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Rydell, A., Nerpin, E., Zhou, X., Lind, L., Lindberg, E., Theorell Haglöw, J., . . . Malinovschi, A. (2023). Cardiovascular disease-linked plasma proteins are mainly associated with lung volume. ERJ Open Research, 9(2), Article ID 00321-2022.
Open this publication in new window or tab >>Cardiovascular disease-linked plasma proteins are mainly associated with lung volume
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2023 (English)In: ERJ Open Research, E-ISSN 2312-0541, Vol. 9, no 2, article id 00321-2022Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Epidemiological studies have shown that impaired lung function is common and associated with increased risk of cardiovascular disease. Increased levels of several inflammatory and cardiovascular disease-related plasma proteins have been associated with impaired lung function. The aim was to study the association between plasma proteomics and forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio.

METHODS: We used a discovery and replication approach in two community-based cohorts, EpiHealth and the Malmö Offspring Study (total n=2874), to cross-sectionally study 242 cardiovascular disease- and metabolism-linked proteins in relation to FEV1, FVC (both % predicted) and FEV1/FVC ratio. A false discovery rate of 5% was used as the significance threshold in the discovery cohort.

RESULTS: Plasma fatty acid-binding protein 4, interleukin-1 receptor antagonist, interleukin-6 and leptin were negatively associated with FEV1 and paraoxonase 3 was positively associated therewith. Fatty acid-binding protein 4, fibroblast growth factor 21, interleukin-1 receptor antagonist, interleukin-6 and leptin were negatively associated with FVC and agouti-related protein, insulin-like growth factor-binding protein 2, paraoxonase 3 and receptor for advanced glycation end products were positively associated therewith. No proteins were associated with FEV1/FVC ratio. A sensitivity analysis in EpiHealth revealed only minor changes after excluding individuals with known cardiovascular disease, diabetes or obesity.

CONCLUSIONS: Five proteins were associated with both FEV1 and FVC. Four proteins associated with only FVC and none with FEV1/FVC ratio, suggesting associations mainly through lung volume, not airway obstruction. However, additional studies are needed to investigate underlying mechanisms for these findings.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:du-45839 (URN)10.1183/23120541.00321-2022 (DOI)000956544900002 ()37009020 (PubMedID)2-s2.0-85152694714 (Scopus ID)
Available from: 2023-04-11 Created: 2023-04-11 Last updated: 2023-05-04Bibliographically approved
Leksell, J., Toft, E., Rosman, J., Eriksson, J. W., Fischier, J., Lindholm-Olinder, A., . . . Nerpin, E. (2023). Virtual clinic for young people with type 1 diabetes: a randomised wait-list controlled study. BMC Endocrine Disorders, 23(1), Article ID 255.
Open this publication in new window or tab >>Virtual clinic for young people with type 1 diabetes: a randomised wait-list controlled study
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2023 (English)In: BMC Endocrine Disorders, E-ISSN 1472-6823, Vol. 23, no 1, article id 255Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The transition from paediatric to adult care for young adults with type 1 diabetes poses unique challenges. Virtual diabetes clinics using smartphone applications offer a promising approach to support self-management and enhance communication with healthcare providers. The primary objective of this study was to evaluate the effects of a virtual diabetes clinic on glycaemic control, treatment satisfaction, and quality of life among young adults diagnosed with type 1.

METHODS: 79 participants with type 1 diabetes aged 18-25 years were included in a prospective, single-centre, randomised, wait-list controlled trial. Participants were randomly assigned to either the intervention group or the wait-list control group. The intervention group received instant access to a virtual care platform called Vista Dialog, which facilitated real-time communication between patients and healthcare providers. Glycosylated haemoglobin (HbA1c) levels, time in range (TIR), time below range (TBR), diabetes treatment satisfaction, and quality of life were assessed at baseline and after 6 months.

RESULTS: Baseline characteristics were similar between the intervention and control groups, except for education level, where there was a skewed distribution between the groups (the intervention group had a lower education level). At the 6-month follow-up, there were no significant differences in HbA1c levels, TIR, TBR, or diabetes treatment satisfaction between the two groups. However, the intervention group demonstrated a significant decrease in the burden on physical health compared with the control group, indicating an improved quality of life.

