50 results on '"Jens Kristoffer Hertel"'
Search Results
2. Differential effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) and fatty acids
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Kirsten A. Berk, Heidi Borgeraas, Ingunn Narverud, Monique T. Mulder, Linn K. L. Øyri, Adrie J. M. Verhoeven, Milada Cvancarova Småstuen, Martin P. Bogsrud, Torbjørn Omland, Jens Kristoffer Hertel, Espen Gjevestad, Njord Nordstrand, Kirsten B. Holven, and Jøran Hjelmesæth
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Lp(a) ,Fatty acids ,Obesity ,Bariatric surgery ,Lifestyle intervention ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background Limited evidence suggests that surgical and non-surgical obesity treatment differentially influence plasma Lipoprotein (a) [Lp(a)] levels. Further, a novel association between plasma arachidonic acid and Lp(a) has recently been shown, suggesting that fatty acids are a possible target to influence Lp(a). Here, the effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) were compared, and it was examined whether the effects were mediated by changes in plasma fatty acid (FA) levels. Methods The study includes two independent trials of patients with overweight or obesity. Trial 1: Two-armed intervention study including 82 patients who underwent a 7-week low energy diet (LED), followed by Roux-en-Y gastric bypass and 52-week follow-up (surgery-group), and 77 patients who underwent a 59-week energy restricted diet- and exercise-program (lifestyle-group). Trial 2: A clinical study including 134 patients who underwent a 20-week very-LED/LED (lifestyle-cohort). Results In the surgery-group, Lp(a) levels [median (interquartile range)] tended to increase in the pre-surgical LED-phase [17(7–68)-21(7–81)nmol/L, P = 0.05], but decreased by 48% after surgery [21(7–81)—11(7–56)nmol/L, P
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- 2022
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3. Association between hepatic steatosis and fibrosis with measures of insulin sensitivity in patients with severe obesity and type 2 diabetes - a cross-sectional study
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Kathrine Aglen Seeberg, Dag Hofsø, Heidi Borgeraas, John Olav Grimnes, Farhat Fatima, Lars Thomas Seeberg, Nils Petter Kvan, Marius Svanevik, Jens Kristoffer Hertel, and Jøran Hjelmesæth
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Severe obesity ,Type 2 diabetes mellitus ,Hepatic steatosis ,Liver fibrosis ,Insulin sensitivity ,Liver fat fraction ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Obesity, non-alcoholic fatty liver disease (NAFLD) and insulin resistance are three pathological conditions highly correlated, but this relationship is not fully elucidated. Hence, we aimed to assess the association of hepatic steatosis and fibrosis with different measures of insulin sensitivity in patients with severe obesity and type 2 diabetes mellitus (T2DM). Methods A cross-sectional study (Oseberg trial) including patients with T2DM referred for bariatric surgery at Vestfold Hospital Trust, Norway. Magnetic resonance imaging (MRI) and the enhanced liver fibrosis (ELF) test was used for estimation of liver fat fraction (LFF) and degree of fibrosis, respectively. Oral and intravenous glucose tolerance tests were applied for estimation of insulin sensitivity (HOMA2S, Matsuda ISI and MinMod SI). Results A total of 100 patients (mean [SD] age 47.5 [9.7] years, 65% women, BMI 42.0 [5.3] kg/m2 and 98% with metabolic syndrome) were included in the analyses. The mean (SD) LFF in the total population was 19.1 (11.5), and the mean (SD) ELF score was 8.46 (0.84), a value representing moderate fibrosis. LFF was inversely associated with HOMA2S and Matsuda ISI, and both measures were significantly higher in the no or low-grade steatosis group compared with the medium-to-high grade steatosis group (mean difference [95% CI] 5.9 [2.2-9.6]%, Cohen’s d = 0.75), and (0.7 [0.3-1.1], Cohen’s d = 0.80, respectively). There was no association between LFF, as a categorical or continuous variable, and MinMod SI. The proportions of patients with none to mild fibrosis, moderate fibrosis and severe fibrosis were 14, 78 and 6%, respectively, and there were no significant associations between level of fibrosis and measures of insulin sensitivity. Conclusions Patients with morbid obesity and T2DM demonstrated high levels of liver fat fraction, and we showed that hepatic steatosis, but not the degree of liver fibrosis, was associated with different measures of insulin sensitivity in patients with severe obesity and T2DM. Further, our results might indicate that the LFF is primarily associated with hepatic, and not peripheral insulin sensitivity. To improve the diagnosis of NAFLD and the prediction of its progression, more studies are needed to reveal the pathological mechanistic pathways involved in NAFLD and insulin sensitivity. Trial registration ClinicalTrials.gov: NCT01778738
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- 2022
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4. Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial
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Jarle Berge, Jøran Hjelmesæth, Ronette L. Kolotkin, Øyvind Støren, Solfrid Bratland-Sanda, Jens Kristoffer Hertel, Espen Gjevestad, Milada Cvancarova Småstuen, Jan Helgerud, and Tomm Bernklev
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VO2max ,Health-related quality of life ,Severe obesity ,Aerobic exercise ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Aerobic exercise is an important part of obesity treatment and may improve health-related quality of life (HRQOL). The objective of this study was to compare the effect of two different exercise programs on health-related quality of life in patients with severe obesity. Methods This was a single-center, open-label, randomized, parallel-group study comparing the effects of a 24-week moderate-intensity continuous training (MICT) program and a combined high-intensity interval training program with MICT (HIIT/MICT). The primary objective (specified secondary outcome) was to assess HRQOL by using the general health dimension of the Short Form Health Survey (SF-36). The secondary objectives were to assess other dimensional SF-36 scores, the impact of weight on the physical and psychosocial aspects of quality of life (IWQOL-Lite), and the burden of obesity-specific weight symptoms (WRSM). Results 73 patients were enrolled and reported patient reported outcome measures, with 71 patients (55% females) allocated to either MICT (n = 34) or HIIT/MICT (n = 37). In the intention-to-treat analysis, general health scores increased between baseline and 24-week follow-up in both the HIIT/MICT group and the MICT group, with a mean change of 13 (95% CI 6–21) points and 11 (95% CI 5–17) points, respectively, with no difference between the groups. The effect sizes of these changes were moderate. The vitality and social functioning scores of SF-36, and the physical function and self-esteem scores of IWQOL-Lite increased moderately in both groups, with no difference between groups. The tiredness, back pain, and physical stamina scores based on WRSM showed moderate to strong changes in both the groups. Conclusions Patients who had completed a combined HIIT/MICT program did not experience larger improvements in general health compared with those completing a clean 24-week MICT program. Exercise may confer general health benefits independent of intensity. Trials registration Regional Committees for Medical and Health Research Ethics south east, Norway, October 23, 2013 (identifier: 2013/1849) and ClinicalTrials.gov December 8, 2014 (identifier: NCT02311738).
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- 2022
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5. Influence of asthma and obesity on respiratory symptoms, work ability and lung function: findings from a cross-sectional Norwegian population study
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Anne Kristin Møller Fell, Jens Kristoffer Hertel, Johny Kongerud, Geir Klepaker, Paul Keefer Henneberger, and Øystein Lunde Holla
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Medicine ,Diseases of the respiratory system ,RC705-779 - Published
- 2021
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6. Association between Body Mass Index, Asymmetric Dimethylarginine and Risk of Cardiovascular Events and Mortality in Norwegian Patients with Suspected Stable Angina Pectoris.
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Heidi Borgeraas, Jens Kristoffer Hertel, Gard Frodahl Tveitevåg Svingen, Eva Ringdal Pedersen, Reinhard Seifert, Ottar Nygård, and Jøran Hjelmesæth
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Medicine ,Science - Abstract
BackgroundAsymmetric dimethylarginine (ADMA) is associated with increased risk of atherosclerotic cardiovascular disease and mortality through inhibition of nitrogen oxide (NO) synthesis. As positive correlations between serum concentrations of NO and body mass index (BMI) have been observed, we aimed to explore whether the potential associations between plasma ADMA levels and the risk of acute myocardial infarction (AMI) and mortality were modified by BMI.MethodsMultivariable Cox proportional hazard models were used to estimate the hazard ratios (HR) for AMI, cardiovascular death and all-cause mortality according to baseline plasma ADMA levels in 4122 patients with suspected stable angina pectoris. Analyses were subsequently repeated in patients with BMI below (low BMI) or above (high BMI) median.ResultsA total of 2982 patients (72%) were men. Median (range) age, plasma ADMA level and BMI were 62 (21-88) years, 0.54 (0.10-1.25) μmol/L and 26.3 (18.5-54.3) kg/m2, respectively. During a mean (standard deviation) follow-up time of 4.7 (1.4) years, 337 (8%) patients suffered from an AMI, 300 (7%) died, whereof 165 (55%) due to cardiovascular disease. Each 0.1 μmol/L increment in plasma ADMA level was associated with an increased risk of AMI (HR (95% CI) 1.21 (1.08, 1.35) and cardiovascular death 1.30 (1.13, 1.49) in participants with low BMI only. Interactions were significant for AMI (p = 0.04) and CV death (p = 0.03). BMI did not modify the association between plasma ADMA levels and all-cause mortality.ConclusionPlasma ADMA levels were associated with risk of AMI and cardiovascular death among patients with low BMI only.
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- 2016
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7. Gastric Bypass Versus Sleeve Gastrectomy in Type 2 Diabetes: Effects on Hepatic Steatosis and Fibrosis
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Rune Sandbu, Nils Petter Kvan, Dag Hofsø, John Olav Grimnes, Jens Kristoffer Hertel, Heidi Borgeraas, Morten Lindberg, Lars Thomas Seeberg, Farhat Fatima, Jøran Hjelmesæth, Milada Cvancarova Småstuen, and Kathrine Aglen Seeberg
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Liver Cirrhosis ,Male ,medicine.medical_specialty ,Sleeve gastrectomy ,medicine.medical_treatment ,Gastric Bypass ,Type 2 diabetes ,Gastroenterology ,law.invention ,Randomized controlled trial ,Gastrectomy ,Fibrosis ,law ,Weight loss ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Norway ,business.industry ,Fatty liver ,nutritional and metabolic diseases ,General Medicine ,Middle Aged ,medicine.disease ,Obesity, Morbid ,Fatty Liver ,Diabetes Mellitus, Type 2 ,Female ,Steatosis ,medicine.symptom ,business ,Body mass index - Abstract
Background Weight loss improves fatty liver disease. No randomized trial has compared the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on liver fat content and fibrosis. Objective To compare the 1-year effects of SG and RYGB on hepatic steatosis and fibrosis. Design Single-center, randomized, controlled trial (Oseberg [ObesitySurgery in Tonsberg]). (ClinicalTrials.gov: NCT01778738). Setting Tertiary care obesity center in Norway. Participants 100 patients (65% female; mean age, 47.5 years; mean body mass index, 42 kg/m2) with type 2 diabetes mellitus (T2DM). Intervention From January 2013 to February 2018, patients were randomly assigned (1:1 ratio) to SG or RYGB. Measurements The primary outcome was remission of T2DM (previously published). Predefined secondary outcomes in the present study were hepatic steatosis and fibrosis assessed by magnetic resonance imaging (liver fat fraction), enhanced liver fibrosis (ELF) test, noninvasive indices, and liver enzymes. Results Liver fat fraction declined similarly after SG (-19.7% [95% CI, -22.5% to -16.9%]) and RYGB (-21.5% [CI, -24.3% to -18.6%]) from surgery to 1-year follow-up, and almost all patients (SG, 94%; RYGB, 100%) had no or low-grade steatosis at 1 year. The ELF score category remained stable in 77% of patients, but 18% experienced worsening of fibrosis at 1 year, with no substantial between-group difference. Limitations Single-center study, short follow-up time, and lack of power for secondary outcomes. Conclusion With an almost complete clearance of liver fat 1 year after surgery, RYGB and SG were both highly effective in reducing hepatic steatosis. Bariatric surgery had less influence on degree of fibrosis in the short term, but assessment of long-term progression is warranted. Primary funding source Vestfold Hospital Trust and the South-Eastern Norway Regional Health Authority.
