Peter Riis Hansen

Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Kidney Injury Molecule 1 (KIM1) in patients with diabetic nephropathy: a cross-sectional study and the effects of lisinopril.

Diabet. Med. 27, 1144–1150 (2010)

Recreational football for disease prevention and treatment in untrained men: a narrative review examining cardiovascular health, lipid profile, body composition, muscle strength and functional capacity

Over the past 10u2005years, researchers have studied the effects of recreational football training as a health-promoting activity for participants across the lifespan. This has important public health implications as over 400 million people play football annually. Results from the first randomised controlled trial, published in the BJSM in January 2009, showed that football increased maximal oxygen uptake and muscle and bone mass, and lowered fat percentage and blood pressure, in untrained men, and since then more than 70 articles about football for health have been published, including publications in two supplements of the Scandinavian Journal of Medicine and Science in Sports in 2010 and 2014, prior to the FIFA World Cup tournaments in South Africa and Brazil. While studies of football training effects have also been performed in women and children, this article reviews the current evidence linking recreational football training with favourable effects in the prevention and treatment of disease in adult men.

Graft patency after off-pump coronary artery bypass surgery is inferior even with identical heparinization protocols: Results from the Danish On-pump Versus Off-pump Randomization Study (DOORS)

OBJECTIVEnTo determine whether graft patency after on-pump and off-pump coronary artery bypass surgery is similar when performed using the same heparinization protocol.nnnMETHODSnIn a randomized, controlled, multicenter trial, 900 patients more than 70 years of age received either on-pump or off-pump coronary artery bypass surgery. Heparin was given to achieve an activated clotting time of 400 seconds before arteriotomy in both groups. After the procedure, protamine sulfate was given to revert the activated clotting time to less than 120 seconds. Coronary angiography was performed 6 months after the operation and graft patency was assessed by independent blinded observers.nnnRESULTSnA total of 481 patients underwent angiography. In the off-pump group, 561 (79%) of 710 grafts were open, 65 (9%) were stenotic, and 84 (12%) were occluded. In the on-pump group, 549 (86%) of 650 grafts were open, 38 (5%) were stenotic, and 63 (9%) were occluded. The difference between the proportion of open grafts was statistically significant in favor of on-pump surgery (P=.01). The proportion of open left internal thoracic artery grafts was 95% in both groups. Perioperative use of intracoronary shunts did not increase the risk of stenosis of the coronary artery distal to the anastomosis.nnnCONCLUSIONSnDespite comparable heparinization, graft patency after off-pump surgery was inferior to that after on-pump surgery.

Variant ASGR1 Associated with a Reduced Risk of Coronary Artery Disease

BACKGROUNDnSeveral sequence variants are known to have effects on serum levels of non-high-density lipoprotein (HDL) cholesterol that alter the risk of coronary artery disease.nnnMETHODSnWe sequenced the genomes of 2636 Icelanders and found variants that we then imputed into the genomes of approximately 398,000 Icelanders. We tested for association between these imputed variants and non-HDL cholesterol levels in 119,146 samples. We then performed replication testing in two populations of European descent. We assessed the effects of an implicated loss-of-function variant on the risk of coronary artery disease in 42,524 case patients and 249,414 controls from five European ancestry populations. An augmented set of genomes was screened for additional loss-of-function variants in a target gene. We evaluated the effect of an implicated variant on protein stability.nnnRESULTSnWe found a rare noncoding 12-base-pair (bp) deletion (del12) in intron 4 of ASGR1, which encodes a subunit of the asialoglycoprotein receptor, a lectin that plays a role in the homeostasis of circulating glycoproteins. The del12 mutation activates a cryptic splice site, leading to a frameshift mutation and a premature stop codon that renders a truncated protein prone to degradation. Heterozygous carriers of the mutation (1 in 120 persons in our study population) had a lower level of non-HDL cholesterol than noncarriers, a difference of 15.3 mg per deciliter (0.40 mmol per liter) (P=1.0×10(-16)), and a lower risk of coronary artery disease (by 34%; 95% confidence interval, 21 to 45; P=4.0×10(-6)). In a larger set of sequenced samples from Icelanders, we found another loss-of-function ASGR1 variant (p.W158X, carried by 1 in 1850 persons) that was also associated with lower levels of non-HDL cholesterol (P=1.8×10(-3)).nnnCONCLUSIONSnASGR1 haploinsufficiency was associated with reduced levels of non-HDL cholesterol and a reduced risk of coronary artery disease. (Funded by the National Institutes of Health and others.).

