Biomedical subjects

Li Yin

Publications and source records attributed to Li Yin.

At least 19 recordsLinked to original sources

PubMed2026

A CqbZIP55-CqPIF3 regulatory module associated with light-responsive flavonoid biosynthesis during quinoa seedling de-etiolation.

Quinoa (Chenopodium quinoa) is an emerging leafy vegetable and microgreen crop rich in health-promoting flavonoids, yet the regulatory mechanisms linking light perception to early metabolic adaptation remain unclear. Here, we integrated phenotypic, transcriptomic, metabolomic, and molecular analyses to investigate early de-etiolation responses in quinoa seedlings. Short-term light exposure rapidly promoted seedling establishment and induced transcriptional programs associated with photosynthesis, carbon metabolism, hormone signaling, and flavonoid biosynthetic gene expression, whereas metabolite changes were more limited, indicating temporal uncoupling between transcriptional activation and metabolic accumulation. Genome-wide bZIP analysis identified CqbZIP55 as a light-responsive regulator that directly binds and activates the CqCHS promoter. CqPIF3 also bound the CqCHS promoter and showed stronger transactivation activity than CqbZIP55 in transient reporter assays. Protein interaction and dual-luciferase assays showed that CqbZIP55 physically interacts with CqPIF3 and modulates CqPIF3-associated promoter activity. Exogenous quercetin upregulated CqbZIP55 and prolonged CqCHS expression, suggesting a candidate metabolite-associated reinforcement mechanism. Together, these findings support functional interplay between CqbZIP55 and CqPIF3 in light-responsive regulation of flavonoid biosynthetic gene expression in quinoa seedlings, while further quinoa-based perturbation and in vivo promoter-occupancy assays are required to establish their physiological role in planta. This study provides a framework for further investigation of photoprotective metabolic regulation in quinoa.

Chenopodium quinoa↗

PubMed2026

MYDGF as a telomerase activator and therapeutic target for osteoarthritis.

Osteoarthritis (OA) involves progressive cartilage breakdown. This is driven by impaired chondrocyte function and an imbalance in the extracellular matrix homeostasis. However, the key upstream regulators that maintain healthy chondrocytes are still not fully known. Here, we report that myeloid-derived growth factor (MYDGF) is a novel regulator of telomerase activity and is critical for cartilage health. Using a genome-wide CRISPR-Cas9 screen with a TERT reporter system, MYDGF was identified as a strong positive regulator of telomerase. Functional studies confirmed that MYDGF positively regulates TERT expression and telomerase activity in both HeLa and ATDC5 cells. In a mouse surgical destabilization of the medial meniscus (DMM) OA model, MYDGF knockout (KO) mice exhibited more severe cartilage damage. Conversely, delivering MYDGF into the knee joint using AAV virus partially alleviated cartilage injury. Transcriptome profiling revealed that MYDGF-deficient chondrocytes exhibit downregulated key pathways involved in matrix building and upregulated inflammatory signals, indicating a shift in cell state. In summary, our work establishes MYDGF as a key upstream factor for both telomerase and cartilage matrix homeostasis remodeling. It connects telomerase function to chondrocyte health. These findings also highlight MYDGF as a promising new target for treating osteoarthritis.

Cartilage degeneration↗

PubMed2006

Control of confounding through secondary samples.

The control of confounding is essential in many statistical problems, especially in those that attempt to estimate exposure effects. In some cases, in addition to the 'primary' sample, there is another 'secondary' sample which, though having no direct information about the exposure effect, contains information about the confounding factors. The purpose of this article is to study the influence of the secondary sample on likelihood inference for the exposure effect. In particular, we investigate the interplay between the efficiency improvement and the possible bias introduced by the secondary sample as a function of the degree of confounding in the primary sample and the sizes of the primary and secondary samples. In the case of weak confounding, the secondary sample can only little improve estimation of the exposure effect, whereas with strong confounding the secondary sample can be much more useful. On the other hand, it will be more important to consider possible biasing effects in the latter case. For illustration, we use a formal example of a generalized linear model and a real example with sparse data from a case-control study of the association between gastric cancer and HM-CAP/Band 120.

Case-Control Studies↗

PubMed2006

Mucin 1 oncoprotein blocks hypoxia-inducible factor 1alpha activation in a survival response to hypoxia.

