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Biomedical subjects

E Jokinen

Publications and source records attributed to E Jokinen.

At least 19 recordsLinked to original sources
PubMed2006

Development of overweight in an atherosclerosis prevention trial starting in early childhood. The STRIP study.

CONTEXT: Recent data indicate a marked increase in the prevalence of obesity among school-aged children. Thus, efficacious programmes that prevent overweight development in children are urgently needed. OBJECTIVE: To evaluate the impact of repeatedly given, individualised dietary and lifestyle counselling on the prevalence of overweight during the first 10 years of life. DESIGN AND PARTICIPANTS: This study was a part of the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP), which is a prospective, randomised trial aimed at reducing the exposure of the intervention children to the known risk factors of atherosclerosis. At the child's age of 7 months, 1062 children were assigned to an intervention group (n=540) or to a control group (n=522). The intervention children received individualised counselling focused on healthy diet and physical activity biannually. Height and weight of the children were measured at least once a year. MAIN OUTCOME MEASURE: Prevalence of overweight and obesity among the intervention and control children by sex and age. Children were classified as overweight or obese if their weight for height was >20% or > or =40% above the mean weight for height of healthy Finnish children, respectively. RESULTS: After the age of 2 years, there were continuously fewer overweight girls in the intervention group than in the control group. At the age of 10 years, 10.2% of the intervention girls and 18.8% of the control girls were overweight (P=0.0439), whereas 11.6% of the intervention boys and 12.1% of the control boys were overweight (P approximately 1.00). Only three children in the intervention group were obese at some age point, whereas 14 control children were classified as obese at some age point. CONCLUSION: Individualised dietary and lifestyle counselling given twice a year since infancy decreases prevalence of overweight in school-aged girls even without any primary energy restrictions.

Atherosclerosis↗
PubMed2004

Effect of endothelin-1 on apoptosis, proliferation, and protein synthesis in cardiomyocytes of newborn albino rats.

Five intraperitoneal injections of endothelin-1 (100 microg/kg) to newborn albino rats on days 2-6 of life did not change the number of nuclei expressing PCNA in the left-ventricular myocardium. The number of nucleoli, area and perimeter of cardiomyocytes (isolated by the method of alkaline dissociation) increased. The number of myocyte nuclei in the state of apoptosis (evaluated by the TUNEL method) increased significantly. Presumably, partial loss of cardiomyocytes as a result of apoptosis activation after treatment with endothelin-1 is compensated by increased size and transcription activity of remaining cardiomyocytes.

Animals↗
PubMed2004

The 21-year follow-up of the Cardiovascular Risk in Young Finns Study: risk factor levels, secular trends and east-west difference.

OBJECTIVES: The Cardiovascular Risk in Young Finns Study is an on-going multicentre study of atherosclerosis precursors in Finnish children and young adults. We have collected risk factor data in the 21-year follow-up performed in 2001. The aims of this analysis were to examine the levels, secular trends and east-west difference in risk factors amongst young adults. DESIGN: Population based follow-up study. SUBJECTS: A total of 2283 participants aged 24-39 years in 2001 (63.5% of the original cohort). MAIN OUTCOME MEASURES: Levels of serum lipids, apolipoproteins, blood pressure and smoking. RESULTS: The mean serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride concentrations in 24-39-year-old adults were 5.16, 3.27, 1.29 and 1.34 mmol L(-1), respectively. Total cholesterol (5.21 vs. 5.12 mmol L(-1), P = 0.046), HDL cholesterol (1.31 vs. 1.28 mmol L(-1), P = 0.027), systolic blood pressure (118 vs. 115 mmHg, P < 0.0001) and diastolic blood pressure (72 vs. 70 mmHg, P < 0.0001) were higher in subjects originating from eastern Finland compared with those from western Finland. Significant secular trends between 1986 and 2001 in 24-year-old subjects (n = 783) included an increase in serum triglycerides and body mass index (BMI), a decrease in blood pressure and HDL cholesterol and a modest 5% decrease in total cholesterol levels. CONCLUSIONS: During the past 15 years, BMI and triglyceride levels have increased in young adults in Finland. At the same time, the reduction in cholesterol concentration has been slow. Consistent with persistent regional differences in cardiovascular morbidity within Finland, our data demonstrate significant differences in the levels of cardiovascular risk factors between subjects originating from eastern and western Finland.

