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Wiberg, Bernice
Publications (5 of 5) Show all publications
Wiberg, B., Lind, M. & Lind, L. (2014). Serum levels of monobenzylphthalate (MBzP) is related to carotid atherosclerosis in the elderly. Environmental Research, 133, 348-352
Open this publication in new window or tab >>Serum levels of monobenzylphthalate (MBzP) is related to carotid atherosclerosis in the elderly
2014 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 133, p. 348-352Article in journal (Refereed) Published
Abstract [en]

Background and objective: Background exposure to environmental contaminants has recently emerged as a new risk factor for cardiovascular disease in general and to atheroclerosis in particular. This cross-sectional study was performed to evaluate if serum concentrations of the phthalate metabolite monobenzylphthalate (MBzP) are related to atheroclerosis in the carotid arteries. Methods: In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (1003 subjects all aged 70) the prevalence of overt plaques and echogenicity (gray-scale median, GSM) of carotid artery plaques were recorded by ultrasound in both of the carotid arteries. The intima-media thickness (IMT) and echogenicity (IM-GSM) of the intima-media complex were also measured. The phthalate metabolite MBzP was analyzed in serum by a liquid chromatograph/tandem mass spectrometer. Results: The circulating level of the phthalate MBzP was related to intima-media thickness (IMT) when adjusting for gender, blood pressure, body mass index (BMI), waist circumference, HDL- and LDL-cholesterol, serum triglycerides, blood glucose and smoking (p=0.034). High levels of MBzP were also strongly associated with an echogenic IM-GSM and plaque GSM (p=0.0001 for both outcomes after adjustment) but not to plaque prevalence (p=0.42). Conclusion: The phthalate metabolite MBzP was strongly related to the echogenicity of intima-media and plaques and also to IMT, independently of traditional CV risk factors. This suggests a role for the phthalate MBzP in the development of atherosclerosis.

Keywords
Phthalate, Endocrine disruptor, Atherosclerosis, Carotids, Intima media thickness
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-231234 (URN)10.1016/j.envres.2014.06.009 (DOI)000339705900045 ()
Available from: 2014-09-08 Created: 2014-09-05 Last updated: 2018-01-11Bibliographically approved
Wiberg, B., Kilander, L., Sundström, J., Byberg, L. & Lind, L. (2012). The relationship between executive dysfunction and post-stroke mortality: a population-based cohort study. BMJ Open, 2(3), e000458
Open this publication in new window or tab >>The relationship between executive dysfunction and post-stroke mortality: a population-based cohort study
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2012 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 3, p. e000458-Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To study the associations of pre-stroke cognitive performance with mortality after first-ever stroke or transient ischaemic attack (TIA).

DESIGN:

A prospective cohort study.

SETTING AND PARTICIPANTS:

In participants having first-ever stroke or TIA during up to 14 years of post-test follow-up (n=155), we investigated the associations of pre-stroke variables and cognitive test results with post-stroke survival. The study is based on those participants of the Uppsala Longitudinal Study of Adult Men who performed cognitive function tests at approximately age 70 (n=919).

PRIMARY OUTCOME MEASURES:

Mortality after first-ever stroke or TIA related to pre-stroke executive performance.

RESULTS:

Eighty-four (54%) of the first-ever stroke/TIA patients died under a median follow-up of 2.5 years after the event. In Cox proportional hazard analyses adjusting for age, education, social group and traditional stroke risk factors, poor performance in Trail Making Test (TMT)-A was related to mortality (HR 1.88 per SD, 95% CI 1.31 to 2.71, p=0.001). The risk of mortality was approximately threefold higher in the highest tertile compared with the lowest tertile (HR TMT-A= 2.90 per SD, 95% CI 1.24 to 6.77, p=0.014). A similar pattern was seen for TMT-B, but Mini-Mental State Examination results were not related to risk of post-stroke mortality.

CONCLUSION:

Executive performance measured by TMT-A and -B before stroke was independently associated with long-term risk of mortality, after first-ever stroke or TIA in a population-based study of older men.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-181576 (URN)10.1136/bmjopen-2011-000458 (DOI)000315044800010 ()22573701 (PubMedID)
Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2018-08-24
Wiberg, B. (2010). Risk Factors for Stroke in Adult Men: A Population-based Study. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>Risk Factors for Stroke in Adult Men: A Population-based Study
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the last decades our knowledge concerning cardiovascular risk factors has grown rapidly through results from longitudinal studies. However, despite new treatment, in Western countries coronary heart disease remains the leading cause of death and stroke is still the leading cause of severe disability.

