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Biomedical subjects

G Berglund

Publications and source records attributed to G Berglund.

At least 19 recordsLinked to original sources
PubMed1999

Dietary patterns in high and low consumers of meat in a Swedish cohort study.

The objective was to examine relationships between meat and other food items which have been associated with higher risk of cancer in the colon and prostate in some epidemiological studies. The study was conducted as a population-based cohort study comprising 11648 subjects (4816 male and 6742 female) born between 1926 and 1945 and living in the city of Malmö, Sweden. Data on mean daily intake of foods and nutrients were assessed with a diet history method combining a 7-day menu book and a food frequency questionnaire. Increasing meat intake, expressed in quintiles and adjusted for energy, was associated with decreasing intakes of poultry, fish, fruits, bread, cereals and cheese in both sexes. Low negative correlations between meat intake and ascorbic acid (r= -0.11) and fiber (r= -0.16 to -0.20) were noted. The average intake of fat from meat out of total fat intake was 13.6% in men and 11.9% in women. No major associations were noted between meat and the cholesterol raising fatty acids C:12:0, C:14:0, C:160 nor for C:20:4 or its precursor C:18:2. In conclusion, our findings indicate that meat consumption is negatively associated with food groups rich in antioxidants and fiber and the positive covariance reported between meat and cancer and coronary heart disease might, therefore, not be directly linked to components in meat.

Adult↗
PubMed1998

[Is antihypertensive treatment a risk factor of coronary disease? Therapy-related triglyceride increase nor diabetes increase the risk].

In an observational study designed to determine whether metabolic changes during long-term antihypertensive drug treatment are associated with an increased risk of coronary heart disease (CHD), 686 middle-aged hypertensive men recruited from a random population screening sample were followed up for 15 years. Antihypertensive treatment predominantly consisted of beta-adrenoceptor blockers and/or thiazide diuretics. CHD and diabetes mellitus were checked for at annual examinations. Time-dependent Cox regression analysis was used to determine correlation between the incidence of CHD and entry characteristics, the monitored serum levels of cholesterol and triglyceride concentrations and the development of diabetes mellitus. Univariate analysis showed the presence of diabetes mellitus a entry to the study and increased baseline serum concentrations of cholesterol and of triglycerides each to be a significant predictor of CHD, the respective relative risks (RR) being 2.12, 1.21 and 1.21. However, analysis of monitored levels of metabolic variables during follow-up showed only an increased serum cholesterol concentration to be significantly and independently associated with CHD (RR 1.07). Although serum triglyceride concentrations increased slightly during follow-up, they were unrelated to the incidence of CHD; nor was onset of diabetes mellitus during follow-up significantly associated with an increased risk of CHD (RR 1.48. Thus, the study showed the presence of metabolic disturbances such as diabetes mellitus and hyperlipidaemia before the start of antihypertensive treatment to be of positive predictive value in middle-aged hypertensive men, and an increase in the monitored serum cholesterol level to be an independent predictor of CHD, whereas neither drug-related diabetes nor an increase in the monitored serum triglyceride concentration seemed to be associated with the occurrence of CHD.

Adrenergic beta-Antagonists↗
PubMed1998

Mortality rates in treated hypertensive men with additional risk factors are high but can be reduced: a randomized intervention study.