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- 2022
8. Serglycin Is Involved in Adipose Tissue Inflammation in Obesity
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Atanaska I. Doncheva, Frode A. Norheim, Marit Hjorth, Mirjana Grujic, Aida Paivandy, Simon N. Dankel, Jens Kristoffer Hertel, Tone G. Valderhaug, Yvonne Böttcher, Johan Fernø, Gunnar Mellgren, Knut T. Dalen, Gunnar Pejler, and Svein O. Kolset
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Inflammation ,Mice, Knockout ,Macrophages ,Immunology ,Vesicular Transport Proteins ,Diet, High-Fat ,Mice, Inbred C57BL ,Disease Models, Animal ,Mice ,Gene Expression Regulation ,Weight Loss ,Adipocytes ,Animals ,Humans ,Immunology and Allergy ,Proteoglycans ,Obesity ,RNA, Messenger - Abstract
Chronic local inflammation of adipose tissue is an important feature of obesity. Serglycin is a proteoglycan highly expressed by various immune cell types known to infiltrate adipose tissue under obese conditions. To investigate if serglycin expression has an impact on diet-induced adipose tissue inflammation, we subjected Srgn+/+ and Srgn−/− mice (C57BL/6J genetic background) to an 8-wk high-fat and high-sucrose diet. The total body weight was the same in Srgn+/+ and Srgn−/− mice after diet treatment. Expression of white adipose tissue genes linked to inflammatory pathways were lower in Srgn−/− mice. We also noted reduced total macrophage abundance, a reduced proportion of proinflammatory M1 macrophages, and reduced formation of crown-like structures in adipose tissue of Srgn−/− compared with Srgn+/+ mice. Further, Srgn−/− mice had more medium-sized adipocytes and fewer large adipocytes. Differentiation of preadipocytes into adipocytes (3T3-L1) was accompanied by reduced Srgn mRNA expression. In line with this, analysis of single-cell RNA sequencing data from mouse and human adipose tissue supports that Srgn mRNA is predominantly expressed by various immune cells, with low expression in adipocytes. Srgn mRNA expression was higher in obese compared with lean humans and mice, accompanied by an increased expression of immune cell gene markers. SRGN and inflammatory marker mRNA expression was reduced upon substantial weight loss in patients after bariatric surgery. Taken together, this study introduces a role for serglycin in the regulation of obesity-induced adipose inflammation.
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- 2022
9. Addendum to: Comparison of the effect of Roux‐en‐Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials
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Heidi Borgeraas, Dag Hofsø, Jens Kristoffer Hertel, and Jøran Hjelmesæth
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Treatment Outcome ,Diabetes Mellitus, Type 2 ,Gastrectomy ,Endocrinology, Diabetes and Metabolism ,Public Health, Environmental and Occupational Health ,Gastric Bypass ,Humans ,Letters to the Editor ,Obesity, Morbid ,Randomized Controlled Trials as Topic - Abstract
Bariatric surgery is an effective treatment option for patients with type 2 diabetes mellitus (T2DM) and obesity. This study aims to compare the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on remission of T2DM. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for studies published between database inception and 21 November 2019. A meta-analysis, using a random effects model, was performed to calculate relative risk (RR) of T2DM remission between the groups in randomized controlled trials (RCTs). Of 2650 records identified, 12 records from 10 different RCTs were finally included. The studies comprised 705 patients with follow-up from 1 to 5 years. The remission rate of T2DM at 1 year was higher among those undergoing RYGB (156/276, 57%) compared with those undergoing SG (128/275, 47%), RR (95% CI) 1.20 (1.00-1.45), P = .047, I
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- 2022
10. Ernæringsrelatert dokumentasjon er mangelfull i journaler til eldre i ernæringsmessig risiko
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Lisa Mari Gaustadnes, Mari Hval Høyem, Marianne Molin, Asta Bye, Andreas Aarvik, Jens Kristoffer Hertel, and Jøran Hjelmesæth
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- 2020
11. Livsstilsendringskurs som fedmebehandling i spesialisthelsetjenesten – kvalitetssikring i praksis
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Lisa Ha Barstad, Randi Størdal Lund, Inger Marie Flakstad, Line Kristin Johnson, Andreas Aarvik, Jens Kristoffer Hertel, and Jøran Hjelmesæth
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- 2020
12. Erosive Esophagitis and Symptoms of Gastroesophageal Reflux Disease in Patients with Morbid Obesity with and without Type 2 Diabetes: a Cross-sectional Study
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Tor-Ivar Karlsen, Dag Hofsø, Rune Sandbu, Asle W. Medhus, Marius Svanevik, Jøran Hjelmesæth, Ronette L. Kolotkin, Jolanta Lorentzen, Birgitte Seip, Heidi Borgeraas, Daniel Sifrim, and Jens Kristoffer Hertel
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Adult ,medicine.medical_specialty ,endocrine system diseases ,Cross-sectional study ,Endocrinology, Diabetes and Metabolism ,Population ,030209 endocrinology & metabolism ,Type 2 diabetes ,Asymptomatic ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,education ,education.field_of_study ,Nutrition and Dietetics ,Norway ,business.industry ,Reflux ,nutritional and metabolic diseases ,Heartburn ,Middle Aged ,medicine.disease ,digestive system diseases ,Obesity, Morbid ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Gastroesophageal Reflux ,GERD ,Female ,030211 gastroenterology & hepatology ,Surgery ,medicine.symptom ,business ,Esophagitis - Abstract
Type 2 diabetes (T2DM) is associated with gastroesophageal reflux disease (GERD) in the general population, but the relationship between these conditions in candidates for bariatric surgery is uncertain. We compared the prevalence of GERD and the association between GERD symptoms and esophagitis among bariatric candidates with and without T2DM. Cross-sectional study of baseline data from the Oseberg study in Norway. Both groups underwent gastroduodenoscopy and completed validated questionnaires: Gastrointestinal Symptom Rating Scale and Gastroesophageal Reflux Disease Questionnaire. Participants with T2DM underwent 24-h pH-metry. A total of 124 patients with T2DM, 81 women, mean (SD) age 48.6 (9.4) years and BMI 42.3 (5.5) kg/m2, and 64 patients without T2DM, 46 women, age 43.0 (11.0) years and BMI 43.0 (5.0) kg/m2, were included. The proportions of patients reporting GERD-symptoms were low (
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- 2020
13. Validation of Ad-DiaRem and ABCD Diabetes Remission Prediction Scores at 1-Year After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in the Randomized Controlled Oseberg Trial
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Farhat Fatima, Jøran Hjelmesæth, Jens Kristoffer Hertel, Marius Svanevik, Rune Sandbu, Milada Cvancarova Småstuen, and Dag Hofsø
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Nutrition and Dietetics ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Gastrectomy ,Endocrinology, Diabetes and Metabolism ,Gastric Bypass ,Humans ,Surgery ,Obesity, Morbid ,Retrospective Studies - Abstract
Prediction of type 2 diabetes (T2DM) remission is an important part of risk-benefit assessment before bariatric surgery.Advanced-DiaRem (Ad-DiaRem) and ABCD diabetes remission scores for sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) were calculated using baseline data. Differences in model discrimination using area under the curve of receiver operating curve (AUC-ROC) and model calibration were tested for complete remission (HbA1c ≤ 6.0% without antidiabetic medications) in the two groups. Optimal cutoff scores were calculated using the Youden index.We randomized 109 patients to either SG or RYGB. With one patient lost to follow-up in each group, the scores were calculated for 54 patients in the SG group and 53 patients in the RYGB group. Both models showed moderate predictive power without any significant difference between the groups: AUC-ROCs (95% CI) for the Ad-DiaRem score (SG versus RYGB) were 0.872 (0.780-0.964) versus 0.843 (0.733-0.954), p = 0.69, and for the ABCD score 0.849 (0.752-0.946) versus 0.750 (0.580-0.920), p = 0.32, respectively. Using optimal cutoff points derived from the whole study population, the actual proportion of diabetes remission was significantly higher than predicted for both the Ad-DiaRem and ABCD scores in the RYGB group. Diabetes duration and glycated haemoglobin predicted diabetes remission in the entire Oseberg population.Both the Ad-DiaRem and ABCD scores showed moderate ability to discriminate between those who achieved remission of T2DM and those who did not after SG and RYGB. Larger studies are needed for the identification of procedure-specific optimal cutoffs. Trial Registration ClinicalTrials.gov Identifier: NCT01778738.
