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1.
Scand J Prim Health Care ; : 1-11, 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34585629

RESUMO

OBJECTIVE: Machine learning (ML) is expected to play an increasing role within primary health care (PHC) in coming years. No peer-reviewed studies exist that evaluate the diagnostic accuracy of ML models compared to general practitioners (GPs). The aim of this study was to evaluate the diagnostic accuracy of an ML classifier on primary headache diagnoses in PHC, compare its performance to GPs, and examine the most impactful signs and symptoms when making a prediction. DESIGN: A retrospective study on diagnostic accuracy, using electronic health records from the database of the Primary Health Care Service of the Capital Area (PHCCA) in Iceland. SETTING: Fifteen primary health care centers of the PHCCA. SUBJECTS: All patients that consulted a physician, from 1 January 2006 to 30 April 2020, and received one of the selected diagnoses. MAIN OUTCOME MEASURES: Sensitivity, Specificity, Positive Predictive Value, Matthews Correlation Coefficient, Receiver Operating Characteristic (ROC) curve, and Area under the ROC curve (AUROC) score for primary headache diagnoses, as well as Shapley Additive Explanations (SHAP) values of the ML classifier. RESULTS: The classifier outperformed the GPs on all metrics except specificity. The SHAP values indicate that the classifier uses the same signs and symptoms (features) as a physician would, when distinguishing between headache diagnoses. CONCLUSION: In a retrospective comparison, the diagnostic accuracy of the ML classifier for primary headache diagnoses is superior to GPs. According to SHAP values, the ML classifier relies on the same signs and symptoms as a physician when making a diagnostic prediction.KeypointsLittle is known about the diagnostic accuracy of machine learning (ML) in the context of primary health care, despite its considerable potential to aid in clinical work. This novel research sheds light on the diagnostic accuracy of ML in a clinical context, as well as the interpretation of its predictions. If the vast potential of ML is to be utilized in primary health care, its performance, safety, and inner workings need to be understood by clinicians.

2.
Commun Biol ; 4(1): 1132, 2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34580418

RESUMO

Platelets play an important role in hemostasis and other aspects of vascular biology. We conducted a meta-analysis of platelet count GWAS using data on 536,974 Europeans and identified 577 independent associations. To search for mechanisms through which these variants affect platelets, we applied cis-expression quantitative trait locus, DEPICT and IPA analyses and assessed genetic sharing between platelet count and various traits using polygenic risk scoring. We found genetic sharing between platelet count and counts of other blood cells (except red blood cells), in addition to several other quantitative traits, including markers of cardiovascular, liver and kidney functions, height, and weight. Platelet count polygenic risk score was predictive of myeloproliferative neoplasms, rheumatoid arthritis, ankylosing spondylitis, hypertension, and benign prostate hyperplasia. Taken together, these results advance understanding of diverse aspects of platelet biology and how they affect biological processes in health and disease.

4.
Nat Genet ; 53(8): 1135-1142, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34282336

RESUMO

Birth weight is a common measure of fetal growth that is associated with a range of health outcomes. It is directly affected by the fetal genome and indirectly by the maternal genome. We performed genome-wide association studies on birth weight in the genomes of the child and parents and further analyzed birth length and ponderal index, yielding a total of 243 fetal growth variants. We clustered those variants based on the effects of transmitted and nontransmitted alleles on birth weight. Out of 141 clustered variants, 22 were consistent with parent-of-origin-specific effects. We further used haplotype-specific polygenic risk scores to directly test the relationship between adult traits and birth weight. Our results indicate that the maternal genome contributes to increased birth weight through blood-glucose-raising alleles while blood-pressure-raising alleles reduce birth weight largely through the fetal genome.


