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Biomedical subjects

H Jokela

Publications and source records attributed to H Jokela.

At least 19 recordsLinked to original sources

Women have a larger and less atherogenic low density lipoprotein particle size than men.

Some epidemiological studies have shown that serum total cholesterol increases with age. especially in women. On the other hand, the risk of coronary artery disease is smaller in women than in men. Earlier studies have shown that a small dense low density lipoprotein (LDL) is more atherogenic than a large LDL. We studied LDL size and apolipoprotein E (apo E) phenotypes in premenopausal and postmenopausal women and in men at the same age. In this study 342 subjects participating in a health screening study were examined. There were four subgroups: 40-year-old men (n = 85), 40-year-old women (n = 80), 70-year old men (n = 88) and 70-year-old women (n = 89). In the present study LDL size was larger (P < 0.01) in women (26.39 +/- 0.07 nm) than in men (25.95 +/- 0.07 nm). We found that LDL size correlated highly positively (r = 0.606; P < 0.001) with serum high density lipoprotein (HDL) concentration and inversely with serum triglyceride concentration (r = -0.627; P < 0.001). Measuring serum HDL cholesterol and triglycerides in health screening studies gives information indirectly about LDL size and its atherogenicity. Apo E phenotype was not significantly associated with serum triglycerides, but was associated with LDL size, LDL cholesterol, total cholesterol and HDL cholesterol. In our sample LDL size decreased and LDL cholesterol and total cholesterol increased according to the most prevalent apo E phenotypes in the order E2/3, E3/3, E3/4 and E4/4. Subjects with phenotype apo E4/4 had the smallest LDL size (25.70 +/- 0.19 nm), the highest total cholesterol (6.53 +/- 0.35 mmol/l) and the lowest HDL cholesterol values (1.28 +/- 0.04 mmol/l). We conclude that there was a significant interaction between sex and age in serum total cholesterol which was highest in older women. However, their LDL size was larger and their LDL is less atherogenic. Apo E phenotype had a significant influence on LDL size.

Adult

Apolipoprotein E polymorphism, serum lipids, myocardial infarction and severity of angiographically verified coronary artery disease in men and women.

In several populations, the apolipoprotein E (apo E) allele epsilon 4 is associated with high concentration of plasma total and low density lipoprotein (LDL)-cholesterol and coronary artery disease (CAD). We determined the apo E phenotypes of 309 patients with angiographically verified CAD and 38 patients without CAD by isoelectric focusing and Western blotting. In men with CAD, the plasma total and LDL-cholesterol increased according to apo E phenotype in the following order: E3/2 < E3/3 < E4/3 < E4/4 (P = 0.03 for total cholesterol, P = 0.007 for LDL-cholesterol). In women, there was a similar trend (P = 0.22 for total cholesterol, P = 0.15 for LDL-cholesterol). The relative frequency of men with three vessel CAD increased (P = 0.43) together with LDL-cholesterol levels (P = 0.05) according to apo E phenotype E3/2, E3/3, E4/3, E4/4. Total and LDL-cholesterol levels were higher in patients with three vessel CAD than in patients with less serious types of CAD (P = 0.02 for total cholesterol, P = 0.007 for LDL-cholesterol). The relative frequency of patients with myocardial infarction increased according to apo E phenotype (P = 0.51). Both in men and women, there were no differences between apo E phenotypes in age at occurrence of the first myocardial infarction. The apo E allele frequencies of patients with CAD vs. without CAD were 2.3% vs. 1.3% for epsilon 2, 79.0% vs. 76.3% for epsilon 3 and 18.7% vs. 22.4% for epsilon 4. There were no statistically significant differences in apo E allele or phenotype frequencies between patients with CAD and without CAD or between patients with CAD and the general Finnish population. Our results support previous studies in suggesting that the apo E allele epsilon 4 is a risk factor for atherosclerosis, which affects plasma total and LDL-cholesterol. In addition, our results suggest that the apo E allele determines the severity of CAD.

