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BACKGROUND: Endurance exercise training promotes the catabolism of branched-chain amino acids (BCAAs) in skeletal muscles. We have previously shown that mitochondrial DNA (mtDNA) haplogroups J and K are markers of low responders in endurance training. In this paper, we hypothesize that BCAA catabolism is a surrogate marker of lower respiratory chain activity attributed to these haplogroups. We evaluated whether exercise-induced changes in amino acid concentrations differ between subjects harbouring mtDNA haplogroups J or K and those with non-JK haplogroups. METHODS: Finnish male conscripts (N = 633) undertook the 12-min Cooper running test at the beginning and end of their military service. The intervention during the service mainly included endurance aerobic exercise and sports-related muscle training. Concentrations of seven amino acids were analysed in the serum using a high-throughput 1H NMR metabolomics platform. Total DNA was extracted from whole blood, and restriction fragment analysis was used to determine mtDNA haplogroups J and K. RESULTS: The concentrations of the seven amino acids were higher following the intervention, with the exception of phenylalanine; interestingly, the increase in the concentrations of three BCAAs was larger in subjects with haplogroup J or K than in subjects with non-JK haplogroups (p = 0.029). MtDNA haplogroups J and K share two common nonsynonymous variants. Structural analysis based on crystallographic data on bovine complexes I and III revealed that the Leu18 variant in cytochrome b encoded by m.14798T > C may interfere with ubiquinone binding at the Qi site in complex III. CONCLUSIONS: The increase in the concentrations of serum BCAAs following exercise intervention differs between subjects harbouring mtDNA haplogroup J or K and those harbouring non-JK haplogroups. Lower response in endurance training and difference in exercise-induced increase in the concentrations of serum BCAAs suggest decreased respiratory chain activity. Haplogroups J and K share m.14798T > C in MT-CYB, which may hamper the function of complex III.
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AIMS: This longitudinal study evaluated associations between glucose metabolism and cognitive performance during a 12-year follow-up. METHODS: We included 714 subjects, which were followedfrom the age 55 to 70 years. Using oral glucose tolerance tests the population was classified as normoglycemic (NGT) and based on WHO diagnostic criteria for diabetes and prediabetes. Cognitive performance was assessed with a verbal fluency (category) test and wordlist learning tests of CERAD-nb, a verbal fluency (letter) test, and trail-making tests A and B. RESULTS: Compared to the normal group subjects with long-lasting prediabetes showed significantly greater decline (4.6 versus 2.9 words) on the verbal fluency (category) test (p = 0.041); subjects with long-lasting type 2 diabetes showed significantly greater decline (13 versus 6 s) on the trail making A test (p = 0.021) and on the wordlist learning test (3.3 versus 1.7 words) (p = 0.013); and a combined group of subjects with prediabetes or incident type 2 diabetes showed significantly greater cognitive decline (3.8 versus 2.9 words) in the verbal fluency (category) test (p = 0.039). CONCLUSION: Prediabetes was associated with cognitive decline during aging. This finding should be incorporated into prevention strategies, because both type 2 diabetes and dementia are increasing world-wide.
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Disfunção Cognitiva , Diabetes Mellitus Tipo 2 , Idoso , Envelhecimento , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Seguimentos , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de RiscoRESUMO
AIMS: To examine the association of physical activity (PA) and sedentary time (ST) with glucose metabolism according to waist circumference (WC) in older people. METHODS: A population-based sample of 702 individuals (aged 67-70 years) wore wrist-worn accelerometers for two weeks and underwent an oral glucose tolerance test. The associations between moderate-to-vigorous (MVPA) and light (LPA) PA, ST, and glucose metabolism across the tertiles of WC were analysed using general linear regression. RESULTS: Among highest WC tertile, LPA negatively associated with fasting insulin (ß = - 0.047, 95% CI - 0.082 to - 0.012), HOMA-IR (ß = - 0.098, 95% CI - 0.184 to - 0.012), and HOMA-ß (ß = - 3.367, CI - 6.570 to - 0.783). ST associated with 120 min glucose (ß = 0.140, CI 0.021 to 0.260). Among lowest WC tertile, MVPA negatively associated with 30 min insulin (ß = - 0.086, 95% CI - 0.168 to - 0.004) and 120 min insulin (ß = - 0.160, 95% CI - 0.257 to - 0.063) and positively associated with Matsuda index (ß = 0.076, 95% CI 0.014 to 0.139). Light PA negatively associated with 120 min insulin (ß = - 0.054, 95% CI - 0.104 to - 0.005). CONCLUSION: With the limitation of the cross-sectional study, reducing ST and increasing LPA may be beneficial for glucose metabolism among abdominally obese older adults. Lean older adults could benefit more from increasing MVPA.
