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  • 1.
    Derks, Ivonne P. M.
    et al.
    Department of Child & Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.
    Bolhuis, Koen
    Department of Child & Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands.
    Yalcin, Zeynep
    Department of Child & Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
    Gaillard, Romy
    Department of Pediatrics, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.
    Hillegers, Manon H. J.
    Department of Child & Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychiatry, Rudolf Magnus Brain Center, Utrecht University Medical Center, Utrecht, the Netherlands.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Lundström, Sebastian
    Center for Ethics, Law and Mental Health, University of Gothenborg, Gothenborg, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    van Beijsterveldt, Catharina E. M.
    Department of Biological Psychology, Vrije University, Amsterdam, the Netherlands.
    Bartels, Meike
    Department of Biological Psychology, Vrije University, Amsterdam, the Netherlands.
    Boomsma, Dorret I.
    Department of Biological Psychology, Vrije University, Amsterdam, the Netherlands.
    Tiemeier, Henning
    Department of Child & Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
    Jansen, Pauline W.
    Department of Child & Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands.
    Testing Bidirectional Associations Between Childhood Aggression and BMI: Results from Three Cohorts2019In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 27, no 5, p. 822-829Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study examined the prospective, potentially bidirectional association of aggressive behavior with BMI and body composition across childhood in three population-based cohorts.

    METHODS: Repeated measures of aggression and BMI were available from the Generation R Study between ages 6 and 10 years (N = 3,974), the Netherlands Twin Register (NTR) between ages 7 and 10 years (N = 10,328), and the Swedish Twin Study of Child and Adolescent Development (TCHAD) between ages 9 and 14 years (N = 1,462). In all samples, aggression was assessed with the Child Behavior Checklist. Fat mass and fat-free mass were available in the Generation R Study. Associations were examined with cross-lagged modeling.

    RESULTS: Aggressive behavior at baseline was associated with higher BMI at follow-up in the Generation R Study (β = 0.02, 95% CI: 0.00 to 0.04), in NTR (β = 0.04, 95% CI: 0.02 to 0.06), and in TCHAD (β = 0.03, 95% CI: -0.02 to 0.07). Aggressive behavior was prospectively associated with higher fat mass (β = 0.03, 95% CI: 0.01 to 0.05) but not fat-free mass. There was no evidence that BMI or body composition preceded aggressive behavior.

    CONCLUSIONS: More aggressive behavior was prospectively associated with higher BMI and fat mass. This suggests that aggression contributes to the obesity problem, and future research should study whether these behavioral pathways to childhood obesity are modifiable.

  • 2.
    Jarvholm, Kajsa
    et al.
    Childhood Obes Unit, Skåne Univ Hosp, Malmö, Sweden; Dept Psychol, Lund Univ, Lund, Sweden.
    Karlsson, Jan
    Fac Med & Hlth, Ctr Hlth Care Sci, Univ Örebro, Örebro, Sweden.
    Olbers, Torsten
    Dept Surg, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Peltonen, Markku
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Marcus, Claude
    Dept Clin Sci Intervent & Technol, Karolinska Inst, Stockholm, Sweden.
    Dahlgren, Jovanna
    Dept Pediat, Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Gronowitz, Eva
    Dept Pediat, Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Johnsson, Per
    Dept Psychol, Lund Univ, Lund, Sweden.
    Flodmark, Carl-Erik
    Childhood Obes Unit, Skåne Univ Hosp, Malmö, Sweden.
    Two-year trends in psychological outcomes after gastric bypass in adolescents with severe obesity2015In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 23, no 10, p. 1966-1972Article in journal (Refereed)
    Abstract [en]

    ObjectiveThis study aimed to evaluate changes in mental health over 2 years in adolescents undergoing gastric bypass. MethodsEighty-eight adolescents (65% girls) aged 13 to 18 years were assessed at baseline and 1 and 2 years after surgery. Generic and obesity-specific questionnaires were used to evaluate outcomes in mental health, also in relation to age- and gender-specific norms. ResultsSymptoms of anxiety (P=0.001), depression (P=0.001), anger (P=0.001), and disruptive behavior (P=0.022) were significantly reduced at 2 years after surgery, as were obesity-related problems (P<0.001). Self-esteem (P<0.001), self-concept (P<0.001), and overall mood (P=0.025) improved significantly. Improvements were mainly observed during the first year after surgery. The second year was characterized by stabilization. Symptoms of anxiety, depression, anger, disruptive behavior, and self-concept were at normative levels after surgery. However, 19% of the adolescents had depressive symptoms in the clinical range. ConclusionsA substantial improvement in mental health in adolescents over the first 2 years after gastric bypass was found. Most adolescents had a level of mental health and self-concept similar to norms, but a marked subgroup showed substantial depressive symptoms 2 years after surgery.

