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Articles by P. M. Nilsson
Total Records ( 3 ) for P. M. Nilsson
  M. Montagnana , C. Fava , P. M. Nilsson , G. Engstrom , B. Hedblad , G. Lippi , P. Minuz , G. Berglund and O. Melander

Background  To determine if the common Pro12Ala polymorphism (rs1801282) of the peroxisome proliferator-activated receptor (PPARG) gene is associated with the metabolic syndrome (MetS) or with its individual components in middle-aged Swedish individuals.

Methods  MetS was defined according to the National Cholesterol Education Program/Adult Panel III (NCEP/ATP III), the International Diabetes Federation (IDF) and the European Group for the Study of Insulin Resistance (EGIR) criteria in a population-based sample of nearly 5000 subjects participating in the Malmö Diet and Cancer-cardiovascular arm.

Results  Of the subjects included in the analysis, 21.8, 29.4 and 20.4% had MetS according to the NCEP/ATP III, IDF and EGIR (only in subjects without diabetes) definitions, respectively. The Pro12Ala was not associated with MetS or with its individual components. These results were similar when patients with diabetes were excluded. Hypertensive and obese ala-carriers had lower fasting glucose and hypertensive ala-carriers also had lower level triglycerides (P < 0.05).

Conclusions  Our data do not support a major role for the Pro12Ala variant of the PPARG gene in MetS and its individual components. The modest difference in triglyceride and glucose levels, restricted to hypertensive and obese subjects in our cohort, suggests that the polymorphism has a minor effect on glucose and lipid metabolism, particularly in individuals at risk for gluco-metabolic disturbances.

  M. I. Pikilidou , A. N. Lasaridis , P. A. Sarafidis , C. D. Befani , G. G. Koliakos , I. M. Tziolas , K. A. Kazakos , J. G. Yovos and P. M. Nilsson
  Aims/hypothesis  To investigate the effect of oral calcium (Ca2+) supplementation on insulin sensitivity measured by the euglycaemic hyperinsulinaemic clamp, intraplatelet cationic concentration of Ca2+ ([Ca2+]i) and the transmembrane sodium-hydrogen exchanger (NHE) activity in erythrocytes in subjects with Type 2 diabetes and hypertension.

Patients and methods  In this parallel randomized controlled single-blinded trial, 31 patients were allocated to receive either 1500 mg of Ca2+ orally, daily (n = 15) or no treatment (n = 16) for 8 weeks. At baseline and at the end of the 8-week period insulin sensitivity, [Ca2+]i and the first isoform of NHE (NHE-1) activity were measured.

Results  At the end of the study, subjects who received Ca2+ supplementation showed higher insulin sensitivity (ΔM-value 0.32 ± 0.5 mmol/min < 0.05) and lower [Ca2+]i (125.0 ± 24.7 to 80.4 ± 10.6 nmol/l, P < 0.05, mean ± sem) and NHE-1 activity (79.5 ± 10.0 to 52.1 ± 6.4 mmol Na/l red cell/h, P < 0.05). None of the above parameters were changed in the control group. Simple regression analysis demonstrated the change in [Ca2+]i significantly determined insulin sensitivity change (β = −0.36, P < 0.05).

Conclusions/interpretation  Oral Ca2+ supplementation improves insulin sensitivity in patients with Type 2 diabetes and hypertension. These changes are likely to be mediated by changes in intracellular ionic Ca2+. NHE-1 activity was also reduced after Ca2+ supplementation but its role in insulin sensitivity requires further investigation.

  S. Gudbjornsdottir , K. Eeg-Olofsson , J. Cederholm , B. Zethelius , B. Eliasson and P. M. Nilsson
  Aims  Patients with Type 2 diabetes and coronary heart disease (CHD) are infrequently treated to risk factor targets in current guidelines. We aimed to examine risk factor management and control levels in a large sample of patients with Type 2 diabetes with CHD.

Methods  This was an observational study of 1612 patients with first incidence of CHD before 2002, and of 4570 patients with first incidence of CHD before 2005, from the Swedish National Diabetes Register (NDR).

Results  In patients with CHD 1-2 years before follow-up, the achievement of cardiovascular risk factor targets (follow-up 2002/follow-up 2005) was: HbA1c < 7%, 47%/54% (P < 0.01); blood pressure ≤ 130/80 mmHg, 31%/40% (P < 0.001); total cholesterol < 4.5 mmol/l, 47%/60% (P < 0.001); and low-density lipoprotein-cholesterol < 2.5 mmol/l, 49%/65% (P < 0.001). Use of medication: antihypertensives, 90%/94% (P < 0.01); lipid-lowering drugs, 75%/86% (P < 0.001); and aspirin, 85%/89% (P < 0.05). A high prevalence of adverse lifestyle characteristics prevailed (2002/2005): overweight [body mass index (BMI) ≥ 25 kg/m2], 86%/85%; obesity (BMI ≥ 30 kg/m2), 41%/42%; smokers in age group < 65 years, 16-23%/18-19%; as well as waist circumference ≥ 102 cm (men) or ≥ 88 cm (women), 68% in 2005.

Conclusions  Patients with a combination of Type 2 diabetes and CHD showed an increased use of lipid-lowering drugs over time, corresponding to improving blood lipid levels. A discrepancy existed between the prevalent use of antihypertensive drugs and the low proportion reaching blood pressure targets. Regretfully, a high prevalence of adverse lifestyle characteristics prevailed. Evidence-based therapy with professional lifestyle intervention and drugs seems urgent for improved quality of secondary prevention in these patients.

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