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Acelerometria , Exercício Físico , Idoso , Estudos Transversais , Glucose , Humanos , Circunferência da CinturaRESUMO
BACKGROUND: We have previously suggested that some of the mutations defining mitochondrial DNA (mtDNA) haplogroups J and K produce an uncoupling effect on oxidative phosphorylation and thus are detrimental for elite endurance performance. Here, the association between haplogroups J and K and physical performance was determined in a population-based cohort of 1036 Finnish military conscripts. RESULTS: Following a standard-dose training period, excellence in endurance performance was less frequent among subjects with haplogroups J or K than among subjects with non-JK haplogroups (p = 0.041), and this finding was more apparent among the best-performing subjects (p < 0.001). CONCLUSIONS: These results suggest that mtDNA haplogroups are one of the genetic determinants explaining individual variability in the adaptive response to endurance training, and mtDNA haplogroups J and K are markers of low-responders in exercise training.
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Militares , DNA Mitocondrial/genética , Exercício Físico , Finlândia , Haplótipos , HumanosRESUMO
Objective: The main objective of this study was to investigate the psychometric properties of the Zung Self-Rating Depression Scale (SDS) and evaluate screening parameters capability of the SDS with the Beck Depression Inventory (BDI-21) among the elderly population. Design: A population-based study Setting: Community Subjects: 520 adults, aged 72-73 years, living in the city of Oulu, Finland. Main outcome measures: The screening parameters of the SDS questions and BDI-21 for detecting severity of depression. The Mini Neuropsychiatric Interview for diagnosing major depression. Results: The optimal cut-off point for the SDS was 39. The sensitivity and specificity parameters for this cut-off point were 79.2% (95% CI 57.8-92.9) and 72.2% (95% CI 67.9-76.1), respectively. Positive and negative predictive values were 12.5% (95% CI 7.7-18.8) and 98.6% (95% CI 96.7-99.5), respectively. Moreover, there was no statistically significant difference in diagnostic accuracy indices of the cut-off points 39 and 40. In a receiver operating characteristic analysis, the area under the curve was 0.85 (95%CI 0.77-0.92) for the SDS total score and 0.89 (95% CI 0.83-0.96) for the BDI-21 (p = 0.137). Conclusion: Using the traditional cut-off point, the SDS was convenient for identifying clinically meaningful depressive symptoms in an elderly Finnish population when compared with the BDI-21 which is one of the most commonly used depression screening scales. The sensitivity and specificity of these two screening tools are comparable. Based on our study, the SDS is convenient for identifying clinically meaningful depressive symptoms among older adults at the community level. Key points The widely used Zung Self-Rating Depression Scale (SDS) has not previously been validated among elderly people at the community level. The sensitivity and specificity of SDS (cut-off point 39) were 79.2% and 72.2%. The positive and negative predictive values for SDS were 12.5% and 98.6%. SDS is convenient for identifying major depression in an elderly population and regarding sensitivity and specificity comparable to BDI-21.
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Depressão/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Avaliação Geriátrica/métodos , Programas de Rastreamento/métodos , Escalas de Graduação Psiquiátrica/normas , Inquéritos e Questionários/normas , Idoso , Feminino , Finlândia , Humanos , Masculino , Psicometria , Sensibilidade e EspecificidadeRESUMO
Inflammation plays a significant role in pathogenesis of diabetes and atherosclerosis. Increased adiposity with an upregulation of cytokines in prediabetes has been associated with vascular inflammation and considered a leading causal factor for type 2 diabetes (T2D). Information on adipokines and inflammatory markers in prediabetes, defined by hemoglobin A1C (HbA1c) 5.7-6.4% in addition to impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), are sparse. We conducted a population-based cross-sectional study (part of a follow-up study) of inhabitants of Oulu, Finland, born in 1935. Inflammatory markers and traditional risk markers of 367 subjects were measured. The glucose status was determined by an oral glucose tolerance test (OGTT) and HbA1c. Inflammatory markers and glycemic levels were analysed using analysis of covariance (ANCOVA). Of the participants, 193 were normoglycemic, 82 had prediabetes and 40 T2D. Inflammatory cytokines were significantly higher in subjects with prediabetes as compared to normoglycemic subjects: IL-4 (14.9 vs 5.9 pg/ml, p = 0.041), IP-10 (251 vs 209 pg/ml, p = 0.05), TNF-α (10.4 vs 6.9 pg/ml, p = 0.027), RANTES (43.3 vs 33.1 pg/ml, p = 0.009), CD40L (3708 vs 1671 pg/ml, p = 0.010) and VEGF (269 vs 174 pg/ml, p = 0.013). These inflammatory cytokines remained significant even after adjustment for waist circumference. The differences in inflammatory markers in prediabetic and T2D subjects were not statistically significant. Prediabetes was associated with low-grade inflammation with increased inflammatory cytokine levels, while the levels in prediabetic subjects were comparable to those in T2D subjects. The associations were independent of visceral adiposity.
