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Biomedical subjects

J Viikari

Publications and source records attributed to J Viikari.

At least 19 recordsLinked to original sources

Tracking of serum fatty acid composition: a 6-year follow-up study in Finnish youths.

The composition of fatty acids in serum cholesteryl esters was analyzed with gas chromatography in 759 Finnish boys and girls aged 3-18 years in 1980 and again in the same subjects in 1983 and in 1986. The mean percentage of linoleate (18:2 n-6) increased from 50.85% in 1980 to 52.60% in 1986, while there was a decrease in myristate (14:0), palmitate (16:0), and eicosapentaenoate (20:5 n-3). The percentage of oleate (18:1) did not change. The stability (tracking) of cholesteryl ester fatty acid composition was examined by calculating linear correlation coefficients among the percentages of each fatty acid at the three study points. For linoleate, 3- and 6-year tracking correlations were 0.59-0.61 and 0.50, respectively; they were of about the same magnitude for arachidonate (20:4 n-6) and lower for the other fatty acids. Results indicate that the serum cholesteryl ester fatty acid composition has somewhat lower tracking than the total cholesterol concentration. The changes in the mean fatty acid composition of the study population obviously reflect a shift from saturated to unsaturated dietary fats.

Adolescent

Replacement of butter on bread by rapeseed oil and rapeseed oil-containing margarine: effects on plasma fatty acid composition and serum cholesterol.

The effects of zero-erucic acid rapeseed oil and rapeseed oil-containing margarine on plasma fatty acid composition and serum cholesterol were studied in butter users (n 43). Compliance to the substitution was followed by fatty acid analysis of total plasma and plasma phospholipids. The amount of substitute fats represented, on average, 21% of total fat and 8% of total energy intake. Changes in the relative fatty acid composition of plasma phospholipids indicated further fatty acid metabolism, and were closely related to the serum cholesterol level. The reduction in saturated fatty acids led to a significant increase in the proportion of n-3 and n-6 polyunsaturated fatty acids (PUFA) with the rapeseed oil diet, whereas the margarine caused a significant rise in n-6 PUFA only. The increase in the proportions of the two PUFA families occurred in accordance with their competitive order, most completely with the rapeseed oil diet. When butter was replaced by rapeseed oil, low-density-lipoprotein-cholesterol decreased by an average of 9.1% without a reduction in high-density-lipoprotein-cholesterol. During margarine substitution the reduction was 5.2%, on average. Of the plasma phospholipids, alpha-linolenic acid and the linoleic:stearic acid ratio, but not oleic acid, were the components most significantly correlated with serum cholesterol levels or the decrease in these levels. The results show that rapeseed oil can act primarily as a source of essential fatty acids, rather than that of monoenes, in the diet of butter users.

Adult

Efficacy and tolerability of isradipine and metoprolol in treatment of hypertension: the Finnish Isradipine Study in Hypertension (FISH).

Eight hundred seventy-six men and women with diastolic blood pressure (DBP) of 95-115 mm Hg during a 4-week placebo period were included in a multicenter trial; 479 patients had previously been treated for hypertension. The patients were randomized to receive isradipine or metoprolol; both groups were comparable for age, weight, height, smoking habits, and duration of hypertension. By the end of the placebo period, 79 patients did not fulfill the final entry criteria and were withdrawn. The isradipine group consisted of 398 patients (164 women and 234 men), and the metoprolol group consisted of 399 patients (173 women and 226 men). The initial dose of isradipine was 1.25 mg twice daily (b.i.d.), and the initial dose of metoprolol was 50 mg b.i.d.; the doses were doubled after 4 weeks if DBP had not decreased to less than or equal to 90 mm Hg. After 8 weeks, the isradipine group began combination therapy with metoprolol 50 mg b.i.d. and the metoprolol group began combination therapy with isradipine 1.25 mg b.i.d. if DBP was not less than or equal to 90 mm Hg. After 8 weeks monotherapy, mean BP (MBP) was reduced by 13/11 mm Hg (161/104 to 148/93) in the isradipine group and by 15/12 mm Hg (160/103 to 145/91) in the metoprolol group. Monotherapy with isradipine normalized DBP to less than or equal to 90 mm Hg in 52% with a mean dose of 4.26 mg daily, and monotherapy with metoprolol normalized DBP in 58% with a mean dose of 155 mg daily.1+