CONCLUSIONS: The implementation of a virtual diabetes clinic using the Vista Dialog platform did not result in significant improvements in glycaemic control or treatment satisfaction compared with usual care. However, it did show potential benefits in terms of reducing the burden on physical health and improving quality of life in young adults with type 1 diabetes. Further research is needed to explore the long-term effects and optimal use of virtual clinics in diabetes management.

TRIAL REGISTRATION: ISRCTN number: 73,435,627 (registration date: 23/10/2019): https://doi.org/10.1186/ISRCTN73435627 . The performance and results of this trial adhere to the guidelines outlined in the CONSORT 2010 (Consolidated Standards of Reporting Trials) recommendations.

Keywords
Glycaemic control, Quality of life, Treatment satisfaction, Type 1 Diabetes, Virtual Diabetes clinic, Young adults
National Category
Nursing Endocrinology and Diabetes
Identifiers
urn:nbn:se:du-47322 (URN)10.1186/s12902-023-01516-x (DOI)001105746000001 ()37990315 (PubMedID)2-s2.0-85177546212 (Scopus ID)
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-01-19Bibliographically approved
Krantz, C., Accordini, S., Alving, K., Corsico, A. G., Demoly, P., Ferreira, D. S., . . . Survey III, T. E. (2022). Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitisation. Clinical and Experimental Allergy, 52(2), 297-311
Open this publication in new window or tab >>Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitisation
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2022 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 52, no 2, p. 297-311Article in journal (Refereed) Published
Abstract [en]

Background

Fractional exhaled nitric oxide (FeNO) is a well-known marker of type-2 inflammation. FeNO is elevated in asthma and allergic rhinitis, with IgE sensitisation as a major determinant.

Objective

We aimed to see if there was an independent association between upper airway inflammatory disorders (UAID) and FeNO, after adjustment for asthma and sensitisation, in a multi-centre population-based study.

Methods

A total of 741 subjects with current asthma and 4,155 non-asthmatic subjects participating in the second follow-up of the European Community Respiratory Health Survey (ECRHS III) underwent FeNO measurements. Sensitisation status was based on measurement of IgE against airborne allergens; information on asthma, UAID and medication was collected through interview-led questionnaires. Independent associations between UAID and FeNO was assessed in adjusted multivariate regression models and test for interaction with perennial sensitisation and asthma on the relation between UAID and FeNO were made.

Results

UAID were associated with higher FeNO after adjusting for perennial sensitisation, asthma and other confounders: with 4.4 (0.9?7.9) % higher FeNO in relation to current rhinitis and 4.8 (0.7?9.2)% higher FeNO in relation to rhinoconjunctivitis. A significant interaction with perennial sensitisation was found in the relationship between current rhinitis and FeNO (p=0.03) and between rhinoconjunctivitis and FeNO (p=0.03). After stratification by asthma and perennial sensitisation, the association between current rhinitis and FeNO remained in non-asthmatic subjects with perennial sensitisation, with 12.1 (0.2?25.5) % higher FeNO in subjects with current rhinitis than in those without.

Conclusions & Clinical Relevance

Current rhinitis and rhinoconjunctivitis was associated with higher FeNO, with an interaction with perennial sensitisation. This further highlights the concept of united airway disease, with correlations between symptoms and inflammation in the upper and lower airways and that sensitisation needs to be accounted for in the relation between FeNO and rhinitis.