Adult↗
PubMed2003

Left atrial and left ventricular function in healthy children and young adults assessed by three dimensional echocardiography.

OBJECTIVE: To establish normal values of left atrial and left ventricular volumes and function in children and young adults using three dimensional echocardiography (3DE). METHODS: 169 healthy subjects aged 2 to 27 years were studied by digitised 3DE. 3DE was achieved using rotational acquisition of planes at 18 degrees intervals from the parasternal view for the left atrium and from the transthoracic apical view for the left ventricle with ECG gating and without respiratory gating. Left atrial and left ventricular volumes could be calculated throughout the heart cycle, and the respective time-volume curves were reconstructed in each subject. RESULTS: For the analysis the subjects were divided into five groups according to body surface area: 0.5-0.75 m2, 0.75-1.0 m2, 1.0-1.25 m2, 1.25-1.5 m2, and over 1.5 m2. Mean (SD) left atrial maximum volume/body surface area was 19.6 (3.5), 21.7 (3.7), 22.0 (4.7), 24.5 (4.8), and 27.4 (6.4) ml/m2; left ventricular maximum volume/body surface area was 50.1 (8.8), 54.9 (10.1), 56.4 (9.9), 58.7 (11.0), and 64.4 (10.3) ml/m2. Left atrial active emptying increased from 19% to 35% with age (r = 0.34, p < 0.001) and with decreasing heart rate (r = -0.28, p < 0.001). CONCLUSIONS: Transthoracic 3DE is well suited for studying the phasic changes in left atrial and left ventricular volumes in young children as well as in adults. The data obtained from 169 healthy subjects will serve as a reference for further studies in patients with various cardiac abnormalities.

Adolescent↗
PubMed2001

Heat shock proteins, HSP25 and HSP70, and apoptosis in developing endocardial cushion of the mouse heart.

Formation of the atrioventricular channels and valves from the endocardial cushion occurs through growth and remodeling of the initial endocardial cushion. This process requires balanced coordination of proliferation and apoptosis by still unknown factors. To detect a possible role for the heat shock proteins 25 and 70 (HSP25 and HSP70) as apoptosis-associated proteins and differentiation factors in the development of the endocardial cushion, we analyzed their temporal and regional occurrence during cell proliferation and apoptosis in E11-E17 embryos. The distribution and timing of these events and factors were consistent with the hypothesis that HSP25 is related to myocardial development whereas HSP70 is related to differentiation of the endocardial cushion by cell proliferation and apoptosis.

Animals↗
PubMed2001

Overlapping and differential localization of Bmp-2, Bmp-4, Msx-2 and apoptosis in the endocardial cushion and adjacent tissues of the developing mouse heart.

The bone morphogenetic proteins BMP-2 and BMP-4 and the homeobox gene MSX-2 are required for normal development of many embryonic tissues. To elucidate their possible roles during the remodeling of the tubular heart into a fully septated four-chambered heart, we have localized the mRNA of Bmp-2, Bmp-4, Msx-2 and apoptotic cells in the developing mouse heart from embryonic day (E)11 to E17. mRNA was localized by in situ hybridization, and apoptotic cells by TUNEL (TDT-mediated dUTP-biotin nick end-labeling) as well as by transmission electron microscopy. By analyzing adjacent serial sections, we demonstrated that the expression of Msx-2 and Bmp-2 strikingly overlapped in the atrioventricular canal myocardium, in the atrioventricular junctional myocardium, and in the maturing myocardium of the atrioventricular valves. Bmp-4 was expressed in the outflow tract myocardium and in the endocardial cushion of the outflow tract ridges from E12 to E14. Msx-2 appeared in the mesenchyme of the atrioventricular endocardial cushion from E11 to E14, while Bmp-2 and Bmp-4 were detected between E11 and E14. Apoptotic cells were also detected in the mesenchyme of the endocardial cushion between E12 and E14. Our results suggest that BMP-2 and MSX-2 are tightly linked to the formation of the atrioventricular junction and valves and that BMP-4 is involved in the development of the outflow tract myocardium and of the endocardial cushion. In addition, BMP-2, BMP-4 and MSX-2 and apoptosis seem to be associated with differentiation of the endocardial cushion.