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- 2021
14. Effect of Aerobic Exercise Intensity on Energy Expenditure and Weight Loss in Severe Obesity-A Randomized Controlled Trial
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Line Kristin Johnson, Milada Cvancarova Småstuen, Eivind Andersen, Jan Helgerud, Catia Martins, Jarle Berge, Jøran Hjelmesæth, Øyvind Støren, Espen Svendsen Gjevestad, and Jens Kristoffer Hertel
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Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Interval training ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Randomized controlled trial ,Weight loss ,law ,Weight Loss ,Aerobic exercise ,Medicine ,Humans ,030212 general & internal medicine ,Exercise physiology ,Exercise ,Nutrition and Dietetics ,business.industry ,Cardiorespiratory fitness ,Original Articles ,medicine.disease ,Obesity ,Exercise Therapy ,Obesity, Morbid ,Basal metabolic rate ,Physical therapy ,Female ,Original Article ,Obesity Biology and Integrated Physiology ,medicine.symptom ,business ,Energy Metabolism - Abstract
Objective This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure. Methods This was a single‐center randomized controlled trial of patients with severe obesity allocated to a 24‐week moderate‐intensity continuous training (MICT) program or a combined MICT with high‐intensity interval training (HIIT/MICT) program. The primary outcome was energy expenditure during exercise (EEDE). Secondary outcomes included resting metabolic rate, cardiorespiratory fitness, and body composition. Results A total of 82 (56% females) patients were screened, and 71 (55% females) patients were allocated to HIIT/MICT (n = 37) or MICT (n = 34). Per‐protocol analysis showed that EEDE increased by 10% (95% CI: 3%‐17%) in the HIIT/MICT group (n = 16) and 7.5% (95% CI: 4%‐10%) in the MICT group (n = 24), with no differences between groups. In the 8‐ to 16‐ week per‐protocol analysis, the HIIT/MICT group had a significantly larger increase in EEDE compared with the MICT group. Resting metabolic rate remained unchanged in both groups. HIIT/MICT and MICT were associated with significant weight loss of 5 kg and 2 kg, respectively. Conclusions Patients completing a 24‐week combined HIIT/MICT program did not achieve a higher EEDE compared with those who completed a 24‐week MICT program. The HIIT/MICT group experienced, on average, a 3‐kg‐larger weight loss than the MICT group. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
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- 2021
15. A novel intragastric balloon for treatment of obesity and type 2 diabetes. A two-center pilot trial
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Christer Julseth Tønnesen, Asle W. Medhus, Tor Erik Mathisen, Magnus Løberg, Michael Bretthauer, Dag Hofsø, Lars Aabakken, Paulina Wieszczy, Jens Kristoffer Hertel, Eli Heggen, Line Kristin Johnson, Mette Kalager, Jøran Hjelmesæth, and Serena Tonstad
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medicine.medical_specialty ,Pilot Projects ,Type 2 diabetes ,Balloon ,Body Mass Index ,Weight loss ,Diabetes mellitus ,medicine ,Humans ,Obesity ,Adverse effect ,Gastric Balloon ,business.industry ,Gastroenterology ,Gastric outlet obstruction ,VDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710 ,medicine.disease ,VDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710 ,Surgery ,Obesity, Morbid ,Clinical trial ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Vomiting ,Feasibility Studies ,medicine.symptom ,business - Abstract
Background and aims: Obesity with type-2 diabetes is a global challenge. Lifestyle interventions have limited effect for most patients. Bariatric surgery is highly effective, but resource-demanding, invasive and associated with serious complications. Recently, a new intragastric balloon was introduced, not requiring endoscopy for placement or removal (Elipse™, Allurion Inc., Natick, MA). The balloon is swallowed in a capsule and filled with water once in the stomach. The balloon self-deflates after 4 months and is naturally excreted. The present trial investigated balloon feasibility, safety and efficacy in patients with obesity and type-2 diabetes. Patients and methods: We treated 19 patients, with type-2 diabetes and body mass index (BMI) of 30.0-39.9 kg/m2 at two Norwegian centers with the Elipse balloon. Patient follow-up during balloon treatment mimicked real-world clinical practice, including dietary plan and outpatient visits. The primary efficacy endpoints were total body weight loss (TBWL) and HbA1c at weeks 16 and 52. Results: All patients underwent balloon insertion uneventfully as out-patients. Mean TBWL and HbA1c reduction after 16 and 52 weeks of balloon insertion was 3.9% (95%CI 2.1-5.7) and 0.8% (95%CI 1.9-3.5); and 7 (95%CI 4-10), and 1 (95%CI -6 to 9) mmol/mol, respectively. Adverse events occurred in two patients (10.5%): one developed gastric outlet obstruction, managed by endoscopic balloon removal; the other excessive vomiting and dehydration, managed conservatively. Conclusions: This first Scandinavian real-world clinical trial with a new minimally invasive intragastric balloon system demonstrated good feasibility, but did not confirm expected efficacy for weight loss and diabetes control.
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- 2021
16. Sleeve gastrectomy confers higher risk of gastroesophageal reflux disease than gastric bypass. A Randomized Controlled Trial From the Oseberg Reflux Working Group
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Asle W. Medhus, Jolanta Lorentzen, Marius Svanevik, Birgitte Seip, Daniel Sifrim, Dag Hofsø, Rune Sandbu, Milada Cvancarova Småstuen, Jøran Hjelmesæth, Heidi Borgeraas, and Jens Kristoffer Hertel
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Sleeve gastrectomy ,medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Esophago gastro duodenoscopy ,Gastric bypass ,Gastroenterology ,Reflux ,Disease ,Type 2 diabetes ,medicine.disease ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,medicine ,business ,Esophagitis - Published
- 2021
17. Influence of asthma and obesity on respiratory symptoms, work ability and lung function: findings from a cross-sectional Norwegian population study
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Geir Klepaker, Øystein L. Holla, Anne Kristin Møller Fell, Paul K. Henneberger, Johny Kongerud, and Jens Kristoffer Hertel
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Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Vital capacity ,Work Capacity Evaluation ,Overweight ,FEV1/FVC ratio ,Diseases of the respiratory system ,Internal medicine ,medicine ,Humans ,Obesity ,Lung ,Asthma ,medicine.diagnostic_test ,RC705-779 ,business.industry ,asthma epidemiology ,medicine.disease ,respiratory tract diseases ,Cross-Sectional Studies ,Sick leave ,Medicine ,medicine.symptom ,business ,Body mass index - Abstract
BackgroundAlthough asthma and obesity are each associated with adverse respiratory outcomes, a possible interaction between them is less studied. This study assessed the extent to which asthma and overweight/obese status were independently associated with respiratory symptoms, lung function, Work Ability Score (WAS) and sick leave; and whether there was an interaction between asthma and body mass index (BMI) ≥25 kg/m2 regarding these outcomes.MethodsIn a cross-sectional study, 626 participants with physician-diagnosed asthma and 691 without asthma were examined. All participants completed a questionnaire and performed spirometry. The association of outcome variables with asthma and BMI category were assessed using regression models adjusted for age, sex, smoking status and education.ResultsAsthma was associated with reduced WAS (OR=1.9 (95% CI 1.4 to 2.5)), increased sick leave in the last 12 months (OR=1.4 (95% CI 1.1 to 1.8)) and increased symptom score (OR=7.3 (95% CI 5.5 to 9.7)). Obesity was associated with an increased symptom score (OR=1.7 (95% CI 1.2 to 2.4)). Asthma was associated with reduced prebronchodilator and postbronchodilator forced expiratory volume in 1 s (FEV1) (β=−6.6 (95% CI −8.2 to −5.1) and −5.2 (95% CI −6.7 to −3.4), respectively) and prebronchodilator forced vital capacity (FVC) (β=−2.3 (95% CI −3.6 to −0.96)). Obesity was associated with reduced prebronchodilator and postbronchodilator FEV1 (β=−2.9 (95% CI −5.1 to −0.7) and −2.8 (95% CI −4.9 to −0.7), respectively) and FVC (−5.2 (95% CI −7.0 to −3.4) and −4.2 (95% CI −6.1 to −2.3), respectively). The only significant interaction was between asthma and overweight status for prebronchodilator FVC (β=−3.6 (95% CI −6.6 to −0.6)).ConclusionsAsthma and obesity had independent associations with increased symptom scores, reduced prebronchodilator and postbronchodilator FEV1 and reduced prebronchodilator FVC. Reduced WAS and higher odds of sick leave in the last 12 months were associated with asthma, but not with increased BMI. Besides a possible association with reduced FVC, we found no interactions between asthma and increased BMI.
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- 2021
18. Laparoscopic gastric bypass versus lifestyle intervention for adolescents with morbid obesity
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Jøran, Hjelmesæth, Jens Kristoffer, Hertel, Ane Hjetland, Holt, Beate, Benestad, Lars Thomas, Seeberg, Morten, Lindberg, Erling, Halvorsen, Pétur Benedikt, Júlíusson, Rune, Sandbu, and Samira, Lekhal
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Male ,Treatment Outcome ,Adolescent ,Weight Loss ,Gastric Bypass ,Humans ,Female ,Laparoscopy ,Life Style ,Body Mass Index ,Obesity, Morbid - Abstract
There is limited evidence for the effectiveness of bariatric surgery in adolescents, and the associated complications. The main objective of the 4XL study was to clarify whether laparoscopic Roux-en-Y gastric bypass (LGBP) combined with lifestyle intervention is a safe and effective treatment method.Data were retrieved from an ongoing non-randomised intervention study of adolescents with morbid obesity that is comparing the effects of gastric bypass combined with lifestyle intervention versus lifestyle intervention alone.Altogether 39 patients (64 % girls) treated with a gastric bypass, and 96 patients (57 % girls) treated with lifestyle intervention were examined prior to the start of treatment and one year later. The average age at inclusion (SD) was 16.7 (1.0) years vs. 15.6 (1.3) years, and average BMI was 45.6 (4.4) vs. 43.3 (4.1) kg/m2 in the two groups. Average (95 % CI) percentage weight loss was 30 % (27 %-33 %) after surgery versus weight gain of 1 % (-1 % to 3 %) in the control group. The difference between the groups was 31 % (95 % CI 27 %-34 %, p0.001). Cardiometabolic risk factors improved only after surgery. After gastric bypass, two early (6 weeks) minor complications were recorded. One year after surgery, 4 (10 %), 8 (21 %) and 4 (10 %) of patients had anaemia, iron deficiency or low vitamin B12 levels respectively, and 20 of 33 patients (61 %) had low two-hour blood glucose (2.8 mmol/l) after oral glucose tolerance testing.The results support previous studies showing that gastric bypass is associated with significant weight loss in adolescent patients with morbid obesity. The 4XL study is currently too small and the follow-up time too short to allow the risk of long-term complications to be assessed.
- Published
- 2020
19. Patient complaints following bariatric surgery 2012-18
- Author
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Randi Størdal, Lund, Jens Kristoffer, Hertel, Rune, Sandbu, and Jøran, Hjelmesæth
- Subjects
Medical Errors ,Norway ,Compensation and Redress ,Bariatric Surgery ,Humans - Abstract
We examined complaints submitted to the Norwegian System of Patient Injury Compensation (NPE) following bariatric surgery, including the background for the complaint, the proportion of patients whose complaints were upheld, and the characteristics of complaints that were upheld.All complaints relating to bariatric surgery performed in the period 2012-18 were reviewed and categorised according to symptoms, findings and events relevant to the outcome of the complaint. Anonymous summaries from the experts' statements were reviewed and categorised according to year of decision, gender, age, basis for compensation or rejection, and whether the intervention was carried out in the public or private health service.Forty-four (26 %) of a total of 171 applications for patient injury compensation were upheld. These applications represented 25 patients who had surgery in the public health service (19 % upheld) and 19 patients who were operated on in the private health service (51 % upheld). The single most common reason for a complaint being upheld (n = 18) was lack of indication for bariatric surgery.More post-bariatric surgery complaints were upheld for lack of indication than for surgical errors. Proper patient selection, good preoperative preparation, good information and shared decision-making are important factors for achieving the best possible bariatric surgery outcome. An interdisciplinary team that monitors patients over time can help ensure the quality of the entire treatment chain.
- Published
- 2020
20. Lifestyle intervention for children and adolescents with severe obesity - results after one year
- Author
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Vilde Aabel, Skodvin, Samira, Lekhal, Kristin Garpestad, Kommedal, Beate, Benestad, Hanna Flækøy, Skjåkødegård, Yngvild Sørebø, Danielsen, Sara-Rebekka Færø, Linde, Mathieu, Roelants, Jens Kristoffer, Hertel, Jøran, Hjelmesæth, and Pétur Benedikt, Júlíusson
- Subjects
Male ,Adolescent ,Norway ,Humans ,Female ,Overweight ,Child ,Life Style ,Body Mass Index ,Obesity, Morbid ,Retrospective Studies - Abstract
Lifestyle interventions for children and adolescents with severe obesity show moderate short-term effects on weight reduction internationally. We evaluated treatment results at two Norwegian specialist outpatient clinics.We performed a retrospective analysis of data from children and adolescents between 3 and 18 years of age collected in 2012-2016. Children and adolescents with severe obesity who attended their one-year follow-up were included. We included in the analyses the following body weight measures: percentage overweight as defined by the International Obesity Task Force cut-off (% IOTF-25); BMI standard deviation score; waist circumference standard deviation score; and body fat percentage at the start of treatment and at one-year follow-up.Of 568 children and adolescents who started treatment, 416 (73 %) attended the one-year check-up. A total of 271 (65 %) patients achieved a reduction in %IOTF-25, while 228 patients (55 %) reduced their BMI standard deviation score. There was a statistically significant mean reduction of all four registered body weight measurements. Altogether 54 of 325 children (17 %) changed category from severe obesity to obesity, 8 (2 %) went from severe obesity to overweight, and 8 of 91 children (9 %) changed category from obesity to overweight or normal weight. The proportion of participants with a reduction of more than 5 % in %IOTF-25 was 43 % (177/416), and a reduction in BMI standard deviation score of more than 0.25 was observed in 23 % (95/416) of participants. Girls responded on average more poorly to the intervention than boys. There was no clinically significant difference in results between the treatment centres.After one year of treatment of children and adolescents with severe obesity in two specialist healthcare centres, we found a moderate mean reduction in weight, waist circumference and body fat percentage, but with large interindividual variation.