  • 3.
    Kotronen, Anna
    et al.
    Department of Medicine, Division of Diabetes, , Helsinki, Finland; Minerva Medical Research Institute, Helsinki, Finland.
    Seppänen-Laakso, Tuulikki
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Westerbacka, Jukka
    Department of Medicine, Division of Diabetes, , Helsinki, Finland.
    Kiviluoto, Tuula
    Department of Surgery, University of Helsinki, Helsinki, Finland.
    Arola, Johanna
    Department of Pathology, HUSLAB, University of Helsinki, Helsinki, Finland.
    Ruskeepää, Anna-Liisa
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Yki-Järvinen, Hannele
    Department of Medicine, Division of Diabetes, , Helsinki, Finland.
    Oresic, Matej
    Örebro University, School of Medical Sciences. VTT Technical Research Centre of Finland, Espoo, Finland.
    Comparison of lipid and fatty acid composition of the liver, subcutaneous and intra-abdominal adipose tissue, and serum2010In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 18, no 5, p. 937-944Article in journal (Refereed)
    Abstract [en]

    Ceramides may mediate saturated fat-induced insulin resistance, but there are no data comparing ceramide concentrations between human tissues. We therefore performed lipidomic analysis of human subcutaneous (SCfat) and intra-abdominal (IAfat) adipose tissue, the liver, and serum in eight subjects. The liver contained (nmol/mg tissue) significantly more ceramides (1.5-3-fold), sphingomyelins (7-8-fold), phosphatidylethanolamines (10-11-fold), lysophosphatidylcholines (7-12-fold), less ether-linked phosphatidylcholines (2-2.5-fold) but similar amounts of diacylglycerols as compared to SCfat and IAfat. The amounts of ceramides and their synthetic precursors, such as palmitic (16:0) free fatty acids and sphingomyelins, differed considerably between the tissues. The liver contained proportionally more palmitic, stearic (18:0), and long polyunsaturated fatty acids than adipose tissues. Stearoyl-CoA desaturase 1 (SCD1) activity reflected by serum, estimated from the 16:1/16:0-ratio, was closely related to that in the liver (r = 0.86, P = 0.024) but not adipose tissues. This was also true for estimated elongase (18:1/16:1, r = 0.89, P = 0.01), and Delta5 (20:4/20:3, r = 0.89, P = 0.012) and Delta6 (18:3[n-6]/18:2, r = 1.0, P < 0.001) desaturase activities. We conclude that the human liver contains higher concentrations of ceramides and saturated free fatty acids than either SCfat or IAfat.

  • 4. Mattsson, Cecilia
    et al.
    Rask, Eva
    Carlström, Kjell
    Andersson, Jonas
    Eliasson, Mats
    Ahrén, Bo
    Söderberg, Stefan
    Olsson, Tommy
    Gender-specific links between hepatic 11beta reduction of cortisone and adipokines2007In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 15, no 4, p. 887-94Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Reduction of cortisone to cortisol is mediated by 11beta-hydroxysteroid dehydrogenase type 1 (11betaHSD1), a putative key enzyme in obesity-related complications. Experimental studies suggest that adipokines, notably leptin and tumor necrosis factor-alpha (TNF-alpha), are of importance for 11betaHSD1 activity. We hypothesized that the regulation of hepatic preceptor glucocorticoid metabolism is gender-specific and associated with circulating levels of leptin and TNF-alpha receptors and/or sex hormones.

    RESEARCH METHODS AND PROCEDURES: A total of 34 males and 38 women (14 premenopausal and 22 postmenopausal) underwent physical examination and fasting blood sampling. Insulin sensitivity was tested by euglycemic hyperinsulinemic clamps, and hepatic 11betaHSD1 enzyme activity was estimated by the conversion of orally-ingested cortisone to cortisol.

    RESULTS: Hepatic 11betaHSD1 activity was negatively associated with leptin and soluble TNF (sTNF) r1 and sTNFr2 in males. These correlations remained significant after adjustment for age and insulin sensitivity, and for sTNF-alpha receptors also after adjustment of BMI and waist circumference. In contrast, 11beta reduction of cortisone was positively associated to leptin in females after adjustment for BMI and waist circumference.

