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Aims: We describe a 22-year prospective observational population-based study that determined the prevalence and incidence of type 2 diabetes (T2D) and intermediate hyperglycaemia (IH), obesity, hypertension, and disorders of lipid metabolism in a middle-age population in the Finnish municipality of Savitaipale.Methods: 1151 people participated in the baseline survey in 1996-1999, following two follow-up examinations, in 2007-2008 and 2018-2019. Follow-up studies comprised clinical measurements, 2-h oral glucose tolerance test and other biochemistry, questionnaires, and registry data.Results: The prevalence of T2D quadrupled to 27% and the proportion of normoglycemic people decreased from 73% to 44% while IH increased only slightly during the 22-year follow-up. A large proportion of people who died between the surveys were diabetic. The mean body mass index (BMI) did not, whereas mean waist circumference increased significantly, by 5-6 cm (P = 0.001) during the 22 years. Systolic blood pressure increased by 13-15 mmHg from baseline (P = 0.0001) but diastolic blood pressure did not. The mean plasma levels of total and LDL-cholesterol decreased 10.8% and 8.9% in women (P = 0.001), 21.5% and 22.2% in men (P = 0.001), respectively, while HDL-cholesterol and triglycerides remained stable. The proportion of those achieving targets in the treatment of dyslipidaemia increased significantly (P < 0.001).Conclusions: In this 22-year prospective follow-up study of in middle-aged Europeans with high participation rates, the progression of dysglycaemia to overt diabetes with aging was rapid, even without a significant change in BMI. [ABSTRACT FROM AUTHOR]

Aims: Was to determine whether the birth weight of the infant predicts prediabetes (impaired fasting glucose, impaired glucose tolerance, or both) and type 2 diabetes (T2DM) during long-term follow-up of women with or without gestational diabetes mellitus (GDM).Methods: The women with or without GDM during their pregnancies in Kuopio University Hospital in 1989-2009 (n=876) were contacted and invited for an evaluation. They were stratified into two groups according to the newborn's birth weight: 10-90th percentile (appropriate-for-gestational-age; AGA) (n=662) and >90th percentile (large-for-gestational-age; LGA) (n=116). Glucose tolerance was investigated with an oral glucose tolerance test after a mean follow-up time of 7.3 (SD 5.1) years.Results: The incidence of T2DM was 11.8% and 0% in the women with and without GDM, respectively, after an LGA delivery. The incidence of prediabetes increased with offspring birth weight categories in the women with and without GDM: from 46.3% and 26.2% (AGA) to 52.9% and 29.2% (LGA), respectively.Conclusions: GDM women with LGA infants are at an increased risk for subsequent development of T2DM and therefore represent a target group for intervention to delay or prevent T2DM development. In contrast, an LGA delivery without GDM does not increase T2DM risk. [ABSTRACT FROM AUTHOR]

Background: The significance of erythrocyte membrane fatty acids (EMFAs) and their ratios to predict hyperglycemia and incident type 2 diabetes is unclear. Objective: We investigated EMFAs as predictors of the worsening of hyperglycemia and incident type 2 diabetes in a 5-y follow-up of a population-based study. Design: We measured EMFAs in 1346 Finnish men aged 45-73 y at baseline [mean ± SD age: 55 ± 6 y; body mass index (in kg/m2): 26.5 ± 3.5]. Our prospective follow-up study included only men who were nondiabetic at baseline and who had data available at the 5-y follow-up visit (n = 735). Results: Our study showed that, after adjustment for confounding factors, palmitoleic acid (16:1n-7; P = 2.8 × 10-7), dihomog- linolenic acid (20:3n-6; P = 2.3 × 10-4), the ratio of 16:1n-7 to 16:0 (P = 1.6 × 10-8) as a marker of stearoyl coenzyme A desaturase 1 activity, and the ratio of 20:3n-6 to 18:2n-6 (P = 9.4 × 10-9) as a marker of Δ6-desaturase activity significantly predicted the worsening of hyperglycemia (glucose area under the curve in an oral-glucose-tolerance test). In contrast, linoleic acid (18:2n-6; P = 0.0015) and the ratio of 18:1n-7 to 16:1n-7 (P = 1.5 × 10-9) as a marker of elongase activity had opposite associations. Statistical significance persisted even after adjustment for baseline insulin sensitivity, insulin secretion, and glycemia. Palmitoleic acid (P = 0.010) and the ratio of 16:1n-7 to 16:0 (P = 0.004) nominally predicted incident type 2 diabetes, whereas linoleic acid had an opposite association (P = 0.004), and n23 polyunsaturated fatty acids did not show any associations. Conclusion: EMFAs and their ratios are associated longitudinally with changes in glycemia and the risk type 2 diabetes [ABSTRACT FROM AUTHOR]