Adult

Blood glycated haemoglobin, serum fructosamine, serum glycated albumin and serum glycated total protein as measures of glycaemia in diabetes mellitus.

Blood glycated haemoglobin (HbAlc), serum fructosamine (FA), serum glycated albumin (GA), and serum glycated total protein (GTP) were determined in 61 subjects (19 pregnant women with gestational diabetes, 24 pregnant women with insulin-dependent diabetes mellitus [IDDM] and 18 nonpregnant subjects with IDDM). FA, GA, and GTP correlated with HbAlc similarly (r = 0.791, 0.816, and 0.794, respectively, p < 0.001). In a subgroup of 22 subjects data on blood glucose home monitoring was recorded and used for calculating mean blood glucose as an index of average glycaemia preceding sampling of the glycation products. Mean blood glucose levels preceding sampling of HbAlc by 2 months and FA, GA, or GTP by three weeks correlated significantly with HbAlc (r = 0.668, p < 0.001) and GA (r = 0.441, p < 0.05) whereas no significant correlation was found between mean blood glucose and FA (r = 0.003) or GTP (r = 0.252). In conclusion, such methods which measure specifically the non-enzymatic glycation of a single species of protein (i.e. FPLC for HbAlc and affinity chromatography for GA) are to be preferred for assessing glycaemia.

Adult

Cardiac systolic time intervals and thyroid hormone levels during treatment of hypothyroidism.

This study was undertaken to compare results of modern serum thyroid hormone assays with cardiac systolic time intervals (STI) during thyroxine treatment in hypothyroid patients. The patients were assessed clinically (Billewicz index) and the STI and serum thyrotropin (TSH), total and free thyroxine (T4) and total and free triiodothyronine (T3) were determined in 16 hypothyroid women (Group I) treated with 50 micrograms increments of thyroxine, and in 13 women who had a history of thyroid carcinoma and high-dose thyroxine replacement therapy and had elevated thyroid hormone concentrations (Group II). The STI of 24 matched healthy female controls were used for reference of STI. The pre-ejection period (PEP) index and the PEP/LVET ratio (left ventricular ejection period) were greater in untreated overtly and mildly hypothyroid patients (p less than 0.05) than in the controls. During stable thyroxine therapy [mean daily dosage for Group I 137.5 (7.3) micrograms and for Group II 220 (61) micrograms] the PEP correlated with serum free T4 (FT4), as measured by a two-step method (SpectriaR) (r = -0.55, p less than 0.01, n = 29) and total T4 (r = -0.51, p less than 0.05, n = 29), but not with TSH, T3, FT3 or FT4 measured by an analogue method Amerlex-M(R). The TRH test was not valuable in follow-up because of the strong correlation between basal TSH and stimulated TSH values (r = 0.95). In conclusion, STI are useful for assessment of the thyroid state in untreated hypothyroid patients. Serum TSH becomes normal in the same time as STI and is the best for follow-up. If serum TSH is low and the patient is on stable thyroxine therapy, we recommend serum FT4 for monitoring thyroxine replacement. Two-step FT4 assays had the best correlation with STI, which has significance in patients with non-thyroidal illness.

Adolescent

Correlation of serum fatty acid composition with dietary intake data in children and young adults.