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Adipocinas/sangue , Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Mediadores da Inflamação/sangue , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/complicações , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Fatores de Risco , Estatísticas não ParamétricasRESUMO
AIMS: To evaluate the influences of alcohol consumption frequency and binge drinking on changes in the body composition, lifestyle habits and physical fitness of healthy young men during military service. METHODS: A population-based study of men performing their military service in the Sodankylä Jaeger Brigade, Finland in 2005. Body composition, fitness and lifestyle habits were evaluated at baseline and 6-12 months follow-up. Alcohol consumption frequency and binge drinking were categorized as: 'not at all', 'at least once a month' and 'at least once a week'. RESULTS: Data were available for 983 participants. Mean (SD) age was 19.2 (1.0) years. At baseline, participants who reported binge drinking at least once a week (29.8%) had the most unfavourable body composition, lifestyle habits and physical fitness compared with the group with no binge drinking. Significant (P < 0.05) mean reductions in % body fat (-2.3%) and weight (-1.8 kg), as well as improvements in lifestyle habits and physical fitness were observed in the weekly binge drinking group during the military service. The reductions in relative weight (%) and % body fat were associated with binge drinking at least once a week (regression coefficient for relative weight -1.39, 95% CI [-2.32; -0.45], P = 0.004, and for % body fat -0.68, 95% CI [-1.35; -0.01], P = 0.049). CONCLUSION: Frequent binge drinking is associated with poorer body composition, lifestyle habits and fitness among young men. Frequent binge drinkers may obtain the greatest benefit of military-service-based exercise intervention, as reflected in the improvements in body composition, lifestyle habits and physical fitness. SHORT SUMMARY: Frequent binge drinking is associated with poorer body composition, lifestyle habits and fitness among young men. The greatest benefit of military service comprehending exercise intervention was observed among those with binge drinking once a week at the baseline, with favourable changes in lifestyle factors, body composition and fitness.
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Consumo de Bebidas Alcoólicas , Consumo Excessivo de Bebidas Alcoólicas , Composição Corporal , Militares , Adiposidade , Adolescente , Adulto , Peso Corporal , Exercício Físico , Feminino , Finlândia , Humanos , Estilo de Vida , Masculino , Aptidão Física , População , Valor Preditivo dos Testes , Adulto JovemRESUMO
AIMS: The aim of this study was to investigate the association between erectile dysfunction and depressive symptoms and testosterone levels among middle-aged men at the community level. METHODS: The study population consisted of 614 men born in 1945 and living in the city of Oulu, Finland. Erectile dysfunction was assessed by the erectile function domain of the International Index of Erectile Function questionnaire and depressive symptoms by the Beck Depression Inventory. Blood samples were collected to measure testosterone and sex hormone-binding globulin level. RESULTS: After adjusting for confounders, erectile dysfunction was statistically significantly associated with depressive symptoms (risk ratio (RR) 1.66, 95% confidence interval (95% CI) 1.29-2.15), as well as with obesity (RR 1.72, 95% CI 1.12-2.62). Neither total nor free testosterone level was associated with erectile dysfunction among our study group. CONCLUSIONS: Depressive symptoms rather than testosterone levels should be taken into consideration while treating middle-aged men with erectile problems at the community level.