Abstract: Aims: A population-based study of 1046 young Finnish men was performed to evaluate whether body composition changes observed during military service are associated with a reduction in prevalence of metabolic syndrome (MetS), and whether the effect is body mass index (BMI)-dependent. Methods: A prospective study of 1046 men (mean age 19.2 years, SD 1.0), with follow-up during 6–12 months of military service in northern Finland. Anthropometry, body composition, biochemical measurements and physical fitness were assessed at baseline and follow-up. MetS was defined using the International Diabetes Federations (IDF) criterion, continuous MetS Z-score calculated, and changes evaluated in BMI categories. Results: Prevalence of MetS at baseline and follow-up was 6.1% and 3.6%, respectively (p <0.001). Prevalence of MetS decreased by 40% (p <0.001) among the obese young men (BMI≥30kg/m2). Reduction in the MetS Z-score was mainly attributable to weight loss and reduced fat mass (p <0.001) and improvement in physical fitness (muscle fitness index, p =0.016). Conclusions: Beneficial exercise-induced changes in body composition significantly reduced the prevalence of MetS among young, obese men. Our findings support the efficacy of increased physical activity for prevention of early-onset cardiovascular disease, particularly among overweight and obese young men. [Copyright &y& Elsevier]

Abstract: Objective: Physical activity is a key component of lifestyle intervention but its independent contribution to weight loss and prevention of cardiovascular disease (CVD) remains unclear. We conducted a population-level follow-up study among young healthy Finnish men undergoing an intensive exercise intervention to examine the independent contribution of exercise to common CVD risk factors. Methods: A prospective study of 1112 young men with mean age of 19.3 years (range 19–28) undergoing military service with structured exercise training program. Endurance (12-min running test) and muscle fitness performance (MFI), body composition, blood pressure and biochemical measurements were obtained at baseline and follow-up (range 6–12months). Results: Both endurance performance and MFI improved during follow-up (+170m (SD 269) and 1.5 points (2.3), respectively, p <0.001 for both). Both improvement in endurance and MFI performance correlated with a reduction in weight, body mass index, waist circumference, fat mass and percentage, visceral fat area (VFA) and diastolic blood pressure (p <0.001 for all). Improvement in endurance performance also correlated with reduction in systolic blood pressure (p =0.042), total and LDL cholesterol (p =0.024 and p <0.0001, respectively) and improvement in MFI with a reduction in triglyceride levels (p =0.012). The 12-min running test correlated with changes in CVD risk factors better than did MFI. Associations between improved exercise performance and reduction in blood pressure, and changes in lipid levels were attributable to reduced weight and VFA. Conclusion: We observed that an isolated, intensive exercise intervention, especially endurance training, significantly improved CVD risk factor levels, attributable to weight loss and reduced visceral fat area. [Copyright &y& Elsevier]

Abstract: Aims: To study screening of high-risk individuals as part of a national diabetes prevention programme in primary health care settings in Finland between 2003 and 2007, and evaluate the cardiometabolic risk profile of persons identified for intervention. Methods: High-risk individuals were identified by the Finnish Diabetes Risk Score (FINDRISC), history of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), cardiovascular disease (CVD), or gestational diabetes. Participants subsequently underwent an oral glucose tolerance test. CVD morbidity risk was estimated by the Framingham Study Risk Equation and CVD mortality risk by the Systematic Coronary Risk Evaluation Formula (SCORE). Results: A high-risk cohort of 10,149 (of whom 30.3% men) was identified (mean age 54.7 for men, 53.0 for women). Altogether 18.8% of men and 11.5% of women had screen-detected diabetes. In total 68.1% of men and 49.4% of women had abnormal glucose tolerance (IFG, IGT or screen-detected diabetes). Furthermore, 43.2% and 41.5% of men, and 13.3% and 11.3% of women, respectively, had a high predicted risk of CVD morbidity or mortality. Conclusion: Prevalence of dysglycemia including undiagnosed diabetes and the predicted risk for CVD was alarmly high in the identified high-risk cohort, particularly in men. [ABSTRACT FROM AUTHOR]