Resistance of carcinoma cells to hypoxic stress is of importance to the growth of solid tumors. The mucin 1 (MUC1) oncoprotein is aberrantly overexpressed by most human carcinomas; however, there is no known relationship between MUC1 and the hypoxic stress response. The present work has demonstrated that MUC1 attenuates activation of hypoxia-inducible factor-1alpha (HIF-1alpha), a regulator of gene transcription in the response of cells to hypoxic stress. In cells with stable gain and loss of MUC1 function, we have shown that MUC1 up-regulates prolyl hydroxylase 3 (PHD3) expression and promotes HIF-1alpha degradation. PHD activity is attenuated by increases in reactive oxygen species (ROS) generated in the hypoxic stress response. Our results further demonstrate that MUC1 blocks hypoxia-induced increases in ROS and thereby potentiates PHD-mediated HIF-1alpha suppression. Importantly, MUC1 also blocks hypoxia-induced apoptosis and necrosis by suppressing accumulation of ROS. These findings indicate that MUC1 attenuates HIF-1alpha activation in a survival response to hypoxic stress.

Apoptosis↗

PubMed2006

Association of access to parks and recreational facilities with the physical activity of young children.

OBJECTIVE: To determine associations of the neighborhood and home television environments with young children's physical activity. METHOD: 32 boys and 27 girls age 4 to 7 years wore accelerometers for 3 weekdays and 1 weekend day. The number of televisions in the home and television watching of the child were monitored using TV Allowance units for 3 weeks. A geographic information system was used to measure neighborhood environment variables. RESULTS: Hierarchical regression analysis was used to predict physical activity, initially controlling for sex, age, socioeconomic status, adiposity, and child television watching in step 1. In step 2, the number of televisions did not significantly increase the amount of variability accounted for in the prediction of physical activity. In step 3, housing density and the interaction of housing density by sex accounted for an incremental 12% (p < 0.05) of the variability and in step 4 percentage park plus recreation area accounted for a further 10% (p < 0.05) of the variability. Greater housing density predicted increased physical activity of boys, but not girls. CONCLUSION: Neighborhoods with increased proximity between homes and a greater proportion of park area are associated with greater physical activity in young children.

Body Mass Index↗

PubMed2006

Dexamethasone-induced adipogenesis in primary marrow stromal cell cultures: mechanism of steroid-induced osteonecrosis.

BACKGROUND: In steroid-induced osteonecrosis, hypertrophy and hyperplasia of marrow fat cells and lipid deposition of osteocytes can be found in the femoral head. However, the precise reason is not clear yet. The aim of this study was to observe the effect of dexamethasone (Dex) on differentiation of marrow stromal cells (MSCs), and to investigate the pathobiological mechanism of steroid-induced osteonecrosis. METHODS: MSCs in cultures were treated with increasing concentrations of Dex (0, 10(-9), 10(-8), 10(-7), and 10(-6) mol/L) continuously for 21 days. The cells, which were exposed to 0 mol/L (control) or 10(-7) mol/L Dex for 4 - 21 days, were then cultured for 21 days without Dex. MSCs were stained with Sudan III. Number of adipocytes was counted under a light microscope. The activity of alkaline phosphatase (ALP) of MSCs treated with 0, 10(-8), 10(-7), and 10(-6) mol/L Dex for 12 days, and that treated with 0 mol/L and 10(-7) mol/L Dex for 8, 10, or 12 days were determined. The levels of triglycerides, osteocalcin and cell proliferation of MSCs treated with 0 mol/L and 10(-7) mol/L Dex were detected. The mRNA expression levels of adipose-specific 422 (aP2) gene and osteogenic gene type I collagen in MSCs treated with 0 mol/L and 10(-7) mol/L Dex for 6 days were analyzed by whole-cell dot-blot hybridization. Statistical analysis was performed using Student's t test and analysis of variance. P values less than 0.05 were considered significant statistically. RESULTS: The number of adipocytes in cultures increased with the duration of MSCs' exposure to Dex and the concentration of Dex. The level of ALP activity in the MSCs decreased with concentration of Dex. In the control group, it was 8.69 times of that in the 10(-7) mol/L Dex group on day 12 (t = 20.51, P < 0.001). The level of triglycerides in 10(-7) mol/L Dex group was 3.40 times of that in the control (t = 11.00, P < 0.001). The levels of cell proliferation and osteocalcin in the control were 1.54 and 2.42 times of that in the 10(-7) mol/L Dex group respectively. As compared to the control, the mRNA expression of adipose-specific 422 (aP2) gene in 10(-7) mol/L Dex group was significantly increased (t = 36.48, P < 0.001), and that of osteogenic gene type I collagen was decreased (t = 42.07, P < 0.001). CONCLUSIONS: Dex can directly induce the differentiation of MSCs into a large number of adipocytes and inhibit their osteogenic differentiation, which provide a novel explanation for the pathologic changes of steroid-induced osteonecrosis.