Assuntos
Peso ao Nascer/genética , Desenvolvimento Fetal/genética , Adulto , Glicemia/genética , Pressão Sanguínea/genética , Estatura/genética , Doenças Cardiovasculares/genética , Feminino , Estudo de Associação Genômica Ampla , Haplótipos , Humanos , Islândia , Recém-Nascido , Masculino , Modelos Genéticos , Polimorfismo de Nucleotídeo Único
5.
Scand J Prim Health Care ; 38(3): 265-271, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32672085

RESUMO

OBJECTIVE: To describe antibiotic prescriptions in out-of-hour (OOH) service in primary care setting in Iceland and to study the indications for prescriptions. DESIGN: A population based retrospective study, using electronic data from the OOH registration system. SETTING: OOH primary care setting in Reykjavik capital area in Iceland. SUBJECTS: All patients that received a prescription for oral antibiotic drug at an OOH service in Reykjavik capital area over a one-year period. MAIN OUTCOME MEASURES: Number of oral antibiotic prescriptions and diagnosis connected to the prescriptions according to age and sex. RESULTS: There were 75,582 contacts with the OOH primary care of which 25,059 contacts resulted in prescription of an oral antibiotic (33%). The most common antibiotic prescribed in total, and for the diagnosis studied, was amoxicillin with clavulanic acid. It was most often prescribed for acute otitis media. Of those diagnosed with otitis media 50% were treated with amoxicillin with clavulanic acid and 40% of those diagnosed with pneumonia received that treatment. The second most prescribed antibiotic was amoxicillin. Most often it was prescribed for sinusitis, in 47% of cases with that diagnosis. CONCLUSION: Antibiotics are often prescribed in OOH primary care in Iceland and a substantial number of the patients diagnosed in OOH primary care with acute otitis media or pneumonia are prescribed broad-spectrum antibiotics. Key points Antibiotic prescription rate is high and broad-spectrum drugs often prescribed in OOH primary care service in Iceland. The results should encourage general practitioners in Iceland to review antibiotic prescriptions in OOH service.

6.
Laeknabladid ; 106(5): 235-240, 2020 05.
Artigo em Islandês | MEDLINE | ID: mdl-32367810

RESUMO

OBJECTIVE: Vitamin D plays a key role for children's growth and physical developement, not only by promoting bone health but also by its influence on extraskeletal systems. The Icelandic Directorate of Health recommends a vitamin D concentration in blood of at least 50 nmol/l. The object of this study was to evaluate the vitamin D status of Icelandic children and youngsters at four different ages, and furthermore to evaluate changes in vitamin D concentrations over time and connection to parathyroid hormone status (S-PTH). MATERIAL AND METHODS: The subjects were students from six elemen-tary schools in Reykjavík, born in 1999. Blood tests were taken four times, in 2006, 2008, 2015 og 2017. Some of the subjects took part in all four tests, but more students joined in 2015 and 2017. RESULTS: In all the tests, around 60% of the subjects had lower vitamin D concentrations than recommended by The Icelandic Directorate of Health. Only 13% met the recommended criteria of a concentration over 50 nmol/l in repeated tests and 38.9% of the subjects had lower concentrations than recommended in at least two tests. There was no significant difference between sexes except that 17 year old girls had significantly higher Vitamin D concentrations than boys (p=0.04). S-PTH was negatively correlated to vitamin D concentrations at ages 7, 15 and 17 but there was not a significant correlation at age 9. S-PTH values were lowest at age 7 and then increased with age. CONCLUSION: The majority of Icelandic children and youngsters have vitamin D concentrations under the values recommended by The Icelandic Directorate of Health. In many cases, the concentrations are repeatedly too low. It is clear that there is a need for increased vitamin D intake within this group if the goal regarding recommended concentrations is to be achieved. However, the influence of vitamin D deficiency on public health is not fully known.


