<p>Inflammation and oxidative stress may be involved in atherogenesis. This thesis describes clinical studies of prostaglandin F_2α (PGF_2α), an inflammatory mediator, and the isoprostane 8-iso-PGF_2α, a reliable indicator of oxidative stress, and cytokine-related inflammatory mediators and indicators in healthy subjects and in a population-based cohort of Swedish men. </p><p>PGF_2α and 8-iso-PGF_2α formation in healthy subjects varied considerably between days with a mean intra-individual coefficient of variation of 41 % and 42 %, respectively. A morning urine sample reflected the basal level of 8-iso-PGF_2α formation as accurately as a 24-hour urine collection, and represents a more practical alternative to the 24-hour urine collection in clinical studies. PGF_2α formation (as measured by urinary 15-keto-dihydro-PGF_2α) was increased in patients with type 2 diabetes and in smokers independent of other cardiovascular risk factors. These results indicated an on-going cyclooxygenase (COX)-mediated inflammatory reaction related to these conditions. Further, an increased formation of isoprostanes (as measured by urinary 8-iso-PGF_2α) was found in patients with type 2 diabetes and in smokers, indicating a high level of oxidative stress in these men. The smokers had also increased levels of the cytokine interleukin-6, indicating an on-going cytokine-related inflammatory reaction. The inflammatory indicators C-reactive protein and serum amyloid A were related to overweight but not independently associated to type 2 diabetes. High levels of serum selenium in middle-aged men predicted reduced formation of PGF_2α and 8-iso-PGF_2α 27 years later.</p><p>In summary, low-grade, chronic COX-mediated and possibly cytokine-related inflammation, and oxidative stress, seem to be joint features of type 2 diabetes and smoking, two major risk factors of atherosclerosis, in elderly men. Inflammation and oxidative stress may represent a possible common pathogenetic link between established risk factors for atherosclerosis and atherogenesis.</p>

<p>In the present thesis dietary markers for intake of milk fat, associations between intake of milk fat and risk factors for coronary heart disease (CHD), and the effects of supplementation with conjugated linoleic acid (CLA) to healthy humans are investigated.</p><p>The dietary fat quality is one of the main lifestyle factors affecting risk for CHD. When studying the associations between diet and health it is important to have accurate dietary information. Objective dietary markers increase the possibilities to interpret dietary surveys.</p><p>In a study of 62 men we demonstrated that the milk fatty acid pentadecanoic acid (15:0) measured in serum lipids can be used as marker for intake of fat from milk products. In the same study we observed inverse correlations between intake of milk fat and certain risk factors for CHD, especially anthropometric variables.</p><p>To further investigate these findings we supplemented humans with CLA, naturally present in milk. CLA has in animals and <i>in vitro</i> been ascribed positive effects on adiposity and glucose and lipid metabolism. When supplementing humans with CLA we observed a slight decrease in body fat, but no effects on other anthropometric variables or serum lipids. However, markers of lipid peroxidation and inflammation increased. From a second supplementation study we concluded that CLA <i>trans </i>10, <i>cis </i>12 induced lipid peroxidation more than did a mixture of isomers.</p><p>We conclude that the inverse associations between milk fat intake and CHD risk factors, and the effects of CLA, are interesting and need further investigation. However, according to current knowledge, the general population is still advised to have a limited intake of total and saturated fat and to instead choose unsaturated fats. In addition, there is to date no medical reasons for humans to take CLA as supplements.</p>

Inflammation and oxidative stress may be involved in atherogenesis. This thesis describes clinical studies of prostaglandin F2α (PGF2α), an inflammatory mediator, and the isoprostane 8-iso-PGF2α, a reliable indicator of oxidative stress, and cytokine-related inflammatory mediators and indicators in healthy subjects and in a population-based cohort of Swedish men. PGF2α and 8-iso-PGF2α formation in healthy subjects varied considerably between days with a mean intra-individual coefficient of variation of 41 % and 42 %, respectively. A morning urine sample reflected the basal level of 8-iso-PGF2α formation as accurately as a 24-hour urine collection, and represents a more practical alternative to the 24-hour urine collection in clinical studies. PGF2α formation (as measured by urinary 15-keto-dihydro-PGF2α) was increased in patients with type 2 diabetes and in smokers independent of other cardiovascular risk factors. These results indicated an on-going cyclooxygenase (COX)-mediated inflammatory reaction related to these conditions. Further, an increased formation of isoprostanes (as measured by urinary 8-iso-PGF2α) was found in patients with type 2 diabetes and in smokers, indicating a high level of oxidative stress in these men. The smokers had also increased levels of the cytokine interleukin-6, indicating an on-going cytokine-related inflammatory reaction. The inflammatory indicators C-reactive protein and serum amyloid A were related to overweight but not independently associated to type 2 diabetes. High levels of serum selenium in middle-aged men predicted reduced formation of PGF2α and 8-iso-PGF2α 27 years later. In summary, low-grade, chronic COX-mediated and possibly cytokine-related inflammation, and oxidative stress, seem to be joint features of type 2 diabetes and smoking, two major risk factors of atherosclerosis, in elderly men. Inflammation and oxidative stress may represent a possible common pathogenetic link between established risk factors for atherosclerosis and atherogenesis.

In the present thesis dietary markers for intake of milk fat, associations between intake of milk fat and risk factors for coronary heart disease (CHD), and the effects of supplementation with conjugated linoleic acid (CLA) to healthy humans are investigated. The dietary fat quality is one of the main lifestyle factors affecting risk for CHD. When studying the associations between diet and health it is important to have accurate dietary information. Objective dietary markers increase the possibilities to interpret dietary surveys. In a study of 62 men we demonstrated that the milk fatty acid pentadecanoic acid (15:0) measured in serum lipids can be used as marker for intake of fat from milk products. In the same study we observed inverse correlations between intake of milk fat and certain risk factors for CHD, especially anthropometric variables. To further investigate these findings we supplemented humans with CLA, naturally present in milk. CLA has in animals and in vitro been ascribed positive effects on adiposity and glucose and lipid metabolism. When supplementing humans with CLA we observed a slight decrease in body fat, but no effects on other anthropometric variables or serum lipids. However, markers of lipid peroxidation and inflammation increased. From a second supplementation study we concluded that CLA trans 10, cis 12 induced lipid peroxidation more than did a mixture of isomers. We conclude that the inverse associations between milk fat intake and CHD risk factors, and the effects of CLA, are interesting and need further investigation. However, according to current knowledge, the general population is still advised to have a limited intake of total and saturated fat and to instead choose unsaturated fats. In addition, there is to date no medical reasons for humans to take CLA as supplements.