Adipogenesis↗

PubMed2006

Vascular endothelial growth factor in serum indicates cardiovascular risk in urology patients.

OBJECTIVE: We hypothesized that a high serum concentration of vascular endothelial growth factor (VEGF), a cytokine involved in prostate growth which is also upregulated in chronic ischemia, indicates an increased risk of cardiovascular disease and death in urology patients. MATERIAL AND METHODS: The serum VEGF concentration was measured in 219 males (mean age 72 years) who sought medical attention because of lower urinary tract symptoms. Data on cardiovascular events and survival were obtained from the hospital registry of Stockholm County and the Death Registry over a period of up to 10 years (mean 6.2 years). RESULTS: After adjusting for the effects of age and smoking, patients with a serum VEGF level in the upper 20% of the cohort (>500 pg/ml) had an increased risk of developing cardiovascular disease (hazard ratio 2.18; 95% CI 1.04-4.60), including acute myocardial infarction (3.36; 1.35-8.41) and stroke (3.98; 1.61-9.86). They also had an increased risk of death (1.74; 1.01-3.00). These differences from patients with a lower serum VEGF concentration (<300 pg/ml) were manifested 2-5 years after the blood sample was taken. CONCLUSION: An elevated VEGF level in peripheral blood was a risk factor for subsequent development of cardiovascular disease.

Aged↗

PubMed2006

Neuronal damage in rat brain and spinal cord after cardiac arrest and massive hemorrhagic shock.

OBJECTIVE: Severe global ischemia often results in severe damage to the central nervous system of survivors. Hind-limb paralysis is a common deficit caused by global ischemia. Until recently, most studies of global ischemia of the central nervous system have examined either the brain or spinal cord, but not both. Spinal cord damage specifically after global ischemia has not been studied in detail. Because the exact nature of the neuronal damage to the spinal cord and the differences in neuronal damage between the brain and spinal cord after global ischemia are poorly understood, we developed a new global ischemia model in the rat and specifically studied spinal cord damage after global ischemia. Further, we compared the different forms of neuronal damage between the brain and spinal cord after global ischemia. DESIGN: Randomized, controlled study using three different global ischemia models in the rat. SETTING: University research laboratory. SUBJECTS: Male, adult Sprague-Dawley rats (300 g). INTERVENTIONS: Animals were divided into three experimental groups, group A (n = 6, survived for 7 days), 12 mins of hemorrhagic shock; group B (n = 6, survived for 7 days), 5 mins of cardiac arrest; or group C (n = 6, each for 6 hrs, 12 hrs, 1 day, 3 days, and 7 days), 7 mins of hemorrhagic shock and 5 mins of cardiac arrest. Motor deficit of the hind limbs was studied 6 hrs to 7 days after resuscitation. Also, nonoperated animals (n = 6) were used as the control. Histologic analysis (hematoxylin and eosin, Fluoro-Jade B, terminal deoxynucleotidyl transferase- mediated dUTP end-labeling [TUNEL], Klüver-Barrera) and ultrastructural analysis using electron microscopy were performed on samples from the CA1 region of the hippocampus and lumbar spinal cord. Demyelination of the white matter of the lumbar spinal cord was analyzed semiquantitatively using Scion Image software. MAIN RESULTS: No paraplegic animals were observed in either group A or B. All group C animals showed severe hind-limb paralysis. Severe neuronal damage was found in the CA1 region of the hippocampus in all groups, and the state of delayed neuronal cell death was similar among the three groups. Neuronal damage in the lumbar spinal cord was detected only in group C animals, mainly in the dorsal horn and intermediate gray matter. Demyelination was prominent in the ventral and ventrolateral white matter in group C. A significant difference was observed between control and group C rats with Scion Image software. Ultrastructural analysis revealed extensive necrotic cell death in the intermediate gray matter in the lumbar spinal cord in group C rats. CONCLUSION: The combination in the global ischemia model (i.e., hemorrhagic shock followed by cardiac arrest) caused severe neuronal damage in the central nervous system. Thereby, hind-limb paralysis after global ischemia might result from spinal cord damage. These results suggest that therapeutic strategies for preventing spinal cord injury are necessary when treating patients with severe global ischemia.