Animals↗
PubMed2001

Transthoracic three-dimensional echocardiography is as good as magnetic resonance imaging in measuring dynamic changes in left ventricular volume during the heart cycle in children.

AIMS: The purpose of the study was to assess the dynamic changes in left ventricular (LV) volume by transthoracic three-dimensional echocardiography (3DE) and to compare the results with those obtained by magnetic resonance imaging (MRI). METHODS AND RESULTS: Thirty healthy children were studied by digitized 3DE and Doppler, and by MRI. Three-dimensional echocardiography of LV was performed by using rotational acquisition from the transthoracic apical view with ECG gating and without respiratory gating. The acquisition of 3DE data took 10-15s. Three-dimensional echocardiography gave similar values to MRI for EDV, ESV and LVM measurements, and the results correlated well. Peak emptying rates by 3DE and MRI were -236.6 and -169.6ml/s and peak filling rates were 215.0 and 215.9ml/s, respectively. Dynamic changes of LV volumes during the heart cycle were detectable with both methods. CONCLUSION: Digitized 3DE performed in the outpatient clinic and MRI were both useful methods for studying the physiological volume changes in left ventricle in children. These methods may be used for further study of the systolic and diastolic function of the left ventricle in various clinical conditions.

Adolescent↗
PubMed2001

Development of left ventricular systolic and diastolic function in preterm infants during the first month of life: a prospective follow-up study.

OBJECTIVES: We studied the left ventricular systolic and diastolic function in preterm infants during the first month of life in comparison with the respective patterns in term neonates. STUDY DESIGN: Serial 2-dimensional/M-mode and Doppler transmitral flow velocity measurements were performed in 20 preterm (gestational age, 32 to 36 weeks) and 25 term infants between days 2 and 5 after birth and at age 1 month. RESULTS: After birth, the early velocity, early integral, early filling fraction, early and atrial velocity ratios, and early and atrial integral ratios were lower in the preterm than in the term infants (P <.01). During the first 4 weeks of life, these values, the atrial velocity, and the atrial integral increased gradually, whereas the atrial filling fraction, diastolic filling time, and deceleration time of early diastolic filling decreased slightly with postnatal age (P <.01) in the preterm infants. At age 1 month their diastolic function reached the level of term infants with the exception of early and atrial integral ratios and atrial filling fraction. The measures of systolic performance were within normal range, but midwall fractional shortening at 2 to 5 days (P <.05), and fractional shortening area (P <.05), as well as midwall fractional shortening (P <.01) at 1 month of age, were slightly inferior in the preterm than in the term infants. During the first month the left ventricular mass and left ventricular mass/body surface area ratio increased more markedly in the preterm than term infants, significantly in both groups (P <.05). CONCLUSIONS: The preterm diastolic patterns represent a transition between the patterns of the fetus and those of term neonates. These changes reflect an improvement in the left ventricular diastolic function, more markedly in relaxation than in compliance. The postnatal increase in the transmitral measures and left ventricular mass suggest marked myocardial adaptation to the extrauterine environment in the preterm infant already during the first month.