- Published
- 2020
21. 78-OR: Glycaemia, Beta-Cell Function, and Incretin Hormones Post-OGTT One Year after Gastric Bypass and Sleeve Gastrectomy in Patients with Morbid Obesity and Type 2 Diabetes: An RCT (Oseberg Study)
- Author
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Jens J. Holst, Kåre I. Birkeland, Bolette Hartmann, Hanne L. Gulseth, Jens Kristoffer Hertel, Rune Sandbu, Farhat Fatima, Dag Hofsø, Marius Svanevik, and Jøran Hjelmesæth
- Subjects
medicine.medical_specialty ,Sleeve gastrectomy ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric bypass ,Incretin ,Repeated measures design ,Beta-cell Function ,Type 2 diabetes ,medicine.disease ,Gastroenterology ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Internal Medicine ,medicine ,business ,Hormone - Abstract
The Oseberg study demonstrated a higher one year remission rate of type 2 diabetes after Roux-en-Y gastric bypass (RYGB) than after sleeve gastrectomy (SG). To explore mechanisms for the superiority of RYGB we assessed changes in glucose, C-peptide and incretin hormones after a 25 g OGTT and an IVGTT and calculated Disposition Indexes (DI) of beta cell function (DIIVGTT and DIOGTT). We used linear mixed models for repeated measures. Patients randomized to either RYGB (n=54) or SG (n=55), had a mean (SD) age of 48 (10) years, BMI 42.3 (5.3) kg/m², HbA1c 66 (18) mmol/mol, and 72 (66%) were women. OGTT and IVGTT were performed in 97% and 91% of patients respectively. At one year, the OGTT-derived glucose levels at 60-120 minutes were significantly lower after RYGB than after SG (all p Disclosure F. Fatima: Other Relationship; Self; South-Eastren Reagional Health Authority Norway. J. Hjelmesæth: Advisory Panel; Self; Novo Nordisk A/S. K.I. Birkeland: None. H.L. Gulseth: None. J.K. Hertel: None. M. Svanevik: None. R. Sandbu: None. B. Hartmann: None. J.J. Holst: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Zealand Pharma A/S. Other Relationship; Spouse/Partner; Antag Therapeutics. D. Hofsø: None.
- Published
- 2020
22. Comparison of the effect of Roux‐en‐Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials
- Author
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Jens Kristoffer Hertel, Dag Hofsø, Heidi Borgeraas, and Jøran Hjelmesæth
- Subjects
medicine.medical_specialty ,Sleeve gastrectomy ,type 2 diabetes mellitus ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Bariatric Surgery/Obesity Comorbidity ,MEDLINE ,030209 endocrinology & metabolism ,Type 2 diabetes ,Gastroenterology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,systematic review ,law ,Internal medicine ,medicine ,030212 general & internal medicine ,business.industry ,Public Health, Environmental and Occupational Health ,Type 2 Diabetes Mellitus ,nutritional and metabolic diseases ,medicine.disease ,Roux-en-Y anastomosis ,Roux‐en‐Y gastric bypass ,Relative risk ,Meta-analysis ,business ,sleeve gastrectomy - Abstract
Summary Bariatric surgery is an effective treatment option for patients with type 2 diabetes mellitus (T2DM) and obesity. This study aims to compare the effects of Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on remission of T2DM. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for studies published between database inception and 21 November 2019. A meta‐analysis, using a random effects model, was performed to calculate relative risk (RR) of T2DM remission between the groups in randomized controlled trials (RCTs). Of 2650 records identified, 12 records from 10 different RCTs were finally included. The studies comprised 705 patients with follow‐up from 1 to 5 years. The remission rate of T2DM at 1 year was higher among those undergoing RYGB (156/276, 57%) compared with those undergoing SG (128/275, 47%), RR (95% CI) 1.20 (1.00‐1.45), P = .047, I 2 = 24.9%, moderate‐quality evidence. Among studies with 2‐ to 5‐year follow‐up, there was no difference in remission rates between the RYGB (132/263, 50%) and SG (121/266, 46%) groups, RR 1.06 (0.94‐1.20), P = .34, I 2 = 0.0%, low‐quality evidence. RYGB resulted in a higher rate of T2DM remission compared with SG after 1 year. The T2DM remission rates did not differ in studies with 2‐ to 5‐year follow‐up.
- Published
- 2020
23. Kommentar til «Den kvasse samtalen»
- Author
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Jøran Hjelmesæth and Jens Kristoffer Hertel
- Subjects
Political science ,MEDLINE ,Library science ,General Medicine - Published
- 2020
24. Pasientklager etter vektreduserende kirurgi 2012–18
- Author
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Rune Sandbu, Jens Kristoffer Hertel, Jøran Hjelmesæth, and Randi Størdal Lund
- Subjects
medicine.medical_specialty ,business.industry ,Compensation (psychology) ,General Medicine ,Norwegian ,language.human_language ,Surgery ,Public health service ,Health services ,Intervention (counseling) ,Surgery outcome ,medicine ,Complaint ,language ,Surgical errors ,business - Abstract
BACKGROUND We examined complaints submitted to the Norwegian System of Patient Injury Compensation (NPE) following bariatric surgery, including the background for the complaint, the proportion of patients whose complaints were upheld, and the characteristics of complaints that were upheld. MATERIAL AND METHOD All complaints relating to bariatric surgery performed in the period 2012-18 were reviewed and categorised according to symptoms, findings and events relevant to the outcome of the complaint. Anonymous summaries from the experts' statements were reviewed and categorised according to year of decision, gender, age, basis for compensation or rejection, and whether the intervention was carried out in the public or private health service. RESULTS Forty-four (26 %) of a total of 171 applications for patient injury compensation were upheld. These applications represented 25 patients who had surgery in the public health service (19 % upheld) and 19 patients who were operated on in the private health service (51 % upheld). The single most common reason for a complaint being upheld (n = 18) was lack of indication for bariatric surgery. INTERPRETATION More post-bariatric surgery complaints were upheld for lack of indication than for surgical errors. Proper patient selection, good preoperative preparation, good information and shared decision-making are important factors for achieving the best possible bariatric surgery outcome. An interdisciplinary team that monitors patients over time can help ensure the quality of the entire treatment chain.
- Published
- 2020
25. Livsstilsbehandling av barn og ungdom med alvorlig fedme – resultater etter ett år
- Author
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Petur Benedikt Juliusson, Jøran Hjelmesæth, Mathieu Roelants, Jens Kristoffer Hertel, Hanna Flækøy Skjåkødegård, Samira Lekhal, Vilde Aabel Skodvin, Kristin Garpestad Kommedal, Sara-Rebekka Færø Linde, Beate Benestad, and Yngvild Sørebø Danielsen
- Subjects
Pediatrics ,medicine.medical_specialty ,Waist ,business.industry ,General Medicine ,Norwegian ,Overweight ,medicine.disease ,Body fat percentage ,Obesity ,language.human_language ,Weight loss ,Lifestyle intervention ,medicine ,language ,Outpatient clinic ,medicine.symptom ,business - Abstract
Background Lifestyle interventions for children and adolescents with severe obesity show moderate short-term effects on weight reduction internationally. We evaluated treatment results at two Norwegian specialist outpatient clinics. Material and method We performed a retrospective analysis of data from children and adolescents between 3 and 18 years of age collected in 2012-2016. Children and adolescents with severe obesity who attended their one-year follow-up were included. We included in the analyses the following body weight measures: percentage overweight as defined by the International Obesity Task Force cut-off (% IOTF-25); BMI standard deviation score; waist circumference standard deviation score; and body fat percentage at the start of treatment and at one-year follow-up. Results Of 568 children and adolescents who started treatment, 416 (73 %) attended the one-year check-up. A total of 271 (65 %) patients achieved a reduction in %IOTF-25, while 228 patients (55 %) reduced their BMI standard deviation score. There was a statistically significant mean reduction of all four registered body weight measurements. Altogether 54 of 325 children (17 %) changed category from severe obesity to obesity, 8 (2 %) went from severe obesity to overweight, and 8 of 91 children (9 %) changed category from obesity to overweight or normal weight. The proportion of participants with a reduction of more than 5 % in %IOTF-25 was 43 % (177/416), and a reduction in BMI standard deviation score of more than 0.25 was observed in 23 % (95/416) of participants. Girls responded on average more poorly to the intervention than boys. There was no clinically significant difference in results between the treatment centres. Interpretation After one year of treatment of children and adolescents with severe obesity in two specialist healthcare centres, we found a moderate mean reduction in weight, waist circumference and body fat percentage, but with large interindividual variation.