Animals↗

PubMed2006

Rapid identification of small interfering RNA that can effectively inhibit the replication of multiple influenza B virus strains.

Influenza B virus is a cause of substantial morbidity and mortality in humans and current vaccination strategies and antiviral drugs only provide limited protection. Here, we report the evaluation of small interfering RNA (siRNA) for repression of viral replication in cultured cells as well as in chicken embryos. Several siRNAs targeting conserved regions of the virus (in chemically synthesized or plasmid-encoded forms) were found to effectively block the replication of the influenza B virus. The siRNAs were found to offer broad protection over several strains of influenza B virus (B/Beijing/76/98, B/Beijing/37/99 and B/Jiangsu/10/03) that differ substantially in their genetic content. The antiviral effects of 500 ng siRNA-encoding plasmids or 60 nmoles synthetic siRNA were found to be comparable to that of 3.6 microg ribavirin. These results indicated that RNA interference warrants further study for management of influenza B virus infections.

Animals↗

PubMed2005

MUC1 oncoprotein blocks glycogen synthase kinase 3beta-mediated phosphorylation and degradation of beta-catenin.

Dysregulation of beta-catenin is of importance to the development of diverse human malignancies. The MUC1 oncoprotein is aberrantly overexpressed by most human carcinomas and associates with beta-catenin. However, the functional significance of the MUC1-beta-catenin interaction is not known. Here, we show that MUC1 increases beta-catenin levels in the cytoplasm and nucleus of carcinoma cells. Previous studies have shown that glycogen synthase kinase 3beta (GSK3beta) phosphorylates beta-catenin and thereby targets it for proteosomal degradation. Consistent with the up-regulation of beta-catenin levels, our results show that MUC1 blocks GSK3beta-mediated phosphorylation and degradation of beta-catenin. To further define the interaction between MUC1 and beta-catenin, we identified a serine-rich motif (SRM) in the MUC1 cytoplasmic domain that binds directly to beta-catenin Armadillo repeats. Mutation of the SRM attenuated binding of MUC1 to beta-catenin and MUC1-mediated inhibition of beta-catenin degradation. Importantly, disruption of the MUC1-beta-catenin interaction with the SRM mutant also attenuated MUC1-induced anchorage-dependent and -independent growth and delayed MUC1-mediated tumorigenicity. These findings indicate that MUC1 promotes transformation, at least in part, by blocking GSK3beta-mediated phosphorylation and thereby degradation of beta-catenin.

Amino Acid Motifs↗

PubMed2005

Orexin-1 receptor expression after global ischemia in mice.

Orexins are neuropeptides that have a range of physiological effects including the regulation of feeding behavior and the sleep-wakefulness cycle. Recently, we reported that level of orexin A in spinal fluid was decreased in the patients of some neurodegenerative diseases and it is considered that orexin A and the receptors might be related to central nervous system disorders. However, the expression and localization of orexin receptors is not elicited well. Therefore, the purpose of this study is to investigate the time-dependent changes and the cellular localization of orexin receptor focusing on orexin-1 receptor (OX1R) in the mouse brain after transient common carotid artery occlusion (tCCAO) model by using immunohistochemical techniques. OX1R immunoreactivity dramatically increased and peaked in the hippocampus and cortex 2 days after tCCAO, but remained unchanged in the hypothalamus. Using double-immunohistochemistry, the OX1R immunopositive cells at 2 days after tCCAO were co-localized not only with neuronal marker, NeuN-immunoreactivity but also with astroglial and oligodendroglial markers, GFAP- and CNPase-immunoreactivities, respectively. These results suggested that OX1R is induced other cells in addition to the neurons during stress such as ischemia and orexins and its receptor might play an important role for ischemic insult.

Animals↗

PubMed2005

Cloning and expression studies of the Dunaliella salina UDP-glucose dehydrogenase cDNA.

