The long-term prognostic value of a standard 12-lead electrocardiogram (ECG) for predicting cardiac events in apparently healthy middle-aged subjects is not well defined.
A total of 9511 middle-aged subjects (mean age 43?±?8.2 years, 52% males) without a known cardiac disease and with a follow-up 40 years were included in the study. Fatal and non-fatal cardiac events were collected from the national registries. The predictive value of ECG was separately analyzed for 10 and 30 years. Major ECG abnormalities were classified according to the Minnesota code.
Subjects with major ECG abnormalities (N?=?1131) had an increased risk of cardiac death after 10-years (adjusted hazard ratio [HR] 1.7; 95% confidence interval [95% CI], 1.1-2.5, p?=?0.009) and 30-years of follow-up (HR 1.3, 95% CI, 1.1-1.5, p?
The effects of acquired obesity on lipid profile and lipoprotein composition in rare BMI-discordant monozygotic (MZ) twin pairs were studied.
Abdominal fat distribution, liver fat (magnetic resonance imaging and spectroscopy), fasting serum lipid profile (ultracentrifugation, gradient gel-electrophoresis, and colorimetric enzymatic methods), and lifestyle factors (questionnaires and diaries) were assessed in 15 BMI-discordant (within-pair difference [?] in BMI >3 kg/m2) and nin concordant (?BMI
To determine the independent associations of dietary preference for fat with obesity without the confounding by genetic effects.
Descriptive comparison of the responses of monozygotic twins discordant for obesity to questions concerning current and past preference for dietary fat, current overconsumption of fatty items and recalled food consumption compared to the co-twin.
The Research and Development Centre of the Social Insurance Institution, Finland.
Twenty-three healthy monozygotic twin pairs who were discordant for obesity (BMI difference at least 3 kg/m(2)).
Obesity status of the twin, as a function of the current and recalled dietary preferences and selected psychosocial variables.
The obese twins reported current preference for fatty foods three times more frequently than the lean co-twin. Moreover, when comparing recalled taste for fat at the time the twins left their parental homes, both the obese and lean co-twins consistently recalled that the obese twin had greater preference for fatty foods in young adulthood, and that the lean twin had less. Psychological characteristics of lean and obese co-twins did not differ.
Acquired preference for fatty foods is associated with obesity, independent of genetic background. Modification of fat preferences may be an important step in the prevention of obesity in the general population.
Adipocyte size and number have been suggested to predict the development of metabolic complications in obesity. However, the genetic and environmental determinants behind this phenomenon remain unclear.
We studied this question in rare-weight discordant (intra-pair difference (?) body mass index (BMI) 3-10 kg m(-2), n=15) and concordant (?BMI 0-2 kg m(-)(2), n=5) young adult (22-35 years) monozygotic twin pairs identified from 10 birth cohorts of Finnish twins (n=5 500 pairs). Subcutaneous abdominal adipocyte size from surgical biopsies was measured under a light microscope. Adipocyte number was calculated from cell size and total body fat (D ? A).
The concordant pairs were remarkably similar for adipocyte size and number (intra-class correlations 0.91-0.92, P
The role of admission blood glucose level on the prognosis of patients with intracerebral haemorrhage has not been elucidated.
To examine this association on the basis of an epidemiologically representative patient material.
249 500 people living in the catchment area of the Central Hospital of Central Finland. The diagnosis of ICH was established if verified by cranial computed tomography (CT) or autopsy.
Of the 416 patients who fulfilled the diagnostic criteria, 30 died before admission and 386 were admitted to the Central Hospital. All 329 patients (290 nondiabetics and 39 diabetics) with both admission blood glucose and cranial CT data were included in the study. The mean blood glucose level was 10.6 mmol/l for nondiabetics who died on the day of onset, 8.6 mmol/l for those dying during days 1 to 28, and 6.8 mmol/l for the 28 day survivors. The corresponding figures for diabetics were 13.9 mmol/l, 12.5 mmol/l, and 9.3 mmol/l. In both nondiabetics and diabetics, patients who died had significantly higher mean glucose than the 28 day survivors (p
Apolipoprotein E (apo E) is a normal constituent of very-low-density lipoproteins and it participates in the metabolism of both low-density lipoproteins (LDL) and apo E-containing lipoproteins. In the present study, the aim was to examine to what extent apo E phenotypes modify central obesity-induced changes in serum lipids, insulin, and blood pressure in obese women. Altogether, 143 middle-aged obese women with a body mass index (in kg/m2) of 28.0-43.0 were examined. Twelve had apo E 3,2 phenotype, 93 had apo E 3,3 phenotype, and 38 had either apo E 4,3 or 4,4 (4,3 + 4,4 group) phenotype. Serum total and LDL cholesterol were lower in the apo E 3,2 group than in other groups, but no significant differences were observed in other lipid variables in this regard. Both systolic and diastolic blood pressure measures tended to be lowest in subjects with apo E 3,2 phenotype and highest in those with apo E 4,3 or 4,4 phenotype (P = 0.08-0.15 for trend). When serum lipids, blood pressure, and insulin were analyzed by waist circumference and apo E phenotype group, it became evident that women who had central obesity and the apo E 4 allele had the highest blood pressures, insulin-glucose ratios, and insulin concentrations. These results suggest that apo E phenotype significantly modifies the central obesity-induced changes in metabolic and hemodynamic variables characteristic of insulin resistance.
