22 research outputs found
Insulin resistance and atherosclerosis : the role of visceral fat
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The main objective of this thesis was to unravel relationships between obesity, insulin resistance, hyperglycemia, and atherosclerosis. It is well-established that patients with type 2 diabetes have a 2- to 3-fold increased risk of cardiovascular disease. We investigated whether insulin resistance and hyperglycemia are associated with atherosclerosis and incident cardiovascular disease before the onset of type 2 diabetes. Obesity can be considered as a common cause of both insulin resistance and atherosclerosis. Therefore, we investigated to what extent associations between insulin resistance, hyperglycemia and atherosclerosis were explained by body fat. We further aimed to study the specific role of visceral fat in the development of insulin resistance and atherosclerosis, and directly assessed abdominal subcutaneous and visceral adipose tissue depots.
 HartstichtingLUMC / Geneeskund
Insulin resistance and atherosclerosis : the role of visceral fat
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The main objective of this thesis was to unravel relationships between obesity, insulin resistance, hyperglycemia, and atherosclerosis. It is well-established that patients with type 2 diabetes have a 2- to 3-fold increased risk of cardiovascular disease. We investigated whether insulin resistance and hyperglycemia are associated with atherosclerosis and incident cardiovascular disease before the onset of type 2 diabetes. Obesity can be considered as a common cause of both insulin resistance and atherosclerosis. Therefore, we investigated to what extent associations between insulin resistance, hyperglycemia and atherosclerosis were explained by body fat. We further aimed to study the specific role of visceral fat in the development of insulin resistance and atherosclerosis, and directly assessed abdominal subcutaneous and visceral adipose tissue depots.
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Insulin Resistance and Risk of Incident Cardiovascular Events in Adults without Diabetes: Meta-Analysis
BACKGROUND Glucose, insulin and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) are markers of insulin resistance. The objective of this study is to compare fasting glucose, fasting insulin concentrations and HOMA-IR in strength of association with incident cardiovascular disease. METHODS We searched the PubMed, MEDLINE, EMBASE, Web of Science, ScienceDirect and Cochrane Library databases from inception to March, 2011, and screened reference lists. Cohort studies or nested case-control studies that investigated the association between fasting glucose, fasting insulin or HOMA-IR and incident cardiovascular disease, were eligible. Two investigators independently performed the article selection, data extraction and risk of bias assessment. Cardiovascular endpoints were coronary heart disease (CHD), stroke or combined cardiovascular disease. We used fixed and random-effect meta-analyses to calculate the pooled relative risk for CHD, stroke and combined cardiovascular disease, comparing high to low concentrations of glucose, insulin or HOMA-IR. Study heterogeneity was calculated with the I(2) statistic. To enable a comparison between cardiovascular disease risks for glucose, insulin and HOMA-IR, we calculated pooled relative risks per increase of one standard deviation. RESULTS We included 65 studies (involving 516,325 participants) in this meta-analysis. In a random-effect meta-analysis the pooled relative risk of CHD (95% CI; I(2)) comparing high to low concentrations was 1.52 (1.31, 1.76; 62.4%) for glucose, 1.12 (0.92, 1.37; 41.0%) for insulin and 1.64 (1.35, 2.00; 0%) for HOMA-IR. The pooled relative risk of CHD per one standard deviation increase was 1.21 (1.13, 1.30; 64.9%) for glucose, 1.04 (0.96, 1.12; 43.0%) for insulin and 1.46 (1.26, 1.69; 0.0%) for HOMA-IR. CONCLUSIONS The relative risk of cardiovascular disease was higher for an increase of one standard deviation in HOMA-IR compared to an increase of one standard deviation in fasting glucose or fasting insulin concentration. It may be useful to add HOMA-IR to a cardiovascular risk prediction model.Development and application of statistical models for medical scientific researc
Overweight and Severe Acute Maternal Morbidity in a Low-Risk Pregnant Population in The Netherlands
Objective:To investigate the association between overweight and severe acute maternal morbidity (SAMM) in a low-risk pregnant population.Design:Nationwide case-control study.Setting:The Netherlands, august 2004 to august 2006.Population:1567 cases from initially primary care and 2994 women from primary care practices as controls, out of 371 012 women delivering in the Netherlands during the study periodMethods:Cases were women with SAMM obtained from a nationwide prospective study. All women in this cohort who initially had low-risk pregnancies were compared with low-risk women without SAMM to calculate odd ratios (ORs) to develop SAMM by body mass index (BMI) category. We divided body mass index in three overweight categories and calculated the ORs (95% CI) of total SAMM and per specific endpoint by logistic regression, with normal weight as reference. We adjusted for age, parity and socio-economic status.Main Outcome Measures:SAMM, defined as Intensive Care Unit (ICU)-admission, Uterine Rupture, Eclampsia or Major Obstetric Haemorrhage (MOH)Results:SAMM was reported in 1567 cases which started as low-risk pregnancies. BMI was available in 1097 (70.0%) cases and 2994 control subjects were included. Analysis showed a dose response relation for overweight (aOR, 1.3; 95% CI, 1.0-1.5), obese (aOR, 1.4; 95% CI, 1.1-1.9) and morbidly obese (aOR, 2.1; 95% CI, 1.3-3.2) women to develop SAMM compared to normal weight. Sub analysis showed the same dose response relation for ICU-admission, Uterine Rupture and Eclampsia. We found no association for MOH.Conclusion:Overweight without pre-existent co-morbidity is an important risk-indicator for developing SAMM. This risk increases with an increasing body mass index. © 2013 Witteveen et al
Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding
Background: SARS-CoV-2 has spread globally. Currently, literature of SARS-CoV-2 in neonates is scarce.
We present a case of a neonate with a high viral load and prolonged virus shedding.
Methods: Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information
and the treatment of a neonate with COVID-19 were recorded.
Results: A 7-day-old boy was admitted to the hospital with fever, lethargy and apnoea. He was found
SARS-CoV-2 RNA positive with an exceptionally high viral load in nasopharyngeal swab and stool. The
father and two maternity nurses at home had detectable SARS-CoV-2 RNA as well. Sequencing showed all
strains belonged to the same cluster. The father was asymptomatic and the maternity nurses developed
symptoms after visiting. In the mother, no SARS-CoV-2 RNA could be found. Six days after admission, the neonate was discharged after clinical improvement with oral antibiotics because of a possible
pyelonephritis. Monitoring the course of this infection showed that SARS-CoV-2 RNA was detectable in
the nasopharynx until day 19 and in stool until day 42 after symptom onset.
Conclusions: This case shows that neonates can have a high viral load of SARS-CoV-2 and can shed the
virus for over one month in stool. Despite the high viral load in the neonate, the mother and a sibling did
not get infected
Configuration of Spheroidene in the Photosynthetic Reaction Center of Rodobacter sphaeroides: A Comparison of Wild-Type and Reconstituted R26
Biological and Soft Matter PhysicsBio-organic Synthesi
Association of fasting triglyceride concentration and postprandial triglyceride response with the carotid intima-media thickness in the middle aged: The Netherlands Epidemiology of Obesity study
Pathophysiology, epidemiology and therapy of agein
Heart rate variability, postprandial responses of glucose and insulin and beta-cell function: the NEO study
Diabetes mellitus: pathophysiological changes and therap