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Biomedical subjects

L Lissner

Publications and source records attributed to L Lissner.

At least 73 records · Page 4Linked to original sources
PubMed1995

Concentrations of blood, serum and urine components in relation to number of amalgam tooth fillings in Swedish women.

Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were examined in 1968/69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The examination was repeated in 1980/81 including a new dental examination. The results from a number of biochemical analyses of blood, serum and urine were analyzed for a possible statistical relationship to number of dental amalgam fillings. As emphasis has been put in the literature on special influence from amalgam on kidney function and on the immunological system, special attention was paid to variables which might reflect these functions in our analyses. When potential confounders were taken into consideration, no significant correlations remained which seemed to be of clinical importance. Specifically, amalgam fillings were not found to be associated with impairment of the kidney function or the immunological status.

Adult↗
PubMed1995

Dietary fat and obesity: evidence from epidemiology.

The epidemiological evidence that a high-fat diet promotes the development of obesity is considered suggestive but not definitive. The purpose of this paper is to provide a review of various epidemiological methods that have been used to address this issue as well as an updated summary of the existing evidence. Ecological studies describing dietary fat intake and obesity at the population level provide mixed results and are likely to be biased by both confounding and unknown data quality factors that differ systematically across the populations studied. Cross-sectional studies are generally in agreement that the concentration of fat in the diet is positively associated with relative weight. Prospective studies of diet in relation to subsequent weight change give inconsistent results. This may be due to behavioural factors such as dieting in response to weight gain; in addition, this type of study rarely takes into account the possible interaction between genetic predisposition and dietary fat in promoting weight gain. Finally, intervention studies in free-living subjects are considered, providing evidence of a consistent but short-lived period of active weight loss on low-fat diets. The experimental evidence on this relationship is more conclusive than the epidemiological evidence, although biological mechanisms remain controversial. Some areas for future epidemiological research involve: longitudinal studies of dietary fat intake as a predictor of growth in children; observational studies relating total dietary fat and specific types of fat to overall as well as regional adiposity; and randomized intervention studies of the effect of low-fat diets with particular emphasis on and familial predisposition to obesity and other possible modifying factors.

Adult↗
PubMed1994

Causes, diagnosis and risks of obesity.

This paper reviews definitions of obesity and evidence concerning risk factors for becoming obese. Modifiable aetiological factors, including diet and physical activity, are described, and possible interactions with genetic predisposition are addressed. The impact of obesity on health and quality of life is then considered. Although epidemiological studies have not observed linear associations between increasing weight-for-height and decreasing longevity, there is a consensus that excess mortality occurs at extremely high body mass index values. Compromised quality of life is also observed at this end of the obesity distribution, and is manifested as decreased psychological well-being, less social integration, and stigmatisation.

Dietary Fats↗
PubMed1994

Testosterone concentrations in women and men with NIDDM.

UNLABELLED: OBJECTIVE--To evaluate androgen concentrations in relation to insulin resistance in men and women with and without NIDDM. Recent studies have indicated the potential importance of the regulation of insulin sensitivity by androgens in both women and men. Low sex hormone binding globulin (SHBG) concentration is an independent risk factor for the development of non-insulin-dependent diabetes mellitus (NIDDM) in women and is strongly associated statistically with signs of insulin resistance. RESEARCH DESIGN AND METHODS--We compared measurements of anthropometric variables and SHBG, steroid hormone, and insulin concentrations of women and men who have NIDDM with those of control subjects. RESULTS--Women with NIDDM had somewhat higher plasma insulin concentrations, lower SHBG, and higher free testosterone values than did control subjects with similar body mass index (BMI). Women with NIDDM had marginally higher waist-to-hip ratios (WHR). Plasma insulin concentrations correlated positively with BMI, WHR, and free testosterone and negatively with SHBG. In multivariate analyses, insulin concentrations remained positively associated with BMI and free testosterone. Men with NIDDM had higher fasting plasma insulin concentrations than did the nondiabetic control subjects. Testosterone and SHBG were lower in the diabetic men than in both control groups. The derived value of free testosterone was not different between groups. Univariate correlation analyses revealed tight statistical couplings between plasma insulin on the one hand and SHBG and testosterone concentrations (negative) on the other. In multivariate analyses, only the insulin-testosterone association remained. CONCLUSIONS: Women with NIDDM have high levels of free testosterone and low levels of SHBG. Insulin resistance is closely correlated with these signs of hyperandrogenicity as well as with obesity. Men with NIDDM also have low levels of SHBG and, in contrast to women, low testosterone values. Insulin values correlate negatively with these hormonal factors. Based on the results of experimental work and intervention studies, we suggest that these androgen abnormalities might be causally related to insulin resistance in NIDDM.

