The association between erectile dysfunction, depressive symptoms and testosterone levels among middle-aged men.

AIMS: The aim of this study was to investigate the association between erectile dysfunction and depressive symptoms and testosterone levels among middle-aged men at the community level. METHODS: The study population consisted of 614 men born in 1945 and living in the city of Oulu, Finland. Erectile dysfunction was assessed by the erectile function domain of the International Index of Erectile Function questionnaire and depressive symptoms by the Beck Depression Inventory. Blood samples were collected to measure testosterone and sex hormone-binding globulin level. RESULTS: After adjusting for confounders, erectile dysfunction was statistically significantly associated with depressive symptoms (risk ratio (RR) 1.66, 95% confidence interval (95% CI) 1.29-2.15), as well as with obesity (RR 1.72, 95% CI 1.12-2.62). Neither total nor free testosterone level was associated with erectile dysfunction among our study group. CONCLUSIONS: Depressive symptoms rather than testosterone levels should be taken into consideration while treating middle-aged men with erectile problems at the community level.

Ten-year natural course of habitual snoring and restless legs syndrome in a population aged 61-63 years at the baseline.

PURPOSE: We investigated the prevalence, natural course, and associated risk factors of habitual snoring (HS) and restless legs syndrome (RLS) over a period of 10 years among an aging population from their early sixties to their seventies. METHODS: A population-based follow-up study among all persons born in 1935 and living in the city of Oulu in northern Finland was conducted. In this study, we examined subjects who had participated in two subsequent surveys conducted in 1996-1998 and 2007-2008. The data were gathered by questionnaires, as well as by laboratory and clinical measurements. RESULTS: Altogether 457 (55%) of the 838 eligible subjects participated in both surveys. The prevalence of both RLS and HS decreased during the 10 years from 21% to 15% and from 26% to 19%, respectively. Half of those who snored in 1996-1998 stopped snoring in 10 years time, and half of those who suffered from restless legs at least three times per week in 1996-1998 suffered from this syndrome never or less than once a week in 2007-2008. The 10-year incidence of new cases of both HS and RLS was 7%. Male gender predicted best the incidence of new HS in 10 years, while the Zung sum score as a marker of depressive symptoms and waist circumference predicted RLS. CONCLUSIONS: Overall, the prevalence of both HS and RLS seems to diminish during aging. The causes behind this still remain unknown and should be investigated with more sophisticated methods.

Prevalence of metabolic syndrome components among the elderly using three different definitions: a cohort study in Finland.

OBJECTIVE: Limited data are available on the metabolic syndrome (MetS) and its components in elderly people (aged 70 years and over) at population level in Northern Europe. A study was undertaken to investigate the prevalence of MetS and its components in an aging population by using different definitions. DESIGN, SETTING, AND SUBJECTS: A cross-sectional study of 539 inhabitants from Northern Finland (mean age 71.9 years) was conducted to investigate the prevalence of MetS, by using the definitions of MetS by the National Cholesterol Education Panel (NCEP), the modified NCEP (NCEPm), and the International Diabetes Federation (IDF). MAIN OUTCOME MEASURES: Prevalence of MetS by the NCEP, NCEP modified, and IDF criteria. RESULTS: Overall, the prevalence of MetS was 24.7%, 35.2%, and 37.2% in men, by NCEP, modified NCEP, and IDF-definitions, respectively. In women the corresponding figures were 20.9%, 33.1%, and 47.8%. Hypertension was the most common component in both men (91.8%) and women (89.0%) by the IDF criteria. Glucose abnormalities were particularly prevalent in men (53.2% by NCEP and 78.4% by IDF criteria). CONCLUSIONS: The most common component was hypertension in both genders. Lower waist-circumference cut-off points of the IDF criteria led to a higher prevalence of MetS particularly in women. Prevalence of MetS varied significantly when measured by different definitions. Nearly half of older women met the IDF definition of MetS, which was more than twofold when compared with NCEP. Clinical practitioners should be aware of the limitations when using set criteria of MetS, in contrast to identifying the individual cardiovascular risk factors and the accumulation of these.

Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study.