Place, publisher, year, edition, pages
John Wiley & Sons, Ltd, 2022
Keywords
asthma, exhaled nitric oxide, FeNO, nasal polyposis, population-based, rhinitis
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:du-38295 (URN)10.1111/cea.14019 (DOI)000703742000001 ()34536262 (PubMedID)2-s2.0-85116724624 (Scopus ID)
Available from: 2021-09-27 Created: 2021-09-27 Last updated: 2023-04-14Bibliographically approved
Nerpin, E., Ferreira, D. S., Weyler, J., Schlunnsen, V., Jogi, R., Raherison Semjen, C., . . . Malinovschi, A. (2021). Bronchodilator response and lung function decline: Associations with exhaled nitric oxide with regard to sex and smoking status. World Allergy Organization Journal, 14(5), Article ID 100544.
Open this publication in new window or tab >>Bronchodilator response and lung function decline: Associations with exhaled nitric oxide with regard to sex and smoking status
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2021 (English)In: World Allergy Organization Journal, E-ISSN 1939-4551, Vol. 14, no 5, article id 100544Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier Inc., 2021
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:du-37362 (URN)10.1016/j.waojou.2021.100544 (DOI)000658539200005 ()34093956 (PubMedID)2-s2.0-85106214518 (Scopus ID)
Available from: 2021-06-14 Created: 2021-06-14 Last updated: 2024-03-06Bibliographically approved
Nerpin, E., Toft, E., Fischier, J., Lindholm-Olinder, A. & Leksell, J. (2020). A virtual clinic for the management of diabetes-type 1: study protocol for a randomised wait-list controlled clinical trial. BMC Endocrine Disorders, 20(1)
Open this publication in new window or tab >>A virtual clinic for the management of diabetes-type 1: study protocol for a randomised wait-list controlled clinical trial
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2020 (English)In: BMC Endocrine Disorders, E-ISSN 1472-6823, Vol. 20, no 1Article in journal (Refereed) Published
National Category
Nursing
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-34996 (URN)10.1186/s12902-020-00615-3 (DOI)000568431800002 ()32891126 (PubMedID)2-s2.0-85090376813 (Scopus ID)
Available from: 2020-09-15 Created: 2020-09-15 Last updated: 2023-09-13Bibliographically approved
Nerpin, E., Olivieri, M., Gislason, T., Olin, A. C., Nielsen, R., Johannessen, A., . . . Malinovschi, A. (2019). Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III. Clinical and Experimental Allergy, 49(7), 969-979
Open this publication in new window or tab >>Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III
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2019 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 7, p. 969-979Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The fractional exhaled nitric oxide (FE NO) is a marker for type 2 inflammation used in diagnostics and management of asthma. In order to use FE NO as a reliable biomarker, it is important to investigate factors that influence FE NO in healthy individuals. Men have higher levels of FE NO than women, but it is unclear whether determinants of FE NO differ by sex.

OBJECTIVE: To identify determinants of FE NO in men and women without lung diseases.

METHOD: FE NO was validly measured in 3,881 healthy subjects that had answered the main questionnaire of the European Community Respiratory Health Survey III without airways or lung disease RESULTS: Exhaled NO levels were 21.3% higher in men compared with women p<0.001. Being in the upper age quartile (60.3-67.6 years) men had 19.2 ppb (95% CI: 18.3, 20.2) higher FE NO than subjects in the lowest age quartile (39.7-48.3 years) p=0.02. Women in the two highest age quartiles (54.6-60.2 and 60.3-67.6 years) had 15.4 ppb (14.7, 16.2), p=0.03 and 16.4 ppb (15.6, 17.1), p=<0.001 higher FE NO, compared with the lowest age quartile. Height was related to 8% higher FE NO level in men (p<0.001) and 5% higher FE NO levels in women (p=0.008). Men who smoked had 37% lower FE NO levels and women had 30% lower levels compared with never-smokers (p<0.001 for both). Men and women sensitized to both grass and perennial allergens had higher FE NO levels compared with non-sensitized subjects 26% and 29%, p<0.001 for both.

CONCLUSION & CLINICAL RELEVANCE: FE NO levels were higher in men than women. Similar effects of current smoking, height, and IgE sensitization were found in both sexes. FE NO started increasing at lower age in women than in men, suggesting that interpretation of FE NO levels in adults aged over 50 years should take into account age and sex. 