Androgens↗
PubMed1994

The natural history of obesity in an obese population and associations with metabolic aberrations.

The natural history of obesity was examined in a nation-wide sample of 1,084 obese men and 1,367 obese women aged 37-59 years who were recruited into a registry of potential subjects for an intervention trial. The registry and intervention studies are jointly referred to as SOS ('Swedish Obese Subjects'). In the registry, the mean body mass index was 37.7 kg/m2 in men and 40.9 kg/m2 in women. Descriptive information on subjects' weight histories and the relative weights of their biological parents was collected by means of a self-administered questionnaire. At a physical examination shortly thereafter, weights, heights and selected cardiovascular risk factors were measured in the fasting state. Virtually all subjects reported weight loss attempts in the past, men and women reported having gained weight during adulthood at a considerably higher rate than that observed in population-based samples. Significant correlations were observed between relative weights of obese males and both of their biological parents, but not between obese women and either of their parents. Indices of medical risk were then examined in relation to individual weight histories. Familial predisposition did not relate to most aspects of current medical risk. However, later-onset obesity tended to be associated with greater cardiovascular risk, while prior weight loss was predictive of an improved risk factor profile. These latter associations were not dependent on a subject's current degree of obesity and were particularly consistent with respect to fasting insulin level.

Adult↗
PubMed1993

Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden.

OBJECTIVE: To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN: Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING: Gothenburg, Sweden. SUBJECTS: 1462 randomly selected women aged 38-60 at start of study. MAIN OUTCOME MEASURES: Total mortality and death from myocardial infarction as predicted by serum cholesterol and triglyceride concentrations, body mass index, and ratio of circumference of waist to circumference of hips. RESULTS: 170 women died during follow up, 26 from myocardial infarction. Serum triglyceride concentration and waist:hip ratio were significantly associated with both end points (relative risk of total mortality for highest quarter of triglyceride concentration v lower three quarters 1.86 (95% confidence interval 1.30 to 2.67); relative risk for waist:hip ratio 1.67 (1.18 to 2.36)). These associations remained after adjustment for background variables. Serum cholesterol concentration and body mass index were initially associated with death from myocardial infarction, but association was lost after adjustment for background variables. Serum triglyceride concentration and waist:hip ratio were independently predictive of both end points (logistic regression coefficient for total mortality for triglyceride 0.514 (SE 0.150), p = 0.0006; coefficient for waist:hip ratio 7.130 (1.92), p = 0.0002) whereas the other two risk factors were not (coefficient for total mortality for cholesterol concentration -0.102 (0.079), p = 0.20; coefficient for body mass index -0.051 (0.027), p = 0.05). CONCLUSIONS: Lipid risk profile appears to be different in men and women given that serum triglyceride concentration was an independent risk factor for mortality while serum cholesterol concentration was not. Consistent with previous observations in men, localisation of adipose tissue was more important than obesity per se as risk factor in women.

Adult↗
PubMed1993

Body weight change, all-cause mortality, and cause-specific mortality in the Multiple Risk Factor Intervention Trial.

OBJECTIVE: To evaluate the relation between weight variability and death in high-risk, middle-aged men participating in the Multiple Risk Factor Intervention Trial (MRFIT). DESIGN: Cohort study with 3.8 years of follow-up. SETTING: Multicenter, collaborative, primary prevention trial conducted at 22 clinical centers in the United States. PARTICIPANTS: Men (n = 10,529) who were 35 to 57 years old at baseline and who were in the upper 10% to 15% of risk for coronary heart disease because of smoking, high blood pressure, and elevated cholesterol level. Participants were seen at least annually for 6 to 7 years for medical evaluations in study clinical centers. MEASUREMENTS: Death from cardiovascular disease (228 deaths) and from all causes (380 deaths). RESULTS: The primary measure of weight variability was the intrapersonal standard deviation of weight (ISD), which was calculated from measured weights obtained at clinic visits during a 6- to 7-year period. All-cause death rates per 1000 person-years of follow-up across ISD quartiles were 8.28, 8.25, 10.57, and 11.07 from the first to fourth quartiles, respectively. After adjusting for baseline risk factors associated with weight change, the relative risk for all-cause mortality in the fourth compared with the first quartile was 1.64 (95% CI, 1.21 to 2.23). Cardiovascular death and ISD showed a similar pattern. The association between weight change and death was not observed in the heaviest men. CONCLUSION: Greater weight variability was associated with a greater risk for cardiovascular disease and all-cause mortality in some types of high-risk men.