Assuntos
Estado Nutricional , Hormônio Paratireóideo/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Adolescente , Fatores Etários , Biomarcadores , Criança , Feminino , Humanos , Islândia/epidemiologia , Estudos Longitudinais , Masculino , Recomendações Nutricionais , Fatores Sexuais , Fatores de Tempo , Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/fisiopatologia
7.
Nat Commun ; 10(1): 4803, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31641117

RESUMO

Features of the QRS complex of the electrocardiogram, reflecting ventricular depolarisation, associate with various physiologic functions and several pathologic conditions. We test 32.5 million variants for association with ten measures of the QRS complex in 12 leads, using 405,732 electrocardiograms from 81,192 Icelanders. We identify 190 associations at 130 loci, the majority of which have not been reported before, including associations with 21 rare or low-frequency coding variants. Assessment of genes expressed in the heart yields an additional 13 rare QRS coding variants at 12 loci. We find 51 unreported associations between the QRS variants and echocardiographic traits and cardiovascular diseases, including atrial fibrillation, complete AV block, heart failure and supraventricular tachycardia. We demonstrate the advantage of in-depth analysis of the QRS complex in conjunction with other cardiovascular phenotypes to enhance our understanding of the genetic basis of myocardial mass, cardiac conduction and disease.


Assuntos
Eletrocardiografia , Coração/fisiologia , Proteínas/genética , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/genética , Feminino , Regulação da Expressão Gênica , Variação Genética , Estudo de Associação Genômica Ampla , Coração/fisiopatologia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/genética , Humanos , Islândia , Masculino , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/genética
9.
Circ Genom Precis Med ; 11(8): e002151, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30354339

RESUMO

BACKGROUND: Dilated cardiomyopathy (DCM) is an important cause of heart failure. Variants in >50 genes have been reported to cause DCM, but causative variants have been found in less than half of familial cases. Variants causing DCM in Iceland have not been reported before. METHODS: We performed a genome-wide association study on DCM based on whole genome sequencing. We tested the association of 32.5 million sequence variants in 424 cases and 337 689 population controls in Iceland. RESULTS: We identified 2 DCM variants in established cardiomyopathy genes, a missense variant p.Phe145Leu in NKX2-5 carried by 1 in 7100 Icelanders ( P=7.0×10-12) and a frameshift variant p.Phe1626Serfs*40 in FLNC carried by 1 in 3600 Icelanders ( P=2.1×10-10). Both variants associate with heart failure and sudden cardiac death. Additionally, p.Phe145Leu in NKX2-5 associates with high degree atrioventricular block and atrial septal defect ( P<1.4×10-4). The penetrance of serious heart disease among carriers of the NKX2-5 variant is high and higher than that of the FLNC variant. CONCLUSIONS: Two rare variants in NKX2-5 and FLNC, carried by 1 in 2400 Icelanders, cause familial DCM in Iceland. These genes have recently been associated with DCM. Given the serious consequences of these variants, we suggest screening for them in individuals with DCM and their family members, with subsequent monitoring of carriers, offering early intervention.


Assuntos
Cardiomiopatia Dilatada/complicações , Cardiomiopatia Dilatada/genética , Morte Súbita Cardíaca/etiologia , Filaminas/genética , Proteína Homeobox Nkx-2.5/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Cardiomiopatia Dilatada/epidemiologia , Estudos de Casos e Controles , Morte Súbita Cardíaca/epidemiologia , Feminino , Mutação da Fase de Leitura , Estudo de Associação Genômica Ampla , Humanos , Islândia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mutação de Sentido Incorreto , Penetrância , Adulto Jovem
10.
Nat Commun ; 9(1): 987, 2018 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-29511194

RESUMO

Aortic valve stenosis (AS) is the most common valvular heart disease, and valve replacement is the only definitive treatment. Here we report a large genome-wide association (GWA) study of 2,457 Icelandic AS cases and 349,342 controls with a follow-up in up to 4,850 cases and 451,731 controls of European ancestry. We identify two new AS loci, on chromosome 1p21 near PALMD (rs7543130; odds ratio (OR) = 1.20, P = 1.2 × 10-22) and on chromosome 2q22 in TEX41 (rs1830321; OR = 1.15, P = 1.8 × 10-13). Rs7543130 also associates with bicuspid aortic valve (BAV) (OR = 1.28, P = 6.6 × 10-10) and aortic root diameter (P = 1.30 × 10-8), and rs1830321 associates with BAV (OR = 1.12, P = 5.3 × 10-3) and coronary artery disease (OR = 1.05, P = 9.3 × 10-5). The results implicate both cardiac developmental abnormalities and atherosclerosis-like processes in the pathogenesis of AS. We show that several pathways are shared by CAD and AS. Causal analysis suggests that the shared risk factors of Lp(a) and non-high-density lipoprotein cholesterol contribute substantially to the frequent co-occurence of these diseases.