The aim was to examine the feasibility and efficacy of a multifactorial risk factor intervention program in hypertensive patients at high cardiovascular risk. Treated hypertensive men, aged 50 to 72 years, with at least one of the following: serum cholesterol concentration > or = 6.5 mmol/L, diabetes mellitus, or smoking were randomized to multifactorial risk factor intervention (n = 253) or usual care (n = 255). The specific intervention was based on group meetings to encourage a lipid lowering diet and smoking cessation. Cholestyramine, nicotinic acid, fibrates, and later statins were used either as single drug therapy or in combination, following agreed guidelines in patients in whom the nonpharmacological intervention was judged to be insufficient. Usual care was given according to clinical practice. The median follow-up time was 6.6 years. Sixty-four patients (25.1%) died in the usual care group, compared with 41 patients (16.2%) in the intervention group (P = .016; 95% confidence interval, relative risk 0.42 to 0.92). The overall risk for fatal and nonfatal cardiovascular events was 29% lower in the intervention group than in the usual care group (P = .041). Relative to usual care, the intervention program lowered mean in-trial serum concentrations of total cholesterol (6.3%, P < .0001), LDL cholesterol (9.1%, P < .0001), and blood glucose (0.2 mmol/L, P < .05). Among smokers, at entry, cotinine-adjusted quit rates were 28% in the intervention group and 11% in the usual care group (P = .012) after 3 years. This study illustrates the very high cardiovascular risk in hypertensive patients 50 to 72 years of age with additional risk factors. The results indicate, however, that the gloomy prognosis may be improved by a dedicated risk factor intervention program.

Aged↗
PubMed1998

Fermented milk products are associated to ulcer disease. Results from a cross-sectional population study.

BACKGROUND: Prevalence of peptic ulcer disease has been associated to diet. Some dietary factors seem to have bactericidal effect which may modify the risk of peptic ulcer disease. The objective was to analyze associations between dietary habits and peptic ulcers. DESIGN: A cross sectional population study. SUBJECTS: One thousand, one hundred and thirty-five subjects out of 11700 randomly invited men and women, aged 46-67 y, participating in a diet and disease study during 1991-1993. The study population comprised of 764 cases with reported peptic ulcer, 142 with dyspeptic symptoms and 229 randomly selected controls. METHODS: X-ray examinations and endoscopies were reviewed and 332 out of 764 peptic ulcer cases were verified. Mean daily intake of foods and nutrients were assessed with a combined 7d menu book and a quantitative food frequency questionnaire, including dietary supplements. RESULTS: Subjects with verified ulcer had lower intake of fermented milk products and vegetables and higher intake of milk, meat and bread than controls. Intake of total fat, saturated and monounsaturated fatty acids and linolenic acid were higher in the ulcer group. Higher intake of fermented milk products, by quintiles showed a decreased ulcer risk; odds ratio 0.82 (0.71-40.95), adjusted for covariates below. Higher intake of milk, by quintiles, was associated with an increased risk of ulcer; odds ratio 1.17 (1.03-1.32). Smoking, foreign ethnicity and being unmarried or divorced were covariates associated to ulcer. CONCLUSION: This study indicates the multifactorial etiology of peptic ulcer including dietary factors. High intake of fermented milk products was associated with decreased risk for ulcer, whereas increased risk was noted for high milk intake.

Aged↗
PubMed1998

Insulin sensitivity, sodium-lithium countertransport and platelet free calcium concentrations in normotensive men with a family history of hypertension.

Peripheral glucose disposal (assessed with the euglycaemic-hyperinsulinaemic clamp technique), Na+-Li+ countertransport in erythrocytes and the cytosolic free Ca2+ concentration in platelets were determined in 36 men from families with essential hypertension in at least two close relatives and in 28 age- and weight-matched men from families without hypertension. All had diastolic blood pressure consistently below 90 mm Hg and a normal oral glucose tolerance test. The mean age of the study population as a whole was 37 years (range 24-46). Insulin sensitivity index values (glucose disposal/serum insulin concentration during the clamp) were lower in the familial hypertension group than in the control group, but the two groups did not differ in Na+-Li+-countertransport, or in the platelet cytosolic free Ca2+ concentration which was correlated to the waist: hip circumference ratio in both groups (r = 0.38 and r = 0.49, respectively). The present findings do not support the hypothesis that an increase in Na+-Li+ countertransport activity or the platelet cytosolic free Ca2+ concentration is a marker of insulin resistance in hypertension prone men.

Adult↗
PubMed1998

Muscle fibre composition and glycogen synthase activity in hypertension-prone men.