    DISCUSSION: Hepatic 11beta reduction shows different links to circulating adipocyte-derived hormones in males and females. This emphasizes the need for further studies on tissue-specific regulation of 11betaHSD1 in both genders.

  • 5.
    Roos, Vendela
    et al.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Rönn, Monika
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Salihovic, Samira
    Örebro University, School of Science and Technology.
    Lind, Lars
    Department of Medicine, Uppsala University, Uppsala, Sweden.
    van Bavel, Bert
    Örebro University, School of Science and Technology.
    Kullberg, Joel
    Department of Oncology, Radiology and Clinical Immunology, Uppsala University, Uppsala, Sweden.
    Johansson, Lars
    Dept Oncol Radiol & Clin Immunol, Uppsala, Sweden; Department of Oncology, Radiology and Clinical Immunology, Uppsala University, Uppsala, Sweden.
    Ahlström, Håkan
    Department of Oncology, Radiology and Clinical Immunology, Uppsala University, Uppsala, Sweden.
    Lind, P. Monica
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Circulating Levels of Persistent Organic Pollutants in Relation to Visceral and Subcutaneous Adipose Tissue by Abdominal MRI2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, no 2, p. 413-418Article in journal (Refereed)
    Abstract [en]

    Objective: We and others have shown relationships between circulating levels of persistent organic pollutants (POPs) and different measures of obesity in both cross-sectional and prospective studies. Since viscerally located fat seems to be the most harmful type, we investigated whether plasma POP levels were more closely related to visceral adipose tissue (VAT) than to subcutaneous adipose tissue (SAT).

    Design and Methods: Thousand hundred and sixteen subjects aged 70 years were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study; 23 POPs were analyzed using high-resolution gas chromatography/ high-resolution mass spectrometry. Abdominal magnetic resonance imaging, measuring VAT and SAT, respectively, was performed in a representative subsample of 287 subjects.

    Results: The less chlorinated polychlorinated biphenyl (PCB) congeners (105 and 118), and the pesticides dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), and trans-nonachlordane (TNC) were positively related to both VAT and SAT, whereas the more highly chlorinated PCBs (153, 156, 157, 169, 170, 180, 194, 206, and 209) were inversely related to both VAT and SAT. PCB189 was related to the VAT/SAT ratio in an inverted U-shaped manner (P = 0.0008).

    Conclusions: In conclusion, the results were in accordance with our previous studies using waist circumference and fat mass as obesity measure. However, the novel finding that PCB189 was related to the VAT/SAT ratio deserves further investigation since exposure to this PCB congener, which has previously been linked to diabetes development, might thereby play a role in the distribution of abdominal adipose tissue.

  • 6.
    Silventoinen, Karri
    et al.
    Department of Social Research, University of Helsinki, Helsinki, Finland; Graduate School of Medicine, Osaka University, Osaka, Japan.
    Tuvblad, Catherine
    Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, Los Angeles, California, USA.
    Kaprio, Jaakko
    Department of Public Health, University of Helsinki, Helsinki, Finland; Institute for Molecular Medicine Finland, Helsinki, Finland .
    Parental Education and Genetics of BMI from Infancy to Old Age: A Pooled Analysis of 29 Twin Cohorts2019In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 27, no 5, p. 855-865Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this study was to analyze how parental education modifies the genetic and environmental variances of BMI from infancy to old age in three geographic-cultural regions.

    METHODS: A pooled sample of 29 cohorts including 143,499 twin individuals with information on parental education and BMI from age 1 to 79 years (299,201 BMI measures) was analyzed by genetic twin modeling.

    RESULTS: Until 4 years of age, parental education was not consistently associated with BMI. Thereafter, higher parental education level was associated with lower BMI in males and females. Total and additive genetic variances of BMI were smaller in the offspring of highly educated parents than in those whose parents had low education levels. Especially in North American and Australian children, environmental factors shared by co-twins also contributed to the higher BMI variation in the low education level category. In Europe and East Asia, the associations of parental education with mean BMI and BMI variance were weaker than in North America and Australia.

    CONCLUSIONS: Lower parental education level is associated with higher mean BMI and larger genetic variance of BMI after early childhood, especially in the obesogenic macro-environment. The interplay among genetic predisposition, childhood social environment, and macro-social context is important for socioeconomic differences in BMI.