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Depressão/epidemiologia , Disfunção Erétil/epidemiologia , Testosterona/sangue , Disfunção Erétil/sangue , Disfunção Erétil/psicologia , Finlândia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To analyse the psychometric properties of the Whooley questions and the 21-item Beck Depression Inventory (BDI-21) in older adults with depression and chronic health problems. DESIGN: A population-based study. SETTING: Community. SUBJECTS: 474 adults, aged 72-73 years, living in the city of Oulu, Finland. MAIN OUTCOME MEASURES: The screening parameters of the Whooley questions and the BDI-21 for detecting major depression. RESULTS: The prevalence of major depression according to the DSM-IV was 5.3% (single or recurrent episode) obtained by the Mini Neuropsychiatric Interview (MINI). The BDI-21 was best able to identify a current episode of major depression with a cut-off point of 11. The sensitivity and specificity of this cut-off point were 88.0% (95% confidence interval (95% CI) 68.8-97.5) and 81.7% (95% CI 77.8-85.2), respectively. The area under the receiver operating characteristics (ROC) curve was 0.89 (95% CI 0.83-0.96). The two Whooley screening questions had a sensitivity of 62.5% (95% CI 40.6-81.2) and either screening question plus the help question had a sensitivity of 66.7% (44.7-84.4). CONCLUSIONS: The Beck Depression Inventory is a valid instrument for the diagnosis of depression in older adults. As a screening measure, the optimal cut-off score should be 11 or higher. Our results indicate that the sensitivity of the Whooley questions is not high enough to be used as a screening scale among the elderly.
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Depressão/diagnóstico , Técnicas e Procedimentos Diagnósticos/instrumentação , Técnicas e Procedimentos Diagnósticos/normas , Inquéritos e Questionários/normas , Idoso , Doença Crônica/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Finlândia , Medicina Geral , Humanos , MasculinoRESUMO
AIMS: A population-based study of 1046 young Finnish men was performed to evaluate whether body composition changes observed during military service are associated with a reduction in prevalence of metabolic syndrome (MetS), and whether the effect is body mass index (BMI)-dependent. METHODS: A prospective study of 1046 men (mean age 19.2 years, SD 1.0), with follow-up during 6-12 months of military service in northern Finland. Anthropometry, body composition, biochemical measurements and physical fitness were assessed at baseline and follow-up. MetS was defined using the International Diabetes Federations (IDF) criterion, continuous MetS Z-score calculated, and changes evaluated in BMI categories. RESULTS: Prevalence of MetS at baseline and follow-up was 6.1% and 3.6%, respectively (p < 0.001). Prevalence of MetS decreased by 40% (p < 0.001) among the obese young men (BMI ≥ 30 kg/m(2)). Reduction in the MetS Z-score was mainly attributable to weight loss and reduced fat mass (p < 0.001) and improvement in physical fitness (muscle fitness index, p = 0.016). CONCLUSIONS: Beneficial exercise-induced changes in body composition significantly reduced the prevalence of MetS among young, obese men. Our findings support the efficacy of increased physical activity for prevention of early-onset cardiovascular disease, particularly among overweight and obese young men.
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Composição Corporal/fisiologia , Exercício Físico/fisiologia , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Adulto , Humanos , Masculino , Síndrome Metabólica/prevenção & controle , Militares , Obesidade/prevenção & controle , Adulto JovemRESUMO
OBJECTIVE: To examine the association between aerobic performance and body composition changes by body mass index (BMI). DESIGN: 6-12 months' follow-up during military service. SETTING: Conscripts entering military service in 2005 in Sodankylä Jaeger Brigade (Finland). SUBJECTS: 945 men (19 years, SD 1 years). MAIN OUTCOME MEASURES: Height, weight, waist circumference, BMI, and aerobic performance (Cooper test) were recorded. Body composition was measured by bioelectrical impedance analysis (BIA). The measured parameters were fat mass (FM), fat free mass (FFM), and visceral fat area (VFA). All the measurements were performed at the beginning and end of service. RESULTS: On average, the military training period improved the running distance by 6.8% (169 m, p < 0.001) and the improvements were more pronounced in overweight (223.9 m/9.5%, p < 0.001) and obese (273.3 m/13.6%, p < 0.001) conscripts. A strong inverse correlation between aerobic performance and body composition changes was observed, especially for weight (r = -0.305, p < 0.001) and VFA (r = -0.465, p < 0.001). A significant association between aerobic performance and changes in weight (p < 0.001), waist circumference (p < 0.001), FM (p < 0.001), and VFA (p < 0.001) by BMI was detected. The associated decrease in weight, waist circumference, FM, and VFA with improved aerobic performance was more substantial between overweight and obese compared with normal-weight subjects. CONCLUSIONS: Favourable changes in body composition are associated with improved aerobic performance during a physical training period such as military service. These findings are pronounced among overweight and obese men and can be applied at the population level in reducing obesity and co-morbidities.