The studies reported in these papers examine the relationships between stroke/transient ischaemic attack (TIA) and a number of different factors measured on two different occasions in men born in Uppsala 1920-1924 and are epidemiological in their character.

The findings indicate that in addition to already established risk factors, indices of an unhealthy dietary fat intake and high serum lipoprotein(a) are independent predictors of stroke/TIA. Among different glucometabolic variables a low insulin sensitivity index derived from the euglycaemic insulin clamp and proinsulin carries a high predictive value for later stroke, independently of diabetes.

Moreover, cognitive test performance measured with Trail Making Test B at age 70 is a strong and independent predictor of brain infarction, indicating that the risk is already increased in the subclinical phase of milder cognitive dysfunction. Performance at a pre-stroke Trail Making Test is also of predictive value for mortality after first-ever stroke/TIA, but none of the studied pre-stroke variables or cognitive tests was found to be related to dependency after an event.

In summary these studies provide further knowledge about predictors of stroke and of mortality after first-ever stroke. They also indicate the possible importance of new markers of risk, such as the level of lipoprotein(a), profile of fatty acids in the diet, low insulin sensitivity derived from clamp investigations, level of proinsulin, and cognitive performance measured with Trail Making Tests.

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. p. 65
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 540
Keywords
risk factor, stroke, TIA, lipoproteins, fatty acids, insulin resistance, proinsulin, clamp, cognitive function, epidemiology, Trail Making Test, stroke mortality, dependency
National Category
Geriatrics
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-120542 (URN)978-91-554-7753-0 (ISBN)
Public defence
2010-05-11, Konferenssalen, Blå Korset, Akademiska sjukhuset, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-20 Created: 2010-03-12 Last updated: 2018-06-26Bibliographically approved
Wiberg, B., Sundström, J., Ärnlöv, J., Terént, A., Vessby, B., Zethelius, B. & Lind, L. (2006). Metabolic risk factors for stroke and transient ischemic attacks in middle-aged men: a community-based study with long-term follow-up. Stroke, 37(12), 2898-2903
Open this publication in new window or tab >>Metabolic risk factors for stroke and transient ischemic attacks in middle-aged men: a community-based study with long-term follow-up
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2006 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 37, no 12, p. 2898-2903Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: The impact of lipometabolic and glucometabolic disturbances on stroke incidence remains to be characterized in detail. We investigated relations of a comprehensive panel of baseline lipometabolic and glucometabolic variables to incident fatal and nonfatal stroke or transient ischemic attack (TIA), and stroke subtypes. METHODS: A community-based prospective study of 2313 middle-aged men invited to a health survey at age 50. RESULTS: During a follow-up of up to 32 years, 421 developed stroke or TIA. In Cox proportional hazards analyses adjusting for treatment with cardiovascular drugs at baseline, 1-standard deviation increases in body mass index, systolic and diastolic blood pressures, serum proinsulin, and lipoprotein(a) were associated with 11 to 35% increased risk for subsequent stroke/TIA. Electrocardiographic left ventricular hypertrophy and smoking were also associated with a higher risk for stroke/TIA. Essentially the same variables were related to brain infarction/TIA. Higher proportions of palmitic (16:0), palmitoleic (16:1), and oleic acid (18:1) in cholesterol esters were associated with an increased risk, whereas a higher proportion of linoleic acid (18:2 n-6) was protective against stroke/TIA. Further adjusting all models also for hypertension, diabetes, the metabolic syndrome, serum cholesterol, atrial fibrillation, cardiovascular disease, smoking, and physical activity, essentially the same pattern was observed. CONCLUSIONS: Indices of an unhealthy dietary fat intake and a high serum lipoprotein (a) level predicted fatal and nonfatal stroke/TIA independently of established risk factors in a community-based sample of middle-aged men followed for 32 years.

Keywords
fatty acids, lipoproteins, risk factors, stroke
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-18469 (URN)10.1161/01.STR.0000249056.24657.8b (DOI)000243411500018 ()17053177 (PubMedID)
Available from: 2006-12-21 Created: 2006-12-21 Last updated: 2017-12-08Bibliographically approved
Wiberg, B., Kilander, L., Sundström, J., Byberg, L. & Lind, L. Cognitive Function Prior to Stroke is a Risk Factor for Post-Stroke Mortality but Not Dependency.
Open this publication in new window or tab >>Cognitive Function Prior to Stroke is a Risk Factor for Post-Stroke Mortality but Not Dependency
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(English)Article in journal (Other academic) Submitted
National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-120536 (URN)
Available from: 2010-03-12 Created: 2010-03-12 Last updated: 2018-08-24
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