Assuntos
Estenose da Valva Aórtica/genética , Estudos de Casos e Controles , Doença da Artéria Coronariana/genética , Estudo de Associação Genômica Ampla , Humanos , Fenótipo , Fatores de Risco
11.
Eur Heart J ; 39(34): 3243-3249, 2018 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-29590334

RESUMO

Aims: Coarctation of the aorta (CoA) accounts for 4-8% of congenital heart defects (CHDs) and confers substantial morbidity despite treatment. It is increasingly recognized as a highly heritable condition. The aim of the study was to search for sequence variants that affect the risk of CoA. Methods and results: We performed a genome-wide association study of CoA among Icelanders (120 cases and 355 166 controls) based on imputed variants identified through whole-genome sequencing. We found association with a rare (frequency = 0.34%) missense mutation p.Arg721Trp in MYH6 (odds ratio = 44.2, P = 5.0 × 10-22), encoding the alpha-heavy chain subunit of cardiac myosin, an essential sarcomere protein. Approximately 20% of individuals with CoA in Iceland carry this mutation. We show that p.Arg721Trp also associates with other CHDs, in particular bicuspid aortic valve. We have previously reported broad effects of p.Arg721Trp on cardiac electrical function and strong association with sick sinus syndrome and atrial fibrillation. Conclusion: Through a population approach, we found that a rare missense mutation p.Arg721Trp in the sarcomere gene MYH6 has a strong effect on the risk of CoA and explains a substantial fraction of the Icelanders with CoA. This is the first mutation associated with non-familial or sporadic form of CoA at a population level. The p.Arg721Trp in MYH6 causes a cardiac syndrome with highly variable expressivity and emphasizes the importance of sarcomere integrity for cardiac development and function.


Assuntos
Coartação Aórtica/genética , Miosinas Cardíacas/genética , DNA/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Mutação de Sentido Incorreto , Cadeias Pesadas de Miosina/genética , Adolescente , Adulto , Coartação Aórtica/metabolismo , Doenças Assintomáticas , Miosinas Cardíacas/metabolismo , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Cadeias Pesadas de Miosina/metabolismo , Linhagem , Estudos Retrospectivos , Adulto Jovem
13.
Laeknabladid ; 103(9): 367-371, 2017 Sep.
Artigo em Islandês | MEDLINE | ID: mdl-29044032

RESUMO

OBJECTIVE: To determine the relationship between serum vitamin D levels and known cardiometabolic risk factors among healthy Icelandic children as well as study these connections independent of body mass index (BMI). METHODS: We assessed the relationship between serum 25-hydroxyvitamin D, adiposity measured as BMI and 7 cardiometabolic risk factors (high blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood glucose and serum insulin). Subjects were 7-year old school children in six randomly selected elementary schools in Reykjavik, Iceland, in the autumn of 2006. RESULTS: Vitamin D was measured amongst 159 children. 35 (22%) were lower than 37,5 nmol/L, 70 (44%) between 37,5-50,0 nmol/L and 55 (34%) over 50 nmol/L. Deficiency was defined as lower than 37,5 nmol/L. No difference was between girls or boys, girls (n:85 = 44,2nmol/L), boys (n:74 = 46,9nmol/L), (p= 0,052). Deficient children had higher BMI (p=0.052), lower HDL (p=0.044) and higher HbA1c (p=0.015), and insulin (p=0.014) than those who had vitamin D higher than 50 nmol/L. Significant correlation was between low levels of vitamin D and high levels of serum insulin (p=0,014) and high levels of HbA1c (p =0,015), independent of BMI. CONCLUSION: Vitamin D deficiency has been associated with the development of cardiovascular disease. It is important to explore the connection between known risk factors and vitamin D and treat those who are deficient of it, especially children and young adults. It is possible that vitamin D deficiency has an effect on cardiovascular risk early in life through insulin resistance and altered blood sugar control. It is important to follow guidelines for giving vitamin D to children, as the result showed that 2/3 of the children were under 50 nmol/L. Key words: Vitamin D, cardiovascular risk factors, insulin Correspondence: Emil L. Sigurdsson emilsig@hi.is.