OBJECTIVES: To study muscle fibre characteristics and glycogen synthase activity in relation to peripheral glucose disposal in skeletal muscle in hypertension-prone men. DESIGN: The hyperinsuliemic euglycemic clamp method was used to calculate insulin sensitivity index (M/I). Muscle biopsies were performed for the analysis of slow-twitch (ST) and fast twitch (FT, low insulin sensitivity and low capillarisation compared to ST fibres) muscle fibres, capillarisation (number of capillaries per fibre) and diffusional index (mean area per fibre divided by capillarisation) of muscle fibres, capillary density (capillaries mm(-2) muscle fibre) and glycogen synthase activity. SUBJECTS: Thirty-two young, healthy, normotensive men with a family history of hypertension (REL) were compared to 2 5 age-matched men with no family history of hypertension (CON) and similar body mass index (BMI). RESULTS: REL had a lower M/I (P = 0.021), lower capillarisation (P = 0.04) and a tendency of a lower diffusional index of subgroup b of FT muscle fibres (P = 0.10) compared to CON. Glycogen synthase activity did not differ between the groups. CONCLUSIONS: Men with a family history of hypertension have less capillaries per FTb fibre and greater diffusion distance from the capillary to the muscle cell compared to controls, which may be a contributory factor to the lower insulin sensitivity in the former group. However, additional investigations are needed to study the causality in this association.

Adult↗
PubMed1998

Evidence for leptin regulation of food intake in humans.

The adipocyte hormone leptin regulates body weight in mice by decreasing food intake and increasing energy expenditure. Whether leptin is of physiological importance for these processes in humans is, however, not clear. We therefore studied the relation between leptin and habitual food intake in 64 healthy postmenopausal women. Dietary habits were assessed with a modified diet history method. Body fat content was measured using bioelectrical impedance. In the 64 women, aged 58.6+/-0.4 yr (mean+/-SD), serum leptin was 19.3+/-12.7 ng/mL, body mass index was 25.0+/-3.5 kg/m2, body fat content was 31.6+/-4.3%, fasting glucose was 4.6+/-0.5 mmol/L, and fasting insulin was 56+/-21 pmol/L. Leptin levels were negatively correlated to total energy intake (r=-0.34; P=0.006), carbohydrate intake (r=-0.36; P=0.004), and total (r=-0.27; P=0.034) as well as saturated fat intake (r=-0.31; P=0.014). Leptin was correlated to the absolute, but not to the percent, intake of these nutrients. When normalized for body fat content, the correlations remained significant. Our results suggest that plasma leptin is involved in the physiological regulation of food intake in humans, and that leptin is related to the quantity rather than the quality of habitual food intake.

Adipose Tissue↗
PubMed1998

Quality control program for storage of biologically banked blood specimens in the Malmö Diet and Cancer Study.

A biological bank has been developed to extend the biochemical and molecular research base for a prospective study on diet and cancer in the city of Malmo, Sweden. The study entered individuals 45-69 years of age, of which 30,382 individuals (45%) participated. Each individual entering the bank has stored samples of viable mononuclear leukocytes (MNLs; -140 degrees C) and granulocytes (GRANs; -80 degrees C) or buffy coats (-140 degrees C), erythrocytes (-80 degrees C), and plasma/serum (-80 degrees C). The bioassays developed to monitor the quality of storage conditions were: (a) viability and growth response to phytohemagglutinin for MNLs; (b) DNA strand breakage for GRANs; (c) NAD content for erythrocytes; and (d) thiol status for plasma/serum. The yield, purity, and storage conditions were all quality controlled, and the samples were determined to be of high standard after 137-190 weeks of storage. No differences in yield and purity were found in samples banked by different laboratory technicians. Growth responses of MNLs were severely reduced (90%) after 40 weeks of storage, which justified switching from the storage of purified MNLs and GRANs to the more cost-effective banking of buffy coats. We conclude that the quality of the banked material, based on the biochemical analysis done, indicate that the storage conditions are optimal at least up to 3.5 years, except for the growth response of MNLs.