Age Distribution

Hormone replacement therapy and atherosclerosis.

Atherosclerotic changes associated with long-term hormone replacement therapy (HRT) were evaluated in 20 postmenopausal women (mean age, 62.8 +/- 6.1 years). The duration of hormone therapy was 10.1 +/- 3.4 (SD) years. For 9 women the HRT was sequential estradiol valerate plus levonorgestrel, for 6 women estradiol valerate plus medroxyprogesterone acetate and for 5 women estradiol valerate alone. Examinations consisted of histologic and biochemical studies of the uterine artery and ultrasonographic examinations of carotid arteries, aorta and iliac arteries. The findings were compared with those in 20 postmenopausal women of similar age and with similar body mass indexes who had never received HRT. Additionally, the same examinations were performed on 10 premenopausal women (48.3 +/- 4.6 years). The uterine artery was histologically normal in all the premenopausal women studied. Among the postmenopausal women without HRT, a histologically normal uterine artery was found in 5% and in women on HRT in 55% of cases (P < .01). In medicolegal autopsies, atherosclerosis in the uterine artery correlated significantly with atherosclerosis in the coronary artery and aorta. The free cholesterol content of the intima media in premenopausal women was lower than in postmenopausal women without HRT. The percentage of linoleic acid in the intima was significantly lower and that of docosapentaenoic acid significantly higher in premenopausal women and in postmenopausal women on HRT than in postmenopausal women without HRT. In the ultrasonographic examination atherosclerosis in the carotid artery was less common in premenopausal women and in women on HRT than in postmenopausal women without HRT. In this material, histologic, biochemical and radiologic studies showed that HRT may be protective against atherosclerosis.

Adult

Apolipoprotein E phenotypes and plasma lipids in diabetic children and adolescents.

Apolipoprotein E (apoE) polymorphism is a genetic determinant of serum lipoprotein levels and coronary heart disease risk. ApoE appears in three major isoforms E2, E3 and E4, coded by corresponding alleles epsilon 2, epsilon 3 and epsilon 4. These give six different phenotypes. Patients with insulin dependent diabetes (IDDM) have been reported to have increased incidence of E2/2 homozygosity. We studied the frequencies of apoE phenotypes and their association with plasma lipids in 201 diabetic children, aged 2-17 years, and in 216 healthy controls with the same age range. Phenotyping was performed directly from plasma by iso-electric focusing and immunoblotting. Plasma total and high density lipoprotein (HDL) cholesterol (C) and triglycerides were determined by routine laboratory methods. Apolipoprotein A1 (apoA1) and B (apoB) were measured by turbidometry. There were no differences in apoE phenotype or allele distributions between the diabetic and control subjects. The frequencies of epsilon 2, epsilon 3, and epsilon 4 in the diabetic and control children were 0.08 versus 0.07, 0.73 versus 0.72 and 0.19 versus 0.21. The difference in apoE2/2 frequencies (2.0 in diabetic and 0.5% in normal children) was not statistically significant. In the diabetic children, there was a distinct relation between apoE phenotype and plasma lipids; presence of apoE2 was associated with the lowest and that of apoE4 with the highest concentrations of total and low density lipoprotein (LDL) C, and apoB. Ratios of HDL-C/LDL-C and apoA1/apoB showed on opposite trend. The influence of apoE polymorphism on plasma lipids was less clear in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Relationship of alcohol consumption to changes in HDL-subfractions.