- Published
- 2020
26. Laparoskopisk gastrisk bypassoperasjon versus livsstilsbehandling av unge med sykelig overvekt
- Author
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Jens Kristoffer Hertel, Jøran Hjelmesæth, Morten Lindberg, Ane Hjetland Holt, Rune Sandbu, Petur Benedikt Juliusson, Samira Lekhal, Erling Halvorsen, Lars Thomas Seeberg, and Beate Benestad
- Subjects
medicine.medical_specialty ,business.industry ,Laparoscopic gastric bypass ,General Medicine ,Percentage weight loss ,Morbid obesity ,Weight loss ,Internal medicine ,Lifestyle intervention ,medicine ,Effective treatment ,Vitamin B12 ,medicine.symptom ,business ,Weight gain - Abstract
BACKGROUND There is limited evidence for the effectiveness of bariatric surgery in adolescents, and the associated complications. The main objective of the 4XL study was to clarify whether laparoscopic Roux-en-Y gastric bypass (LGBP) combined with lifestyle intervention is a safe and effective treatment method. MATERIAL AND METHOD Data were retrieved from an ongoing non-randomised intervention study of adolescents with morbid obesity that is comparing the effects of gastric bypass combined with lifestyle intervention versus lifestyle intervention alone. RESULTS Altogether 39 patients (64 % girls) treated with a gastric bypass, and 96 patients (57 % girls) treated with lifestyle intervention were examined prior to the start of treatment and one year later. The average age at inclusion (SD) was 16.7 (1.0) years vs. 15.6 (1.3) years, and average BMI was 45.6 (4.4) vs. 43.3 (4.1) kg/m2 in the two groups. Average (95 % CI) percentage weight loss was 30 % (27 %-33 %) after surgery versus weight gain of 1 % (-1 % to 3 %) in the control group. The difference between the groups was 31 % (95 % CI 27 %-34 %, p
- Published
- 2020
27. Association of time of obesity onset with comorbidities in treatment-seeking men and women with severe obesity
- Author
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Jens Kristoffer Hertel, L. H. Barstad, Jøran Hjelmesæth, Heidi Borgeraas, Jan Magnus Fredheim, and R. Størdal Lund
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Treatment seeking ,business.industry ,Endocrinology, Diabetes and Metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Severe obesity ,medicine.disease ,Tertiary care ,Obesity ,Comorbidity ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Risk factor ,business - Abstract
Objectives Early obesity onset is a risk factor for specific comorbidities in adulthood, but whether this relationship is present in men and women with severe obesity is unknown. This study aimed to examine whether obesity onset in childhood or adolescence, as compared with adulthood, is associated with higher odds of comorbidities in men and women with severe obesity. Methods A cross-sectional study of treatment-seeking men and women with severe obesity attending a tertiary care centre in Norway, from 2006 to 2017, was performed. Results A total of 4,583 participants (69.13% women) were included. Almost all men (99.69%) and women (99.18%) suffered from ≥1 comorbidities. Compared with women, men were older (mean [SD]) (45.54 [12.14] vs. 42.56 [12.00] years, p 20 years), was associated with lower odds (OR [95% CI]) of obstructive sleep apnoea (OSA) in men (0.69 [0.53, 0.91], p
- Published
- 2018
28. Økonomistyring utfordrer sykepleieledere ireformerte norske sykehus
- Author
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Jens Kristoffer Hertel and Runar Danielsen
- Subjects
Semi-structured interview ,Nursing ,Resource management ,General Medicine ,Sociology ,Nursing management - Published
- 2018
29. Gender-related differences in cardiometabolic risk factors and lifestyle behaviors in treatment-seeking adolescents with severe obesity
- Author
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Petur Benedikt Juliusson, Samira Lekhal, L. H. Barstad, Jens Kristoffer Hertel, Line Kristin Johnson, and Jøran Hjelmesæth
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Health Behavior ,030209 endocrinology & metabolism ,Severity of Illness Index ,Cardiovascular risk factor ,03 medical and health sciences ,Screen time ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Severity of illness ,medicine ,Humans ,Gender differences ,030212 general & internal medicine ,Child ,Life Style ,business.industry ,lcsh:RJ1-570 ,Lifestyle behavior ,lcsh:Pediatrics ,Patient Acceptance of Health Care ,medicine.disease ,Cardiovascular disease ,Obesity ,Metabolic syndrome ,Physical activity level ,Obesity, Morbid ,Cross-Sectional Studies ,Blood pressure ,Cardiovascular Diseases ,Pediatrics, Perinatology and Child Health ,Female ,business ,Severe obesity ,Dyslipidemia ,Research Article - Abstract
Background Obesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls. Methods Cross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis. Results Mean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders. Conclusions Male treatment-seeking adolescents with severe obesity had a more unfavorable set of metabolic and behavioral risk factors for cardiovascular disease than girls. Our results indicate that lifestyle behavioral markers should be thoroughly assessed in both genders, and possible gender-related differences in risk profile should be taken into account in future treatment programs.
- Published
- 2018
30. Dietary changes 1 year after sleeve gastrectomy compared with gastric bypass in an rct
- Author
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Jens Kristoffer Hertel, Line Kristin Johnson, Jøran Hjelmesæth, L. H. Barstad, and Dag Hofsø
- Subjects
Sleeve gastrectomy ,medicine.medical_specialty ,Nutrition and Dietetics ,Randomized controlled trial ,law ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric bypass ,medicine ,business ,law.invention ,Surgery - Published
- 2020
31. A139 Gastric bypass and sleeve gastrectomy for hepatic steatosis in type 2 diabetes – a randomized controlled trial
- Author
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Nils Petter Kvan, Rune Sandbu, Jens Kristoffer Hertel, Dag Hofsø, Kathrine Aglen Seeberg, Jøran Hjelmesæth, Farhat Fatima, Marius Svanevik, John Olav Grimnes, and Heidi Borgeraas
- Subjects
medicine.medical_specialty ,Sleeve gastrectomy ,business.industry ,medicine.medical_treatment ,Gastric bypass ,Type 2 diabetes ,medicine.disease ,Surgery ,law.invention ,Randomized controlled trial ,law ,medicine ,Steatosis ,business - Published
- 2019
32. Single-centre, triple-blinded, randomised, 1-year, parallel-group, superiority study to compare the effects of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function in subjects with morbid obesity: a protocol for the Obesity surgery in Tønsberg (Oseberg) study
- Author
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Dag Hofsø, Tor Olav Widerøe Hillestad, Heidi Borgeraas, Tor-Ivar Karlsen, Tone Gretland Valderhaug, Morten Lindberg, Rune Sandbu, Jolanta Lorentzen, Jens Kristoffer Hertel, Marius Svanevik, Kåre I. Birkeland, Jøran Hjelmesæth, Erling Halvorsen, Ronette L. Kolotkin, Farhat Fatima, Nils Petter Kvan, Njord Nordstrand, Birgitte Seip, Line Kristin Johnson, Hanne L. Gulseth, Kathrine Aglen Seeberg, and John Olav Grimnes
- Subjects
Male ,medicine.medical_specialty ,Sleeve gastrectomy ,β-cell function ,medicine.medical_treatment ,Gastric Bypass ,Bariatric Surgery ,030209 endocrinology & metabolism ,Type 2 diabetes ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Superiority Trial ,Randomized controlled trial ,Clinical Protocols ,law ,Gastrectomy ,Diabetes mellitus ,Internal medicine ,Insulin-Secreting Cells ,medicine ,Protocol ,Humans ,030212 general & internal medicine ,VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 ,Glycated Hemoglobin ,business.industry ,Norway ,General Medicine ,medicine.disease ,Roux-en-Y anastomosis ,morbid obesity ,Obesity, Morbid ,Diabetes and Endocrinology ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Female ,Laparoscopy ,type 2 diabetes ,business ,Epidemiologic Methods ,Body mass index ,randomised controlled trial ,sleeve gastrectomy - Abstract
IntroductionBariatric surgery is increasingly recognised as an effective treatment option for subjects with type 2 diabetes and obesity; however, there is no conclusive evidence on the superiority of Roux-en-Y gastric bypass or sleeve gastrectomy. The Oseberg study was designed to compare the effects of gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function.Methods and analysisSingle-centre, randomised, triple-blinded, two-armed superiority trial carried out at the Morbid Obesity Centre at Vestfold Hospital Trust in Norway. Eligible patients with type 2 diabetes and obesity were randomly allocated in a 1:1 ratio to either gastric bypass or sleeve gastrectomy. The primary outcome measures are (1) the proportion of participants with complete remission of type 2 diabetes (HbA1c≤6.0% in the absence of blood glucose-lowering pharmacologic therapy) and (2) β-cell function expressed by the disposition index (calculated using the frequently sampled intravenous glucose tolerance test with minimal model analysis) 1 year after surgery.Ethics and disseminationThe protocol of the current study was reviewed and approved by the regional ethics committee on 12 September 2012 (ref: 2012/1427/REK sør-øst B). The results will be disseminated to academic and health professional audiences and the public via publications in international peer-reviewed journals and conferences. Participants will receive a summary of the main findings.Trial registration numberNCT01778738;Pre-results.
- Published
- 2019
33. Associations between cardiorespiratory fitness and weight loss in patients with severe obesity undergoing an intensive lifestyle intervention program: retrospective cohort study
- Author
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Jarle Berge, Espen Svendsen Gjevestad, Jens Kristoffer Hertel, Milada Cvancarova Småstuen, Jøran Hjelmesæth, and Øyvind Støren
- Subjects
Lifestyle intervention ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,Diabetes mellitus ,Internal medicine ,Weight Loss ,Medicine ,Humans ,030212 general & internal medicine ,Treadmill ,Exercise ,Life Style ,Retrospective Studies ,lcsh:RC648-665 ,business.industry ,Weight change ,VO2 max ,Retrospective cohort study ,Cardiorespiratory fitness ,General Medicine ,medicine.disease ,Obesity, Morbid ,Cardiorespiratory Fitness ,medicine.symptom ,business ,Severe obesity ,Energy Metabolism ,VO2max ,Research Article - Abstract
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver Background To assess the association between cardiorespiratory fitness (CRF) and weight changes in treatment seeking patients with severe obesity who underwent a 1-year intensive lifestyle intervention (ILI) program. Methods Retrospective cohort study conducted at a tertiary care outpatient rehabilitation center from November 1, 2013 through January 1, 2017. CRF was measured as maximal oxygen consumption during a maximal oxygen uptake (VO2max) test on a treadmill or bicycle at baseline and after 3 months. Results A total of 180 patients had a baseline mean (SD) BMI 41.1 (4.8) kg/m2 and CRF of 79.4 (14.9) mL·kg-0.75·min− 1. Patients with a baseline CRF above median achieved a greater 3-month and 1-year weight loss compared with patients with CRF below median; mean (95% CI) 2.5 kg (1.3, 3.8) and 4.0 kg (0.8, 7.2), respectively. In addition, patients with 3-month changes of CRF above median had 4.0 kg (0.9, 7.1) greater weight loss at 1-year follow-up than those below median. Conclusions Among patients with severe obesity who underwent a 1-year ILI program, higher baseline CRF was associated with significantly larger weight loss after 3 months and 1 year. In addition, those with higher initial 3-month CRF changes had greater weight loss at 1 year. Trial registration Retrospectively registered in Regional Committees for Medical and Health Research Ethics (REC) south east September 22, 2016 (2016/1414) and clinicaltials.gov August 13, 2018 (identifier: NCT03593798)
- Published
- 2019
34. Gastric bypass versus sleeve gastrectomy in patients with type 2 diabetes (Oseberg): a single-centre, triple-blind, randomised controlled trial
- Author
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Milada Cvancarova Småstuen, Line Kristin Johnson, Darko Stefanovski, Jøran Hjelmesæth, Rune Sandbu, Tone Gretland Valderhaug, Heidi Borgeraas, Marius Svanevik, Jens Kristoffer Hertel, Dag Hofsø, Njord Nordstrand, Farhat Fatima, Hanne L. Gulseth, Kåre I. Birkeland, and Morten Lindberg
- Subjects
medicine.medical_specialty ,Sleeve gastrectomy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric bypass ,030209 endocrinology & metabolism ,Randomised controlled trials ,Type 2 diabetes ,law.invention ,Morbid obesity ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Randomized controlled trial ,Regional health authority ,law ,Internal Medicine ,Medicine ,In patient ,030212 general & internal medicine ,health care economics and organizations ,business.industry ,General surgery ,medicine.disease ,Single centre ,Gastric bypasses ,business ,Bariatric procedures - Abstract
Background For patients with obesity and type 2 diabetes, weight loss improves insulin sensitivity and β-cell function, and can induce remission of diabetes. The comparative efficacy of various bariatric procedures for the remission of type 2 diabetes has not been fully elucidated. We aimed to compare the effects of the two most common bariatric procedures, gastric bypass and sleeve gastrectomy, on remission of diabetes and β-cell function. Methods We conducted a single-centre, triple-blind, randomised trial at Vestfold Hospital Trust (Tønsberg, Norway), in which patients (aged ≥18 years) with type 2 diabetes and obesity were randomly assigned (1:1) to receive gastric bypass or sleeve gastrectomy (the Oseberg study). Randomisation was performed with a computerised random number generator and a block size of 10. Treatment allocation was masked from participants, study personnel, and outcome assessors and was concealed with sealed opaque envelopes. Surgeons used identical skin incisions during both surgeries and were not involved in patient follow-up. The primary clinical outcome was the proportion of participants with complete remission of type 2 diabetes (HbA 1c of ≤6·0% [42 mmol/mol] without the use of glucose-lowering medication) at 1 year after surgery. The primary physiological outcome was disposition index (a measure of β-cell function) at 1 year after surgery, as assessed by an intravenous glucose tolerance test. Primary outcomes were analysed in the intention-to-treat and per-protocol populations. This trial is ongoing and closed to recruitment, and is registered with ClinicalTrials.gov, NCT01778738. Findings Between Oct 15, 2012, and Sept 1, 2017, 1305 patients who were preparing for bariatric surgery were screened, of whom 319 consecutive patients with type 2 diabetes were assessed for eligibility. 109 patients were enrolled and randomly assigned to gastric bypass (n=54) or sleeve gastrectomy (n=55). 107 (98%) of 109 patients completed 1-year follow-up, with one patient in each group withdrawing after surgery (per-protocol population). In the intention-to-treat population, diabetes remission rates were higher in the gastric bypass group than in the sleeve gastrectomy group (risk difference 27% [95% CI 10 to 44]; relative risk [RR] 1·57 [1·14 to 2·16], p=0·0054); results were similar in the per-protocol population (risk difference 27% [95% CI 10 to 45]; RR 1·57 [1·14 to 2·15], p=0·0036). In the intention-to-treat population, disposition index increased in both groups (between-group difference 55 [–111 to 220], p=0·52); results were similar in the per-protocol population (between-group difference 21 [–214 to 256], p=0.86). In the gastric bypass group, ten of 54 participants had early complications and 17 of 53 had late side-effects. In the sleeve gastrectomy group, eight of 55 participants had early complications and 22 of 54 had late side-effects. No deaths occurred in either group. Interpretation Gastric bypass was found to be superior to sleeve gastrectomy for remission of type 2 diabetes at 1 year after surgery, and the two procedures had a similar beneficial effect on β-cell function. The use of gastric bypass as the preferred bariatric procedure for patients with obesity and type 2 diabetes could improve diabetes care and reduce related societal costs.