BACKGROUND: Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, at least as long as the intervention continues. In the extended follow-up of the Finnish Diabetes Prevention Study, we assessed the extent to which the originally-achieved lifestyle changes and risk reduction remain after discontinuation of active counselling. METHODS: Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomly assigned to intensive lifestyle intervention or control group. After a median of 4 years of active intervention period, participants who were still free of diabetes were further followed up for a median of 3 years, with median total follow-up of 7 years. Diabetes incidence, bodyweight, physical activity, and dietary intakes of fat, saturated fat, and fibre were measured. FINDINGS: During the total follow-up, the incidence of type 2 diabetes was 4.3 and 7.4 per 100 person-years in the intervention and control group, respectively (log-rank test p=0.0001), indicating 43% reduction in relative risk. The risk reduction was related to the success in achieving the intervention goals of weight loss, reduced intake of total and saturated fat and increased intake of dietary fibre, and increased physical activity. Beneficial lifestyle changes achieved by participants in the intervention group were maintained after the discontinuation of the intervention, and the corresponding incidence rates during the post-intervention follow-up were 4.6 and 7.2 (p=0.0401), indicating 36% reduction in relative risk. INTERPRETATION: Lifestyle intervention in people at high risk for type 2 diabetes resulted in sustained lifestyle changes and a reduction in diabetes incidence, which remained after the individual lifestyle counselling was stopped.

Insulin resistance and depressive symptoms in young adult males: findings from Finnish military conscripts.

OBJECTIVE: To investigate whether the association between insulin resistance (IR) and depressive symptoms is present already in young adult males. The association between IR and depression has been poorly studied, although the existence of a connection of Type II diabetes with depression is well established. We previously demonstrated at epidemiological level in two groups of men aged 31 years and 61 to 63 years that IR is linked with depressive symptoms. METHODS: In a cross-sectional study, involving 1054 healthy Finnish male military conscripts of about 19 years of age, IR was defined through homeostasis model assessment (HOMA-IR). The severity of the depressive symptoms was evaluated through a Finnish modification of the 13-item Beck Depression Inventory (R-BDI). Moderate-to-severe depressive symptoms were said to be present, if the R-BDI score was > or = 8, and mild depressive symptoms were present if the R-BDI score was 5 to 7. RESULTS: After adjusting for confounders, moderate-to-severe depressive symptoms increased the risk for IR, as defined by the highest decile of the HOMA-IR, up to 2.8-fold (odds ratio = 2.8; 1.2-6.5). Mild depressive symptoms were not significantly associated with IR. CONCLUSIONS: In young adult males, co-occurring strictly defined IR seems to be positively associated with current moderate-to-severe depressive symptoms.

Metabolic syndrome in connection with BMI in young Finnish male adults.

The purpose of this study was to investigate the prevalence of metabolic syndrome (MetS) and its components in relation to different Body Mass Index (BMI) categories in young Finnish males. Different components of MetS were assessed in 1099 healthy Finnish male military conscripts of about 19 years of age. Prevalence of MetS and its components, according to criteria given by the International Diabetes Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (ATPIII), were calculated for different BMI categories. Based on the complete sample, prevalence of MetS, according to IDF and ATPIII criteria, was 6.8 and 3.5%, respectively. MetS prevalence increased in parallel with an increase in BMI. In obese persons it occurred in 55.4 and 27.2% according to IDF and ATPIII criteria, respectively. Our observations on MetS prevalences (which were especially high in obese service men) were in line with those few studies carried out earlier in the USA. We recommend that health education focus on those individuals that show an elevated risk of developing, already in young adulthood, cardiovascular disease and type 2 diabetes.

Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study.

Clinical trials have demonstrated that lifestyle changes can prevent type 2 diabetes, but the importance of leisure-time physical activity (LTPA) is still unclear. We carried out post hoc analyses on the role of LTPA in preventing type 2 diabetes in 487 men and women with impaired glucose tolerance who had completed 12-month LTPA questionnaires. The subjects were participants in the Finnish Diabetes Prevention Study, a randomized controlled trial of lifestyle changes including diet, weight loss, and LTPA. There were 107 new cases of diabetes during the 4.1-year follow-up period. Individuals who increased moderate-to-vigorous LTPA or strenuous, structured LTPA the most were 63-65% less likely to develop diabetes. Adjustment for changes in diet and body weight during the study attenuated the association somewhat (upper versus lower third: moderate-to-vigorous LTPA, relative risk 0.51, 95% CI 0.26-0.97; strenuous, structured LTPA, 0.63, 0.35-1.13). Low-intensity and lifestyle LTPA and walking also conferred benefits, consistent with the finding that the change in total LTPA (upper versus lower third: 0.34, 0.19-0.62) was the most strongly associated with incident diabetes. Thus increasing physical activity may substantially reduce the incidence of type 2 diabetes in high-risk individuals.