Epidemiological studies have consistently shown an apparent protective effect of moderate alcohol consumption on coronary artery disease (CAD). This has been considered to be due to the rise in the high-density cholesterol lipoprotein (HDL-cholesterol). Since the response of the HDL-subfractions to moderate or heavy dose of alcohol is less clear, we now compared the high-density lipoprotein cholesterol status between groups consuming different amounts of alcohol. In this population-based survey serum total high-density lipoprotein cholesterol and its HDL2 and HDL3 subfractions were blindly compared between 264 consecutive middle-aged men (37 teetotallers, 137 moderate drinkers, 90 heavy drinkers) participating in a voluntary health screening and 104 male alcoholics. Alcohol consumption correlated significantly (P < 0.001) with total HDL-cholesterol, HDL2, HDL3 when all subjects (n = 368) were included but the correlation disappeared when alcoholics were excluded (n = 264). In comparison with teetotallers, alcoholics had significantly higher total HDL-cholesterol, HDL2 and HDL3 values (P < 0.001). Moderate or heavy intake of alcohol had no effect on HDL2 but increased the HDL3-fraction. If the protective effect of moderate alcohol consumption is mediated by high-density lipoprotein, it may not be accounted for by changes in the HDL2-fraction. The observed increases in the concentration of the HDL3-fraction, however, suggest that this subfraction may not be inert with respect to coronary disease and could possibly have a role in the protective effect.

Adult

Determination of creatinine in serum and urine by cation-exchange high-pressure liquid chromatography.

We describe an HPLC method for quantifying creatinine, separating the analyte from other compounds in serum and urine by cation-exchange chromatography and measuring its absorbance at 234 nm. The precision of the method (CV) varied from 2.9% (mean creatinine concentration, 31 mumol/L) to 1.7% (361 mumol/L) within a series of assays and from 3.9% (34 mumol/L) to 2.4% (391 mumol/L) between series. A comparison with the Jaffé method, as performed with a Technicon SMA analyzer, gave the regression line yHPLC = 1.00xJaffé - 12.0 (n = 141, r = 0.998, and Syx = 19). Results also are comparable with those of an enzymatic method, if the enzymatic method is standardized with a serum-based standard when serum samples are measured. An aqueous standard has to be used for enzymatic determination of creatinine in urine.

Chromatography, High Pressure Liquid

Late carotid restenosis: aetiologic factors for recurrent carotid artery stenosis during long-term follow-up.

During a fourteen-year-period 257 patients underwent carotid endarterectomy in an unselected population of 700,000 inhabitants. The incidence of haemodynamically significant restenosis was 13.5% in 133 vessels in 116 patients studied by duplex scanning 28 to 209 months following carotid endarterectomy. The most striking differences between patent and restenosed cases were in serum cholesterol, triglyceride and HDL-cholesterol levels. The patients with a long-term low cholesterol (less than 6.5 mmol/l), low triglyceride (less than 1.42 mmol/l) and high HDL cholesterol (greater than 1.0 mmol/l) levels had significantly less high grade restenosis (P less than 0.05). Apolipoprotein A-I and B had no significant effect, but if the lowest limit of normal apolipoprotein A-I level was considered as 1.27 g/l the difference was significant. The frequency of a high-grade restenosis in patients with diabetes mellitus and coronary heart disease was not significantly increased, but supports the view that these are risk factors in the development of atherosclerotic changes in an operated carotid artery. The incidence of recurrent stenosis appears to be unrelated to hypertension, claudication, obesity, smoking, operative factors or to the indication for surgery. Men were more prone than women to get a high-grade restenosis. Postoperative treatment with acetylsalicylic acid was most effective, the incidence was only half of that expected, whereas the anticoagulants or a combination of acetylsalicylic acid and dipyridamole were of no benefit. Haematocrit, RBC, platelet count and thrombocrit were contradictory.

Adult

Urinary citrate excretion in patients with urolithiasis and normal subjects.

Citrate is a normal constituent of urine which combines with calcium to form a soluble salt. Urinary citrate excretion was examined in patients with urolithiasis and normal subjects by a specific enzymatic technique. There was a considerable overlap in the urinary citrate excretion between normal subjects and stone-formers, but the citrate-creatinine ratio, the citrate-calcium ratio and the citrate-magnesium-calcium ratio, which were all highly significantly lower (p less than 0.001) in stone-formers than in controls, proved most reliable in discriminating between these groups.