Adult↗
PubMed1993

The reproducibility and validity of a self-administered semiquantitative food frequency questionnaire in subjects from South Dakota and Wyoming.

Most validation studies of food frequency questionnaires have been done in populations capable of reporting their diet with unusual accuracy. In this study of ranchers and subjects selected at random, we compared nutrient intakes as assessed with multiple diet records with those assessed with a self-administered food frequency questionnaire (the Harvard-Willett instrument with 116 food items). One hundred thirty-eight subjects from South Dakota and Wyoming, 64 males and 74 females, completed at least one food frequency questionnaire and multiple 1-day diet records (mean = 5 days) during a 6-month to 1-year period. Of invited subjects, 88% participated; 59% of participants had a high school education or less. For 22 dietary nutrients (excluding supplements) and alcohol, the median crude correlation between intakes based on diet records and the food frequency questionnaire completed before the diet records was 0.42; after adjustment for energy, age, and sex, and after correction for attenuation in the correlation coefficients due to error from a limited number of diet records, the median correlation was 0.52. Correlations for men and women were similar. The validity of the food frequency questionnaire in this population was similar to that reported previously and supports the use of self-administered food frequency questionnaires in studies of general populations.

Data Collection↗
PubMed1993

Adipose tissue fatty acids and dietary fat sources in relation to endometrial cancer: a retrospective study of cases in remission, and population-based controls.

This study describes associations between early-stage endometrial cancer and type of dietary fat consumed, based on (i) adipose tissue fatty acid content (a biomarker for dietary fat) and (ii) self-reported frequencies of selected high-fat foods. Because obesity may be associated with high dietary fat intake as well as endometrial cancer, a secondary objective is to determine whether the observed dietary associations are statistically independent of body composition, assessed as percent body fat. To achieve these aims, we examined 20 cases of endometrial cancer in remission and 20 community controls, all aged 55-64. Abdominal adipose tissue biopsies from cases contained significantly higher concentrations of saturated fatty acids of intermediate chain length (C12-C16), lower ratios of polyunsaturated to saturated fatty acids (P:S ratio), and lower concentrations of C18 polyunsaturated as well as C18 saturated fatty acids. These differences were independent of degree of adiposity measured in a whole body 40K counter and several measurements of regional fat distribution. In addition, each subject's consumption of 20 high-fat items was reported by means of a semiquantitative food frequency questionnaire. Analysis of these data indicated that cases consumed more animal-derived fats, again independent of obesity. In particular, cases used more butter in cooking, ate more bacon, and drank more whole milk. Animal-derived fat intake displayed an inverse association both with the P:S ratio and the C18 polyunsaturated fatty acid content of adipose tissue, lending internal validity to the dietary data. These findings are consistent with the hypothesis that the type of dietary fat consumed may influence the occurrence of endometrial cancer.

Adipose Tissue↗
PubMed1993

"The Göteborg Quality of Life Instrument"--a psychometric evaluation of assessments of symptoms and well-being among women in a general population.

OBJECTIVE: To examine with psychometric analysis techniques the potential for constructing valid composite variables of "The Göteborg Quality of Life Instruments". DESIGN: Prospective population study of women in 1974-75 and in 1980-81. SETTING: City of Göteborg, Sweden. PARTICIPANTS: Representative samples of the general population of women in five age strata between 44 and 66 years of age in 1974-75, followed 1980-81 including new cohorts of women aged 26 and 38. 1302 women were examined in 1974-75 and 1408 in 1980-81. MAIN OUTCOME MEASURE: "The Göteborg Quality of Life instrument", constructed in the early 1970s to measure symptoms and well-being in a population study of men. RESULTS: Four multi-item scales were identified with satisfactory reliability and validity, i.e., they met defined criteria of multi-item scales and benefit from higher reliability than single questions. The psychological symptom scale comprised all ten questions intended to reflect depression and tension, while the physical symptom scale included all six pain questions, the general symptoms dizziness, breathlessness, and nausea, and general fatigue that belonged to both symptom scales. The social well-being scale comprises all well-being questions believed to reflect the broad concept of life satisfaction. The physical-mental wellbeing scale reflected satisfaction with both general and mental health. Several symptom and well-being questions were clearly outside the main clusters and should be treated as single items. CONCLUSIONS: Use of a few, distinct scales instead of a number of single questions should increase statistical power because the number of comparisons is greatly reduced and problems of chance findings are thus minimized.