Assuntos
Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adiposidade , Fatores Etários , Biomarcadores/sangue , Glicemia/análise , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Criança , Feminino , Hemoglobina A Glicada/análise , Nível de Saúde , Humanos , Islândia/epidemiologia , Insulina/sangue , Resistência à Insulina , Lipídeos/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Fatores de Risco , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/fisiopatologia
14.
Laeknabladid ; 103(9): 365, 2017 Sep.
Artigo em Islandês | MEDLINE | ID: mdl-29044031
16.
BMC Fam Pract ; 17: 69, 2016 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-27267943

RESUMO

BACKGROUND: The prevalence of multimorbidity is increasing worldwide, presumably leading to an increased use of medicines. During the last decades the use of hypnotic and anxiolytic benzodiazepine derivatives and related drugs has increased dramatically. These drugs are frequently prescribed for people with a sleep disorder often merely designated as "insomnia" in the medical records and lacking a clear connection with the roots of the patients' problems. Our aim was to analyse the prevalence of multimorbidity in primary healthcare in Iceland, while concurrently investigating a possible association with the prevalence and incidence of hypnotic/anxiolytic prescriptions, short-term versus chronic use. METHODS: Data were retrieved from a comprehensive database of medical records from primary healthcare in Iceland to find multimorbid patients and prescriptions for hypnotics and anxiolytics, linking diagnoses (ICD-10) and prescriptions (2009-2012) to examine a possible association. Nearly 222,000 patients, 83 % being local residents in the capital area, who contacted 16 healthcare centres served in total by 140 general practitioners, were set as a reference to find the prevalence of multimorbidity as well as the prevalence and incidence of hypnotic/anxiolytic prescriptions. RESULTS: The prevalence of multimorbidity in the primary care population was 35 %, lowest in the young, increasing with age up to the 80+ group where it dropped somewhat. The prevalence of hypnotic/anxiolytic prescriptions was 13.9 %. The incidence rate was 19.4 per 1000 persons per year in 2011, and 85 % of the patients prescribed hypnotics/anxiolytics were multimorbid. Compared to patients without multimorbidity, multimorbid patients were far more likely to be prescribed a hypnotic and/or an anxiolytic, OR = 14.9 (95 % CI = 14.4-15.4). CONCLUSIONS: Patients with multiple chronic conditions are common in the primary care setting, and prevalence and incidence of hypnotic/anxiolytic prescriptions are high. Solely explaining use of these drugs by linear thinking, i.e. that "insomnia" leads to their prescription is probably simplistic, since the majority of patients prescribed these drugs are multimorbid having several chronic conditions which could lead to sleeping problems. However, multimorbidity as such is not an indication for hypnotics, and doctors should be urged to greater caution in their prescribing, bearing in mind non-pharmacological therapy options.


Assuntos
Ansiolíticos/uso terapêutico , Doença Crônica/epidemiologia , Prescrições de Medicamentos/estatística & dados numéricos , Hipnóticos e Sedativos/uso terapêutico , Atenção Primária à Saúde/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comorbidade , Estudos Transversais , Feminino , Seguimentos , Humanos , Islândia/epidemiologia , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Adulto Jovem
17.
J Bone Miner Metab ; 34(5): 580-6, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26220169