Cardiovascular effects of 3 months of football training in overweight children examined by comprehensive echocardiography: a pilot study

Abstract We examined effects of a 3-month football training programme in overweight children using comprehensive echocardiography and peripheral arterial tonometry. Twenty preadolescent overweight children (17 boys, 3 girls aged 8–12 yrs; body mass index [BMI] ≥ 85th percentile) participated in a structured 3-month football training programme, consisting of 4 weekly 60–90 min sessions with mean heart rate (HR) > 80% of HRmax (football group, FG). A parallel control group (CG) included 11 children (7 boys, 4 girls) of equivalent age from an obesity clinic. After 3 months, systolic blood pressure was unchanged in FG, but had increased in CG (112 [s 6] vs. 122 [10] mmHg, P = 0.02). FG demonstrated increased left ventricular (LV) posterior wall diameter (0.60 [0.07] vs. 0.68 [0.10] cm, P < 0.001) and an improved right ventricular systolic function determined by tricuspid annular plane systolic excursion (TAPSE, 2.01 [0.29] vs. 2.27 [0.28] cm, P = 0.003). Measures of LV systolic function showed only discrete alterations and two-dimensional (2D) global strain was not changed. After 3 months, global isovolumetric relaxation time (IVRTglobal) had increased in FG (64.0 [7.5] vs. 73.9 [9.4] ms, P < 0.001) while other examined LV diastolic function variables were not altered. No echocardiographic changes were observed in CG. Between-group differences in pre-post delta values were observed for systolic blood pressure, TAPSE, and IVRTglobal (P = 0.02–0.03). We conclude that short-term football training may have positive structural and functional effects on the cardiovascular system in overweight preadolescent children.

A preliminary study: Effects of football training on glucose control, body composition, and performance in men with type 2 diabetes

The effects of regular football training on glycemic control, body composition, and peak oxygen uptake (VO2peak) were investigated in men with type 2 diabetes mellitus (T2DM). Twenty‐one middle‐aged men (49.8u2009±u20091.7 yearsu2009±u2009SEM) with T2DM were divided into a football training group (FG; nu2009=u200912) and an inactive control group (CG; nu2009=u20099) during a 24‐week intervention period (IP). During a 1‐h football training session, the distance covered was 4.7u2009±u20090.2u2009km, mean heart rate (HR) was 83u2009±u20092% of HRmax, and blood lactate levels increased (Pu2009<u20090.001) from 2.1u2009±u20090.3 to 8.2u2009±u20091.3u2009mmol/L. In FG, VO2peak was 11% higher (Pu2009<u20090.01), and total fat mass and android fat mass were 1.7u2009kg and 12.8% lower (Pu2009<u20090.001), respectively, after IP. After IP, the reduction in plasma glucose was greater (Pu2009=u20090.02) in FG than the increase in CG, and in FG, GLUT‐4 tended to be higher (Pu2009=u20090.072) after IP. For glycosylated hemoglobin (HbA1), an overall time effect (Pu2009<u20090.01) was detected after 24 weeks. After IP, the number of capillaries around type I fibers was 7% higher (Pu2009<u20090.05) in FG and 5% lower (Pu2009<u20090.05) in CG. Thus, in men with T2DM, regular football training improves VO2peak, reduces fat mass, and may positively influence glycemic control.

Additive prognostic value of plasma N-terminal pro-brain natriuretic peptide and coronary artery calcification for cardiovascular events and mortality in asymptomatic patients with type 2 diabetes

BackgroundIn patients with type 2 diabetes, cardiovascular disease (CVD) is the major cause of morbidity and mortality. We evaluated the combination of NT-proBNP and coronary artery calcium score (CAC) for prediction of combined fatal and non-fatal CVD and mortality in patients with type 2 diabetes and microalbuminuria (>30xa0mg/24-h), but without known coronary artery disease. Moreover, we assessed the predictive value of a predefined categorisation of patients into a high- and low-risk group at baseline.MethodsProspective study including 200 patients. All received intensive multifactorial treatment. Patients with baseline NT-proBNP >45.2xa0ng/L and/or CAC ≥400 were stratified as high-risk patients (nu2009=u2009133). Occurrence of fatal- and nonfatal CVD (nu2009=u200940) and mortality (nu2009=u200926), was traced after 6.1xa0years (median).ResultsHigh-risk patients had a higher risk of the composite CVD endpoint (adjusted hazard ratio [HR] 10.6 (95xa0% confidence interval [CI] 2.4-46.3); pu2009=u20090.002) and mortality (adjusted HR 5.3 (95xa0% CI 1.2-24.0); pu2009=u20090.032) compared to low-risk patients. In adjusted continuous analysis, both higher NT-proBNP and CAC were strong predictors of the composite CVD endpoint and mortality (pu2009≤u20090.0001). In fully adjusted models mutually including NT-proBNP and CAC, both risk factors remained associated with risk of CVD and mortality (pu2009≤u20090.022). There was no interaction between NT-proBNP and CAC for the examined endpoints (pu2009≥u20090.31).ConclusionsIn patients with type 2 diabetes and microalbuminuria but without known coronary artery disease, NT-proBNP and CAC were strongly associated with fatal and nonfatal CVD, as well as with mortality. Their additive prognostic capability holds promise for identification of patients at high risk.