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- 2019
35. Influence of Obesity on Work ability, Respiratory Symptoms, and Lung Function in Adults with Asthma
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Johny Kongerud, Anne Kristin Møller Fell, Geir Klepaker, Øystein L. Holla, Martin Veel Svendsen, Paul K. Henneberger, and Jens Kristoffer Hertel
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Spirometry ,Vital capacity ,medicine.medical_specialty ,Adolescent ,Vital Capacity ,Work Capacity Evaluation ,Comorbidity ,Risk Assessment ,Severity of Illness Index ,Body Mass Index ,Young Adult ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,Reference Values ,Surveys and Questionnaires ,Internal medicine ,Humans ,Medicine ,Obesity ,030212 general & internal medicine ,Asthma ,Analysis of Variance ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Immunoglobulin E ,Middle Aged ,medicine.disease ,Respiratory Function Tests ,respiratory tract diseases ,Cross-Sectional Studies ,030228 respiratory system ,Linear Models ,Population study ,Female ,Sick Leave ,business ,Body mass index - Abstract
Background: Asthma is defined by variable respiratory symptoms and lung function, and may influence work ability. Similarly, obesity may contribute to respiratory symptoms, affect lung function, and reduce work ability. Thus, assessment of the influence of obesity on work ability, respiratory symptoms, and lung function in adults with asthma is needed. Objectives: We hypothesized that patients with obesity and asthma have more respiratory symptoms and reduced work ability and lung function compared with normal-weight patients with asthma. Methods: We examined 626 participants with physician-diagnosed asthma, aged 18–52 years, recruited from a cross-sectional general population study using a comprehensive questionnaire including work ability score, the asthma control test (ACT), height and weight, and spirometry with reversibility testing. Results: Participants with a body mass index (BMI) ≥30 kg/m2 (i.e., obese) had a higher symptom score (OR 1.78, 95% CI 1.14–2.80), current use of asthma medication (1.60, 1.05–2.46), and incidence of ACT scores ≤19 (poor asthma control) (1.81, 1.03–3.18) than participants with BMI ≤24.9 kg/m2 (i.e., normal weight). Post-bronchodilator forced vital capacity (FVC) as a percentage of predicted (β coefficient –4.5) and pre-bronchodilator forced expiratory volume in 1 s as a percentage of predicted (FEV1) (β coefficient –4.6) were negatively associated with BMI ≥30 kg/m2. We found no statistically significant association of BMI >30 kg/m2 (compared to BMI 2) with sick leave (1.21, 0.75–1.70) or reduced work ability (1.23, 0.74–2.04). Conclusions: There were indications that patients with obesity had a higher symptom burden, poorer asthma control, higher consumption of asthma medication, and reduced lung function, in particular for FVC, compared with normal-weight patients.
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- 2019
36. Health-related quality of life after camp-based family obesity treatment: an RCT
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Tor-Ivar Karlsen, Jøran Hjelmesæth, Ronette L. Kolotkin, Samira Lekhal, Beate Benestad, Milada Cvancarova Småstuen, Rønnaug Ødegård, Silje Steinsbekk, and Jens Kristoffer Hertel
- Subjects
medicine.medical_specialty ,obesity ,medicine.medical_treatment ,Psychological intervention ,030209 endocrinology & metabolism ,law.invention ,rehabilitation ,Treatment and control groups ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Pediatri: 760 ,law ,Medicine ,030212 general & internal medicine ,Rehabilitation ,Intention-to-treat analysis ,business.industry ,medicine.disease ,patient perspective ,Obesity ,Pediatrics, Perinatology and Child Health ,Physical therapy ,Original Article ,business ,Body mass index - Abstract
ObjectiveTo compare the effects of a 2-year camp-based immersion family treatment for obesity with an outpatient family-based treatment for obesity on health-related quality of life (HRQoL) in two generations.DesignRandomised controlled trial.SettingRehabilitation clinic, tertiary care hospital and primary care.PatientsFamilies with at least one child (7–12 years) and one parent, both with obesity.InterventionsSummer camp for 2 weeks, with four repetition weekends, or lifestyle school, including four outpatient days over 4 weeks. Behavioural techniques to promote a healthier lifestyle.Main outcome measuresChildren’s and parents’ HRQoL were assessed using generic and obesity-specific measures. Outcomes were analysed using linear mixed models according to intention to treat, and multiple imputations were used for missing data.ResultsNinety children (50% girls) with a mean (SD) age of 9.7 (1.2) years and body mass index 28.7 (3.9) kg/m2 were included in the analyses. Summer camp children had an estimated mean (95% CI) of 5.3 (0.4 to 10.1) points greater improvement in adiposity-specific HRQoL score at 2 years compared with the lifestyle school children, and this improvement was even larger in the parent proxy-report, where mean difference was 7.3 (95% CI 2.3 to 12.2). Corresponding effect sizes were 0.33 and 0.44. Generic HRQoL questionnaires revealed no significant differences between treatment groups in either children or parents from baseline to 2 years.ConclusionsA 2-year family camp-based immersion obesity treatment programme had significantly larger effects on obesity-specific HRQoL in children’s self-report and parent proxy-reports in children with obesity compared with an outpatient family-based treatment programme.Trial registration numberNCT01110096.
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- 2018
37. Does Body Mass Index and asthma affect work ability? Cross-sectional data from the general population in Telemark, Norway
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Jens Kristoffer Hertel, Johny Kongerud, Anne Kristin Møller Fell, Martin Veel Svendsen, and Geir Klepaker
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education.field_of_study ,Cross-sectional data ,business.industry ,Population ,Regression analysis ,medicine.disease ,Affect (psychology) ,Obesity ,respiratory tract diseases ,medicine ,Work ability ,education ,business ,Body mass index ,Asthma ,Demography - Abstract
Introduction: Obesity affects a growing proportion of the general population and is prevalent also among subjects with asthma. Studies have demonstrated that both body mass index (BMI) and asthma may impact work ability, but the evidence has been inconclusive. Aims and Objectives: To assess the association between self-reported work ability, and BMI and asthma, and whether there is a synergistic interaction between obesity and asthma on work ability. Methods: Cross-sectional data on self-reported work ability and BMI were obtained in 2013 from 11137 subjects engaged in paid work during the past 12 months, aged 16 to 50 years, from a random sample of the general population of Telemark, Norway. Self-rated work ability was assessed using the Work Ability Score (WAS). Associations between WAS and BMI and by asthma status were examined using multiple logistic regression analysis. Results: The inclusion of the interaction term asthma*BMI in the regression model did not reveal any synergetic effect between asthma and BMI (data not shown). Conclusion: There was a dose-response relationship between reduced work ability and increasing BMI. Asthma was associated with reduced work ability, but there was no indication of a synergetic effect between asthma and obesity in terms of work ability.
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- 2018
38. A289 BMI LOSS AND RESOLUTION OF DIABETES FIVE YEARS AFTER STANDARD AND DISTAL ROUX- EN-Y GASTRIC BYPASS
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Ingvild Kristine Blom-Høgestøl, Hilde Risstad, Jon Kristinsson, Dag Hofsø, Jøran Hjelmesæth, Jens Kristoffer Hertel, Rune Sandbu, Odd Bjørn Salte, Marius Svanevik, and Tom Mala
- Subjects
medicine.medical_specialty ,business.industry ,Diabetes mellitus ,Resolution (electron density) ,Gastric bypass ,medicine ,Surgery ,business ,medicine.disease ,Roux-en-Y anastomosis - Published
- 2019
39. A106 Gastroesophageal reflux disease in patients with severe obesity and type 2 diabetes one year after sleeve gastrectomy or Roux-en-Y gastric bypass. A randomized controlled trial
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Marius Svanevik, Jolanta Lorentzen, Rune Sandbu, Dag Hofsø, Tor-Ivar Karlsen, Asle W. Medhus, Jens Kristoffer Hertel, Jøran Hjelmesæth, Heidi Borgeraas, and Birgitte Seip
- Subjects
Sleeve gastrectomy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gastric bypass ,Reflux ,Type 2 diabetes ,Disease ,medicine.disease ,Roux-en-Y anastomosis ,law.invention ,Surgery ,Randomized controlled trial ,law ,Medicine ,In patient ,business - Published
- 2019
40. Cardiometabolic risk factors differ among adolescents with obesity in three European countries - a cross sectional study
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Nicoletta Marazzi, Fiorenza Agosti, Petur Benedikt Juliusson, Wolfgang Siegfried, Milada Cvancarova Småstuen, Jens Kristoffer Hertel, Jøran Hjelmesæth, Alessandro Sartorio, Samira Lekhal, and Beate Benestad
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Male ,Pediatric Obesity ,Waist ,Adolescent ,Cross-sectional study ,Population ,Blood Pressure ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,030225 pediatrics ,medicine ,Humans ,Outpatient clinic ,Registries ,Obesity ,030212 general & internal medicine ,education ,Retrospective Studies ,Metabolic Syndrome ,education.field_of_study ,business.industry ,Regular Article ,General Medicine ,Cardiometabolic risk factors ,medicine.disease ,Adolescence ,Europe ,Cross-Sectional Studies ,Dyslipidemia ,Pediatrics, Perinatology and Child Health ,Female ,Metabolic syndrome ,business ,Body mass index ,Regular Articles ,Demography ,Cohort study - Abstract
Aim: We aimed to compare modifiable cardiometabolic risk factors among treatment‐seeking adolescents with obesity in Italy, Germany and Norway. Methods: This retrospective, registry‐based, cross‐sectional cohort study included 2,327 (59% girls) 12–18 year‐old adolescents with obesity from three tertiary care outpatient clinics in Europe, between 1999 and 2015. The prevalence of cardiometabolic risk factors was compared between clinics, and multivariate logistic regression models including gender, age, waist circumference and body mass index were used to assess the associations between population and cardiometabolic risk. Results: In total, 1,396 adolescents (60% girls) from Italy, 654 (58% girls) from Germany and 277 (51% girls) from Norway were included. The mean ± SD age was 15.2 ± 1.6 years, body mass index 38.8 ± 6.5 kg/m2 and body mass index standard deviation score 3.21 ± 0.43. The prevalence of elevated nonhigh‐density lipoprotein‐cholesterol in Norway, Germany and Italy was 60%, 54% and 45%, while the prevalence of high systolic or diastolic blood pressure (≥130 or ≥85 mmHg) were 15%, 46% and 66%, respectively. Conclusion: Cardiometabolic risk factors among treatment‐seeking adolescents with obesity from Italy, Germany and Norway differed across the populations in this study, which might imply that preventive clinical work should reflect such differences. publishedVersion
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- 2018
41. Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities
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Morten Lindberg, Rune Sandbu, Milada Cvancarova Småstuen, Jens Kristoffer Hertel, Jøran Hjelmesæth, Dag Hofsø, Gunn Signe Jakobsen, and Njord Nordstrand
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Adult ,Male ,medicine.medical_specialty ,Bariatric Surgery ,030209 endocrinology & metabolism ,Comorbidity ,Body Mass Index ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,medicine ,Humans ,030212 general & internal medicine ,Adverse effect ,Depression (differential diagnoses) ,Original Investigation ,business.industry ,Depression ,Remission Induction ,Absolute risk reduction ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Obesity, Morbid ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Relative risk ,Ferritins ,Hypertension ,Female ,business ,Body mass index ,Cohort study - Abstract
Importance The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). Exposures Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. Main Outcomes and Measures Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. Results Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P Conclusions and Relevance Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process.
