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Hammar, Ulf
Publications (4 of 4) Show all publications
Ek, A., Lewis Chamberlain, K., Sorjonen, K., Hammar, U., Etminan Malek, M., Sandvik, P., . . . Nowicka, P. (2019). A Parent Treatment Program for Preschoolers With Obesity: A Randomized Controlled Trial. Pediatrics, 144(2), Article ID e20183457.
Open this publication in new window or tab >>A Parent Treatment Program for Preschoolers With Obesity: A Randomized Controlled Trial
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2019 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 144, no 2, article id e20183457Article in journal (Refereed) Published
Abstract [en]

Background And Objectives: Early obesity treatment seems to be the most effective, but few treatments exist. In this study, we examine the effectiveness of a parent-only treatment program with and without booster sessions (Booster or No Booster) focusing on parenting practices and standard treatment (ST).

Methods: Families of children 4 to 6 years of age with obesity were recruited from 68 child care centers in Stockholm County and randomly assigned to a parent-only program (10 weeks) with or without boosters (9 months) or to ST. Treatment effects on primary outcomes (BMI z score) and secondary outcomes (BMI and waist circumference) during a 12-month period were examined with linear mixed models. The influence of sociodemographic factors was examined by 3-way interactions. The clinically significant change in BMI z score (−0.5) was assessed with risk ratios.

Results: A total of 174 children (mean age: 5.3 years [SD = 0.8]; BMI z score: 3.0 [SD = 0.6], 56% girls) and their parents (60% foreign background; 39% university degree) were included in the analysis (Booster, n = 44; No Booster, n = 43; ST, n = 87). After 12 months, children in the parent-only treatment had a greater reduction in their BMI z score (0.30; 95% confidence interval [CI]: −0.45 to −0.15) compared with ST (0.07; 95% CI: −0.19 to 0.05). Comparing all 3 groups, improvements in weight status were only seen for the Booster group (−0.54; 95% CI: −0.77 to −0.30). The Booster group was 4.8 times (95% CI: 2.4 to 9.6) more likely to reach a clinically significant reduction of ≥0.5 of the BMI z score compared with ST.

Conclusion: A parent-only treatment with boosters outperformed standard care for obesity in preschoolers.

Keywords
primary care, intervention, family support, children
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-389455 (URN)10.1542/peds.2018-3457 (DOI)000484366800015 ()31300528 (PubMedID)
Funder
Swedish Research Council, K2015-99X-22713-01-3-Vinnova, 2011-3443The Karolinska Institutet's Research FoundationMagnus Bergvall FoundationFredrik och Ingrid Thurings StiftelseHelge Ax:son Johnsons stiftelse
Available from: 2019-07-14 Created: 2019-07-14 Last updated: 2019-10-18Bibliographically approved
Almby, K. E., Abrahamsson, N., Lundqvist, M. H., Hammar, U., Thombare, K., Panagiotou, A., . . . Eriksson, J. (2019). Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery. European Journal of Endocrinology, 181(2), 161-171
Open this publication in new window or tab >>Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery
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2019 (English)In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 181, no 2, p. 161-171Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of the study was to explore the role of GLP-1 receptor activation on the counter-regulation and symptoms of hypoglycemia in subjects who have undergone gastric bypass surgery (GBP).

Design: Experimental hyperinsulinemic-hypoglycemic clamp study.

Methods: Twelve post-GBP subjects participated in a randomized cross-over study with two hyperinsulinemic, hypoglycemic clamps (glucose nadir 2.7 mmol/L) performed on separate days with concomitant infusions of the GLP-1 analog exenatide or with saline, respectively. Continuous measurements of metabolites and counter-regulatory hormones as well as assessments of heart rate variability and symptoms of hypoglycemia were performed throughout the clamps.

Results: No effect of GLP-1 receptor activation on counter-regulatory hormones (glucagon, catecholamines, cortisol, GH) or glucose infusion rate was seen, but we found indications of a downregulation of the sympathetic relative to the parasympathetic nerve activity, as reflected in heart rate variability. No significant differences in symptom of hypoglycemia were observed.

Conclusions/interpretation: Short-term exposure to a GLP-1 receptor agonist does not seem to impact the counter-regulatory hormonal and metabolic responses in post-GBP subjects during hypoglycemic conditions, suggesting that the improvement in symptomatic hypoglycemia post-GBP seen following treatment with GLP-1 receptor agonists may be mediated by mechanism not directly involved in counter-regulation.

