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Biomedical subjects

K Landin

Publications and source records attributed to K Landin.

32 records · Page 2Linked to original sources
PubMed1991

Hypertension as a metabolic disorder--an overview.

Hypertension is related to several conditions with abnormalities in carbohydrate and lipid metabolism, such as obesity and impaired glucose tolerance. However, perturbed metabolism is also seen in non-obese hypertensive individuals. In addition, hypertension is linked to impaired fibrinolysis and elevated levels of the plasminogen activator inhibitor of endothelial type (PAI-1). Insulin resistance and hyperinsulinaemia in essential hypertension may be an important cause of these metabolic and fibrinolytic abnormalities. Whether hyperinsulinaemia is the cause of hypertension is currently unknown. However, it is clear that the relationship between hypertension and insulin is complex, and further studies are required to clarify this association. Based on the evidence states, it is suggested that insulin resistance and hyperinsulinaemia play a role in hypertension. However, it is also clear that hyperinsulinaemia occurs in the absence of hypertension, which suggests that other factors, such as genetic susceptibility, may be important.

Coronary Disease↗
PubMed1990

Abdominal obesity is associated with an impaired fibrinolytic activity and elevated plasminogen activator inhibitor-1.

Recent epidemiologic studies have shown that abdominal obesity, characterized by a high waist to hip circumference ratio (WHR), is associated with increased cardiovascular morbidity and mortality. The present study examines components of the fibrinolytic system in obese and lean middle-aged women with a high and low WHR. Ten women in each group were carefully matched with respect to age, body weight, lean body mass, and body fat. Fibrinogen and endothelial type of plasminogen activator inhibitor -1 (PAI-1) were significantly elevated in the obese women with a high WHR compared with the obese women with a low WHR or with both groups of lean women. In addition, obese women with a high WHR exhibited a greater metabolic risk profile (elevated glucose, insulin, and triglyceride levels). When all subjects were pooled for the analyses, both fibrinogen and PAI-1 levels correlated positively with glucose and insulin levels. PAI-1 was also negatively related to degree of insulin sensitivity measured with the euglycemic clamp technique. In the obese groups, WHR but not body mass index (BMI), correlated with PAI-1 levels. No such correlations were seen in the lean groups. In conclusion, the data show that a high WHR in obese, but not lean middle-aged women, is associated with an impaired fibrinolytic activity. This perturbation becomes enhanced when it is associated with hyperinsulinemia and insulin resistance, which is a typical feature of abdominal obesity.

Cardiovascular Diseases↗
PubMed1990

Increased insulin resistance and fat cell lipolysis in obese but not lean women with a high waist/hip ratio.

Increased lipolysis in abdominal adipocytes has been suggested to be of importance for the insulin resistance typical for abdominal obesity. In order to differentiate between fat distribution, measured as waist/hip ratio (WHR), and amount of body fat, glucose disposal during a euglycaemic clamp as well as lipolysis in isolated cells from abdominal and gluteo-femoral regions were studied in 20 obese and 20 lean postmenopausal women with a high (n = 10) and low (n = 10) WHR, respectively. The lipolytic response was increased in cells from obese women irrespective of region. Furthermore, lipolysis was enhanced in abdominal compared with the gluteo-femoral cells in obese women with a high WHR. Fasting blood glucose and insulin were increased in both groups of obese women while the degree of insulin resistance was most pronounced in the obese women with a high WHR. It is concluded that increased body fat is associated with both insulin resistance and increased lipolysis, and that this relationship is stronger in the presence of a high WHR. A high WHR may increase the expression of obesity as a risk for insulin resistance and this may be mediated through an increased lipolytic rate.

Adipose Tissue↗
PubMed1990

Elevated fibrinogen and plasminogen activator inhibitor (PAI-1) in hypertension are related to metabolic risk factors for cardiovascular disease.

The relationship between hypertension, glucose metabolism, fibrinogen and plasminogen activator inhibitor of endothelial cell type (PAI-1) was studied under conditions in which the influence of obesity and adipose tissue distribution (waist/hip ratio) were controlled. Twenty-two non-obese, middle-aged men with normal blood pressure (n = 11) and untreated mild hypertension (n = 11), respectively, participated in the study. Cholesterol, triglyceride and insulin levels were higher in hypertensive men than in the control group. Glucose disposal was studied as an indicator of insulin sensitivity using the euglycaemic clamp technique. The insulin effect tended to be less marked in men with hypertension. PAI-1 was higher in hypertensive men compared to the controls. A strong positive correlation was observed between PAI-1 and insulin levels as well as blood pressure. PAI-1 and fibrinogen levels correlated negatively with the rate of glucose disposal. Thus, even in these non-obese and mildly hypertensive individuals, an enhanced metabolic risk factor profile for cardiovascular disease was found. The metabolic aberrations were related to elevated fibrinogen and PAI-1 levels which, in turn, increase the risk of thrombus formation.