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- 2018
42. Impact of body weight, low energy diet and gastric bypass on drug bioavailability, cardiovascular risk factors and metabolic biomarkers: protocol for an open, non-randomised, three-armed single centre study (COCKTAIL)
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Jens Kristoffer Hertel, Veronica Krogstad, Tor-Ivar Karlsen, Eva Skovlund, Anna-Lena Ek, Tommy B. Andersson, Cecilia Karlsson, Philip Carlo Angeles, Line Kristin Johnson, Maria Heijer, Jøran Hjelmesæth, Ida Robertsen, Anders Åsberg, Shalini Andersson, Rune Sandbu, and Hege Christensen
- Subjects
Oncology ,Male ,030226 pharmacology & pharmacy ,law.invention ,Tertiary Care Centers ,0302 clinical medicine ,Weight loss ,law ,Risk Factors ,Protocol ,Omeprazole ,media_common ,Clinical Trials as Topic ,Clinical pharmacology ,Norway ,Area under the curve ,General Medicine ,Obesity, Morbid ,Pharmaceutical Preparations ,Cardiovascular Diseases ,cardiology ,Body Composition ,Female ,medicine.symptom ,medicine.drug ,Drug ,medicine.medical_specialty ,media_common.quotation_subject ,Gastric Bypass ,basic sciences ,Biological Availability ,030209 endocrinology & metabolism ,03 medical and health sciences ,Pharmacokinetics ,Internal medicine ,Weight Loss ,medicine ,Humans ,Rosuvastatin ,Caloric Restriction ,business.industry ,Pharmacology and Therapeutics ,Bioavailability ,Linear Models ,clinical pharmacology ,business ,Biomarkers - Abstract
IntroductionRoux-en-Y gastric bypass (GBP) is associated with changes in cardiometabolic risk factors and bioavailability of drugs, but whether these changes are induced by calorie restriction, the weight loss or surgery per se, remains uncertain. The COCKTAIL study was designed to disentangle the short-term (6 weeks) metabolic and pharmacokinetic effects of GBP and a very low energy diet (VLED) by inducing a similar weight loss in the two groups.Methods and analysisThis open, non-randomised, three-armed, single-centre study is performed at a tertiary care centre in Norway. It aims to compare the short-term (6 weeks) and long-term (2 years) effects of GBP and VLED on, first, bioavailability and pharmacokinetics (24 hours) of probe drugs and biomarkers and, second, their effects on metabolism, cardiometabolic risk factors and biomarkers. The primary outcomes will be measured as changes in: (1) all six probe drugs by absolute bioavailability area under the curve (AUCoral/AUCiv) of midazolam (CYP3A4 probe), systemic exposure (AUCoral) of digoxin and rosuvastatin and drug:metabolite ratios for omeprazole, losartan and caffeine, levels of endogenous CYP3A biomarkers and genotypic variation, changes in the expression and activity data of the drug-metabolising, drug transport and drug regulatory proteins in biopsies from various organs and (2) body composition, cardiometabolic risk factors and metabolic biomarkers.Ethics and disseminationThe COCKTAIL protocol was reviewed and approved by the Regional Committee for Medical and Health Research Ethics (Ref: 2013/2379/REK sørøst A). The results will be disseminated to academic and health professional audiences and the public via presentations at conferences, publications in peer-reviewed journals and press releases and provided to all participants.Trial registration numberNCT02386917.
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- 2018
43. Severe obesity is a limitation for the use of body mass index standard deviation scores in children and adolescents
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Samira Lekhal, Jøran Hjelmesæth, Yngvild Sørebø Danielsen, Mathieu Roelants, Petur Benedikt Juliusson, Jens Kristoffer Hertel, and Beate Benestad
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Male ,Pediatrics ,medicine.medical_specialty ,Pediatric Obesity ,Adolescent ,030209 endocrinology & metabolism ,Norwegian ,Tertiary care ,Standard deviation ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Reference Values ,030225 pediatrics ,Medicine ,Humans ,Growth Charts ,Child ,Paediatric patients ,business.industry ,General Medicine ,Severe obesity ,medicine.disease ,Obesity ,language.human_language ,Obesity, Morbid ,Cross-Sectional Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,language ,Female ,business ,Bioelectrical impedance analysis ,Body mass index - Abstract
Aim We analysed the distribution of the body mass index standard deviation scores (BMI-SDS) in children and adolescents seeking treatment for severe obesity, according to the International Obesity Task Force (IOTF), World Health Organization (WHO) and the national Norwegian Bergen Growth Study (BGS) BMI reference charts and the percentage above the International Obesity Task Force 25 cut-off (IOTF-25). Methods This was a cross-sectional study of 396 children aged four to 17 years, who attended a tertiary care obesity centre in Norway from 2009 to 2015. Their BMI was converted to SDS using the three growth references and expressed as the percentage above IOTF-25. The percentage of body fat was assessed by bioelectrical impedance analysis. Results Regardless of which BMI reference chart was used, the BMI-SDS was significantly different between the age groups, with a wider range of higher values up to 10 years of age and a more narrow range of lower values thereafter. The distributions of the percentage above IOTF-25 and percentage of body fat were more consistent across age groups. Conclusions Our findings suggest that it may be more appropriate to use the percentage above a particular BMI cut-off, such as the percentage above IOTF-25, than the IOTF, WHO and BGS BMI-SDS in paediatric patients with severe obesity.
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- 2017
44. Camp-based family treatment of childhood obesity: randomised controlled trial
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Jøran Hjelmesæth, Samira Lekhal, Rønnaug Ødegård, Milada Cvancarova Småstuen, Vidar Halsteinli, Beate Benestad, and Jens Kristoffer Hertel
- Subjects
Male ,Family therapy ,Pediatric Obesity ,Pediatrics ,medicine.medical_specialty ,Psychological intervention ,Camp-based family treatments ,Randomised controlled trials ,Childhood obesity ,Body Mass Index ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030225 pediatrics ,medicine ,Humans ,Healthy Lifestyle ,Obesity ,030212 general & internal medicine ,Child ,Family-based treatment ,Analysis of Variance ,business.industry ,medicine.disease ,Treatment Outcome ,Camping ,Pediatrics, Perinatology and Child Health ,Body Composition ,Outpatient programmes ,Family Therapy ,Female ,Original Article ,Health education ,Metabolic ,Analysis of variance ,business ,Risk Reduction Behavior ,Body mass index ,RCT - Abstract
ObjectiveTo compare the effectiveness of a 2-year camp-based family treatment programme and an outpatient programme on obesity in two generations.DesignPragmatic randomised controlled trial.SettingRehabilitation clinic, tertiary care hospital and primary care.PatientsFamilies with at least one child (7–12 years) and one parent with obesity.InterventionsSummer camp for 2 weeks and 4 repetition weekends or lifestyle school including 4 days family education. Behavioural techniques motivating participants to healthier lifestyle.Main outcome measuresChildren: 2-year changes in body mass index (BMI) SD score (SDS). Parents: 2-year change in BMI. Main analyses: linear mixed models.ResultsNinety children (50% girls) were included. Baseline mean (SD) age was 9.7 (1.2) years, BMI 28.7 (3.9) kg/m2 and BMI SDS 3.46 (0.75). The summer-camp children had a lower adjusted estimated mean (95% CI) increase in BMI (−0.8 (−3.5 to −0.2) kg/m2), but the BMI SDS reductions did not differ significantly (−0.11 (−0.49 to 0.05)). The 2-year baseline adjusted BMI and BMI SDS did not differ significantly between summer-camp and lifestyle-school completers, BMI 29.8 (29.1 to 30.6) vs 30.7 (29.8 to 31.6) kg/m2 and BMI SDS 2.96 (2.85 to 3.08) vs 3.11 (2.97 to 3.24), respectively. The summer-camp parents had a small reduction in BMI (−0.9 (−1.8 to −0.03) vs −0.8 (−2.1 to 0.4) in the lifestyle-school group), but the within-group changes did not differ significantly (0.3 (−1.7 to 2.2)).ConclusionsA 2-year family camp-based obesity treatment programme had no significant effect on BMI SDS in children with severe obesity compared with an outpatient family-based treatment programme.Trial registration numberNCT01110096.