Blood Banks↗
PubMed1998

Feasibility and quality of biological banking of human normal and tumor tissue specimens as sources of DNA for the Malmö Diet and Cancer Study.

Human tumor and normal tissue specimens, which were collected from autopsy material 1-6 days postmortem, were compared with similar tissue specimens collected within 2 h after surgical resection and transport to the pathology department. The end point criteria used to evaluate the quality of the specimens for biological banking purposes were the extractability and yield of high molecular weight DNA and UV absorption ratios at 260:280 after collection and immediate storage of the specimens at -80 degrees C. The data demonstrated that autopsy material was a quality source of DNA, although of not such high quality as surgical biopsy specimens <2 h after resection. The advantages of using autopsy material to supplement surgical specimen collection sent to pathology, as opposed to using specimen collection at surgery wards or formalin-fixed material, as sources of DNA are: (a) large amounts of tumor and normal tissues from a variety of organ sites can be obtained without regard to the patient's health status; (b) a higher percentage of retrieval of incident cases of cancer in prospective designed trials is more likely to be achieved; and (c) the extractable DNA is of sufficiently high enough quality to permit direct analyses by molecular hybridization and sequence methodologies.

Autopsy↗
PubMed1997

Is the wish to participate in a cancer rehabilitation program an indicator of the need? Comparisons of participants and non-participants in a randomized study.

In parallel with a randomized study of the 'starting again' rehabilitation program for cancer patients, a group of 73 non-participants were monitored (another 20 patients declined monitoring). In comparison with participants (intervention + control), gender, diagnosis, and 10 out of 18 dependent measures differed significantly at baseline. The non-participants group included more men, mostly with cancer of the prostate and irrespective of gender, they showed lower problem levels than participants throughout. Thus, the wish to participate seems to be an indicator of the need for assistance in the rehabilitation process. Social validation of effects was performed by comparing the non-participants with the intervention group. The rationale for this comparison is that non-participants presumably felt so well that they were in no need of rehabilitation. Effects on three variables were socially validated: patients' appraisal of having received sufficient information, physical strength and fighting spirit. No negative effects on outcome variables resulting from being randomized to the control condition (resentful demoralization) were detected when non-participants were compared with controls over one year. Further analysis showed that although a few patients in the control group may have experienced resentful demoralization, this did not significantly affect the outcome variables.

Adaptation, Psychological↗
PubMed1997

Association between Helicobacter pylori and gastric carcinoma in the city of Malmö, Sweden. A prospective study.

BACKGROUND: We have investigated the association between Helicobacter pylori and gastric carcinoma through a nested case-control study in a single city. METHODS: From a cohort of 32,906 residents recruited from 1974 through 1992, 56 cases of gastric adenocarcinoma and 224 matched controls were selected. The mean interval between serum collection and diagnosis was 5.7 years. Frozen serum or plasma samples were analysed for IgG antibodies against H. pylori with an enzyme-linked immunosorbent assay. RESULTS: The overall seropositivity prevalence in gastric cancer cases was 82%, compared with 49% in controls, giving an odds ratio (OR) of 5.0 (95% confidence interval (CI), 2.2-11.5). Partial gastrectomy because of peptic ulcer 5 to 36 year before diagnosis of gastric cancer could be a confounding factor. With exclusion of 10 such cases, H. pylori seropositivity among cases was 78%, as compared with 50% in matched controls (OR, 3.9; 95% CI, 1.7-9.2). Tumours of the cardia were not associated with H. pylori (OR, 0.92; 95% CI, 0.23-3.7), which is in contrast to tumours of the fundus, corpus, and antrum, which were significantly associated (OR, 11.1; 95% CI, 2.4-71.8). This difference in location was significant (P < 0.01). CONCLUSION: There is a significant association between prior infection with H. pylori and later development of gastric carcinoma, and the association is related to noncardia gastric cancer.

Adenocarcinoma↗
PubMed1996

Diabetes mellitus and raised serum triglyceride concentration in treated hypertension--are they of prognostic importance? Observational study.

