Biomedical subjects

T Rönnemaa

Publications and source records attributed to T Rönnemaa.

At least 19 recordsLinked to original sources

PubMed1996

Effects of prospective, randomized cholesterol-lowering dietary intervention and apolipoprotein E phenotype on serum lipoprotein(a) concentrations of infants aged 7-24 mo.

A high serum lipoprotein(a) [Lp(a)] concentration is associated with increased risk of coronary artery disease. Few external factors are able to markedly modify serum Lp(a) concentrations. The aim of this study was to evaluate how serum Lp(a) concentrations of infants between 7 and 24 mo of age change in a cholesterol-lowering dietary intervention, and to assess the influence of apolipoprotein (apo) E phenotypes on serum Lp(a) concentrations. The intervention children (n=394) had serum cholesterol, non-high-density-lipoprotein cholesterol, and cholesterol corrected for Lp(a)-cholesterol values (P for all <0.001) lower than those of the control children (n=390), but median serum Lp(a) concentrations at the age of 24 mo were not different from those of control children. Serum Lp(a) values differed according to the apo E phenotype as the median Lp(a) values increased from E2/2 to E3/2, E4/2, E3/3, E4/3, and to E4/4 (P for the difference=0.023, Mann-Whitney U test). Our results suggest that apo E phenotype influences serum Lp(a) concentrations noticeably, but the effect of the cholesterol-lowering dietary intervention was not significant in subjects aged 24 mo.

Apolipoproteins E↗

PubMed1996

Predictors of stroke in middle-aged patients with non-insulin-dependent diabetes.

BACKGROUND AND PURPOSE: The risk of stroke is known to be markedly elevated in patients with non-insulin-dependent diabetes mellitus (NIDDM), but the information on risk factors predicting stroke events in middle-aged NIDDM patients is limited. Therefore, we evaluated the significance of different cardiovascular risk factors with respect to the incidence of stroke in middle-aged NIDDM patients. METHODS: Levels of cardiovascular risk factors were determined at baseline in 1059 NIDDM patients (581 men, 478 women) and 1373 nondiabetic control subjects (638 men, 735 women), aged from 45 to 64 years, in eastern and western Finland. These patients were followed up for 7 years with respect to stroke events. RESULTS: Altogether, 34 NIDDM patients (13 men, 21 women) and 5 nondiabetic subjects (4 men, 1 woman) died from stroke, and 125 NIDDM patients (61 men, 64 women) and 30 (18 men, 12 women) nondiabetic subjects had a fatal or nonfatal stroke. The risk of stroke in NIDDM men was about threefold and in NIDDM women fivefold higher than that in corresponding nondiabetic subjects. Previous history of stroke increased the risk of a new stroke event by threefold. Patients with hyperglycemia (plasma glucose > 13.4 mmol/L) and high hemoglobin A1 (> 10.7%) had about a twofold higher risk of stroke than patients with better glycemic control. Low levels of high-density lipoprotein cholesterol (< 0.90 mmol/L), high levels of total triglyceride (> 2.30 mmol/L), and the presence of hypertension were associated with a twofold increase in the risk of stroke mortality or morbidity. CONCLUSIONS: Our prospective population-based study gives evidence that previous history of stroke, hypertension, hyperglycemia, and dyslipidemia are strong predictors of stroke in middle-aged patients with NIDDM.

Blood Glucose↗

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

The role of insulin in clustering of serum lipids and blood pressure in children and adolescents. The Cardiovascular Risk in Young Finns Study.