The enzyme UDP-glucose dehydrogenase (EC 1.1.1.22) converts UDP-glucose to UDP-glucuronate. Plant UDP-glucose dehydrogenase (UGDH) is an important enzyme in the formation of hemicellulose and pectin, the components of primary cell walls. A cDNA, named DsUGDH, (GeneBank accession number: AY795899) corresponding to UGDH was cloned by RT-PCR approach from Dunaliella salina. The cDNA is 1941-bp long and has an open reading frame encoded a protein of 483 amino acids with a calculated molecular weight of 53 kDa. The derived amino acids sequence shows high homology with reported plants UGDHs, and has highly conserved amino acids motifs believed to be NAD binding site and catalytic site. Although UDP-glucose dehydrogenase is a comparatively well characterized enzyme, the cloning and characterization of the green alga Dunaliella salina UDP-glucose dehydrogenase gene is very important to understand the salt tolerance mechanism of Dunaliella salina. Northern analyses indicate that NaCl can induce the expression the DsUGDH.

Amino Acid Sequence↗

PubMed2004

Delayed expressed TNFR1 co-localize with ICAM-1 in astrocyte in mice brain after transient focal ischemia.

Intercellular adhesion molecule-1 (ICAM-1) is expressed after brain ischemia and is participated in the induction of neuronal cell death. Recently, we have reported that ICAM-1 is localized in astrocytes in the chronic phase of ischemia. However, the regulation of astroglial ICAM-1 after brain ischemia is not elucidated in detail. Therefore, we examined the gene and protein expression of TNFR1 after transient middle cerebral artery occlusion (tMCAO) by using real time-PCR and immunohistochemistry. Moreover, we determined the relationship of TNFR1 and ICAM-1 in the astrocyte in chronic phase of ischemia. Increased expression of TNFR1 mRNA in the ipsilateral cortex was noted slightly during ischemia and was significantly increased at 12 h after reperfusion. Few TNFR1-like imuunoreactivity (TNFR1-LI) was observed in the cortex of normal animals. However, TNFR1-LI was increased at 1 h during ischemia, then it was decreased at 3-6 h, and was increased again at 12-24 h after reperfusion in the core of ischemic area. TNFR1-LI was demonstrated in both neurons and astrocytes but not in oligodendrocytes and microglia/macrophages at 24 h after reperfusion. At 96 h after tMCAO, TNFR1-LI was increased in the perifocal region and it appeared to be displayed the astrocyte-like cells. By use of double immunostaining method, we found that the ICAM-1-LI was overlapped with GFAP-LI. Our data indicates that the expression of TNFR1 is up-regulated in accordance with ischemic insult and delayed expressed TNFR1-LI co-localized with ICAM-1-LI in astrocytes after tMCAO. These results suggest that astroglial ICAM-1 is regulated by TNF-alpha dependent pathway.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗

PubMed2004

Expression of tumor necrosis factor alpha in nerve fibers and oligodendrocytes after transient focal ischemia in mice.

The expression of tumor necrosis factor alpha (TNFalpha) increases and participates in several central nervous system (CNS) disorders. However, its expression after transient middle cerebral artery occlusion (tMCAO) in mice is not fully discussed yet. Therefore, we examined gene expression and protein localization of TNFalpha in brain using real-time polymerase chain reaction (PCR) and immunostaining after 1 h tMCAO in mice. After 1 h of ischemic conditions, we observed an increase in the expression of TNFalpha mRNA from basal level. While the expression decreased immediately to control level after reperfusion, it increased again significantly at 24 and 48 h after tMCAO. TNFalpha-like immunoreactivity (TNFalpha-LI) was slightly detected in fibrous structures of the neurons before ischemia. After ischemia, TNFalpha-LI spread widely to the soma of neurons and became more abundant in the nerve fibers, including axonal and dendritic processes. Moreover, TNFalpha-LI was also expressed in the oligodendrocytes and, occasionally, in microglia/macrophages, but not in astrocytes 24 h after tMCAO. These results suggest that TNFalpha shows biphasic expression that corresponds with ischemia and reperfusion, and might play a role in various cells to regulate CNS disorders such as neuronal and oligodendritic cell death after transient ischemia.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗

PubMed2004

MUC1 oncoprotein activates the FOXO3a transcription factor in a survival response to oxidative stress.

The MUC1 transforming protein is aberrantly overexpressed by most human carcinomas. Recent studies demonstrated that MUC1 confers a protective function against oxidative stress-induced apoptosis; however, the mechanisms responsible for this response are not known. The present work demonstrates that MUC1 regulates FKHRL1/FOXO3a, a member of the forkhead family of transcription factors that induces oxidant scavenging and DNA repair. We show that MUC1 attenuates activation of the phosphoinositide 3-kinase --> phospho-Akt/PKB pathway in HCT116 colon carcinoma cells and thereby decreases FOXO3a phosphorylation. MUC1 is expressed as an N-terminal ectodomain that is tethered to the cell surface by a C-terminal transmembrane subunit. The results demonstrate that the MUC1 cytoplasmic domain is sufficient to induce FOXO3a activation and attenuation of oxidative stress. We also demonstrate that stable down-regulation of endogenous MUC1 in ZR-75-1 breast cancer cells inactivates FOXO3a, increases intracellular oxidant levels, and sensitizes cells to H(2)O(2)-induced necrosis. These findings indicate that MUC1 regulates the FOXO3a signaling pathway in a survival response to oxidative stress.