Association of insulin resistance linked diseases and hair loss in elderly men. Finnish population-based study.

Previous investigations have shown an association of androgenetic alopecia (AGA) with insulin resistance related disorders such as ischemic heart disease. An association between AGA and anthropometric abnormalities linked with insulin resistance and heredity in women aged 63 years has also been shown. We therefore compared 63-year-old men with AGA and ones with normal hair status for insulin resistance linked parameters. A population of 245 men aged 63 years, who were participants in a population-based cross-sectional study in the City of Oulu, underwent a medical check-up including assessment of hair status on the Hamilton-Norwood scale and determination of anthropometric measures, blood pressure, fasting glucose and serum lipids. Fifty eight per cent of the men reported extensive hair loss (grade III-VII). Hypertension and the use of antihypertensive drugs were common among men with AGA (61% vs. 45% and 50% vs. 26%, respectively). The rates of diabetes and hyperinsulinemia (21% vs. 12% and 61% vs. 49%) were higher among men with AGA compared to those with normal hair status but no difference was seen in other factors. Our findings show that AGA is common among Finnish men aged 63 years but that it is also associated with insulin linked disturbances, such as hypertension and diabetes. Such men developing AGA might benefit from attention in medical check-up.

Associations of microalbuminuria and blood pressure with carotid, aortic and femoral atheromatous plaques in elderly Finns.

AIMS: To evaluate the possible associations of microalbuminuria (MA) and blood pressure (BP) with the ultrasonographic manifestations of carotid, aortic and femoral atherosclerosis in 65-year-old Finns. METHODS: Ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance (IGT) and 57 normoglycemic subjects (NGT). Urinary albumin and creatinine concentrations were measured from an early morning spot urine sample, and the urinary albumin-to-creatinine ratio (ACR) of > or = 2.5 mg/mmol in men and > or = 3.5 mg/mmol in women was used as a measure of MA. Hypertension was defined as either a systolic BP of > or = 160 mmHg or a diastolic BP of > or = 95 mmHg or being on antihypertensive medication. RESULTS: Eighteen subjects were microalbuminuric and 176 subjects normoalbuminuric. MA was associated with diabetes mellitus and high systolic and diastolic BP. The subjects were divided into two groups according to the median total number of carotid, aortic and femoral plaques: > or = 9 versus 0-8 plaques. A high number of plaques were associated with hypertension, male gender, smoking and MA. When the study subjects were stratified according to hypertension, it turned out that MA was associated with a high number of plaques in hypertensive, but not in nonhypertensive subjects. According to the results of logistic regression analysis with a high number of plaques as the dependent variable, the unadjusted OR for smoking was 6.0 (95% CI 2.4-15.3) in hypertensive subjects. Microalbuminuria was of borderline statistical significance (OR 4.5, 95% CI 0.9-22.9). After adjustment for systolic blood pressure and fasting glucose concentration, the OR for microalbuminuria was reduced to 3.3 (95% CI 0.6-18.4).

The relationship of glucose tolerance to sleep disorders and daytime sleepiness.

The purpose of the study was to find out if snoring, sleep apnea and daytime sleepiness are independent indices of obesity related to type two diabetes (T2D), and whether depression is independently associated with features of sleep apnea. A population-based cohort study was conducted among 593 subjects (245 men and 348 women) born in 1935 and living in Oulu in 1996-1998. Glucose status was determined with a standard 2h oral glucose tolerance test, and sleeping disorders were recorded on the Epworth sleepiness scale (ESS) and in a questionnaire of five questions about sleeping and snoring. Depression was measured by the Zung self-rated depression scale. Insulin sensitivity was measured by quantitative insulin sensitivity check index. Habitual snoring was more common in diabetic subjects than in subjects with impaired glucose regulation (IGR) or normal glucose tolerance (NGT). All sleep disorders associated with neck circumference, waist circumference and body mass index (BMI). There was also a relationship between impaired insulin sensitivity and habitual snoring in bivariate analysis. In multiple logistic regression analysis, depression associated independently with daytime sleepiness (OR 3.00, 95% CI 1.40-6.46). Type 2 diabetes (T2D) (OR 1.93, 95% CI 1.04-3.57) and smoking (OR 1.69, 95% CI 1.00-2.84) associated independently with habitual snoring. BMI (OR 1.20, 95% CI 1.09-1.34) and male gender (OR 2.61, 95% CI 1.05-6.72) associated independently with sleep apnea. In a multiple regression model, BMI, neck circumference and habitual snoring associated independently with T2D. Habitual snoring was associated with T2D and impaired insulin sensitivity. Daytime sleepiness seemed to be linked with depression but not with using sleep medication, IGR and T2D.