The percentage compositions of fatty acids in serum cholesteryl esters and phospholipids were analysed with gas chromatography in 759 nine- to 24-year-old Finns. The correlations of serum fatty acids with dietary fat intake data were calculated from a 48-h recall survey. The dietary P/S ratio had correlations of r = 0.50 and r = 0.40 with linoleate (18:2) in serum cholesteryl esters and phospholipids, respectively. The intake of fish and fish products correlated positively with the percentages of eicosapentaenoate (20:5 n-3) and docosahexaenoate (22:6 n-3) in both cholesteryl esters and phospholipids. Dietary intake of saturated fat correlated positively with the percentages of all saturated fatty acids in cholesteryl esters and with myristate (14:0) in phospholipids. The intake of monounsaturated fats did not correlate positively with serum monoenes. In conclusion, the dietary P/S ratio is well reflected in the fatty acid composition of serum cholesteryl esters and phospholipids, the intake of saturated fats less well, and the intake of monounsaturated fats not at all.

Adolescent

Serum cholesterol levels during and after Kawasaki disease.

Serum total cholesterol and high-density lipoprotein (HDL) cholesterol concentrations were studied in paired sera from 23 patients (16 boys) with Kawasaki disease (KD) during acute illness and in 35 patients (21 boys) 5.4 to 7.7 years after KD. Total cholesterol and HDL cholesterol concentrations were significantly lower (paired t test, p = 0.0001) in samples taken within 30 days of the onset of illness (3.32 +/- 0.85 mmol/L (128 +/- 33 mg/dl) and 0.54 +/- 0.25 mmol/L (20.8 +/- 9.7 mg/dl) than in the second samples taken 2 to 16 months after onset of disease (4.16 +/- 0.93 mmol/L (161 +/- 35 mg/dl) and 1.24 +/- 0.35 mmol/L (47.2 +/- 13.9 mg/dl). The lowest total cholesterol levels were observed in samples taken 6 to 9 days after the onset of KD (p = 0.019). No correlations were seen between the highest erythrocyte sedimentation rate, C-reactive protein, or thrombocyte counts and the acute or convalescent cholesterol levels. In patients studied 5.4 to 7.7 years after recovery from KD, the mean total cholesterol concentrations were still lower than in healthy Finnish children. In girls the HDL cholesterol concentrations were similar, whereas 3 of the 18 boys studied had HDL cholesterol values more than 2 SDs below the mean for healthy boys. There was no correlation between the serum cholesterol concentrations and coronary artery abnormalities. These data lead us to infer that KD does not cause such permanent changes in cholesterol metabolism as to be considered a risk factor for atherosclerosis beyond that caused by the disease itself.

Child

Obesity in children, adolescents and young adults.

The prevalence of obesity in Finnish children, adolescents and young adults aged three to 24 years was estimated in three surveys performed within the multicentre project, "Cardiovascular Risk in Young Finns" (1980, 1983, 1986). Obesity was defined as either body mass index (weight/height) or skinfold thickness (triceps or subscapular) or both greater than 90th percentiles of age and sex-specific reference data for white children. Its mean prevalences among 9- to 18-year old boys and girls in three surveys (95% confidence limits) were 3.6% (3.1-4.2) and 2.1% (1.7-2.6) as estimated in terms of body mass index and triceps skinfold thickness or 4.3% (3.9-4.9) and 2.6% (2.2-3.1) according to body mass index and subscapular skinfold thickness. Thus the 9- to 18-year old boys were on average more often obese than the girls, but no statistically significant changes in the prevalence of obesity were observed over the period 1980-1986. Body mass index and triceps or subscapular skinfold thicknesses vary in sensitivity as indicators of obesity.

Adolescent

Serum lipids and lipoproteins in children, adolescents and young adults in 1980-1986.