OBJECTIVE: To analyse whether metabolic changes during long term treatment with antihypertensive drugs are associated with an increased risk of coronary heart disease. DESIGN: Observational study. SETTING: Gothenburg, Sweden. SUBJECTS: 686 middle aged hypertensive men, recruited after screening of a random population sample, and followed for 15 years during treatment with predominantly beta adrenoceptor blockers or thiazide diuretics, or both. Coronary heart disease and diabetes mellitus were registered at yearly patient examinations. Entry characteristics, as well as within study serum concentrations of cholesterol and triglycerides and the development of diabetes mellitus, were related to the incidence of coronary heart disease in a time dependent Cox's regression analysis. MAIN OUTCOME VARIABLE: Coronary heart disease morbidity. RESULTS: Diabetes mellitus, raised serum cholesterol and triglyceride concentrations present at the beginning of the study were all significantly predictive of coronary heart disease in univariate analysis. The relative risk of diabetes mellitus and of a 1 mmol/l increase in the cholesterol and triglyceride concentrations was 2.12 (95% confidence interval 1.11 to 4.07), 1.21 (1.05 to 1.39), and 1.21 (1.03 to 1.43) respectively. However, when the within study metabolic variables were analysed, only the serum cholesterol concentration was significantly and independently associated with coronary heart disease (relative risk 1.07 (1.02 to 1.13)). Although the triglyceride concentrations increased slightly during the follow up, the within study serum triglyceride concentrations were not associated with the incidence of coronary heart disease (1.04 (0.96 to 1.10)). New diabetes mellitus-that is, onset during follow up-was not significantly associated with an increased risk for coronary heart disease (1.48 (0.37 to 6.00)). CONCLUSIONS: Metabolic disturbances such as diabetes mellitus and hyperlipidaemia presenting before the start of antihypertensive treatment have a prognostic impact in middle aged, treated hypertensive men. Moreover, while within study cholesterol concentration was an independent predictor of coronary heart disease, drug related diabetes mellitus and raised serum triglyceride concentrations that are associated with treatment do not seem to have any major impact on the coronary heart disease prognosis in this category of patients.

Adrenergic beta-Agonists↗
PubMed1996

Urinary albumin excretion--a predictor of risk of cardiovascular disease. A prospective 10-year follow-up of middle-aged nondiabetic normal and hypertensive men.

To study how the risk of cardiovascular disease changes with increasing levels of urinary albumin excretion (UAE), we prospectively studied a random sample of 120 49-year-old men with a wide range of blood pressures. Based on diastolic blood pressure (DBP), the subjects were divided into normotensives (DBP < 90 mm Hg; n = 21), borderline hypertensives (DBP 90 to 94 mm Hg; n = 30), mild hypertensives (DBP 95 to 104 mm Hg; n = 45) and moderate to severe hypertensives (DBP > 105 mm Hg; n = 24). None had been previously treated for hypertension or had secondary hypertension, diabetes mellitus, or other cardiovascular diseases at baseline. Heart and kidney function and metabolic and hormonal variables were with beta-blockade, diuretics, or hydralazine. The cardiovascular morbidity during 10 years of follow-up was studied. The hypertensives were treated with beta-blockade, diuretics, or hydralazine. The cardiovascular morbidity during 10 years of follow-up was studied. The 19 subjects who developed cardiovascular disease had significantly higher baseline UAE than the group that did not (median value 16.6 mg/24 h; range 3.5 to 73, and 9.7 mg/24 h, range 0 to 308, respectively). UAE correlated to systolic blood pressure (P = .0115) and DBP (P = .031), but not to smoking behavior or serum cholesterol. The risk of cardiovascular disease was associated with UAE and smoking independently of blood pressure (P = .001 and P = .015, respectively), and the risk increased continuously with increasing UAE. The initial UAE thus emerged as an efficient and independent predictor of cardiovascular disease in middle-aged hypertensive and normotensive men. UAE appeared to be a stronger predictor than blood pressure and serum cholesterol.