Health-related quality of life and physical well-being among a 63-year-old cohort of women with androgenetic alopecia; a Finnish population-based study.

BACKGROUND: The aim of this study was to assess the possible associations between female androgenetic alopecia (AGA), insulin resistance and health-related quality of life (HRQOL)-linked factors in women. We hypothesized that not only the mental aspects but also certain physical aspect of women's health, such as insulin resistance, have an important role in the determination of HRQOL among women with hair loss. METHODS: A population-based cohort of 330 healthy women aged 63 years, who participated in this study in the City of Oulu in Northern Finland, underwent a medical check-up including assessment of hair status on Ludwig's scale. Background data were collected with a standard questionnaire including a validated RAND 36-Item Health Survey (RAND-36) questionnaire. RESULTS: 105 (31%) women with AGA and 225 (69%) controls completed the RAND-36 questionnaire. The women with AGA were more insulin-resistant than the women with normal hair (QUICKI 0.337 vs. 0.346, p = 0.012). Impaired glucose regulation (IGR) was more prevalent among the former than the latter group (39% vs. 25%). The mean RAND-36 scores were significantly lower on the dimensions of physical functioning, role limitation due to physical health and general health, but not on the mental or social dimensions, among the women with AGA compared with the controls. In multivariate logistic regression analyses with the lowest quintiles of the HRQOL dimensions as the dependent variables and AGA, depression, marital status, education and IGR or QUICKI as independent variables, AGA was independently associated with role limitations due to physical health (2.2, 95% CI 1.20-4.05, 2.45 95% CI 1.32-4.55, respectively). CONCLUSION: In women aged 63 years, AGA was associated with role limitations due to physical health. Furthermore, the prevalence rates of IGR and insulin resistance measured by QUICKI were higher among the women with hair loss than those with normal hair.

Prevalence of the metabolic syndrome and its components: findings from a Finnish general population sample and the Diabetes Prevention Study cohort.

OBJECTIVE: To assess the prevalence of the metabolic syndrome (MetS) in two independent Finnish study cohorts. RESEARCH DESIGN AND METHODS: The prevalence of the MetS by modified World Health Organization criteria was analyzed in different categories of glucose tolerance in a cross-sectional, population-based sample of 2,049 individuals (FINRISK) aged 45-64 years and in 522 participants of the Finnish Diabetes Prevention Study (DPS) with impaired glucose tolerance (IGT). RESULTS: In the FINRISK cohort, the MetS was present in 38.8% of the men and 22.2% of the women. The prevalence was 14.4 and 10.1% in subjects with normal glucose tolerance, 74.0 and 52.2% in subjects with impaired fasting glucose, 84.8 and 65.4% in subjects with IGT, and 91.5 and 82.7% in subjects with type 2 diabetes in men and women, respectively. Among women, the prevalence of the MetS increased with increasing age. In the DPS cohort, the MetS was present in 78.4% of the men and 72.2% of the women with IGT. CONCLUSIONS: The MetS was extremely common in middle-aged subjects The high prevalence in men was mostly due to their high waist-to-hip ratio. The prevalence of the MetS increased in both sexes with deterioration in glucose regulation. Approximately 75% of the subjects with IGT had the MetS. Because the syndrome includes the major risk factors for atherosclerotic vascular diseases and is the major antecedent for type 2 diabetes, concerted preventive action should be targeted to control all the features of the MetS.

Low insulin sensitivity measured by both quantitative insulin sensitivity check index and homeostasis model assessment method as a risk factor of increased intima-media thickness of the carotid artery.