A multicentre study on atherosclerosis precursors in young Finns aged three to 18 years was started in 1980 (3596 subjects) serum lipid concentrations (cholesterol, HDL (high density lipoprotein) cholesterol and triglycerides) were determined (n = 3554) and the apolipoproteins A-I and B measured (n = 1355). Two follow-up studies were carried out in 1983 (n = 2851) and 1986 (n = 2489), when HDL-subfractions (HDL-2-cholesterol and HDL-3-cholesterol) were also determined. Apolipoproteins A-I and B were measured again in 1986 (n = 1202). Serum total cholesterol concentration has fallen by about 1% annually during the 1980's from 5.07 mmol/l (1980) to 4.79 mmol/l (1986) in 9- to 18-year old children and adolescents. Mean values of serum triglycerides have slightly increased during the follow-up from 0.79 mmol/l to 0.84 mmol/l, respectively. In children and young adults (3-24 years) the mean cholesterol concentration was highest at the age of six and lowest during puberty. Concentrations of serum cholesterol, LDL (low density lipoprotein) cholesterol apoprotein B and triglycerides were higher in eastern than in western Finland in 1980 and 1983, but these differences were smaller in 1986, with the exception of serum triglycerides. Both in 1983 and in 1986 HDL-2-cholesterol was lower in the west than in the east, whereas HDL-3-cholesterol was higher in the former. The favourable changes in lipid levels should be reflected in future morbidity and mortality rates from coronary heart disease in Finland.

Adolescent

Serum insulin and other cardiovascular risk indicators in children, adolescents and young adults.

We wanted to determine the levels of fasting serum insulin during growth, the tracking of serum insulin, and the correlation of serum insulin with other coronary heart disease risk indicators in children and young adults. In 1986 2433 subjects, aged nine to 24 were studied, and insulin data were available from the same population in 1980 and 1983. Serum insulin levels showed a peak during puberty in both sexes and the decline in insulin continued after the age of 21. Tracking of serum insulin was only moderate, especially in females and young boys. Serum insulin correlated positively with body mass index, concentrations of serum triglycerides, and blood pressure, and inversely with the concentration of high density lipoprotein cholesterol. High triglycerides, high systolic blood pressure, and low level of high density lipoprotein cholesterol clustered among subjects within the highest insulin quartile. Our results suggest that the insulin resistance phenomenon, caused mainly by obesity and leading to unfavourable levels of other coronary heart disease risk indicators, is already developing in children and young adults. This suggests that preventing obesity in early life is important.

Adolescent

Composition of the diet of young Finns in 1986.

The aim was to describe the energy intake and composition of the diet of 1200 9-, 12-, 15-, 18-, 21- and 24-year-old Finns in 1986 and changes in their diet from 1980 to 1986. Data on food consumption were collected using the 48 h recall method. In 1980 protein accounted for 14%, fat for 38% and carbohydrates for 48% of total energy intake, and in 1986 for 15%, 38% and 47%, respectively. The mean P/S ratio increased from 0.24 to 0.31 while the regional differences in the intakes of fatty acids remained unchanged, the P/S ratio being higher in urban than in rural areas and higher in western than in eastern Finland. In 1986 the diet of 15-, 18- and 24-year-old males contained more fat, saturated fatty acids and monounsaturated fatty acids but less sucrose than that of females. The difference in the diet between young men and women, if continued, might increase the male/female ratio at risk for coronary heart disease, which is already pronounced in Finland.

Adolescent

Predictive validity of preadolescent type A determinants for type A dimensions in young adulthood--a 6-year follow-up.

This study examined the predictive validity of preadolescent Type A determinants for Type A dimensions in young adulthood (n = 375). Predictive variables, i.e. hyperactivity, aggression, social maladjustment and self-esteem were measured when the subjects were aged 12. Type A dimensions, i.e. hard-driving, competitiveness plus aggression and impatience were measured in the same subjects when they were aged 18. "Impatience" was predicted by means of preadolescent hyperactivity, and "competitiveness-aggression" by social maladjustment. "Hard-driving", which was most strongly related to CHD risk factor levels in young adulthood, was anteceded by the subject's feeling that he or she could not cope with life. This supports the hypothesis that Type A behaviour is a coping mechanism: a person tries to cope with stress by increasing his or her level of achievement.

