Showing papers by "Calle Bengtsson published in 1993"

Swedish obese subjects (SoS) - an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined

Abstract: This part of an on-going intervention trial analyses impacts of obesity on psychosocial factors and health. The study sample comprised 800 obese men (BMI > or = 34 kg/m2) and 943 women (BMI > or = 38 kg/m2) ranging in age from 37 to 57 years. All participants completed standardized health-related quality of life measures, a validated obesity-specific eating inventory and study-specific questionnaires on current and past health status, use of medical care and medications, socioeconomic status, dietary habits, physical activity habits, weight history and familial history of obesity. Chronic patients and population samples were used as reference. The obese reported distinctly poorer current health and less positive mood states than the reference subjects, women being worse than men. Anxiety and/or depression on a level indicating psychiatric morbidity were more often seen in the obese and again women reported more affliction than men. Furthermore, the average poor mental well-being was worst than in chronically ill or injured patients, such as rheumatoid, cancer survivors and spinal cord injured persons. Predictors of perceived health and psychosocial functioning could be discerned using a comprehensive system of statistical analyses (16-28% explained variance). A background of both somatic and psychiatric morbidity was decisive for the health and psychosocial functioning in the obese; joint symptoms and angina pectoris dominated among somatic variables. Physical inactivity was the most prominent of traditional risk factors. The number of dieting attempts and body image were important weight correlates. Our results provide further evidence to the effect that severe obesity is a crippling condition.

Screening for iron deficiency: an analysis based on bone-marrow examinations and serum ferritin determinations in a population sample of women.

Abstract: Efficacy of different methods in screening for iron deficiency was re-examined in a randomly selected sample of 38-year-old women (n = 203) with known iron status based on absence/presence of stainable iron in bone-marrow smears. The study was made in 1968-69. Serum ferritin (SF) was determined in 1978 in frozen sera using the Ramco IRMA and, in 1992, samples were re-analysed using a RIA calibrated with the International Standard 80/602 for SF determination. The effect of storage on SF was calculated from a previously established relationship (courtesy of Dr Mark Worwood, Cardiff) between the results obtained with the Ramco assay and assays calibrated with IS 80/602. The distributions in iron replete and iron deficient women showed less overlap (diagnostic efficiency 91%) for SF than for other haematological parameters. The best discrimination was obtained at SF < 16 micrograms/l (specificity 98%; sensitivity 75%). Absence of iron stores was associated with signs of an iron deficient erythropoiesis, starting already at SF 25-40 micrograms/l. Use of multiple criteria to diagnose iron deficiency falsely reduces prevalence figures for iron deficiency.

Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden.

Abstract: OBJECTIVE--To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN--Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING--Gothenburg, Sweden. SUBJECTS--1462 randomly selected women aged 38-60 at start of study. MAIN OUTCOME MEASURES--Total mortality and death from myocardial infarction as predicted by serum cholesterol and triglyceride concentrations, body mass index, and ratio of circumference of waist to circumference of hips. RESULTS--170 women died during follow up, 26 from myocardial infarction. Serum triglyceride concentration and waist:hip ratio were significantly associated with both end points (relative risk of total mortality for highest quarter of triglyceride concentration v lower three quarters 1.86 (95% confidence interval 1.30 to 2.67); relative risk for waist:hip ratio 1.67 (1.18 to 2.36)). These associations remained after adjustment for background variables. Serum cholesterol concentration and body mass index were initially associated with death from myocardial infarction, but association was lost after adjustment for background variables. Serum triglyceride concentration and waist:hip ratio were independently predictive of both end points (logistic regression coefficient for total mortality for triglyceride 0.514 (SE 0.150), p = 0.0006; coefficient for waist:hip ratio 7.130 (1.92), p = 0.0002) whereas the other two risk factors were not (coefficient for total mortality for cholesterol concentration -0.102 (0.079), p = 0.20; coefficient for body mass index -0.051 (0.027), p = 0.05). CONCLUSIONS--Lipid risk profile appears to be different in men and women given that serum triglyceride concentration was an independent risk factor for mortality while serum cholesterol concentration was not. Consistent with previous observations in men, localisation of adipose tissue was more important than obesity per se as risk factor in women.

"The Göteborg Quality of Life Instrument"--a psychometric evaluation of assessments of symptoms and well-being among women in a general population.