In adults hyperinsulinaemia is associated with an atherogenic risk profile including obesity, low levels of HDL-cholesterol, high levels of triglycerides and elevated blood pressure. To examine these associations in the young we studied the cross-sectional relationships of insulin with obesity indices (body mass index, subscapular skinfold thickness), serum lipids and blood pressure in 1,865 children, adolescents and young adults aged 6-24 years. We also used longitudinal data to study the value of a single insulin measurement to predict high risk factor levels and clustering of multiple risk factors after a 6-year follow-up. In cross-sectional analyses the levels of triglycerides, HDL-cholesterol, systolic blood pressure and obesity indices were usually significantly different across the quartiles of fasting insulin in both sexes among children, adolescents and young adults. In general, no associations were seen with total cholesterol or LDL-cholesterol. In prospective analysis elevated baseline insulin was related to the incidence of hypertriglyceridaemia (> or = 95th percentile) at the follow-up. This relationship persisted even after adjustments for baseline obesity or 6-year change in obesity status. Moreover, baseline insulin concentration was higher in subjects who subsequently showed clustering of high triglycerides, low HDL-cholesterol and high systolic blood pressure levels at the follow-up. We conclude that high fasting insulin levels measured in children and adolescents predict the development of hypertriglyceridaemia years later. In addition, high insulin levels seem to precede the development of a potentially atherogenic risk factor profile including low HDL-cholesterol, high triglycerides and high systolic blood pressure.

Adolescent↗

PubMed1995

Does NIDDM increase the risk for coronary heart disease similarly in both low- and high-risk populations?

Finland has marked regional differences in the occurrence of coronary heart disease (CHD). Although the causes for these differences in CHD mortality and morbidity in the Finnish population are unknown, it offers an excellent opportunity to investigate the effects of non-insulin-dependent diabetes mellitus (NIDDM) on CHD risk in two populations differing significantly with respect to the occurrence of CHD. Therefore, we carried out a 7-year prospective population-based study including a large number of patients with NIDDM (East Finland: 253 men and 257 women; West Finland: 328 men, 221 women) and corresponding non-diabetic subjects (East Finland: 313 men, 336 women; West Finland: 325 men, 399 women). In both study populations the presence of NIDDM increased significantly the risk for CHD events (CHD mortality or all CHD events including CHD mortality or non-fatal myocardial infarction). Diabetic men had 3-4 fold higher and diabetic women 8-11-fold higher risk for CHD than corresponding non-diabetic subjects. Both non-diabetic and diabetic subjects had odds ratios (East vs West) for CHD events of about 2 indicating a similar East-West difference in the CHD risk. Regional difference was quite similar in men and women. These results imply that factors related to NIDDM, independently of conventional risk factors and the occurrence of atherothrombosis in the background population, must play a major role in the pathogenesis of atherosclerotic vascular disease in NIDDM diabetes.

Analysis of Variance↗

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

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

Intensive physical and psychosocial training program for patients with chronic low back pain. A controlled clinical trial.

STUDY DESIGN: The authors conducted a controlled clinical trial with 1-year follow-up to define the effectiveness of an intensive physical and psychosocial training program on patients with low back pain. SUMMARY OF BACKGROUND DATA: The intervention group included 152 patients (mean age 40.5 yr, Million index 45.1/100), and the reference group included 141 patients (mean age 40.4 yr, Million-index 44.5/100). METHODS: The progressive intervention program consisted of intensive physical training and psychosocial activation. The outcomes were physical and psychosocial measures, the pain and disability index (Million), sick leaves, and occupational handicap. RESULTS: The intervention was more efficient with respect to physical measures and pain and disability index. There were only mild or no differences in changes between the study groups in psychologic variables, sick leaves, or retirement. CONCLUSIONS: The intervention program could improve physical disability, but to improve occupational handicap, activities of the whole society (social legislation, labor market policy) are needed.

Absenteeism↗

PubMed1994

Cardiac rehabilitation and return to work after coronary artery bypass surgery.

The work situation of 66 male patients who underwent elective coronary artery bypass surgery (CABS) and who had been randomly allocated to receive cardiac rehabilitation (group R) was compared with the work situation of 59 similar patients allocated to receive only standard care (group H). The follow-up time was one year. The proportions of subjects working in groups R and H were 26% and 20% (p = ns) before the CABS, 45% and 34% (p = ns) 6 months and 56% and 38% (p = ns) 12 months after the CABS, respectively. The increase in proportion of subjects who worked was significant in both groups at both 6 and 12 months after the CABS (p < 0.05 for all changes). The increases were not significantly different between the whole groups, but in patients younger than 55 years of age, return to work was more frequent in group R than in group H (at 12 months 60% vs. 35%, p for the difference in change = 0.02). Stepwise logistic regression analysis of the factors influencing return to work showed that a patient's judgement of his own working capacity as good 6 months after CABS (odds ratio (OR) 8.5, confidence interval (CI) 2.3-32.0), functional class I 6 months after the CABS (OR 6.7, CI 1.8-24.5), his desire to work (OR 6.4, CI 1.6-26.0) and absence from work of less than 3 months before the CABS (OR 4.9, CI 1.2-20.2) were significant positive predictors of return to work 1 year after the CABS.