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- 2017
45. Next-generation sequencing of the monogenic obesity genes LEP, LEPR, MC4R, PCSK1 and POMC in a Norwegian cohort of patients with morbid obesity and normal weight controls
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Øyvind L. Busk, Anne Kristin Møller Fell, Jens Kristoffer Hertel, Gry B. N. Nordang, Kristian Tveten, Jøran Hjelmesæth, Hans Ivar Hanevik, and Øystein L. Holla
- Subjects
0301 basic medicine ,Adult ,Leptin ,Male ,Pro-Opiomelanocortin ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Population ,Biology ,Biochemistry ,03 medical and health sciences ,Exon ,Young Adult ,Endocrinology ,Age Distribution ,Mutation Rate ,Genetic variation ,Genetics ,Humans ,splice ,Genetic Predisposition to Disease ,education ,Child ,Molecular Biology ,Gene ,education.field_of_study ,Norway ,Case-control study ,Genetic Variation ,High-Throughput Nucleotide Sequencing ,Sequence Analysis, DNA ,Middle Aged ,Obesity, Morbid ,030104 developmental biology ,Proprotein Convertase 1 ,Case-Control Studies ,Cohort ,Receptor, Melanocortin, Type 4 ,Receptors, Leptin ,Female - Abstract
Background Rare sequence variants in at least five genes are known to cause monogenic obesity. In this study we aimed to investigate the prevalence of, and characterize, rare coding and splice site variants in LEP , LEPR , MC4R , PCSK1 and POMC in patients with morbid obesity and normal weight controls. Method Targeted next-generation sequencing of all exons in LEP , LEPR , MC4R , PCSK1 and POMC was performed in 485 patients with morbid obesity and 327 normal weight population-based controls from Norway. Results In total 151 variants were detected. Twenty-eight (18.5%) of these were rare, coding or splice variants and five (3.3%) were novel. All individuals, except one control, were heterozygous for the 28 variants, and the distribution of the rare variants showed a significantly higher carrier frequency among cases than controls (9.9% vs. 4.9%, p = 0.011). Four variants in MC4R were classified as pathogenic or likely pathogenic. Conclusion Four cases (0.8%) of monogenic obesity were detected, all due to MC4R variants previously linked to monogenic obesity. Significant differences in carrier frequencies among patients with morbid obesity and normal weight controls suggest an association between heterozygous rare coding variants in these five genes and morbid obesity. However, additional studies in larger cohorts and functional testing of the novel variants identified are required to confirm the findings.
- Published
- 2016
46. Diagnostic accuracy of the GerdQ questionnaire in the assessment of erosive esophagitis in patients preparing for bariatric surgery
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Jolanta Lorentzen, Tor-Ivar Karlsen, Marius Svanevik, Daniel Sifrim, Rune Sandbu, Jøran Hjelmesæth, Asle W. Medhus, Ronette L. Kolotkin, Jens Kristoffer Hertel, Heidi Borgeraas, Dag Hofsø, and Birgitte Seip
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,medicine ,030211 gastroenterology & hepatology ,030209 endocrinology & metabolism ,Surgery ,In patient ,Diagnostic accuracy ,business ,Erosive esophagitis - Published
- 2017
47. The association between severity of King’s Obesity Staging Criteria scores and treatment choice in patients with morbid obesity: a retrospective cohort study
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Milada Cvancarova Småstuen, Jens Kristoffer Hertel, Rune Sandbu, Jøran Hjelmesæth, Gunn Signe Jakobsen, Tone Gretland Valderhaug, and Erlend T. Aasheim
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medicine.medical_specialty ,Epidemiology ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Physical Therapy, Sports Therapy and Rehabilitation ,Odds ,Morbid obesity ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,medicine ,030212 general & internal medicine ,Prospective cohort study ,Bariatric surgery ,business.industry ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,Retrospective cohort study ,medicine.disease ,Obesity ,Metabolic syndrome ,Physical therapy ,business ,Body mass index ,Research Article - Abstract
Background The King’s Obesity Staging Criteria (KOSC) comprises of a four-graded set of health related domains. We aimed to examine whether, according to KOSC, patients undergoing bariatric surgery differed from those opting for conservative treatment. Methods We graded 2142 consecutive patients with morbid obesity attending our centre from 2005-10 into the following KOSC domains: airway/apnoea, body mass index (BMI), cardiovascular risk (CV-risk), diabetes mellitus, economic complications, functional limitations, gonadal dysfunction, and perceived health status/body image. Both patients and physicians agreed upon treatment choice through a shared decision making process. Results A total of 1329 (62%) patients opted for lifestyle intervention and 813 (37%) for bariatric surgery as their first treatment choice. The patients treated with bariatric surgery were younger (42 vs. 44 years, p
- Published
- 2016
48. Association between Body Mass Index, Asymmetric Dimethylarginine and Risk of Cardiovascular Events and Mortality in Norwegian Patients with Suspected Stable Angina Pectoris
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Jens Kristoffer Hertel, Eva Ringdal Pedersen, Ottar Nygård, Jøran Hjelmesæth, Gard Frodahl Tveitevåg Svingen, Heidi Borgeraas, and Reinhard Seifert
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0301 basic medicine ,Male ,Physiology ,Myocardial Infarction ,Blood Pressure ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Pathology and Laboratory Medicine ,Vascular Medicine ,Body Mass Index ,Coronary artery disease ,Angina ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Medicine and Health Sciences ,Myocardial infarction ,Immune Response ,Multidisciplinary ,Norway ,Hazard ratio ,Drugs ,Hematology ,Middle Aged ,Body Fluids ,Blood ,Physiological Parameters ,Cardiology ,Medicine ,Female ,Nitrogen Oxides ,Anatomy ,Research Article ,medicine.medical_specialty ,Endocrine Disorders ,Science ,Immunology ,Arginine ,Blood Plasma ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Internal medicine ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Humans ,Angina, Stable ,Pharmacology ,Inflammation ,business.industry ,Body Weight ,Statins ,Biology and Life Sciences ,medicine.disease ,030104 developmental biology ,Blood pressure ,chemistry ,Metabolic Disorders ,Asymmetric dimethylarginine ,business ,Body mass index - Abstract
BackgroundAsymmetric dimethylarginine (ADMA) is associated with increased risk of atherosclerotic cardiovascular disease and mortality through inhibition of nitrogen oxide (NO) synthesis. As positive correlations between serum concentrations of NO and body mass index (BMI) have been observed, we aimed to explore whether the potential associations between plasma ADMA levels and the risk of acute myocardial infarction (AMI) and mortality were modified by BMI.MethodsMultivariable Cox proportional hazard models were used to estimate the hazard ratios (HR) for AMI, cardiovascular death and all-cause mortality according to baseline plasma ADMA levels in 4122 patients with suspected stable angina pectoris. Analyses were subsequently repeated in patients with BMI below (low BMI) or above (high BMI) median.ResultsA total of 2982 patients (72%) were men. Median (range) age, plasma ADMA level and BMI were 62 (21-88) years, 0.54 (0.10-1.25) μmol/L and 26.3 (18.5-54.3) kg/m2, respectively. During a mean (standard deviation) follow-up time of 4.7 (1.4) years, 337 (8%) patients suffered from an AMI, 300 (7%) died, whereof 165 (55%) due to cardiovascular disease. Each 0.1 μmol/L increment in plasma ADMA level was associated with an increased risk of AMI (HR (95% CI) 1.21 (1.08, 1.35) and cardiovascular death 1.30 (1.13, 1.49) in participants with low BMI only. Interactions were significant for AMI (p = 0.04) and CV death (p = 0.03). BMI did not modify the association between plasma ADMA levels and all-cause mortality.ConclusionPlasma ADMA levels were associated with risk of AMI and cardiovascular death among patients with low BMI only.
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- 2016
49. Serum trans fatty acids, asymmetric dimethylarginine and risk of acute myocardial infarction and mortality in patients with suspected coronary heart disease: a prospective cohort study
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Rolf K. Berge, Pavol Bohov, Ottar Nygård, Jens Kristoffer Hertel, Jøran Hjelmesæth, Per Magne Ueland, Heidi Borgeraas, and Reinhard Seifert
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0301 basic medicine ,Male ,medicine.medical_specialty ,Asymmetric dimethylarginine ,Clinical chemistry ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Myocardial Infarction ,Clinical nutrition ,Coronary Artery Disease ,Acute myocardial infarction ,030204 cardiovascular system & hematology ,Arginine ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Prospective Studies ,Mortality ,Prospective cohort study ,Aged ,Biochemistry, medical ,business.industry ,Research ,Biochemistry (medical) ,Middle Aged ,Trans Fatty Acids ,medicine.disease ,Cardiovascular disease ,030104 developmental biology ,chemistry ,Cohort ,Cardiology ,Female ,Trans fatty acid ,business ,Lipidology - Abstract
Background Trans fatty acids (TFAs) have been found to impair flow mediated vasodilation and nitric oxide (NO) production. We sought to examine if serum TFA levels are associated with plasma levels of the NO inhibitor asymmetric dimethylarginine (ADMA) and if possible relationships between serum TFA and cardiovascular morbidity or mortality are mediated or modified by plasma ADMA levels. Methods The cohort included patients who underwent coronary angiography for suspected coronary heart disease in 2000–2001. Serum trans 16:1n7 and trans 18:1 isomers were determined by gas liquid chromatography and the summation of these two TFAs is reported as TFA (percentage by weight (wt%) or concentration). Associations between TFAs and ADMA were estimated by calculating the Spearman’s rank correlation coefficient (ρ), and risk associations with AMI, cardiovascular death and all-cause mortality across quartiles of TFAs (wt% or concentration) were explored by Cox modeling. Results A total of 1364 patients (75 % men) with median (25th,75th percentile) age 61 (54, 69) years, serum TFA 0.46 (0.36, 0.56) wt% and plasma ADMA 0.59 (0.50, 0.70) μmol/L were studied. Serum TFA levels (ρ = 0.21, p
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- 2015
50. The Chromosome 9p21 CVD- and T2D-Associated Regions in a Norwegian Population (The HUNT2 Survey)
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Carl G. P. Platou, Helge Ræder, Jens Kristoffer Hertel, Kristian Midthjell, Anders Molven, Stefan Johansson, Ottar Nygård, Kristian Hveem, Pål R. Njølstad, and Øyvind Helgeland
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Article Subject ,Endocrinology, Diabetes and Metabolism ,Population ,Norwegian ,computer.software_genre ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Endocrinology ,Chromosome (genetic algorithm) ,Midical sciences: 700::Basic medical, dental and veterinary sciences: 710::Medical genetics: 714 [VDP] ,Medicine ,cardiovascular diseases ,education ,License ,education.field_of_study ,lcsh:RC648-665 ,Endocrine and Autonomic Systems ,business.industry ,Creative commons ,language.human_language ,Genealogy ,Medisinske fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Medisinsk genetikk: 714 [VDP] ,Midical sciences: 700::Clinical medical sciences: 750::Endocrinology: 774 [VDP] ,language ,Data mining ,Medisinske fag: 700::Klinisk medisinske fag: 750::Endokrinologi: 774 [VDP] ,business ,computer ,Research Article - Abstract
Background.Two adjacent regions upstreamCDKN2Bon chromosome 9p21 have been associated with type 2 diabetes (T2D) and progression of cardiovascular disease (CVD). The precise location and number of risk variants have not been completely delineated and a possible synergistic relationship between the adjacent regions is not fully addressed. By a population based cross-sectional case-control design, we genotyped 18 SNPs upstream ofCDKN2Btagging 138 kb in and around two LD-blocks associated with CVD and T2D and investigated associations with T2D, angina pectoris (AP), myocardial infarction (MI), coronary heart disease (CHD; AP or AMI), and stroke using 5,564 subjects from HUNT2.Results.Single point and haplotype analysis showed evidence for only one common T2D risk haplotype (rs10757282∣rs10811661: OR = 1.19,P=2.0×10-3) in the region. We confirmed the strong association between SNPs in the 60 kb CVD region with AP, MI, and CHD(P<0.01). Conditioning on the lead SNPs in the region, we observed two suggestive independent single SNP association signals for MI,rs2065501 (P=0.03)andrs3217986 (P=0.04).Conclusions.We confirmed the association of known variants within the 9p21 interval with T2D and CHD. Our results further suggest that additional CHD susceptibility variants exist in this region.
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- 2015
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