Anthropometry↗
PubMed1989

Importance of obesity for the metabolic abnormalities associated with an abdominal fat distribution.

Obese people with a high waist/hip ratio (W/H ratio) have an increased risk for cardiovascular disease. The present study was designed to separately analyze the importance of obesity and the regional fat distribution for the metabolic risk factors. Blood pressure, glucose tolerance, insulin, and plasma lipid levels were studied in lean and obese postmenopausal women with a high or low W/H ratio. The individuals within each group were carefully matched for age, lean body mass, and body fat. The risk factors associated with a high W/H ratio (elevated blood pressure, blood lipids, and glucose levels) were found in the obese but not in the lean women. Furthermore, lean women with a high W/H ratio tended to have a lower metabolic risk factor profile than obese women with a low W/H ratio. These findings document the importance of obesity in expressing the metabolic risk factors for cardiovascular disease associated with a high W/H ratio.

Abdomen↗
PubMed1989

Increased skeletal muscle Na/K-ratio in obese men, but not in women, with glucose intolerance.

Obesity is associated with glucose intolerance. Glucose is to a large extent disposed in the skeletal muscle. Peripheral insulin resistance, as well as decreased enzymatic activity in the skeletal muscle, has been suggested in type II diabetes. Potassium is essential for such enzymatic reactions. In this study, obese men, but not women, with glucose intolerance tended to have a lower total body potassium per kg body weight, indicating a smaller muscle mass, than weight-matched normoglycaemic men. They also had a lower skeletal muscle potassium content per 100 g dry weight (P less than 0.05) and a higher muscle Na/K-ratio (P less than 0.05) compared with obese men with normal glucose tolerance. Muscle fat and muscle sodium content were higher in obese men than in women with the same body mass index (P less than 0.01). The muscle electrolyte changes can be explained by a decrease in the insulin mediated Na/k-pump activity across the cell membrane or a smaller number of insulin receptors on the skeletal muscle cell in patients with glucose intolerance.

Anthropometry↗
PubMed1989

Addison's disease, malignant lymphoma and death from cerebral giant cell arteritis.

A 61-year-old woman with Addison's disease and malignant lymphoma for several years was admitted to hospital with a 2-month history of fatigue and a 7 kg weight loss. The erythrocyte sedimentation rate was 92 mm h-1 and a temporal biopsy was performed as a part of the clinical investigation. She suddenly suffered a paresis of the right arm, sudden blindness and her blood pressure fell to 100/60 mmHg. Hydrocortisone was given intravenously followed by betamethasone, and an Addison crisis as well as a giant cell arteritis (GCA) was suspected. Activity in the malignant lymphoma was also a possibility. The patient did not improve and died 8 d later. The temporal biopsy indicated GCA. The autopsy showed a pronounced intimal inflammatory reaction of the intracerebral arteries and an infarction in the left posterior hemisphere. A possible link between GCA and other autoimmune diseases is discussed.

Addison Disease↗
PubMed1989

Skeletal muscle potassium increases after diet and weight reduction in obese subjects with normal and impaired glucose tolerance.

Body composition calculated from total body potassium and skeletal muscle potassium were studied in middle-aged obese men and women with normal and impaired glucose tolerance as well as Type II diabetes before and after advice on calorie reduction during twelve months. The subjects were compared with healthy lean men and women. Mean weight loss was 6.6 kg (P less than 0.05). Lean body mass and body fat decreased 2.0 kg (P less than 0.05) and 4.6 kg (P less than 0.05), respectively. Total body potassium decreased by a mean of 146 +/- 49 mmol (P less than 0.01). Obese men with Type II diabetes and impaired glucose tolerance had lower total body potassium and muscle potassium levels than obese healthy men. After dieting, the obese men and women increased their muscle potassium levels with a mean of 2.8 mmol/100 fat-free dry weight to 42.6 +/- 2.6 mmol/100 g fat-free dry weight (P less than 0.05), but they were still below the levels of the lean controls, 44.4 +/- 1.3 MMOL/100 g fat-free dry weight, (P less than 0.01). Increase in skeletal muscle potassium was correlated to decrease in body weight, r = 0.55 (P less than 0.01) and to decrease in fasting blood glucose, r = 0.42 (P less than 0.05).

Blood Glucose↗
PubMed1988

Decreased skeletal muscle potassium in obesity.