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Composição Corporal/fisiologia , Exercício Físico , Militares , Aptidão Física/fisiologia , Adolescente , Adulto , Índice de Massa Corporal , Impedância Elétrica , Finlândia , Humanos , Masculino , Consumo de Oxigênio/fisiologia , Circunferência da Cintura , Adulto JovemRESUMO
OBJECTIVE: Limited data are available on the metabolic syndrome (MetS) and its components in elderly people (aged 70 years and over) at population level in Northern Europe. A study was undertaken to investigate the prevalence of MetS and its components in an aging population by using different definitions. DESIGN, SETTING, AND SUBJECTS: A cross-sectional study of 539 inhabitants from Northern Finland (mean age 71.9 years) was conducted to investigate the prevalence of MetS, by using the definitions of MetS by the National Cholesterol Education Panel (NCEP), the modified NCEP (NCEPm), and the International Diabetes Federation (IDF). MAIN OUTCOME MEASURES: Prevalence of MetS by the NCEP, NCEP modified, and IDF criteria. RESULTS: Overall, the prevalence of MetS was 24.7%, 35.2%, and 37.2% in men, by NCEP, modified NCEP, and IDF-definitions, respectively. In women the corresponding figures were 20.9%, 33.1%, and 47.8%. Hypertension was the most common component in both men (91.8%) and women (89.0%) by the IDF criteria. Glucose abnormalities were particularly prevalent in men (53.2% by NCEP and 78.4% by IDF criteria). CONCLUSIONS: The most common component was hypertension in both genders. Lower waist-circumference cut-off points of the IDF criteria led to a higher prevalence of MetS particularly in women. Prevalence of MetS varied significantly when measured by different definitions. Nearly half of older women met the IDF definition of MetS, which was more than twofold when compared with NCEP. Clinical practitioners should be aware of the limitations when using set criteria of MetS, in contrast to identifying the individual cardiovascular risk factors and the accumulation of these.
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Síndrome Metabólica/epidemiologia , Terminologia como Assunto , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Finlândia/epidemiologia , Humanos , Masculino , PrevalênciaRESUMO
PURPOSE: We investigated the prevalence, natural course, and associated risk factors of habitual snoring (HS) and restless legs syndrome (RLS) over a period of 10 years among an aging population from their early sixties to their seventies. METHODS: A population-based follow-up study among all persons born in 1935 and living in the city of Oulu in northern Finland was conducted. In this study, we examined subjects who had participated in two subsequent surveys conducted in 1996-1998 and 2007-2008. The data were gathered by questionnaires, as well as by laboratory and clinical measurements. RESULTS: Altogether 457 (55%) of the 838 eligible subjects participated in both surveys. The prevalence of both RLS and HS decreased during the 10 years from 21% to 15% and from 26% to 19%, respectively. Half of those who snored in 1996-1998 stopped snoring in 10 years time, and half of those who suffered from restless legs at least three times per week in 1996-1998 suffered from this syndrome never or less than once a week in 2007-2008. The 10-year incidence of new cases of both HS and RLS was 7%. Male gender predicted best the incidence of new HS in 10 years, while the Zung sum score as a marker of depressive symptoms and waist circumference predicted RLS. CONCLUSIONS: Overall, the prevalence of both HS and RLS seems to diminish during aging. The causes behind this still remain unknown and should be investigated with more sophisticated methods.
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Síndrome das Pernas Inquietas/diagnóstico , Síndrome das Pernas Inquietas/epidemiologia , Ronco/diagnóstico , Ronco/epidemiologia , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Finlândia , Inquéritos Epidemiológicos , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Circunferência da CinturaRESUMO
OBJECTIVE: We compared the prevalences and overlap between intermediate hyperglycemia (IH), defined by a hemoglobin A(1c) (A1C) 5.7-6.4%, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: Oral glucose tolerance test results and A1C measurements were evaluated as markers of IH in an unselected cohort of 486 nondiabetic adults from Finland. RESULTS: The overall prevalence of IH was 34%. Prevalences of isolated A1C 5.7-6.4%, IGT, and IFG were 8.0, 13.2, and 4.5%, respectively. Overlap between these three markers was uncommon. Isolated A1C 5.7-6.4% was associated with a higher BMI compared with isolated IFG and IGT and with a more adverse lipid profile compared with isolated IFG. CONCLUSIONS: Prevalence of isolated IH was high, with limited overlap between the definitions. Differences in cardiovascular disease risk factors were observed among the groups. This study demonstrates that an A1C of 5.7-6.4% detects, in part, different individuals with IH compared with IFG and IGT.
