumption of a particular alcohol type to the total intake. For most diseases, the effect of ethanol predominates over that of substances in the beverage type, which makes the density method less relevant in alcohol analyses.

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PubMedDate not supplied

Stroke case fatality in Denmark from 1977 to 1992: the Copenhagen City Heart Study.

BACKGROUND AND PURPOSE: Stroke mortality rates have decreased in Denmark but little is known about the reasons for these changes. One possible explanation is decreased case-fatality, and the aim of the present investigation was to study trends in case-fatality for first-ever stroke in a large population-based cohort study in Copenhagen, Denmark. SUBJECTS AND METHODS: The Copenhagen City Heart Study comprised 19,698 inhabitants in Copenhagen, Denmark. Linkage to two national registers enabled identification of all subjects irrespective of participation in the study examinations. Follow-up in the present study was from January 1, 1977 to December 31, 1992. Case fatality after 7 days, 28 days, 1 year and 1 year in 28-day survivors was assessed for first-ever stroke. Uniform identification and validation methods made it possible to estimate trends in case-fatality. The World Health Organization's definition of stroke was used, and stroke was categorized into either unspecified stroke, ischemic infarction, intracerebral hemorrhage, or subarachnoid hemorrhage. The effect of time was estimated by means of multiple logistic regression analyses adjusting for gender, age at onset and type of stroke. RESULTS: A total of 1,213 strokes occurred during the study period from 1977 to 1992 in the study population. The case-fatality was highest during the first 28 days, and especially the initial 7 days; thereafter a steady state was reached. From the period 1977-1980 to the period 1989-1992 case-fatality did not change in analyses of 7-day case-fatality odds ratio (OR) = 1.14 (95% confidence interval, CI: 0.98-1.33), or of 28-day case-fatality OR = 1.06 (95% CI: 0.92-1.20), or of 1-year case-fatality OR = 0.95 (95% CI: 0.84-1.07). In the 1-year case-fatality, including only 28-day survivors, a significant decrease was found OR = 0.81 (95% CI: 0.67-0.97). Men had a significantly lower 7-day case-fatality than women; OR = 0.73 (95% CI: 0.52-0.99), but the difference attenuated in subsequent analyses and did not remain statistically significant. CONCLUSION: During the period 1977-1992, the 1-year case-fatality decreased in stroke patients who survived the initial 28 days, whereas no changes were observed in 7-day, 28-day and 1-year case-fatality.

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