Keywords
FENO, IgE sensitization, healthy population, smoking
National Category
Clinical Medicine
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-29858 (URN)10.1111/cea.13394 (DOI)000474610200004 ()30934155 (PubMedID)2-s2.0-85064513946 (Scopus ID)
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2021-11-12Bibliographically approved
Nerpin, E., Joao, F. A., Alving, K., Jansson, C. & Malinovschi, A. (2018). Blood cell counts and C-reactive protein inrelation to lung function in NHANES 2007-2010. In: : . Paper presented at ERS 2018 Paris International Congress, Madrid 28 Sept - 2 October.
Open this publication in new window or tab >>Blood cell counts and C-reactive protein inrelation to lung function in NHANES 2007-2010
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2018 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background:

Low-grade systemic inflammation is associated with impaired lung function. Few studies have examined if C-reactive protein (CRP), blood eosinophil (B-Eos), and blood neutrophil (B-Neu) counts offer additive information in relation to lung function. The aim of this study was to analyse associations between CRP, BEos, and B-Neu and effects on lung function, with special regards to additive information.

Methods:

Cross-sectional study on 7,753 participants, 20-80 years of age, in the National Health and Nutrition Examination Survey. Gender-based tertiles for CRP, B-Eos, and B-Neu were analyzed in relation to forced expiratory volume in 1 second (FEV1 % predicted), forced vital capacity (FVC % predicted), and FEV1/FVC ratio.

Results:

CRP, B-Eos, and B-Neu were inversely related to FEV1 and FVC. Only B-Eos and B-Neu were inversely related to FEV1/FVC ratio. Further, lower lung function was found with increased number of elevated

inflammatory markers in the highest tertile (one, two or three vs. non elevated) for FEV1 (% predicted): β-coefficients (95% CI) -2.20(-2.98, -1.41), -4.43 (-5.39, -3.45), and -6.43(-8.07, -4.79), all P=0.001; FVC (% predicted): -1.70 (-2.42, -0.98), -3.17 (-4.06, -2.29), and -5.34 (-6.85, -3.84), all P=0.001.

Conclusion:

CRP, B-Eos, and B-Neu offer independent and additive information in relation to lower FEV1 and FVC in the general population. This indicates that a combination of biomarkers yields more information than the biomarkers assessed individually. The mechanisms appear to be different, as B-Neu and B-Eos seem to relate more closely to obstructive impairment, e.g., lower FEV1/FVC ratio, which was not found for CRP.

Keywords
Inflammation, Epidemiology, Spirometry
National Category
Basic Medicine
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-28923 (URN)
Conference
ERS 2018 Paris International Congress, Madrid 28 Sept - 2 October
Available from: 2018-11-25 Created: 2018-11-25 Last updated: 2021-11-12Bibliographically approved
Nerpin, E., Jarvis, D., Olivieri, M., Gislason, T., Olin, A., Jansson, C. & Malinovschi, A. (2018). Different relation between exhaled nitric oxide and lung function with regard to current smoking. In: : . Paper presented at ERS 2018 Paris International Congress, Madrid 28 Sept - 2 Oct..
Open this publication in new window or tab >>Different relation between exhaled nitric oxide and lung function with regard to current smoking
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2018 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background: Exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation. Smokingreduces FeNO by 30-60%. Weak positive relation between lung function and FeNO has been inconsistently described. This has not been separately for smokers. Therefore we investigated the relation between lung function and FeNO with regard to smoking.

Methods: FeNO and lung function post-bronchodilation (BD) were measured in 4813 subjects from the European Community Respiratory Health Survey III. GLI reference values were used. Smoking habits were self-reported.

Results: Current smokers with FEV1 <lower limit of normal (LLN) had lower FeNO levels (ppb, geometric mean (95%CI)) than subjects with FEV1 ≥LLN: 10.1 (9.1, 11.1) vs 11.7 (11.3, 12.2), p=0.005, while the opposite was found in non-smokers: 20.0 (18.4, 21.6) vs 18.5 (18.2, 18.8), p=0.03. This interaction with current smoking was significant both before and after adjustments for study centres, age, BMI and gender (p=0.001 and p=0.004). Current smokers with FEV1/FVC <LLN had lower FeNO than current smokers with FEV1/FVC ≥LLN: 10.5 (9.4, 11.6) vs 11.6 (11.2, 12.1), p=0.04, and the opposite was found in non-smokers: 20.8 (19.1, 22.7) vs 18.4 (18.1, 18.8), p<0.001. There was a significant interaction with current smoking both in unadjusted and adjusted models (both p<0.001).