The effect of body weight on total body potassium, skeletal muscle electrolytes and fat content was studied in seven lean and seven obese middle-aged men and seven lean and eight obese middle-aged women. Total body potassium and total body fat increased with body weight (p less than 0.01 and less than 0.05 for men, and p less than 0.05 and p less than 0.001 for women, respectively). So did muscle fat in men (p less than 0.01), while muscle tissue potassium was decreased in both obese men (p less than 0.001) and obese women (p less than 0.05). The skeletal muscle Na/K-ratio tended to be higher in obese men (p less than 0.1) but was not related to body weight in women. Skeletal muscle magnesium was higher (p less than 0.01) in obese men than in lean men. No differences between lean and obese women were found. Obese men had higher diastolic blood pressure (p less than 0.05) than lean men, while there was no difference between obese and lean women. Compared with lean subjects, obese subjects thus had lower relative skeletal muscle mass and men, especially, had more fat and less potassium in the skeletal muscle.

Adipose Tissue↗
PubMed1988

Glycogen and lactate synthetic pathways in human skeletal muscle in relation to obesity, weight reduction and physical training.

The effects of obesity, weight reduction, and physical condition on the concentrations of glucose-6-phosphate (G-6-P) and glycogen, and the activities of glycogen synthase (GS) and lactate dehydrogenase (LD) were determined in resting vastus or gastrocnemius muscles of 40 healthy subjects. In obese women the activity of GS was 50% (P less than 0.05) lower than in lean women with similar levels of glycogen and G-6-P, whereas no difference was found in the activity of LD. Calorie restriction induced a 4.5% (P less than 0.05) decrease in body weight from 82.5 kg corresponding to a 3.2% (P less than 0.05) decrease in body mass index from 30.9 kg m-2. The total and fractional activities of glycogen synthase were increased by 50% (P less than 0.05), whereas muscle glycogen content was reduced by 40% (P less than 0.05). The G-6-P concentration and the activity of LD remained unchanged. In well-trained young men the concentrations of G-6-P and glycogen were, respectively, 250% (P less than 0.05) and 50% (P less than 0.05) higher than in non-trained. The fractional and total activities of GS were 90% (P less than 0.05) and 50% (P less than 0.05) higher, respectively, and the total activity of LD was only half (P less than 0.05) that of non-trained subjects. In conclusion, physical training enhances the activity of GS, despite a concomitantly increased glycogen content, and thus seems to exert a more efficient stimulus on glycogen synthase than weight reduction. It is indicated that physical training may provide a clinically important contribution to blood glucose reduction in hyperglycaemic conditions.

Body Weight↗
PubMed1984

Athlete's bradycardia as an embolising disorder? Symptomatic arrhythmias in patients aged less than 50 years.

One hundred and sixty consecutive patients less than 50 years of age (mean 38 years) referred for long term electrocardiographic recording were evaluated retrospectively. Significant cardiac arrhythmias were detected in 51 of 107 (48%) patients examined because of syncope or dizzy spells or both. Of 39 patients examined for cardiac complaints or presumed complex arrhythmias, 15 (38%) had significant arrhythmias. Of 14 patients examined because of otherwise unexplained strokes, nine had slow sinus rates. Of these, one patient had recently undertaken moderately intensive athletic activity and four had been undertaking vigorous athletic activities for several years. All of the 12 active athletes who were followed up on account of syncope or dizzy spells were free of symptoms after reducing their athletic activities. The cardiac rhythm returned to normal in four out of five who underwent repeat long term electrocardiographic recording. It is suggested that vigorous athletic activity in subjects of 30-50 years of age may transform the adaptative bradycardia of the athlete into a condition similar to the embolising sick sinus syndrome.

Adult↗
PubMedDate not supplied

Brachytherapy for clinically localized prostate cancer: results at 7- and 8-year follow-up.

In recent years, there has been a resurgence of interest in interstitial radiation as a cost-effective and efficient method of treating organ-confined prostate cancer. We describe our 7- and 8-year results with transperineal Iodine-125 and Palladium-103 implantation. A total of 551 consecutive patients were treated. Of these, 320/551 (58%) received implant alone (Group I), and 231/551 (42%)--considered higher risk patients--were also treated with a modest dose (45 Gy) of external beam irradiation (Group II). The median follow-up for Group I was 55 months, and for Group II, 60 months. At 7 years, the actuarial freedom from biochemical failure (prostate-specific antigen (PSA) < or = 1.0 ng/mL) was 80% in Group I patients, and, at 8 years, 65% in Group II patients. Morbidity was minimal if patients had not undergone prior transurethral prostate resections. The results indicate that interstitial radiation is a valid treatment for clinically localized prostate cancer.

Actuarial Analysis↗