The present study evaluated the association of ultrasonographic manifestations of carotid atherosclerosis with glucose status, various components of the insulin resistance syndrome, and insulin sensitivity measured by a novel quantitative insulin sensitivity check index (QUICKI = 1/[log(I0) + log (G0)]). Carotid ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance and 57 normoglycemic subjects. QUICKI and insulin resistance measured by a HOMA (homeostasis model assessment) method had a high negative correlation (r = -0.995, P < 0.001). QUICKI was lower in diabetic subjects (0.319 +/- 0.022) than in subjects with impaired glucose tolerance (0.334 +/- 0.027) or normoglycemia (0.335 +/- 0.022, P = 0.002). There was an increasing trend in the mean and maximal intima-media thickness (IMT) of the common carotid artery (CCA) with worsening of glucose status. The maximal IMT of the CCA correlated inversely with QUICKI (r = -0.158, P = 0.027). The prevalence of severe CCA atherosclerosis (maximal IMT of the CCA > or = 1.2 mm) was 41% in men and 16% in women (P < 0.001). It was also associated with a long (> or =26 yr) smoking history. The prevalence of severe CCA atherosclerosis was 11% in the highest QUICKI tertile, 36% in the middle tertile, and 33% in the lowest tertile (P = 0.002). Systolic blood pressure was higher and high-density lipoprotein cholesterol lower in subjects with severe CCA atherosclerosis, compared with those without it. In multiple regression analysis, the adjusted odds ratio for severe CCA atherosclerosis was 5.7 (95% confidence interval, 2.2-15.1) in subjects in the two lowest tertiles of QUICKI, compared with those in the highest tertile.

Reduction in metabolic syndrome among obese young men is associated with exercise-induced body composition changes during military service.

AIMS: A population-based study of 1046 young Finnish men was performed to evaluate whether body composition changes observed during military service are associated with a reduction in prevalence of metabolic syndrome (MetS), and whether the effect is body mass index (BMI)-dependent. METHODS: A prospective study of 1046 men (mean age 19.2 years, SD 1.0), with follow-up during 6-12 months of military service in northern Finland. Anthropometry, body composition, biochemical measurements and physical fitness were assessed at baseline and follow-up. MetS was defined using the International Diabetes Federations (IDF) criterion, continuous MetS Z-score calculated, and changes evaluated in BMI categories. RESULTS: Prevalence of MetS at baseline and follow-up was 6.1% and 3.6%, respectively (p < 0.001). Prevalence of MetS decreased by 40% (p < 0.001) among the obese young men (BMI ≥ 30 kg/m(2)). Reduction in the MetS Z-score was mainly attributable to weight loss and reduced fat mass (p < 0.001) and improvement in physical fitness (muscle fitness index, p = 0.016). CONCLUSIONS: Beneficial exercise-induced changes in body composition significantly reduced the prevalence of MetS among young, obese men. Our findings support the efficacy of increased physical activity for prevention of early-onset cardiovascular disease, particularly among overweight and obese young men.

Exercise during military training improves cardiovascular risk factors in young men.

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

Limited overlap between intermediate hyperglycemia as defined by A1C 5.7-6.4%, impaired fasting glucose, and impaired glucose tolerance.

OBJECTIVE: We compared the prevalences and overlap between intermediate hyperglycemia (IH), defined by a hemoglobin A(1c) (A1C) 5.7-6.4%, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: Oral glucose tolerance test results and A1C measurements were evaluated as markers of IH in an unselected cohort of 486 nondiabetic adults from Finland. RESULTS: The overall prevalence of IH was 34%. Prevalences of isolated A1C 5.7-6.4%, IGT, and IFG were 8.0, 13.2, and 4.5%, respectively. Overlap between these three markers was uncommon. Isolated A1C 5.7-6.4% was associated with a higher BMI compared with isolated IFG and IGT and with a more adverse lipid profile compared with isolated IFG. CONCLUSIONS: Prevalence of isolated IH was high, with limited overlap between the definitions. Differences in cardiovascular disease risk factors were observed among the groups. This study demonstrates that an A1C of 5.7-6.4% detects, in part, different individuals with IH compared with IFG and IGT.

Postchallenge glucose, A1C, and fasting glucose as predictors of type 2 diabetes and cardiovascular disease: a 10-year prospective cohort study.