Adult↗
PubMed1993

Validity and reproducibility of a self-administered dietary questionnaire in obese and non-obese subjects.

The validity and reproducibility of a self-administered dietary questionnaire has been tested with specific attention to differences between obese and non-obese subjects. To test the validity, the dietary questionnaire was compared with 4-day food records, 24-h energy expenditure (24EE) and nitrogen excretion in 45 obese and 19 non-obese men and women. Energy intake was 2% higher (non-significantly) from questionnaire than from food records in the non-obese, but 35% higher (P < 0.001) in the obese. Comparing energy intake from the questionnaire with estimated 24EE, the questionnaire gave 4% higher values in both the non-obese and obese, differences which were not significant. The reproducibility in the obese sample that completed the questionnaire twice was comparable to that observed in normal populations. These data suggest that it is possible to obtain information on obese subjects' dietary intake that is at least as valid and reproducible as that from normal weight individuals.

Adult↗
PubMed1992

Diabetes incidence in users and non-users of antihypertensive drugs in relation to serum insulin, glucose tolerance and degree of adiposity: a 12-year prospective population study of women in Gothenburg, Sweden.

As part of a prospective population study in Gothenburg, Sweden, women aged 50 years were subjected to an intravenous glucose tolerance test on entry to the study and followed up for 12 years. Manifest diabetes was the only end-point registered in this part of the study. Of 352 initially non-diabetic women, 17 (4.8%) subjects developed diabetes, with a fourfold increased risk in women taking antihypertensive drugs (diuretics or beta-blockers, or both) compared with women who were not taking such medication. The increased risk was observed independently of initially measured glucose metabolism variables and degree of adiposity, although the incidences were higher overall if the use of antihypertensive drugs was combined with fasting hyperinsulinaemia and adiposity. This study provides further evidence to support the view that diuretics and beta-blockers are precipitators of type 2 diabetes mellitus.

Adrenergic beta-Antagonists↗
PubMed1992

Fasting insulin in relation to subsequent blood pressure changes and hypertension in women.

The role of hyperinsulinemia in the development of hypertension is not well understood, particularly insofar as both conditions relate to obesity. The present analysis examines the hypothesis that hyperinsulinemia, independent of obesity, precedes hypertension and natural blood pressure increases in women. The subjects were 50-year-old women from a prospective population study in Gothenburg, Sweden. Fasting insulin levels were determined at baseline (1968-1969) and were evaluated in relation to subsequent hypertension. Blood pressures were measured at the initial physical examination and at the 6- and 12-year follow-up examinations. The first analysis presented here (n = 278) identified incident cases of hypertension during the 12-year follow-up period, whereas the second analysis (n = 219) examined continuous changes in blood pressure. In both analyses, degree, type, and changes in obesity were considered as possible confounding factors. High fasting insulin values were predictive of subsequent incidence of hypertension over the 12-year follow-up period. Subjects with insulin values above the 75th percentile experienced three times more hypertension than did those below the 25th percentile. There was also a significant association between insulin at baseline and increases in diastolic (but not systolic) blood pressure. The positive relations between fasting insulin, on one hand, and diastolic blood pressure changes and hypertension, on the other, could not be explained by confounding effects of body mass index, waist/hip ratio, or weight gain. These findings are consistent with the hypothesis that fasting insulin levels may be one predisposing factor in the etiology of hypertension.

Blood Pressure↗
PubMed1992

Smoking initiation and cessation in relation to body fat distribution based on data from a study of Swedish women.

In a representative sample of Swedish women, smokers were significantly less obese than nonsmokers. However, a smoker was likely to have significantly more upper-body fat than a nonsmoker of similar body mass index. Women who quit smoking experienced less upper-body fat deposition than would be expected by their accompanying weight gain, suggesting that weight gained as a consequence of smoking cessation is not preferentially deposited in the region associated with increased cardiovascular risk.