Blood Flow Velocity↗
PubMed2000

Prospective, randomized, infancy-onset trial of the effects of a low-saturated-fat, low-cholesterol diet on serum lipids and lipoproteins before school age: The Special Turku Coronary Risk Factor Intervention Project (STRIP).

BACKGROUND: We showed previously that repeated dietary counseling during the first 3 years of life reduces the concentration of serum nonfasting cholesterol. We have now extended the study to children 5 years of age and analyzed fasting blood samples, enabling LDL cholesterol calculations for the first time. METHODS AND RESULTS: Families of 7-month-old infants (n=1062) were randomized to a control group (n=522) or an intervention group (n=540) that received individualized dietary counseling with the aims of a fat intake of 30% to 35% of daily energy, a saturated/monounsaturated/polyunsaturated fatty acid ratio of 1:1:1, and a cholesterol intake of <200 mg/d. Nutrient intakes were studied biannually, nonfasting serum lipid values were studied annually, and fasting values were studied at 5 years of age. The intervention children always had lower intakes of saturated fat and cholesterol than the control children. The intervention boys had 0.39 mmol/L (P:<0.0001) lower mean serum cholesterol values than the control boys between 13 and 60 months of age, but among girls, the difference was of marginal significance (0.15 mmol/L, P:=0.052). Five-year-old intervention boys had 9% lower mean serum LDL cholesterol concentrations than the control boys (P:=0.0002; 95% CI, -0.39 to -0.12 mmol/L), whereas no difference was observed in girls. In both sexes, serum triglyceride concentrations were similar in the 2 groups. CONCLUSIONS: The restriction of saturated fat and cholesterol intake by repeated, individualized dietary counseling since infancy resulted in lower serum total and LDL cholesterol concentrations at 5 years of age. However, the effect was significant only in boys.

Age of Onset↗
PubMed2000

Apolipoprotein E4 phenotype increases non-fasting serum triglyceride concentration in infants - the STRIP study.

As genetically determined apolipoprotein E (apo E) phenotypes influence serum cholesterol concentration, we analysed whether serum triglyceride values are also affected by the apo E phenotypes in infants. Non-fasting serum triglyceride values were measured in 7- and 13-month-old participants in the STRIP project, a randomised, prospective trial aimed at reducing children's exposure to known atherosclerosis risk factors (n=1062). The mean+/-S.D. non-fasting serum triglyceride concentrations in 7-month-old infants with apo E4/4 (n=36), E3/4 (n=209), E3/3 (n=412), and E2/3 (n=66) were 2. 05+/-1.24, 1.81+/-0.90, 1.63+/-0.90, and 1.71+/-0.83 mmol/l, respectively. Triglyceride concentrations were higher in infants with apo E4/4 or 3/4 than in those with apo E3/3 (P-value for difference 0.01 and 0.009, respectively). The apo E phenotype similarly influenced non-fasting serum triglyceride concentrations at the age of 13 months. The differences in serum triglyceride values in apo E4(+) infants (apo E3/4 and 4/4 infants combined) and apo E4(-) infants (apo E2/3 and 3/3 infants combined) occurred independently of the relative weight of the infant, milk type used at 7 months of age (breast milk or formula), and time elapsed from the previous meal. To conclude, apo E phenotypes regulate non-fasting serum triglyceride values in healthy infants. Apo E3/4 and apo E4/4 predispose infants to higher values than apo E3/3 phenotype, suggesting that the varepsilon4 allele may increase atherosclerosis risk also via it's effect on postprandial triglyceride metabolism.

Apolipoprotein E4↗
PubMed2000

Efficiency of left ventricular diastolic function increases in healthy full-term infants during the first months of life. A prospective follow-up study.