OBJECTIVE: A1C has been proposed as a new indicator for high risk of type 2 diabetes. The long-term predictive power and comparability of elevated A1C with the currently used high-risk indicators remain unclear. We assessed A1C, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) as predictors of type 2 diabetes and cardiovascular disease (CVD) at 10 years. RESEARCH DESIGN AND METHODS: This prospective population-based study of 593 inhabitants from northern Finland, born in 1935, was conducted between 1996 and 2008. An oral glucose tolerance test (OGTT) was conducted at baseline and follow-up, and A1C was determined at baseline. Those with a history of diabetes were excluded from the study. Elevated A1C was defined as 5.7-6.4%. Incident type 2 diabetes was confirmed by two OGTTs. Cardiovascular outcome was measured as incident CVD or CVD mortality. Multivariate log-binomial regression models were used to predict diabetes, CVD, and CVD mortality at 10 years. Receiver operating characteristic curves compared predictive values of A1C, IGT, and IFG. RESULTS: Incidence of diabetes during the follow-up was 17.1%. Two of three of the cases of newly diagnosed diabetes were predicted by a raise in >or=1 of the markers. Elevated A1C, IGT, or IFG preceded diabetes in 32.8, 40.6, and 21.9%, respectively. CVD was predicted by an intermediate and diabetic range of 2-h glucose but only by diabetic A1C levels in women. CONCLUSIONS: A1C predicted 10-year risk of type 2 diabetes at a range of A1C 5.7-6.4% but CVD only in women at A1C >or=6.5%.

Physical activity and body composition changes during military service.

PURPOSE: To examine how body composition changes in different body mass index (BMI) categories among young Finnish men during military service, which is associated with marked changes in diet and physical activity. In addition, this study examined how reported previous physical activity affected the body composition changes. METHODS: Altogether 1003 men (19 yr) were followed throughout their military service (6-12 months). Height, weight, BMI, waist circumference, and waist-to-hip ratio (WHR) were recorded. Previous physical activity was assessed at the beginning of the service by a questionnaire. Body composition was measured by bioelectrical impedance assessments (BIA) at the beginning and at the end of the service. The measured parameters were fat mass (FM), fat percentage (fat %), fat-free mass (FFM), visceral fat area (VFA), lean body mass (LBM), and skeletal muscle mass (SMM). RESULTS: On average, military training decreased weight by 0.7%, FM by 9.7%, fat % by 6.6%, and VFA by 43.4%. FFM increased by 1.3%, LBM by 1.2%, and SMM by 1.7%. The group of underweight and normal-weight men gained weight, FM, and FFM, whereas overweight and obese men lost weight and FM and gained FFM. FM was most reduced in the groups of overweight (20.8%) and obese (24.9%) men. The amount of VFA was reduced in all BMI groups (38%-44%). Among overweight men who reported being inactive previous to the military service, more beneficial changes in body composition were observed compared with those who reported being physically active. CONCLUSIONS: The lifestyle changes associated with military service markedly reduce fat tissue and increase the amount of lean tissue. These beneficial changes are prominent among previously inactive subjects with high BMI.

Association of abnormal glucose tolerance with self-reported sleep apnea among a 57-year-old urban population in Northern Finland.

AIMS: We examined the associations between glucose tolerance and sleep apnea in a 57-year-old unselected urban population in Northern Finland, taking into account some determinants of sleep apnea. METHODS: A population-based health survey was conducted in a population of 555 women and 438 men born in 1945 and living in the city of Oulu in 2001. Glucose status was determined with a standard 2-h oral glucose tolerance test. Sleeping disorders were recorded on the Epworth Sleepiness Scale (ESS) and a questionnaire including 5 questions about sleeping and snoring. The Zung Self-rated Depression Scale (ZSDS) was used to assess depressive symptoms. Logistic regression was used in the estimation of odds ratios (OR) for the associations of sleep apnea with the covariates. RESULTS: Sleep apnea was found to be associated with type 2 diabetes (OR 2.56, 95% CI 1.20-5.47) and newly diagnosed type 2 diabetes (OR 2.42 95% CI 1.01-5.82), but the estimated association with impaired glucose regulation (IGR) was coupled with a wide margin of error (OR 0.91, 95% CI 0.43-1.93) when adjusted for the following covariates: gender, current smoking, hypertension, hs-CRP, physical activity, waist circumference, and Zung depression scale. CONCLUSIONS: There seems to be a positive association between sleep apnea and type 2 diabetes, and even with newly diagnosed type 2 diabetes, but we could not establish an association with IGR.