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Glicemia/metabolismo , Jejum/sangue , Intolerância à Glucose/sangue , Intolerância à Glucose/metabolismo , Hemoglobinas Glicadas/metabolismo , Hiperglicemia/sangue , Hiperglicemia/metabolismo , Idoso , Feminino , Finlândia , Humanos , MasculinoRESUMO
OBJECTIVE: Physical activity is a key component of lifestyle intervention but its independent contribution to weight loss and prevention of cardiovascular disease (CVD) remains unclear. We conducted a population-level follow-up study among young healthy Finnish men undergoing an intensive exercise intervention to examine the independent contribution of exercise to common CVD risk factors. METHODS: A prospective study of 1112 young men with mean age of 19.3 years (range 19-28) undergoing military service with structured exercise training program. Endurance (12-min running test) and muscle fitness performance (MFI), body composition, blood pressure and biochemical measurements were obtained at baseline and follow-up (range 6-12 months). RESULTS: Both endurance performance and MFI improved during follow-up (+170 m (SD 269) and 1.5 points (2.3), respectively, p<0.001 for both). Both improvement in endurance and MFI performance correlated with a reduction in weight, body mass index, waist circumference, fat mass and percentage, visceral fat area (VFA) and diastolic blood pressure (p<0.001 for all). Improvement in endurance performance also correlated with reduction in systolic blood pressure (p=0.042), total and LDL cholesterol (p=0.024 and p<0.0001, respectively) and improvement in MFI with a reduction in triglyceride levels (p=0.012). The 12-min running test correlated with changes in CVD risk factors better than did MFI. Associations between improved exercise performance and reduction in blood pressure, and changes in lipid levels were attributable to reduced weight and VFA. CONCLUSION: We observed that an isolated, intensive exercise intervention, especially endurance training, significantly improved CVD risk factor levels, attributable to weight loss and reduced visceral fat area.
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Doenças Cardiovasculares/prevenção & controle , Exercício Físico , Militares , Adolescente , Adulto , Antropometria , Composição Corporal , Finlândia , Humanos , Masculino , Medicina Militar , Obesidade/complicações , Estudos Prospectivos , Risco , Fatores de RiscoRESUMO
OBJECTIVE: A1C has been proposed as a new indicator for high risk of type 2 diabetes. The long-term predictive power and comparability of elevated A1C with the currently used high-risk indicators remain unclear. We assessed A1C, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) as predictors of type 2 diabetes and cardiovascular disease (CVD) at 10 years. RESEARCH DESIGN AND METHODS: This prospective population-based study of 593 inhabitants from northern Finland, born in 1935, was conducted between 1996 and 2008. An oral glucose tolerance test (OGTT) was conducted at baseline and follow-up, and A1C was determined at baseline. Those with a history of diabetes were excluded from the study. Elevated A1C was defined as 5.7-6.4%. Incident type 2 diabetes was confirmed by two OGTTs. Cardiovascular outcome was measured as incident CVD or CVD mortality. Multivariate log-binomial regression models were used to predict diabetes, CVD, and CVD mortality at 10 years. Receiver operating characteristic curves compared predictive values of A1C, IGT, and IFG. RESULTS: Incidence of diabetes during the follow-up was 17.1%. Two of three of the cases of newly diagnosed diabetes were predicted by a raise in >or=1 of the markers. Elevated A1C, IGT, or IFG preceded diabetes in 32.8, 40.6, and 21.9%, respectively. CVD was predicted by an intermediate and diabetic range of 2-h glucose but only by diabetic A1C levels in women. CONCLUSIONS: A1C predicted 10-year risk of type 2 diabetes at a range of A1C 5.7-6.4% but CVD only in women at A1C >or=6.5%.