Adaptation, Psychological

Dimensions of the coronary arteries in children.

The extent of narrowing of the coronary arteries was measured in a series of 106 children who died accidentally. The outer radius of left main stem coronary artery increases from 1.06 mm at the age of 1 to 1.67 mm at 15. The left anterior descending branch increased with age from 0.70 to 1.35 mm and the inner radius from 0.55 to 1.10 mm. The mean thickness of the media and intima also increased with age; the correlation between thickness and weight was less pronounced. The coronary arteries thickened concomitantly with the size of the artery but that was due mainly to thickening of the intima. Substantial narrowing was found in the youngest age groups and the extent did not correlate with age but with the size of the vessel. The greatest narrowing was 57% of the arterial lumen. The measured dimensions will serve as normal values for the coronary arteries in Finnish children at autopsy.

Adolescent

Association of apolipoprotein E and B polymorphisms with serum lipids.

Genetic polymorphism of apolipoprotein E (apoE) and the Xbal restriction-fragment-length polymorphisms (RFLP) of the gene for apolipoprotein B (apoB) have both been shown to be associated with plasma lipid concentration. We studied the combined effect of these gene polymorphisms on serum cholesterol concentrations in 300 subjects aged nine to 18 years. In three way ANOVA, there was a statistically significant interaction between the effects of apoE phenotype and gender on serum cholesterol (P = 0.009). Therefore, males and females were analysed separately by two way ANOVA: there was no interaction between the effects of apoE phenotype and apoB Xbal polymorphism in either gender. In females, there were independent effects of both the apoE phenotype (P = 0.020) and the apoB Xbal genotype (P = 0.037) on serum cholesterol, but in males these effects were not statistically significant. These data suggest that variations at the apolipoprotein B and E gene locus play a role in the determination of serum cholesterol concentration in young female Finns.

Adolescent

DNA polymorphisms of the apolipoprotein B and A-I/C-III genes are associated with variations of serum low density lipoprotein cholesterol level in childhood.

A number of restriction fragment length polymorphisms (RFLPs) of the apolipoprotein B (apoB) and apolipoprotein A-I/C-III(apoA-I/C-III) genes have been found to be associated with serum lipoprotein levels in many adult populations. In order to examine whether these genetic polymorphisms influence serum lipoprotein levels in childhood and adolescence, we determined the apoB XbaI and apoA-I/C-III SstI genotypes and serum lipoprotein concentrations in 307 healthy Finns aged 9 to 21 years. In the age groups of 9, 12, and 15 years, subjects homozygous for the X2 allele (the XbaI site present) of the apoB gene had mean serum low-density lipoprotein (LDL) cholesterol levels (3.69, 3.43, and 3.15 mmol/l, respectively) that were 12-20% higher than those in subjects homozygous for the absence of this allele (3.08, 3.02, and 2.80 mmol/l, respectively). This association was more significant in males than in females. At the age of 9 to 18 years, subjects carrying the S2 allele (SstI site present) of the apoA-I/C-III gene complex had an approximately 6-15% higher mean serum LDL-cholesterol level than those homozygous for its absence. The combined genotype X2+S2+ (the simultaneous presence of the X2 allele and the S2 allele) was associated with an even more marked elevation of serum LDL-cholesterol level than either allele alone. As an example, the serum LDL cholesterol concentration was 20% higher in 9-year-old subjects with at least one X2 and one S2 allele than in those without either allele (3.55 vs. 2.97 mmol/l, P less than 0.005). The S2 allele was found to be significantly more frequent in eastern than in western Finland, whereas no significant areal differences were seen in the occurrence of the X2 allele. In conclusion, genetic variations of the apoB and apoA-I/C-III gene loci influence serum lipoprotein concentrations already in childhood.

Adolescent