Albuminuria↗
PubMed1996

Progression of atherosclerosis in middle-aged men: effects of multifactorial intervention.

OBJECTIVE: To determine the effect of multifactorial intervention against cardiovascular risk factors on ultrasound-determined progression of atherosclerosis in healthy middle-aged men. DESIGN: One hundred and forty-nine healthy middle-aged men were assigned to an intervention group (IG) or a control group (CG). SUBJECTS: The participants had moderately increased risk-factor scores for cardiovascular disease. They were recruited from a health screening programme at the Preventive Medicine Section, Department of Medicine, Lund University, University Hospital, Malmö. During the study period, 32 of the subjects were lost to follow-up, leaving 59 in the IG and 58 in the CG. INTERVENTION: The IG subjects underwent multifactorial intervention for 2 years, the goal being to help them stop smoking and to reduce their blood lipids and blood pressure. MAIN OUTCOME MEASURES: Intima-media thickness and plaque score in the right carotid artery were ultrasonographically determined initially and after 2 years. Blood lipids and blood pressure were measured at the same time, and in the IG also after 3, 6, 12 and 18 months after entry into the study. RESULTS: At the entry into the study, there were no significant differences in major risk factors or ultrasound variables between IG and CG. Blood lipids and smoking decreased significantly during the 2 years of intervention in the IG, whilst these factors remained unchanged in the CG. Intima-media thickness and plaque scores increased significantly in both groups. CONCLUSIONS: No effects on ultrasound variables could be detected after 2 years of multifactorial intervention. A more aggressive intervention programme, possibly more dependent on pharmacological treatment, may be required to obtain reduced progression or regression of atherosclerosis.

Adult↗
PubMed1996

Cardiovascular risk groups and mortality in an urban swedish male population: the Malmö Preventive Project.

OBJECTIVES: To describe the size, overlap and mortality of four cardiovascular risk groups, in order to give a scientific background for the prevention of cardiovascular disease in a representative urban population. SETTING: Section of Preventive Medicine, Department of Medicine, Malmö University Hospital, Malmö, Sweden. SUBJECTS: Between 1974 and 1984 22444 men born between 1949 and 1921, constituting 75% of the total male population in these age groups, took part in a comprehensive screening examination aimed at detecting risk factors for cardiovascular disease. INTERVENTIONS: Those at high-risk of developing cardiovascular disease were referred to their general practitioner or to special clinics for hypertension, hyperlipidaemia and diabetes. The follow-up, which lasted until the end of 1991, averaged 12.2 years. MAIN OUTCOME MEASURES: Total death (n = 1450) and death from ischaemic heart disease (IHD) (n = 471). RESULTS: Hypertension was found in 13%, hypercholesterolaemia in 19% and diabetes mellitus in 2.6% of the subjects; 49% of the subjects smoked. Multiple risk factors were found in over 17% of the total cohort. Despite the intervention, all-cause mortality during follow-up was increased three-fold in smokers and in men with hypercholesterolaemia, four-fold in hypertensive men and five-fold in men with diabetes, compared to men with no risk factors. The vast majority of deaths (81%) occurred in men who smoked, had hypertension or had high serum cholesterol. Ischaemic heart disease (IHD) was increased five-fold in smokers, seven-fold in men with hypercholesterolaemia, nine-fold in hypertensive men and 12-fold in men with diabetes. Again, the vast majority of IHD deaths (86%) occurred in the first three categories. Combinations of risk factors substantially increased total mortality as well as IHD mortality. CONCLUSIONS: The large proportion (64%) of the population with risk factors for cardiovascular disease and the substantially (5-12-fold) increased IHD mortality in those risk groups, calls for actions aimed at preventing premature IHD deaths. Such action should include measures directed towards the whole population and comprehensive treatment programmes for high-risk individuals, including intervention to stop smoking. The substantial overlap between risk factors calls for one high-risk clinic caring for all risk groups.

Adult↗