Place, publisher, year, edition, pages
BIOSCIENTIFICA LTD, 2019
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-390513 (URN)10.1530/EJE-19-0171 (DOI)000472835100013 ()31176298 (PubMedID)
Funder
Swedish Diabetes AssociationErnfors FoundationEXODIAB - Excellence of Diabetes Research in Sweden
Available from: 2019-08-12 Created: 2019-08-12 Last updated: 2019-08-12Bibliographically approved
Kennedy, B., Peura, S., Hammar, U., Vicenzi, S., Hedman, A., Almqvist, C., . . . Fall, T. (2019). Oral Microbiota Development in Early Childhood. Scientific Reports, 9, Article ID 19025.
Open this publication in new window or tab >>Oral Microbiota Development in Early Childhood
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 19025Article in journal (Refereed) Published
Abstract [en]

Early life determinants of the oral microbiota have not been thoroughly elucidated. We studied the association of birth and early childhood characteristics with oral microbiota composition using 16 S ribosomal RNA (rRNA) gene sequencing in a population-based Swedish cohort of 59 children sampled at 6, 12 and 24 months of age. Repeated-measurement regression models adjusted for potential confounders confirmed and expanded previous knowledge about the profound shift of oral microbiota composition in early life. These alterations included increased alpha diversity, decreased beta diversity and alteration of bacterial composition with changes in relative abundance of 14 of the 20 most common operational taxonomic units (OTUs). We also found that birth characteristics, breastfeeding and antibiotic use were associated with overall phyla distribution and/or with the relative abundance of specific OTUs. Further, we detected a novel link between morning salivary cortisol level, a physiological marker of neuroendocrine activity and stress, and overall phyla distribution as well as with decreased abundance of the most common OTU mapped to the Streptococcaceae family. In conclusion, a major part of the maturation of the oral microbiome occurs during the first two years of life, and this development may be influenced by early life circumstances.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2019
National Category
Genetics
Identifiers
urn:nbn:se:uu:diva-402239 (URN)10.1038/s41598-019-54702-0 (DOI)000503073900001 ()31836727 (PubMedID)
Funder
Swedish National Infrastructure for Computing (SNIC), SNIC sens2018616Swedish Research Council, 2015-03477Swedish Research Council, 2015-02434_3Swedish Research Council, 2018-02640Knut and Alice Wallenberg FoundationStockholm County CouncilSwedish Heart Lung FoundationSwedish Asthma and Allergy AssociationForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2020-01-16 Created: 2020-01-16 Last updated: 2020-01-22Bibliographically approved
Yi-Ting, L., Fall, T., Hammar, U., Gustafsson, S., Ingelsson, E., Ärnlöv, J., . . . Sundström, J. (2019). Proteomic Analysis of Longitudinal Changes in Blood Pressure. JOURNAL OF CLINICAL MEDICINE, 8(10), Article ID 1585.
Open this publication in new window or tab >>Proteomic Analysis of Longitudinal Changes in Blood Pressure
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2019 (English)In: JOURNAL OF CLINICAL MEDICINE, ISSN 2077-0383, Vol. 8, no 10, article id 1585Article in journal (Refereed) Published
Abstract [en]

Hypertension is the leading risk factor for premature death worldwide. The identification of modifiable causes of hypertension remains an imperative task. We aimed to investigate associations between 79 proteins implicated in cardiovascular disease and longitudinal blood pressure (BP) changes in three Swedish prospective cohorts. In a discovery phase, we investigated associations between baseline circulating protein levels assessed with a proximity extension assay and BP stage progression at follow-up 5 years later among persons without BP-lowering drugs at baseline in two independent community-based cohorts from the Prospective Investigation of the Vasculature in Uppsala Seniors study (PIVUS) and the Uppsala Longitudinal Study of Adult Men (ULSAM). We used an independent cohort, the Malmo Diet and Cancer Study (MDC), for replication. The primary outcome of BP stage progression was defined as per the 2017 AHA/ACC (American Heart Association/American College of Cardiology) Guideline BP categories. We also investigated associations of protein levels with changes in BP on a continuous scale, and meta-analyzed all three cohorts. Levels of renin were associated with BP stage progression with a 5% false discovery rate (FDR) in the ULSAM (n = 238) and PIVUS (n = 566) cohorts, but we could not replicate this association in the MDC cohort (n = 2659). The association in the discovery cohorts was modest, with an odds ratio for BP stage progression over 5 years of 1.33 (95% confidence interval 1.14 to 1.56) per standard deviation of baseline renin. In conclusion, we could not find any novel robust associations with longitudinal BP increase in a proximity extension assay-based proteomics investigation in three cohorts.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
proteomics, blood pressure, hypertension, prospective cohort
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-400097 (URN)10.3390/jcm8101585 (DOI)000498398500083 ()31581667 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20041151
Available from: 2020-01-07 Created: 2020-01-07 Last updated: 2020-01-07Bibliographically approved
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