Postnatal changes in left ventricular diastolic filling and systolic cardiac performance were studied monthly by serial echocardiographic measurements from days 3-5 up to six months in 20 healthy full-term infants. The fractional shortening area (FSA = (left ventricular end-diastolic area - end-systolic area)/end-diastolic area) was assessed for systolic performance, and transmitral pulsed-wave Doppler flow velocity patterns were analysed for diastolic function. FSA remained stationary during the observation. After birth, left ventricular peak early (E) and atrial (A) velocities and the respective integrals were lower than at one month of age (47+/-5 vs. 63+/-6 cm/s and 44+/-6 vs. 57+/-5 cm/s and 3.33+/-0.40 vs. 4.05+/-0.53 cm and 2.74+/-0.40 vs. 3.18+/-0.53 cm; P < 0.05). During the next five months, the early parameters (E velocity and E integral) increased but the atrial indices (A velocity and A integral) did not change. During the whole observation the E/A velocity ratio, the E/A integral ratio and the early filling fraction (EFF) increased. The early filling deceleration time was longer during the first month than later (87+/-10 vs. 72+/-13 ms; P < 0.05). In conclusion, age-related changes were observed in the diastolic but not in the systolic performance in healthy full-term infants during the first six months. The most intensive changes took place in the early and atrial transmitral parameters during the first month of life, suggesting an improvement in both left ventricular relaxation and compliance. During the following five months, the early mitral parameters increased but the atrial diastolic values remained stable. These changes may mainly be determined by the improvement in left ventricular relaxation.

Aging↗
PubMed2000

Fatty acid composition of serum cholesterol esters as a reflector of low-saturated-fat, low-cholesterol diet in young children: the STRIP project. The Special Turku coronary Risk factor Intervention Project.

STRIP (the Special Turku coronary Risk factor Intervention Project) is an ongoing intervention trial which aims at a permanent reduction in the intake of saturated fat and cholesterol starting in childhood. A total of 75 intervention and 63 control children was studied consecutively at the ages of 7 and 13 mo, and 2, 3 and 5 y to evaluate the influence of such intervention on serum cholesterol ester (CE) fatty acid composition, a widely used biomarker of fatty acid intake. Analysis of 4-d food records showed that total intake of fat and of saturated fat increased with age in both groups of children but was constantly lower in intervention than in control children, e.g. at the age of 5 y the mean intakes of total fat and of saturated fatty acids were 31.1 E% and 33.9 E% and 12.1 E% and 14.6 E% in intervention and control children, respectively (p = 0.009 and 0.0001, respectively). Serum CE fatty acid compositions did not differ between the 2 groups at any age; the mean proportion of CE linoleic acid was 52.4% and 52.0% in 5-y-old intervention and control children, respectively. Correlation analysis showed, however, that the percentage of linoleic acid and of polyunsaturated fatty acids in CE reflected well the respective dietary intakes (r = 0.36; p = 0.0001 for both coefficients). In conclusion, CE fatty acid composition did not differ between the intervention and control groups, whereas CE linoleic and total polyunsaturated fatty acids reflected well the differences in their intakes at the individual level.

Child, Preschool↗
PubMed2000

Sodium intake of 1 to 5-year-old children: the STRIP project. The Special Turku Coronary Risk Factor Intervention Project.

The aim of this study is to examine sodium intake and dietary sodium sources of 1-5-y-old children in a prospective, randomized long-term coronary heart disease prevention trial, focused on dietary fat modification. Counselling included no advice about reducing salt in the children's diets. Food consumption of 100 intervention children and 100 control children was recorded for 3 consecutive days at the age of 13 mo and for 4 consecutive days at the ages of 3 and 5 y. Sodium intakes were calculated using the Micro Nutrica program. Children's mean daily sodium (NaCl) consumption (intervention and control children combined) was 1600+/-527 mg (4.0+/-1.3 g), 1900+/-504 mg (4.8+/-1.3 g) and 2200+/-531 mg (5.5+/-1.3 g) at the ages of 13 mo and 3 and 5 y, respectively. The intervention children consumed as much or slightly more sodium than the control children at all ages studied. Half the sodium consumption was derived from added salt in commercially prepared or homemade foods. Milk, meat products, bread and cereals were other important sodium sources. In conclusion, nutrition counselling in the Special Turku Coronary Risk Factor Intervention Project (STRIP) trial, with its main focus on the quality of fat in child nutrition, has had minimal influence on children's sodium intake. To avoid excessive sodium intake in children, dietary counselling should include information about salt use, and food manufacturers should be encouraged to provide more low-sodium products.