Age Factors↗
PubMed1992

Family history of diabetes in relation to different types of obesity and change of obesity during 12-yr period. Results from prospective population study of women in Göteborg, Sweden.

OBJECTIVE--To assess the relationship between family history and different types of obesity and change in obesity in a longitudinal population study. RESEARCH DESIGN AND METHODS--A longitudinal population study of 1462 randomly selected women (38-60 yr old) was conducted in Göteborg, Sweden, in 1968-69. The women were restudied after 12 yr. RESULTS--A family history of diabetes in mothers but not fathers showed, in univariate analysis, a significant positive association with obesity expressed as BMI. A family history of diabetes in the mothers was inversely related to body fat distribution expressed as WHR. No other association was observed between family history of diabetes and WHR. The association with BMI was independent of age, WHR, smoking habits, blood glucose, systolic blood pressure, serum cholesterol, serum triglycerides, maternal obesity, and the incidence of diabetes during the 12-yr follow-up period. Twelve years later, in 1980-1981, an independent association still existed between family history for diabetes and BMI measured at that examination, whereas there was no relationship with WHR. Women who had a family history of diabetes increased their BMI significantly more during the 12-yr follow-up compared with the women without a family history of diabetes, whereas there was no difference for the change of WHR. Family history of coronary heart disease and family history of cancer did not correlate to any kind of obesity. CONCLUSIONS--These findings indicate that family history of diabetes is related to overall obesity but not to abdominal adiposity per se.

Adipose Tissue↗
PubMed1992

Energy and macronutrient intake in relation to cancer incidence among Swedish women.

Two dietary reporting methods were used to examine associations between macronutrient intake and subsequent cancer incidence in a cohort of Swedish women born between 1908 and 1930. 1361 subjects gave 23-h dietary recalls at their baseline examinations in 1968-1969, and 412 of them also provided detailed dietary histories. The cohort was followed up 19 years later by means of linkages with the National Cancer and Death Registries. Both dietary methods indicated that subjects who were ranked in the highest tertile of energy intake, relative to the lowest, were at significantly greater risk of developing cancer (all-site). Relative risks across energy intake tertiles were 1, 1.15 and 2.04, respectively, using the dietary history method and 1, 1.02 and 1.55 using the 24-h recall data. Examination of specific macronutrient energy sources indicated that dietary fat and carbohydrate are likely to have made the largest contribution to this association. However, after adjustment for total energy, none of the individual macronutrients was significantly associated with all-site cancer, by either dietary reporting method. When expressed as a percentage of total energy, low protein density of the diet was associated with increased cancer risk, by both dietary methods. However, this appeared to be a function of high energy intake rather than low protein intake. Simultaneous statistical adjustment for seven potential confounders of the association between energy intake and cancer was performed using both the 24-h recall and the dietary history data.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Variability of body weight and health outcomes in the Framingham population.

BACKGROUND: Fluctuation in body weight is a common phenomenon, due in part to the high prevalence of dieting. In this study we examined the associations between variability in body weight and health end points in subjects participating in the Framingham Heart Study, which involves follow-up examinations every two years after entry. METHODS: The degree of variability of body weight was expressed as the coefficient of variation of each subject's measured body-mass-index values at the first eight biennial examinations during the study and on their recalled weight at 25 years of age. Using the 32-year follow-up data, we analyzed total mortality, mortality from coronary heart disease, and morbidity due to coronary heart disease and cancer in relation to intraindividual variation in body weight, including only end points that occurred after the 10th biennial examination. We used age-adjusted proportional-hazards regression for the data analysis. RESULTS: Subjects with highly variable body weights had increased total mortality (P = 0.005 for men, P = 0.01 for women), mortality from coronary heart disease (P = 0.009 for men, P = 0.009 for women), and morbidity due to coronary heart disease (P = 0.0009 for men, P = 0.006 for women). Using a multivariate analysis that also controlled for obesity, trends in weight over time, and five indicators of cardiovascular risk, we found that the positive associations between fluctuations in body weight and end points related to mortality and coronary heart disease could not be attributed to these potential confounding factors. The relative risks of these end points in subjects whose weight varied substantially, as compared with those whose weight was relatively stable, ranged from 1.27 to 1.93. CONCLUSIONS: Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.

Adult↗