Göran Hallmans

Leptin is a risk marker for first-ever hemorrhagic stroke in a population-based cohort

BACKGROUND AND PURPOSE Leptin, important for body weight regulation, may be involved in the pathogenesis of the insulin resistance syndrome, associated with cardiovascular disease. We tested to determine whether leptin is a risk marker for first-ever stroke in a nested case-referent study. METHODS We identified 113 patients with first-ever stroke (94 with ischemic and 19 with hemorrhagic stroke) who, before the stroke, had participated in population-based health surveys in northern Sweden. Referents were matched for sex, age, date and type of health survey, and geographic region. Blood pressure (BP), body mass index (BMI), and presence of smoking, diabetes, and hypertension were recorded. Total cholesterol, insulin, and leptin were analyzed in stored samples. Risk markers for first-ever stroke were analyzed by conditional logistic regression analysis. RESULTS Patients with hemorrhagic stroke had higher levels of BMI and systolic and diastolic BPs. Leptin levels were 72% and 59% higher in males and females, respectively, with hemorrhagic stroke versus referents. Patients with ischemic stroke more often had hypertension, diabetes mellitus, and higher fasting glucose and insulin levels. A diagnosis of hypertension and elevated systolic and diastolic BPs were significant risk markers for first-ever hemorrhagic stroke in univariate analysis. High leptin (OR=20.55; 95% CI, 1.12 to 376.7) levels together with hypertension (OR=16.28; 95% CI, 1.49 to 177.3) remained as significant risk markers in a multivariate model. The combination of high leptin and high systolic or diastolic BP were associated with a profoundly increased risk for hemorrhagic stroke (OR=22.11; 95% CI, 1.57 to 310.9). Diabetes, hypertension, and obesity (BMI >/=27), together with high levels of insulin, glucose, systolic and diastolic BP, were significant risk markers for first-ever ischemic stroke in univariate analysis. Hypertension (OR=2.10; 95% CI, 1.14 to 3.86) remained as an independent risk marker in a multivariate model. CONCLUSIONS Plasma leptin is strongly associated with an increased risk for first-ever hemorrhagic stroke, independent of other risk markers for cardiovascular disease. Leptin may be an important link in the development of cardiovascular disease in obesity.

Oat Bran, Rye Bran, and Soybean Hull Increase Goblet Cell Volume Density in the Small Intestine of the Golden Hamster a Histochemical and Stereologic Light-Microscopic Study

Small-intestinal morphology, particularly the amount of goblet cells, was studied in Syrian golden hamsters fed either a low-fibre (0.5% fibre) diet or the same diet supplemented with oat bran, rye bran, or soybean hull (12% fibre) during 6 weeks. All fibre diets increased the density of goblet cell volume to epithelial volume and to villus volume in the ileum and to some extent in the jejunum and also the number of goblet cells related to surface traces of villi both in the proximal and distal small intestine. The weight of the small intestine and the circumference and the volume of the intestinal wall in the ileum were greater in the rye bran diet group as compared with all the other groups, suggesting hyperplasia. These results suggest that oat bran, rye bran, and soybean hull supplementation might result in higher goblet cell secretory activity in both the proximal and distal small intestine of hamsters. The various fibre sources influenced the small-intestinal wall differently.

The Effects of Occlusive Dressings on Inflammation and Granulation Tissue Formation in Excised Wounds in Rats

The effects on the healing of full-thickness excisional wounds treated with either of two occlusive dressings (Mezinc or Duoderm) were compared with the effects of gauze soaked in saline. The wounds were made on 86 rats and were examined clinically, histologically and biochemically four, eight and twelve days after wounding. Four days postoperatively the Duoderm-treated wounds differed significantly from the other two groups. Clinically, an adherent discolored gelatinous mass remained after removal of the firm part of the Duoderm dressing. Histologically it corresponded to a superficial exudate containing polymorphonuclear leukocytes (PMNs), macrophages and condensed foreign material. There was also a more extensive inflammatory reaction in the underlying tissues compared with gauze or Mezinc treatment and debris was seen in vesicles extracellularly and in foamy macrophages. Foamy macrophages were only seen in the Duoderm-treated wounds. These macrophages were mainly confined to the granulation tissue, which was about twice as thick as in the other two treatment groups twelve days after excision.

Metabolic risk factors and skin cancer in the Metabolic Syndrome and Cancer Project (Me-Can)

Background  Little is known about the associations of metabolic aberrations with malignant melanoma (MM) and nonmelanoma skin cancer (NMSC).

Effects of Zinc Oxide in an Occlusive, Adhesive Dressing on Granulation Tissue Formation

The role of zinc in an occlusive, adhesive dressing (Zn-tape) was investigated in two experiments in the rat. In the first one Zn-tape was compared with a similar tape without zinc components and also with an inert plastic coated fabric with regard to the wound inflammatory reaction in excisional wounds. In the second experiment we attempted to assess possible systemic effects of zinc absorbed from Zn-tape-treated excisional wounds by studying the granulation tissue formation in subcutaneously implanted Ivalon sponges. The excisional wounds were treated with either the Zn-tape or a titanium tape in which the Zinc oxide was replaced by an equivalent amount of titanium dioxide (Ti-tape). The granulation tissue produced was evaluated histologically, histochemically and biochemically. The plain adhesive mass and the Titape elicited an intense inflammatory reaction as indicated both by high activities of alkaline phosphatases and histological examination. The Zn-tape reduced inflammatory processes in the granu...

Granulation tissue formation and metabolism of zinc and copper in alloxan-diabetic rats.

The early wound healing phases, and zinc and copper metabolism were assessed in traumatized insulin dependent diabetic rats. Granulation tissue was obtained by implanting Ivalon sponges subcutaneously and analysed on the fourth and seventh postoperative days by applying quantitative biochemical methods. The DNA content on day 4 and the amounts of RNA, hydroxyproline and hemoglobin on day 7 were significantly lower in granulation tissue from diabetic rats. The alkaline phosphatase activity, a marker for polymorphonuclear leukocytes (PMNs), was raised in the diabetic granulation tissue. The concentrations of zinc and copper were found to be increased in the kidney of diabetic rats compared with operated, non-diabetic controls. Our data suggest that the early granulation tissue formation is disturbed, with a prolonged inflammatory phase, decreased collagen formation and reduced vascularization. Zinc and copper are accumulated in the kidney of rats with uncontrolled, insulin dependent diabetes mellitus.