Coronary Artery Bypass↗

PubMed1994

Is there a sex difference in the association of plasma insulin level and insulin sensitivity with serum lipids and lipoproteins?

Previous studies on the relationship between the plasma insulin level, insulin sensitivity (SI), serum lipids, and lipoproteins have been performed predominantly in men. Therefore, we investigated whether there is a sex difference in the association of insulin level during an oral glucose tolerance test and SI with lipids and lipoproteins among normoglycemic men and women aged 53 to 61 years. SI was determined by the minimal model from the frequently sampled intravenous glucose tolerance test (IVGTT). There were no correlations between total cholesterol or low-density lipoprotein (LDL) cholesterol and insulin level or SI. High-density lipoprotein (HDL) cholesterol correlated inversely with fasting insulin (r = -.26, P < .05 in men; r = -.29, P < .01 in women) and 2-hour insulin (r = -.31, P < .01 in men; r = -.39, P < .001 in women) and positively with SI (r = .28, P = .05 in men; r = .43, P < .001 in women). Total and very-low-density lipoprotein (VLDL) triglycerides correlated positively with fasting insulin (r = .43, P < .001 in men; r = .42, P < .001 in women) and 2-hour insulin (r = .50, P < .001 in men; r = .31, P < .01 in women) and inversely with (r = -.49, P < .001 in men; r = -.40, P < .001 in women). In multiple regression analyses including age, body mass index (BMI), waist to hip ratio, 2-hour glucose, fasting or 2-hour insulin, and SI, only BMI was associated with HDL cholesterol level in men.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1994

Clustering and six year cluster-tracking of serum total cholesterol, HDL-cholesterol and diastolic blood pressure in children and young adults. The Cardiovascular Risk in Young Finns Study.

Clustering and tracking of serum total cholesterol, high-density lipoprotein cholesterol (HDL-C) and diastolic blood pressure were studied in children and young adults. "High-risk" individuals were defined as those having these risk factors at the age and sex specific upper tertile (lowest tertile for HDL-C). Among older boys risk factors occurred at adverse levels more often than expected by chance. Cluster-tracking was assessed as the probability of remaining in the extreme tertiles during follow-up. Approximately 25% of subjects initially at "risk" remained there for 6 years. Subjects who became high-risk individuals during the follow-up expressed greater increase in obesity indices, started to consume more saturated fat and cholesterol and became physically active less often compared to those subjects who were initially at risk, but no longer at the follow-up.

Adolescent↗

PubMed1994

Can treatment outcome of chronic low back pain be predicted? Psychological disease consequences clarifying the issue.

OBJECTIVE: To search for generalizable, psychological predictors of chronic pain treatment outcome. DESIGN: The prognostic power of the psychological predictors, classified into subareas of function, i.e., impairments, disabilities, and handicaps, was compared in predictive situations varying with the quality of patient samples, programs, and outcome measures. SETTING: Four rehabilitation centers in Finland providing "functioning activation" or more passive "spa resort" treatment programs for low back pain patients. PATIENTS: 173 low back pain patients for whom the inpatient rehabilitation program was funded by the Finnish Social Insurance Institution. OUTCOME MEASURES: The measures were panel assessment of global functioning (DSM III Axis V), self-report of handicap (Million), panel assessment of handicap (WHO index), panel assessment of adherence (four rating scales), and self-report of well-being (Faces scale). RESULTS: Multivariate, stepwise regression analyses suggested that the disability and handicap measures of functioning may be more effective predictors than impairment measures, which, however, add to the variance explained by the former. However, the predictive power of psychological impairments, disabilities, and handicaps varied with differences in patient group, outcome measure, and program. CONCLUSION: The "general predictors" of chronic pain treatment outcome may be difficult to find. Therefore, planning treatment for the individual patient may always have to be based on accurate multiaxial and multidimensional assessment of patient functioning.