Conclusion: Higher FeNO relates with lower FEV1 and FEV1/FVC-ratio among non-smoking individuals, suggesting that the obstruction is related with airways inflammation. In current smokers, higher FeNO relates with better preserved lung function and this finding warrants further studies to understand the underlying mechanisms. Presented on behalf of ECRHS III (www.ecrhs.org)

National Category
Basic Medicine
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-28924 (URN)
Conference
ERS 2018 Paris International Congress, Madrid 28 Sept - 2 Oct.
Available from: 2018-11-25 Created: 2018-11-25 Last updated: 2021-11-12Bibliographically approved
Nerpin, E., Jacinto, T., Fonseca, J. A., Alving, K., Janson, C. & Malinovschi, A. (2018). Systemic inflammatory markers in relation to lung function in NHANES. 2007–2010. Respiratory Medicine, 142, 94-100
Open this publication in new window or tab >>Systemic inflammatory markers in relation to lung function in NHANES. 2007–2010
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2018 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 142, p. 94-100Article in journal (Refereed) Published
Abstract [en]

Background Low-grade systemic inflammation, mainly assessed by C-reactive protein (CRP), has been associated with impaired lung function. Few studies have studied if CRP, blood eosinophils, and blood neutrophils offer additive information in relation to lung function. Objectives To analyse associations between lung function and CRP, blood eosinophils, and blood neutrophils, with special regard to additive information of combining the inflammatory markers. Methods Cross-sectional study on 7753 participants, 20–80 years of age, in the National Health and Nutrition Examination Survey. Gender-based tertiles for CRP, blood eosinophils, and blood neutrophils were analysed in relation to the following lung function parameters: forced expiratory volume in 1 s (FEV1% predicted), forced vital capacity (FVC % predicted), and FEV1/FVC ratio. Results CRP, blood eosinophils, and blood neutrophils levels were inversely related to FEV1 and FVC. Only blood eosinophils and blood neutrophils were inversely related to FEV1/FVC ratio. Further, lower lung function was found with increased number of elevated inflammatory markers in the highest tertile (one, two or three vs. non elevated) for FEV1 (β-coeff., −2.20, −4.43, and −6.43, p < 0.001) and FVC (β-coeff., −1.70, −3.15 and −5.33, p < 0.001), respectively. Conclusions & clinical relevance CRP, blood eosinophils, and blood neutrophils offer independent and additive information in relation to lower FEV1 and FVC in the general population. This indicates that a combination of biomarkers yields more information than the biomarkers assessed individually.

Keywords
Inflammation, CRP, Blood eosinophils, Blood neutrophils
National Category
Clinical Medicine
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-28458 (URN)10.1016/j.rmed.2018.07.011 (DOI)000443001500015 ()30170809 (PubMedID)2-s2.0-85051648358 (Scopus ID)
Available from: 2018-09-03 Created: 2018-09-03 Last updated: 2021-11-12Bibliographically approved
Brück, K., Jager, K. J., Dounousi, E., Kainz, A., Nitsch, D., Ärnlöv, J., . . . Ferraro, P. M. (2015). Methodology used in studies reporting chronic kidney disease prevalence: a systematic literature review. Nephrology, Dialysis and Transplantation, 30(Supp. 4), iv6-iv16
Open this publication in new window or tab >>Methodology used in studies reporting chronic kidney disease prevalence: a systematic literature review
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2015 (English)In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 30, no Supp. 4, p. iv6-iv16Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods.

METHODS: For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers.

RESULTS: We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m(2) in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval.

CONCLUSIONS: The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study results.

National Category
Clinical Medicine
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-18989 (URN)10.1093/ndt/gfv131 (DOI)26209739 (PubMedID)
Available from: 2015-08-12 Created: 2015-08-12 Last updated: 2021-11-12Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3880-2132

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