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Glicemia/metabolismo , Doenças Cardiovasculares/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Jejum/sangue , Intolerância à Glucose/metabolismo , Hemoglobinas Glicadas/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Humanos , Estudos ProspectivosRESUMO
PURPOSE: To examine how body composition changes in different body mass index (BMI) categories among young Finnish men during military service, which is associated with marked changes in diet and physical activity. In addition, this study examined how reported previous physical activity affected the body composition changes. METHODS: Altogether 1003 men (19 yr) were followed throughout their military service (6-12 months). Height, weight, BMI, waist circumference, and waist-to-hip ratio (WHR) were recorded. Previous physical activity was assessed at the beginning of the service by a questionnaire. Body composition was measured by bioelectrical impedance assessments (BIA) at the beginning and at the end of the service. The measured parameters were fat mass (FM), fat percentage (fat %), fat-free mass (FFM), visceral fat area (VFA), lean body mass (LBM), and skeletal muscle mass (SMM). RESULTS: On average, military training decreased weight by 0.7%, FM by 9.7%, fat % by 6.6%, and VFA by 43.4%. FFM increased by 1.3%, LBM by 1.2%, and SMM by 1.7%. The group of underweight and normal-weight men gained weight, FM, and FFM, whereas overweight and obese men lost weight and FM and gained FFM. FM was most reduced in the groups of overweight (20.8%) and obese (24.9%) men. The amount of VFA was reduced in all BMI groups (38%-44%). Among overweight men who reported being inactive previous to the military service, more beneficial changes in body composition were observed compared with those who reported being physically active. CONCLUSIONS: The lifestyle changes associated with military service markedly reduce fat tissue and increase the amount of lean tissue. These beneficial changes are prominent among previously inactive subjects with high BMI.
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Composição Corporal/fisiologia , Exercício Físico , Militares , Finlândia , Humanos , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
AIMS: We examined the associations between glucose tolerance and sleep apnea in a 57-year-old unselected urban population in Northern Finland, taking into account some determinants of sleep apnea. METHODS: A population-based health survey was conducted in a population of 555 women and 438 men born in 1945 and living in the city of Oulu in 2001. Glucose status was determined with a standard 2-h oral glucose tolerance test. Sleeping disorders were recorded on the Epworth Sleepiness Scale (ESS) and a questionnaire including 5 questions about sleeping and snoring. The Zung Self-rated Depression Scale (ZSDS) was used to assess depressive symptoms. Logistic regression was used in the estimation of odds ratios (OR) for the associations of sleep apnea with the covariates. RESULTS: Sleep apnea was found to be associated with type 2 diabetes (OR 2.56, 95% CI 1.20-5.47) and newly diagnosed type 2 diabetes (OR 2.42 95% CI 1.01-5.82), but the estimated association with impaired glucose regulation (IGR) was coupled with a wide margin of error (OR 0.91, 95% CI 0.43-1.93) when adjusted for the following covariates: gender, current smoking, hypertension, hs-CRP, physical activity, waist circumference, and Zung depression scale. CONCLUSIONS: There seems to be a positive association between sleep apnea and type 2 diabetes, and even with newly diagnosed type 2 diabetes, but we could not establish an association with IGR.
Assuntos
Intolerância à Glucose/complicações , Síndromes da Apneia do Sono/complicações , População Urbana/estatística & dados numéricos , Depressão/epidemiologia , Feminino , Finlândia/epidemiologia , Intolerância à Glucose/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Síndromes da Apneia do Sono/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Ronco , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To investigate whether the association between insulin resistance (IR) and depressive symptoms is present already in young adult males. The association between IR and depression has been poorly studied, although the existence of a connection of Type II diabetes with depression is well established. We previously demonstrated at epidemiological level in two groups of men aged 31 years and 61 to 63 years that IR is linked with depressive symptoms. METHODS: In a cross-sectional study, involving 1054 healthy Finnish male military conscripts of about 19 years of age, IR was defined through homeostasis model assessment (HOMA-IR). The severity of the depressive symptoms was evaluated through a Finnish modification of the 13-item Beck Depression Inventory (R-BDI). Moderate-to-severe depressive symptoms were said to be present, if the R-BDI score was > or = 8, and mild depressive symptoms were present if the R-BDI score was 5 to 7. RESULTS: After adjusting for confounders, moderate-to-severe depressive symptoms increased the risk for IR, as defined by the highest decile of the HOMA-IR, up to 2.8-fold (odds ratio = 2.8; 1.2-6.5). Mild depressive symptoms were not significantly associated with IR. CONCLUSIONS: In young adult males, co-occurring strictly defined IR seems to be positively associated with current moderate-to-severe depressive symptoms.