Adult↗

PubMed1994

Measurement of low back mobility, isometric strength and isoinertial performance with isostation B-200 triaxial dynamometer: reproducibility of measurement and development of functional indices.

The reproducibility of measurements with the triaxial lumbar dynamometer Isostation B-200 was measured in 61 volunteers with or without low back problems. Both for the intra- and interrater measurements the reproducibility was good (r = 0.76-0.89) for lateral flexions and almost as good (r = 0.76-0.87) for the sum of all ranges of motion (SROM). The corresponding reproducibilities were excellent (r = 0.82-0.99) for the isometric strength and good (r = 0.60-0.90) for isoinertial flexion-extension repetition test parameters in the main (primary axis) direction. A number of parameters were combined into three functional indices: the reproducibility for "power" and "work" index was good (r = 0.76-0.94) in both intra- and interrater conditions, whereas for "movement" index it was somewhat weaker (r = 0.53-0.87). It is concluded that parameters: lateral flexions, SROM, isometric strength, and functional indices (power and work) are reproducible enough to use in further studies.

Adult↗

PubMed1994

Myocardial infarct size and mortality in patients with non-insulin-dependent diabetes mellitus.

OBJECTIVES: To study the infarct size and mortality in patients with non-insulin-dependent diabetes mellitus (NIDDM) and in non-diabetic subjects with their first acute myocardial infarction. DESIGN: Seven year follow-up study of large representative cohorts of patients with non-insulin-dependent diabetes mellitus and non-diabetic subjects (study 1) and the FINMONICA acute myocardial infarction register study in 1988-89 (study 2). SETTING: Populations of the districts of the Kuopio University Hospital and Turku University Central Hospital (study 1). Populations of Kuopio and North Karelia provinces and Turku/Loimaa area (study 2). SUBJECTS: Study 1: 1059 patients with non-insulin dependent diabetes mellitus and 1373 non-diabetic subjects aged 45-64 years at baseline; during the follow-up 166 patients with non-insulin-dependent diabetes mellitus (91 men and 75 women) and 30 non-diabetic subjects (25 men and five women) were hospitalized for their first acute myocardial infarction. Study 2: 1622 patients aged 25-64 years hospitalized for their first acute myocardial infarction; 144 patients (90 men and 54 women) had non-insulin-dependent diabetes mellitus and 1153 (890 men and 263 women) were non-diabetic. MAIN OUTCOME MEASURES: The infarct size was assessed on the basis of maximum levels of serum cardiac enzymes (studies 1 and 2) and QRS-score (study 1). RESULTS: No differences were found in maximum levels of serum cardiac enzymes between diabetic and non-diabetic patients. Similarly QRS-score gave no suggestion of a difference in infarct size between diabetic and non-diabetic patients. In both studies mortality before hospital admission was similar in diabetic and non-diabetic patients, but mortality within 28 days from hospital admission was twice as high in diabetic patients as in non-diabetic patients. Cardiac failure was the main cause of death significantly more often in diabetic patients than in non-diabetic patients (study 2). CONCLUSIONS: Poorer prognosis of acute myocardial infarction in diabetic patients appears not to be explained by a larger infarct size but probably by adverse effects of the diabetic state itself on myocardial function.

Cause of Death↗

PubMed1994

Age and gender specific serum lipid and apolipoprotein fractiles of Finnish children and young adults. The Cardiovascular Risk in Young Finns Study.