  • 7.
    Simonyte, Kotryna
    et al.
    Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden.
    Rask, Eva
    Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Näslund, Ingmar
    Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Angelhed, Jan-Erik
    Department of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Lönn, Lars
    Department of Radiology and Vascular Surgery, Faculty of Health Sciences, Rigshospital, Copenhagen, Denmark.
    Olsson, Tommy
    Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden.
    Mattsson, Cecilia
    Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden.
    Obesity is accompanied by disturbances in peripheral glucocorticoid metabolism and changes in FA recycling2009In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 17, no 11, p. 1982-7Article in journal (Refereed)
    Abstract [en]

    The glucocorticoid activating enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11betaHSD1) is of major interest in obesity-related morbidity. Alterations in tissue-specific cortisol levels may influence lipogenetic and gluco/glyceroneogenetic pathways in fat and liver. We analyzed the expression and activity of 11betaHSD1 as well as the expression of phosphoenolpyruvate carboxykinase (PEPCK), sterol regulatory element binding protein (SREBP), and fatty acid synthase (FAS) in adipose and liver and investigated putative associations between 11betaHSD1 and energy metabolism genes. A total of 33 obese women (mean BMI 44.6) undergoing gastric bypass surgery were enrolled. Subcutaneous adipose tissue (SAT), omental fat (omental adipose tissue (OmAT)), and liver biopsies were collected during the surgery. 11betaHSD1 gene expression was higher in SAT vs. OmAT (P = 0.013), whereas the activity was higher in OmAT (P = 0.009). The SAT 11betaHSD1 correlated with waist circumference (P = 0.045) and was an independent predictor for the OmAT area in a linear regression model. Energy metabolism genes had AT depot-specific expression; higher leptin and SREBP in SAT than OmAT, but higher PEPCK in OmAT than SAT. The expression of 11betaHSD1 correlated with PEPCK in both AT depots (P = 0.05 for SAT and P = 0.0001 for OmAT). Hepatic 11betaHSD1 activity correlated negatively with abdominal adipose area (P = 0.002) and expression positively with PEPCK (P = 0.003). In human obesity, glucocorticoid regeneration in the SAT is associated with central fat accumulation indicating that the importance of this specific fat depot is underestimated. Central fat accumulation is negatively associated with hepatic 11betaHSD1 activity. A disturbance in peripheral glucocorticoid metabolism is associated with changes in genes involved in fatty acid (FA) recycling in adipose tissue (AT).

  • 8.
    Svensson, Per-Arne
    et al.
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Anveden, Asa
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Romeo, Stefano
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Peltonen, Markku
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Ahlin, Sofie
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Burza, Maria Antonella
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Carlsson, Bjorn
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Jacobson, Peter
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Lindroos, Anna-Karin
    Food Data Div, Natl Food Agcy, Uppsala, Sweden.
    Lonroth, Hans
    Inst Clin Sci, Dept Surg, Sahlgrenska Acad, Gothenburg Univ, Gothenburg, Sweden.
    Maglio, Cristina
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Dept Surg.
    Sjoholm, Kajsa
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Wedel, Hans
    Nordic School of Public Health, Gothenburg, Sweden.
    Soderpalm, Bo
    Inst Neurosci & Physiol, Sahlgrenska Acad, Gothenburg Univ, Gothenburg, Sweden.
    Sjostrom, Lars
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Carlsson, Lena M. S.
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Alcohol consumption and alcohol problems after bariatric surgery in the swedish obese subjects study2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, no 12, p. 2444-2451Article in journal (Refereed)
    Abstract [en]

    Objective Increased sensitivity to alcohol after gastric bypass has been described. The aim of this study was to investigate whether bariatric surgery is associated with alcohol problems. Design and Methods The prospective, controlled Swedish Obese Subjects (SOS) study enrolled 2,010 obese patients who underwent bariatric surgery (68% vertical banded gastroplasty (VBG), 19% banding, and 13% gastric bypass) and 2,037 matched controls. Patients were recruited between 1987 and 2001. Data on alcohol abuse diagnoses, self-reported alcohol consumption, and alcohol problems were obtained from the National Patient Register and questionnaires. Follow-up time was 8-22 years. Results During follow-up, 93.1% of the surgery patients and 96.0% of the controls reported alcohol consumption classified as low risk by the World Health Organization (WHO). However, compared to controls, the gastric bypass group had increased risk of alcohol abuse diagnoses (adjusted hazard ratio [adjHR] = 4.97), alcohol consumption at least at the WHO medium risk level (adjHR = 2.69), and alcohol problems (adjHR = 5.91). VBG increased the risk of these conditions with adjHRs of 2.23, 1.52, and 2.30, respectively, while banding was not different from controls. Conclusions Alcohol consumption, alcohol problems, and alcohol abuse are increased after gastric bypass and VBG.

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