Child, Preschool↗
PubMed2000

Special Turku Coronary Risk Factor Intervention Project for Babies (STRIP).

BACKGROUND: Introducing nutritional and lifestyle principles to children in late infancy may permanently improve their adherence to a low-saturated fat, low-cholesterol diet, thus reducing of coronary risk factors, but worries about possible effects on growth and development have hampered such an approach. OBJECTIVE: The Special Turku Coronary Risk Factor Intervention Project for Babies (STRIP) aimed to decrease exposure to known environmental atherosclerosis risk factors in children 7-36 mo of age. DESIGN: Repeated, individualized counseling aimed at promoting a fat intake of 30% of energy and a 1:1:1 ratio of saturated to monounsaturated to polyunsaturated fat intake was provided (n = 540 intervention children; 284 boys). Nutrition was discussed superficially with the families of the control children (n = 522; 266 boys) and food intake was recorded at 3-6-mo intervals by use of 3-4-d food diaries. Serum lipids were measured at 6-12-mo intervals and growth was monitored regularly. RESULTS: Fat intake of the intervention (control) children provided 29.5% (29.4%) of energy at the age of 8 mo, 26.6% (28.5%) of energy at 13 mo, 30.5% (33.5%) of energy at 24 mo, and 31. 5% (33.5%) of energy at 36 mo. The intervention children consistently consumed less saturated fat than did the control children (P: <0.0001). Recommended intakes of other nutrients (except vitamin D and occasionally iron) were reached irrespective of the amount and type of dietary fat. Serum cholesterol, non-HDL cholesterol, and HDL-cholesterol concentrations were 3-6% lower in the intervention children than in the control children. The intervention had no effect on height, weight, or head circumference gain. Fat intake did not predict children's growth patterns. CONCLUSION: Repeated, individualized counseling in early childhood aimed at reducing consumption of saturated fat and cholesterol was effective and feasible and did not restrict growth in circumstances in which children were regularly monitored.

Child Development↗
PubMed2000

Left atrial volume assessed by transthoracic three dimensional echocardiography and magnetic resonance imaging: dynamic changes during the heart cycle in children.

OBJECTIVE: To assess the dynamic changes in left atrial volume by transthoracic three dimensional echocardiography and compare the results with those obtained by magnetic resonance imaging (MRI). DESIGN AND PATIENTS: 30 healthy children (15 boys and 15 girls, aged 8 to 13 years) underwent examination by three dimensional echocardiography and MRI. METHODS: Three dimensional echocardiography of the left atrium was performed using rotational acquisition of planes at 18 degrees intervals from the parasternal window with ECG gating and without respiratory gating. Volume estimation by MRI was performed with a slice thickness of 4-8 mm and ECG triggering during breath holding in deep inspiration. A left atrial time-volume curve was reconstructed in each child. RESULTS: Left atrial maximum and minimum volumes averaged 24.0 ml/m(2) and 7. 6 ml/m(2) by three dimensional echocardiography, and 22.1 ml/m(2) and 11.9 ml/m(2) by MRI. The greater left atrial minimum volume in the latter was at least in part a result of breath holding. Dynamic changes in left atrial volume during the heart cycle were detectable by both methods. The higher temporal resolution of three dimensional echocardiography allowed a more precise evaluation of different phases. CONCLUSIONS: Three dimensional echocardiography and MRI were both useful methods for studying the physiological volume changes in the left atrium in children. These methods may be used for further study of the systolic and diastolic function of the heart.

Adolescent↗