Apoptosis↗

PubMed2004

Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients.

We have conducted a historical cohort study to assess cardiovascular mortality among psoriasis patients. Using the Swedish Inpatient Registry, we selected 8991 patients hospitalized for psoriasis at dermatological wards. To represent an outpatient cohort, 19,757 members of the Swedish Psoriasis Association were selected. Mortality from cardiovascular diseases was compared with the general population. We found no increased cardiovascular mortality among outpatients with psoriasis (standardized mortality ratio, SMR 0.94; 95% confidence interval, CI: 0.89-0.99). The overall risk among inpatients admitted at least once was increased by 50% (SMR 1.52; 95% CI: 1.44-1.60). The excess risk increased with increasing number of hospital admissions (p for trend <0.001). Cardiovascular mortality was higher among those admitted at younger ages (p for trend <0.001; SMR 2.62, 95% CI: 1.91-3.49, for patients aged 20 to 39 years at first admission). Young age at first admission appeared to further increase the risk among those who were repeatedly admitted. We conclude that a diagnosis of psoriasis per se does not appear to increase the risk for cardiovascular mortality. Severe psoriasis, however, here measured as repeated admissions, and early age at first admission, is associated with increased risk for cardiovascular death.

Adolescent↗

PubMed2004

Animal models to study adult stem cell-derived, in vitro-generated islet implantation.

Type 1 diabetes (T1D) is an autoimmune disease characterized by hyperglycemia following the destruction of the insulin-producing beta cells of the pancreatic islets of Langerhans by the body's own immune system. Although routine insulin injections can provide diabetic patients with their daily insulin requirements, this treatment is not always effective in maintaining normal glucose levels. A true "cure" is considered possible only through replacement of the beta cell mass, by pancreas transplantation, islet implantation, or implantation of nonendocrine cells modified to secrete insulin. With the recent success of islet implantation to reverse T1D, this procedure has become a welcome therapy for T1D patients. Unfortunately, this procedure is hampered by the limited number of transplantation quality pancreata available for the harvesting of islets. This shortage has sparked great interest in finding a replacement for organ donation, primarily the possible use of stem cell-derived islets starting with stem cells, or alternatively the harvesting of nonhuman islets. This review focuses on progress with growing islets in the laboratory from stem cells and a comparison between this developing technology and the current use of islets harvested from nonhuman sources.

Animals↗

PubMed2004

Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964-95.

OBJECTIVE: Although short term prognosis has improved in patients with systemic lupus erythematosus (SLE) during the early disease course, less is known about the longterm prognosis. METHODS: A cohort of 4737 patients with a diagnostic code of SLE was identified 1964-94 in the Swedish Hospital Discharge Register and followed by linkage to the Cause of Death Register until the end of 1995. Mortality was separately analyzed in 3 different calendar periods (1964-75, 1975-84, 1985-95). The relative risk of death was estimated as standardized mortality ratio (SMR) using the Swedish population as a reference. RESULTS: In total 2314 patients were deceased. Mortality was 3-fold increased (SMR = 3.63, 95% CI 3.49, 3.78) and cardiovascular disease (CVD) was the major cause of death. Patients aged 20-39 years at the first discharge had a 16-fold increased risk of death from coronary heart disease (SMR = 15.99, 95% CI 10.4, 23.6). All-cause mortality had decreased since 1975 and the reason for this decrease was entirely due to a decrease in causes attributed to SLE, but not CVD. Patients aged 20-39 years at the first discharge had a pronounced decrease in mortality, with SMR 33.59 (95% CI 24.3, 45.3) before 1975 compared with SMR 14.23 (95% CI 8.70, 22.0) after 1984. CONCLUSION: Cardiovascular disease was the major cause of death in patients with SLE and young patients had a pronounced increased risk of death. Even if all-cause mortality had declined during the last 2 decades due to causes attributed to SLE, the risk of cardiovascular death remained unchanged.

Adult↗