Calcium

Comparison of indirect diagnostic methods for hypolactasia.

The aim of this study was to continue our previously published work and to compare the different indirect diagnostic methods for hypolactasia with the lactase to sucrase ratio obtained by jejunal biopsy. The following tests were performed in 63 adult patients: the breath hydrogen test, the lactose tolerance test with ethanol (serum galactose measurement after oral lactose load with ethanol), the urinary lactose tolerance test (urinary galactose measurement after oral lactose load with ethanol), and the strip test (like the former but using a special test strip for urinary galactose). Specificities of all these tests were good (96-98%). The 3-h breath hydrogen test was less sensitive (69%) than the other methods (81-94%). The strip test is recommended for the general practitioner for the diagnosis of this common cause of abdominal complaints.

Adolescent

Serum lipids in Finnish and Japanese postmenopausal women.

Serum lipids were measured in 30 Finnish and Japanese postmenopausal women. Total cholesterol, HDL cholesterol, LDL cholesterol, apo B and the HDL cholesterol/apo A1 ratio were higher in Finnish than in Japanese women. The LDL cholesterol/apo B and apo A1/apo B ratios were lower in Finns than in Japanese. In serum phospholipids the percentage of arachidonic acid was higher and the percentage of the n - 3 fatty acids, eicosapentaenoic acid and docosahexaenoic acid, and the eicosapentaenoic acid/arachidonic acid ratio were lower in Finnish than in Japanese women. No significant correlations were found between serum oestrone levels and lipid parameters.

Apolipoproteins

Strip test is reliable in common prevalences of hypolactasia.

The object of this study was to compare the indirect diagnostic methods on the basis of urinary galactose determination in the diagnosis of lactose malabsorption with the actual lactase activities. One hundred and seven patients were studied. The specificity and sensitivity of the strip test were 97%. With 30% actual prevalence the positive predictive value was 94%, and the negative predictive value was 99%. In common prevalences of hypolactasia the strip test was reliable.

Adolescent

Serum selenium, vitamin A, vitamin E and cholesterol concentrations in Finnish and Japanese postmenopausal women.

Serum concentrations of vitamins A and E, selenium, and cholesterol were measured in 30 Finnish and 30 Japanese postmenopausal women. While both groups had identical serum vitamin A levels, the other serum factors differed significantly between the groups, the Finns having higher serum vitamin E and cholesterol and lower serum selenium levels. Adjusted to serum cholesterol, which correlated significantly with vitamin E in both groups, the vitamin E levels were, however, similar in the groups. The differences in the serum levels of these nutritional factors may be associated with the differences in the risk of coronary heart disease and cancer between Finnish and Japanese populations.

Cholesterol

Evaluation of a new inhibitor test for isoamylase on Hitachi 705 analyser.

We describe a simple and rapid method for measuring pancreatic and salivary type amylases using the Hitachi 705 analyser. The determination is based on the inhibition of salivary amylase using an inhibitor isolated from wheat germ. The precision of the proposed method was very good: within-day precision varied from 0.4 to 2.5% (CV) and day-to-day precision from 2.2 to 3.7% (CV). The new application correlated well with another commercially available inhibition method. As the standardization is very stable and the assay procedure exactly the same as for the total amylase assay, the proposed method is suitable for routine isoamylase determination. Reference values for pancreatic and salivary amylase activities are presented.

Autoanalysis

Serum albumin assay with bromcresol purple dye.

Serum albumin was assayed with bromcresol purple using routine clinical chemical photometric analysers. Bromcresol purple and bromcresol green dyes were compared, and albumin assays using these dyes were compared to those made by radial immunodiffusion and rocket immunoelectrophoresis. Bromcresol purple seems to be insensitive to all serum proteins except albumin, and this dye is correlated linearly with radial immunodiffusion and with rocket electrophoresis.

Bromcresol Green