Browsing by Author "Groop, Per-Henrik"
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Tynjälä, Anniina; Forsblom, Carol; Groop, Per-Henrik; Gordin, Daniel; Harjutsalo, Valma (2020)The fact that individuals with type 1 diabetes (T1D) are at greater risk for cardiovascular disease and premature death, can only partly be explained by traditional risk factors. Interestingly, T1D is accompanied by arterial stiffening that correlates with microvascular and macrovascular complications. The aim of this study was to find out whether arterial stiffness predicts all-cause mortality in individuals with T1D. Augmentation index (AIx), a measure of arterial pulse wave reflections, is used to estimate stiffness in the resistance arteries and can be determined non-invasively from pulse wave analysis by applanation tonometry. The data consisted of 906 individuals with T1D from the FinnDiane Study that have been examined for arterial stiffness, cardiovascular risk factors and diabetic complications at baseline between 2001 and 2015. After a median follow-up of 8.2 (5.7-9.7) years, 67 individuals had died according to mortality data from Statistics Finland. They had higher baseline AIx (28 [21-33] vs. 19 [9-27] %, P < 0.001) compared to those alive. This association was independent of related risk factors (age, sex, BMI, HbA1c, triglycerides, renal function and past cardiovascular events) in Cox regression analysis (hazard ratio 1.042 [1.007-1.078], P = 0.017). Arterial stiffness estimated by AIx independently predicted all-cause mortality in T1D. Promising pharmacological agents counteracting arterial stiffness include inhibitors of the renin-angiotensin-aldosterone system and sodium-glucose co-transporter 2, and research data on their effect in individuals with T1D is constantly growing. Our finding suggests that detecting early arterial stiffening individuals with T1D could be useful in targeting a more aggressive treatment for high-risk individuals.
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Lampenius, Ina; Parente, Erika; Groop, Per-Henrik; Harjutsalo, Valma (2023)Aim To evaluate the associations between alcohol consumption and body fat distribution in type 1 diabetes (T1D). Methods DXA assessed the body composition of 548 adults with T1D from the Finnish Diabetic Nephropathy Study. Visceral fat mass (VFM) ≥ 0.7% of body weight for women and ≥ 1.1% for men defined central obesity (CO), whereas body fat mass (BFM) ≥ 40.4% for women and ≥ 31.8% for men defined general obesity (GO). Alcohol consumption data were collected via questionnaires. One standard dose = 12g of pure alcohol. Participants were classified as abstainers, low-risk, moderate-risk and high-risk alcohol consumers. We used linear and logistic regression models for analyses. Results The higher the alcohol consumption the higher the VFM% (r2=0.23, β=0.083, p=0.04) in both sexes. BFM% presented a similar pattern in men (r2=0.12, β=0.160, p=0.01), but not in women. One weekly dose increase of alcohol consumption increases the odds of CO by 3% (OR 1.03, p=0.037), but not GO. The odds of CO (OR 7.3, p=0.003) and GO (OR 5.3, p=0.007) increase with high-risk, but not with low- and moderate-risk consumptions. Conclusions In adults with T1D, alcohol consumption is linearly associated with VFM% regardless of sex, whereas the association with BFM% is sex-dependent. Keywords: type 1 diabetes, alcohol consumption, obesity, visceral fat.
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Lehto, Markku; Harjutsalo, Valma; Järvinen, Asko; Kirveskari, Juha; Forsblom, Carol; Groop, Per-Henrik; Simonsen, Johan Rasmus (2015)Tidigare studier har visat en högre frekvens av bakterieinfektioner hos patienter med diabetes, men de specifika riskfaktorerna har varit oklara. Målet med vår studie var att underöka incidensen av bakterieinfektioner och deras koppling till kronisk hyperglykemi och diabetesnefropati hos patienter med typ 1 diabetes. Vi undersökte frekvensen av bakterieinfektioner hos patienter med typ 1 diabetes (n=4748) och deras kontrollpatienter som hade justerats för ålder och kön (n=12 954). Vi använde landsomfattande register ur vilka vi samlade information på årliga uppköp av antibiotika och epikrisdiagnoser mellan 1996 och 2009. Diabetesnefropati klassificerades enligt graden av albuminuri. Resultat: Frekvensen av bakterieinfektioner som krävde sjukhusvård och det årliga antalet uppköp av antibiotika var högre hos patienter med typ 1 diabetes, jämfört med kontrollpatienterna. Resultaten korrelerade även med svårighetsgraden av diabetesnefropati. Mängden årliga uppköp av antibiotika korrelerade med graden av kronisk hyperglykemi. Studien visar för första gången sambandet mellan bakterieinfektioner, kronisk hyperglykemi och diabetesnefropati.
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Bergdal, Rebecka; Harjutsalo, Valma; Groop, Per-Henrik; Mutter, Stefan (2024)Objective. Hyperglycemia and dyslipidemia are well-known risk factors for coronary artery disease (CAD) in type 1 diabetes. The impact of long-term cumulative exposure to these risk factors is less explored. We investigated the relationship between cumulative glycemic and lipid exposure and CAD in individuals with type 1 diabetes. Research Design and Methods. This longitudinal study included 3,495 adults with type 1 diabetes from the FinnDiane cohort, without end-stage kidney disease and no history of CAD or stroke at the study baseline. Total cumulative glycemic exposure (CGEtot) and cumulative hyperglycemic exposure (CGEhg), accounting only for time spent above an HbA1c of 7% (53 mmol/mol), were calculated from diabetes diagnosis. Results. During a median follow-up of 19.4 years, 534 participants had their first-ever CAD event. CGEhg (odds ratio 1.03 [95% CI 1.02-1.05], P <0.001) and cumulative exposure to LDL cholesterol, triglycerides, and non-HDL cholesterol all significantly increased the odds for incident CAD. The highest tertile of CGEhg associated with a 2-fold odds increase for incident CAD. CGEtot was not significantly associated with CAD after adjusting for cumulative lipid exposure. Conclusions. Both hyperglycemia and dyslipidemia are independently associated with CAD in type 1 diabetes. These findings emphasize the importance of reaching an HbA1c below 7% (53 mmol/mol) as well as calling on health care professionals to not settle for suboptimal glucose control, but to continue their support and encouragement towards better management of diabetes.
Now showing items 1-4 of 4