We present fractile data on serum lipids and apolipoproteins A-l and B for children and young adults from the cardiovascular risk in young Finns study cohort of 1986. The sample comprised 2370 fasting children and young adults (1114 males and 1256 females) aged 9, 12, 15, 18, 21 and 24 years. The determinations were performed in duplicate with standard methods. LDL-cholesterol values were calculated. The limits for clearly pathological values (exceeding the 97.5th percentile) irrespective of age and gender were 7.5 mmol/l, 5.0 mmol/l, 3.5 mmol/l and 1.4 g/l for serum total cholesterol, LDL-cholesterol, triglycerides and apolipoprotein B, respectively. Corresponding values (below the 2.5th percentile) for HDL-cholesterol, apolipoprotein A-l, HDL2- and HDL3-cholesterol were 0.80 mmol/l, 1.0 mg/l, 0.20 mmol/l and 0.70 mmol/l, respectively. Approximately 79%, 33% and 7% of males had serum total cholesterol values greater than 4.0 mmol, 5.0 mmol/l and 6.0 mmol/l, respectively. Corresponding percentages for females were 87%, 43% and 10%. However, age-related differences were marked. The prevalence of values, e.g. greater than 6 mmol/l according to age, ranged from 6 to 13% in females and from 3 to 12% in males, emphasizing the need for age-specific reference values. Additionally, postpubertal values for total and LDL-cholesterol tended to be slightly lower compared to prepubertal values, indicating that the reference values for adults do not apply to adolescents and young adults. The age-related changes in lipid levels were evident in each fractile and were especially accentuated in higher fractiles. Fluctuations with age were more pronounced in males than in females. These results are intended to be applied as reference values for diagnosing dyslipidemias.

Adolescent↗

PubMed1994

Clustering of risk factors for coronary heart disease in children and adolescents. The Cardiovascular Risk in Young Finns Study.

Clustering of selected coronary heart disease (CHD) risk factors was studied in a cohort of 3457 children and adolescents, aged 3-18 years. Subjects were defined as "high-risk" individuals if their values for serum LDL cholesterol, systolic blood pressure and obesity index (sum of biceps, triceps and subscapular skinfolds) exceeded the age- and gender-specific 75th percentile of the present study cohort. Clustering was studied by using the observed/expected ratio (O/E ratio). Statistically significant clustering was observed as 3.1% of all subjects belonged to the high-risk group (O/E ratio = 2.0, p < 0.001). Under the assumption of no association, only 1.56% would have been expected. Clustering was stronger in boys (3.6%) than in girls (2.6%). When other lipid variables (total cholesterol, HDL cholesterol, triglycerides) or obesity indices (subscapular, biceps, triceps skinfolds, the subscapular/triceps ratio and BMI) were used in the analyses, the degree of clustering remained essentially the same. The tendency of risk factors to cluster increased with age in boys, whereas in girls the strongest clustering was usually seen in the age group 9-12 years. When a fourth risk factor (low HDL cholesterol) was added to the analyses, the tendency of risk factors to occur simultaneously became even greater. Aggregation of multiple risk factors was strongest in boys who presented the highest levels of these risk factors. Common risk factors for CHD cluster in children and adolescents. The gender differences observed here may partly explain why males develop CHD more often than females in adulthood.(ABSTRACT TRUNCATED AT 250 WORDS)

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

Insulin sensitivity is not an independent determinant of plasma plasminogen activator inhibitor-1 activity.

It recently has been hypothesized that increased plasma plasminogen activator inhibitor-1 (PAI-1) activity could be a possible link between insulin resistance and coronary heart disease. However, it is not known whether insulin sensitivity per se is a determinant of plasma PAI-1 activity or whether other intermediates could explain this association. We investigated the relationship between plasma PAI-1 activity and insulin sensitivity, obesity, distribution of body fat, blood pressure, plasma insulin concentration, and serum lipid levels in normoglycemic men (n = 61) and women (n = 77) 53 to 61 years old who participated in a previous population-based study. Insulin sensitivity was estimated by the minimal model from a frequently sampled intravenous glucose tolerance test. In univariate analyses, PAI-1 correlated positively with body mass index, waist-to-hip ratio (WHR), fasting and 2-hour insulin levels, and triglyceride level in both men and women. Furthermore, in women PAI-1 correlated inversely with high-density lipoprotein (HDL) cholesterol level. There was an inverse relationship between PAI-1 and insulin sensitivity (r = -.39, P < .01 in men; r = -.38, P < .001 in women). In multivariate analyses in men, insulin sensitivity failed to show any significant association with PAI-1. In contrast, triglyceride level and body mass index were independently associated with PAI-1. Also in women, insulin sensitivity was not independently associated with PAI-1. In women, WHR and HDL cholesterol concentration or WHR and 2-hour insulin concentration were independently related to PAI-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