Abstract: Objective - To examine with psychometric analysis techniques the potential for constructing valid composite variables of »The Goteborg Quality of Life Instrument«.Design - Prospective population study of women in 1974–75 and in 1980–81.Setting - City of Goteborg, Sweden.Participants - Representative samples of the general population of women in five age strata between 44 and 66 years of age in 1974–75, followed 1980–81 including new cohorts of women aged 26 and 38. 1302 women were examined in 1974–75 and 1408 in 1980–81.Main outcome measure - »The Goteborg Quality of Life instrument«, constructed in the early 1970s to measure symptoms and well-being in a population study of men.Results - Four multi-item scales were identified with satisfactory reliability and validity, i.e., they met defined criteria of multi-item scales and benefit from higher reliability than single questions. The psychological symptom scale comprised all ten questions intended to reflect depression and tension, while the physical sympt...

Smoking — A risk factor for hypothyroidism

Abstract: Smoking is associated with a spectrum of disorders. Recent reports have shown decreased serum concentrations of thyrotropin in euthyroid smokers, and there is an association between smoking and development of goiter (toxic and euthyroid). In a 12-year follow-up of a randomly selected sample of women we found a strong association between smoking at the time of initial screening and later development of hypothyroidism, the relative risk for a female smoker to develop hypothyroidism being 3.9 (95% confidence interval 1.6–9.1). There was, however, no association between smoking habits at the end of the follow-up and hypothyroidism. This indicates that several women who developed hypothyroidism may have done so in association with a change in smoking habits.

Number of amalgam fillings in relation to cardiovascular disease, diabetes, cancer and early death in Swedish women

Abstract: – Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were initially examined in 1968–69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The incidences of myocardial infarction, stroke, diabetes, cancer and overall mortality were determined during a 20-yr follow-up period. Women with few amalgam tooth fillings had increased incidence of myocardial infarction, stroke, diabetes and early death compared with women with a large number of fillings. However, the significant inverse correlations between number of amalgam tooth fillings and the endpoints studied disappeared when number of teeth and socioeconomic group were included in a multivariate analysis. The study thus did not provide any evidence for a correlation between amalgam fillings and cardiovascular disease, diabetes, cancer or early death.

Hormones, Body Composition and Cardiovascular Risk

Abstract: Over the last ten years an increased knowledge on the relationships between body composition and health has been achieved. The health hazards of being obese have finally been proven and several studies have also indicated an increased morbidity and mortality among extemely lean subjects (review, ref.1.2). Furthermore, relationships between the adipose tissue (AT) distribution and cardiovascular risks have been demonstrated (review, ref. 1,2). Most of these studies have used just weight and height or. in the case of cross-sectional studies, simple two-compartment models based on density, total body potassium and/or total body water to describe the body composition. Similarly, the AT distribution has been estimated from skinfold- and waist/hip-circumference ratios (W/H) in most studies. Some cross-sectional studies have used single or a small number of computed tomography (CT) scans to determine visceral and subcutaneous AT areas. In a stricter sense, not even this is sufficient, since AT areas can not be expressed as a percentage of the total AT volume and therefore regional area determinations can not describe the AT distribution or changes of this distribution. As shortly summarized below we have used CT for total as well as regional volume determinations of AT. muscles and other organs. This organ-oriented approach has certain advantages over traditional body composition techniques which only give constituents such as fat, water, potassium, nitrogen or calcium.

The interrelationships between fasting serum insulin level, obesity and blood pressure in women: Results from a cross-sectional population study of women in Gothenburg, Sweden

Abstract: This study is based on a representative population sample of women in Gothenburg, Sweden. Three hundred and thirty-six 50-year-old nondiabetic women, not taking any antihypertensive medication, were included in the study. They underwent a comprehensive examination programme, where body weight, body height, waist and hip circumferences, systolic and diastolic blood pressures and fasting serum insulin concentration were measured. Fasting serum insulin concentration was significantly correlated with systolic and diastolic blood pressures. After controlling for both body mass index (BMI) and waist to hip circumference ratio (WHR), fasting serum insulin concentration remained independently associated with blood pressure (P=0.001 for systolic blood pressure, P=0.06 for diastolic blood pressure). When stratified for BMI or WHR the correlations between fasting serum insulin concentration and blood pressure remained significant only in the upper 50th precentiles of BMI and WHR. When relating pressure to different levels of fasting serum insulin concentration there seems to be a threshold at an insulin concentration corresponding to the upper quartile limit (at approximately 17μU/ml), above which level the blood pressure rises more obviously. The same phenomenon was seen for systolic and diastolic blood pressures. (Hypertens Res 1993; 16: 197-201)