A large number of studies have shown that obesity is both under genetic control and influenced by several environmental factors, including energy expenditure and intake. Several studies in animals and humans have furthermore suggested that certain environmental factors, such as a high fat intake, may modify the expression of the genes responsible for weight gain. The present study examined whether physical activity, measured at the baseline examination in 1975, was likely to play a differential role in subsequent weight changes in the following 6 y in 1571 monozygotic and 3029 dizygotic, same-sex twin pairs from the Finnish Twin Cohort Study. A hierarchical multiple-regression analysis was used to test for gene-environment interactions by identifying significant three-way interactions between genetic factors, physical activity, and weight change. The results showed that associations between weight change in twin A and twin B were significantly stronger for monozygotic than for same-sex dizygotic twins at all levels of physical activity. Additionally, in the monozygotic men the strength of the association varied with physical activity level, and the association between the change in body mass index between the twin pairs with the highest physical activity level was about three times stronger (beta = 0.40) than the association in twin pairs with the lowest physical activity level (beta = 0.15, P for trend = 0.002). In pairs of dizygotic men, and in both monozygotic and dizygotic women, similarity in body mass index change was independent of physical activity level (all P > 0.14). The present study showed that genetic factors may modify the effects of physical activity on weight change, and suggests that a sedentary lifestyle may have an obesity-promoting effect in men with a genetic predisposition.
Nutritional epidemiology is increasingly shifting its focus from studying single nutrients to the exploration of the whole diet utilizing dietary pattern analysis. We analyzed associations between habitual diet (including macronutrients, dietary patterns, biomarker of fish intake) and lipoprotein particle subclass profile in young adults.
Complete dietary data (food-frequency questionnaire) and lipoprotein subclass profile (via nuclear magnetic resonance spectroscopy) were available for 663 subjects from the population-based FinnTwin12 study (57% women, age: 21-25 y). The serum docosahexaenoic to total fatty acid ratio was used as a biomarker of habitual fish consumption. Factor analysis identified 5 dietary patterns: "Fruit and vegetables", "Meat", "Sweets and desserts", "Junk food" and "Fish". After adjustment for sex, age, body mass index, waist circumference, physical activity, smoking status and alcohol intake, the "Junk food" pattern was positively related to serum triglycerides (r = 0.12, P = 0.002), a shift in the subclass distribution of VLDL toward larger particles (r = 0.12 for VLDL size, P
Exercise behavior, cardiorespiratory fitness, and obesity are strongly influenced by genetic factors. By studying young adult twins, we examined to what extent these interrelated traits have shared genetic and environmental etiologies. We studied 304 twin individuals selected from the population-based FinnTwin16 study. Physical activity was assessed with the Baecke questionnaire, yielding three indexes: sport index, leisure-time index, and work index. In this study, we focused on sport index, which describes sports participation. Body composition was determined using dual-energy X-ray absorptiometry and cardiorespiratory fitness using a bicycle ergometer exercise test with gas exchange analysis. The Baecke sport index was associated with high maximal oxygen uptake adjusted for lean body mass (Vo(2max)[adj]) (r = 0.40), with low body fat percentage (BF%) (r = -0.44) and low waist circumference (WC) (r = -0.29). Heritability estimates for the key traits were as follows: 56% for sport index, 71% for Vo(2max)[adj], 77% for body mass index, 66% for WC, and 68% for BF%. The association between sport index and Vo(2max) was mostly explained by genetic factors (70%), as were both the association between sport index and BF% (71%) and that between sport index and WC (59%). Our results suggest that genetic factors explain a considerable part of the associations between sports participation, cardiorespiratory fitness, and obesity.
Evidence of the role of body mass index (BMI) as a risk factor for sudden cardiac death (SCD) is conflicting, and how electrocardiographic (ECG) SCD risk markers perform in subjects with different BMIs is not known. In this study, a general population cohort consisting of 10,543 middle-aged subjects (mean age 44 years, 52.7% men) was divided into groups of lean (BMI 30, n = 1,445) subjects. Cox proportional hazards models adjusted for confounders were used to assess the risk for SCD associated with BMI and the risk for SCD associated with ECG abnormalities in subjects with different BMIs. The overweight and obese subjects were at increased risk for SCD (hazard ratios [95% CIs] were 1.33 [1.13 to 1.56], p = 0.001 and 1.79 [1.44 to 2.23], p