Cardiovascular function is better in veteran football players than age‐matched untrained elderly healthy men

The aim of the study was to determine whether lifelong football training may improve cardiovascular function, physical fitness, and body composition. Our subjects were 17 male veteran football players (VPG; 68.1u2009±u20092.1 years) and 26 healthy age‐matched untrained men who served as a control group (CG; 68.2u2009±u20093.2 years). Examinations included measurements of cardiac function, microvascular endothelial function [reactive hyperemic index (RHI)], maximum oxygen uptake (VO2max), and body composition. In VPG, left ventricular (LV) end‐diastolic volume was 20% larger (Pu2009<u20090.01) and LV ejection fraction was higher (Pu2009<u20090.001). Tissue Doppler imaging revealed an augmented LV longitudinal displacement, i.e., LV shortening of 21% (Pu2009<u20090.001) and longitudinal 2D strain was 12% higher (Pu2009<u20090.05), in VPG. In VPG, resting heart rate was lower (6u2009bpm, Pu2009<u20090.05), and VO2max was higher (18%, Pu2009<u20090.05). In addition, RHI was 21% higher (Pu2009<u20090.05) in VPG. VPG also had lower body mass index (Pu2009<u20090.05), body fat percentage, total body fat mass, android fat percentage, and gynoid fat percentage (all Pu2009<u20090.01). Lifelong participation in football training is associated with better LV systolic function, physical fitness, microvascular function, and a healthier body composition. Overall, VPG have better cardiovascular function compared with CG, which may reduce their cardiovascular morbidity and mortality.

Effects of tofacitinib on cardiovascular risk factors and cardiovascular outcomes based on phase III and long-term extension data in patients with plaque psoriasis

BACKGROUNDnPsoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis.nnnOBJECTIVEnWe sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients with plaque psoriasis.nnnMETHODSnChanges in select CV risk factors and the incidence rate (IR) of MACEs were evaluated in patients who were treated with tofacitinib.nnnRESULTSnTofacitinib treatment was associated with small, dose-dependent increases in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, while the total/HDL cholesterol ratio was unchanged. There were no changes in blood pressure and glycated hemoglobin levels; C-reactive protein levels decreased. The IRs of a MACE were low and similar for both tofacitinib doses. Among 3623 subjects treated with tofacitinib, the total patient-years of exposure was 5204, with a median follow-up of 527xa0days, and the IR of MACEs was 0.37 (95% confidence interval, 0.22-0.57) patients with events per 100 patient-years.nnnLIMITATIONSnThere was relatively short follow-up time for patients who had MACEs.nnnCONCLUSIONSnWhile treatment with tofacitinib is associated with a small increase in cholesterol levels, the total/HDL cholesterol ratio does not change, there are no unfavorable changes in several CV risk factors, and the incidence of MACEs is low.

Effects of recreational football on women’s fitness and health: adaptations and mechanisms

The review describes the fitness and health effects of recreational football in women aged 18–65xa0years. The review documents that 2u2009×u20091xa0h of recreational football training for 12–16xa0weeks causes marked improvements in maximal oxygen uptake (5–15%) and myocardial function in women. Moreover, mean arterial blood pressure was shown to decrease by 2–5xa0mmHg in normotensive women and 6–8xa0mmHg in hypertensive women. This review also show that short-term (<u20094xa0months) and medium-term (4–16xa0months) recreational football training has major beneficial impact on metabolic health profile in women, with fat losses of 1–3xa0kg and improvements in blood lipid profile. Lastly, 2u2009×u20091xa0h per week of recreational football training for women elevates lower extremity bone mineralisation by 1–5% and whole-body bone mineralization by 1–2% within 4–12-month interventions. These training adaptations are related to the high heart rates, high number of fast runs, and multiple changes of direction and speed occurring during recreational football training for untrained women. In conclusion, regular small-sided football training for women is an intense and versatile type of training that combines elements of high-intensity interval training (HIIT), endurance training and strength training, thereby providing optimal stimuli for cardiovascular, metabolic and musculoskeletal fitness. Recreational football, therefore, seems to be an effective tool for prevention and treatment of lifestyle diseases in young and middle-aged women, including hypertension, type 2 diabetes and osteopenia. Future research should elucidate effects of football training for elderly women, and as treatment and rehabilitation of breast cancer patients and other women patient groups.