RESUMO

The importance of vitamin D for children's bone health has been well established, but the effects of less severe deficiency are not fully known. The main objective of this study was to assess the vitamin D status of Icelandic children at the age of 7, and again at 9 years of age, and the association of vitamin D status with bone mineral content and bone accrual over 2 years. We invited 321 children to participate in this study, and 267 (83 %) took part; 211 (79 %) underwent a DXA scan and 164 were again scanned 2 years later; 159 (60 %) vitamin D samples were measured and 119 (75 %) were measured again 2 years later. At age 7, 65 % of the children had vitamin D concentrations <50 nmol/l, and at age 9 this figure was 60 %. At age 7, 43 % of the children had insufficient amounts of vitamin D (37.5-50 nmol/l), and 22 % had a vitamin D deficiency (<37.5 nmol/l). In linear regression analysis, no association was found between vitamin D and bone mineral content. Furthermore, there was no significant difference in bone accrual over 2 years for the children with insufficient or deficient vitamin D at both ages, compared to those having more than 50 nmol/l at both time points. More than 60 % of Icelandic children have inadequate concentrations of vitamin D in serum repeatedly over a 2-year interval. However, vitamin D in the range did not have a significant effect on bone mineral content or accrual at ages 7 and 9.


Assuntos
Densidade Óssea , Vitamina D/análogos & derivados , Criança , Feminino , Humanos , Islândia , Masculino , Vitamina D/sangue
18.
Laeknabladid ; 101(9): 411-3, 2015 09.
Artigo em Islandês | MEDLINE | ID: mdl-26374821

RESUMO

One of the more common reasons patients seek medical advice after traveling in tropical countries are skin eruptions. Here we describe two cases of individuals who, after traveling to south east Asia, developed a skin eruption later diagnosed as cutaneous larva migrans. This particular skin condition is common among travelers to countries where the hookworm responsible is endemic. The diagnosis is based on travel history and clinical examination. The patients were treated with albendazole with good results and complete resolution of the symptoms.


Assuntos
Larva Migrans/diagnóstico , Prurido/diagnóstico , Viagem , Albendazol/uso terapêutico , Antinematódeos/uso terapêutico , Ásia , Humanos , Islândia , Larva Migrans/tratamento farmacológico , Larva Migrans/parasitologia , Prurido/tratamento farmacológico , Prurido/parasitologia , Resultado do Tratamento , Adulto Jovem
20.
Scand J Prim Health Care ; 32(4): 149-55, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25424464

RESUMO

OBJECTIVE: To assess the effectiveness of a two-year school-based intervention, consisting of integrated and replicable physical activity and nutritional education on weight, fat percentage, cardiovascular risk factors, and blood pressure. DESIGN AND SETTING: Six elementary schools in Reykjavik were randomly assigned to be either intervention (n = 3) or control (n = 3) schools. Seven-year-old children in the second grade in these schools were invited to participate (n = 321); 268 (83%) underwent some or all of the measurements. These 286 children were followed up for two years. INTERVENTION: Children in intervention schools participated in an integrated and replicable physical activity programme, increasing to approximately 60 minutes of physical activity during school in the second year of intervention. Furthermore, they received special information about nutrition, and parents, teachers, and school food service staff were all involved in the intervention. Subjects. 321seven-year-old schoolchildren. MAIN OUTCOME MEASURES: Blood pressure, obesity, percentage of body fat, lipid profile, fasting insulin. RESULTS: Children in the intervention group had a 2.3 mmHg increase in systolic blood pressure (SBP) and a 2.9 mmHg increase in diastolic blood pressure (DBP) over the two-year intervention period, while children in the control group increased SBP by 6.7 mmHg and DPB by 8.4 mmHg. These changes were not statistically significant. Furthermore there were no significant changes in percentage body fat, lipid profile, or fasting insulin between the intervention and control schools. CONCLUSION: A two-year school-based intervention with increased physical activity and healthy diet did not have a significant effect on common cardiovascular risk factors.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Promoção da Saúde/métodos , Atividade Motora , Instituições Acadêmicas , Criança , Análise por Conglomerados , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Humanos , Islândia , Estudos Longitudinais , Masculino , Educação Física e Treinamento/organização & administração , Fatores de Risco
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