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outcomes.

Design, setting and population: Population-based study of all men aged 40 years or older in the Central Denmark Region from 2004 to 2009. National registers were used to divide family practices in four groups based on their adjusted PSA test rate. We analyzed associations between PSA test rate and PC related outcomes.

Results: 368 practices and 303,117 men were included. 3942 incident PCs were diagnosed. IRR comparing the highest testing group (group 4) with the least testing group (group 1) were 1.17 (95%CI, 0.93-1.47) for trans-rectal ultrasound of the prostate, 1.77 (1.54-2.02) for biopsy, 1.36 (1.21-1.53) for PC diagnosis, 1.59 (1.35-1.87) for local stage disease and no differences regarding regional or distant disease stages. The IRR was 2.30 (1.76-3.01) for prostatectomy and 1.30 (1.04-1.64) for radiotherapy. PC-specific and overall mortality showed no differences between the groups.

The 5-year relative survival was 74.0% (67.9%-79.6%) in group 1 and 79.6%

(74.6%-84.3%) in group 4.

Conclusions and relevance: Variation in PSA test rates between family practices was significantly associated with the incidence of PC, the use of diagnostic and surgical procedures and relative survival, but had no association with mortality. This is important new knowledge concerning consequences of practice-level variations in PSA testing.

O02.03 Karen Fjeldborg HUMAN ADIPOSE TISSUE MACROPHAGES ARE SKEWED IN AN ANTI-INFLAMMATORY DIRECTION IN OBESITY

K. Fjeldborg1, S. Bønløkke1, H. Møller2, B. Richelsen1,3

1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 2Department of Clinical Biochemistry, Aarhus University Hospital,

3Department of Clinical Medicine, Aarhus University

Background: Macrophages in adipose tissue (AT) are increased in obesity and associated with low grade inflammation. In rodents, the phenotype of macrophages is changed to a pro-inflammatory (M1) profile by obesity.

Objective: We aimed to characterize the phenotype of macrophages in AT in humans in relation to obesity and insulin resistance.

Design: In subcutaneous AT samples from lean and obese subjects, the gene-expression levels of the general macrophage markers (CD68 and CD14), M1/pro-inflammatory markers (TNF-α, MCP-1, and IL-6) and the M2/anti-inflammatory markers (CD163, CD206, and IL-10) were determined by RT-PCR. Insulin resistance was determined by HOMA-IR.

Results: All macrophage markers were elevated in AT from obese

compared to lean subjects (p<0.001). To determine the phenotype of the macrophages we used the level of CD14 to adjust for the total number of macrophages. The relative expression of CD163 and IL-10 were elevated, and TNF-α and IL-6 were reduced in macrophages from obese lean subjects (all p<0.05). HOMA-IR was positively associated with CD14 expression

(r: 0.37, P<0.001), and in a multivariate regression analysis CD163 was the 48

only macrophage marker significantly associated with HOMA-IR (β:0.57, p<0.05).

Conclusion: There is an increased expression of macrophage markers in obesity and, contrary to rodents, we found a preponderance of M2 and a decrement of M1 markers in AT from obese subjects. Moreover, CD163 was the only macrophage marker associated with HOMA-IR after multiple adjustments.

O02.04 ACUTE EFFECTS OF RESISTANCE EXERCISE CONTRACTION MODE AND PROTEIN SUPPLEMENTATION ON MUSCLE PROTEIN SYNTHESIS AND HYPERTROPHY SIGNALLING

S.K. Rahbek1, J. Farup1, A.B. Møller2, M.H. Vendelbo3, L. Holm4, N. Jessen2, 3, K.

Vissing1

1Section for Sport Science, Department of Public Health, Aarhus University,

2Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, 3Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark, 4Institute of Sports Medicine, Bispebjerg Hospital and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark

Introduction: The purpose was to comparatively investigate how eccentric (ECC) versus concentric (CON) muscle contraction mode with and without whey protein hydrolysate (WPH) versus carbohydrate (PLA) affect the protein synthesis and Akt-mTORC1 signalling.

Method: 24 subjects were allocated into either the WPH or the PLA group.

Subjects were infused with 13C6-phenylalnine tracer for measurement of muscular fractional synthesis rate (FSR). Subjects completed a single bout of maximal knee extensor exercise with isolated unilateral knee extension performed as ECC versus CON contraction. Muscle biopsies were taken from both legs prior to 1, 3 and 5 hours after the exercise. Western blot analysis was used to assess changes in phosphorylation of muscle Akt, mTORC1 and p70S6K.

Results: A contraction mode × time interaction was observed at the phosphorylation level of mTORC1 (p<0.001). Accordingly, at 3 and 5 hours post exercise, ECC lead to a greater increase of the phosphorylation level than CON. There was no effect of contraction mode on phosphorylation levels of Akt and p70S6K, but a time effect was observed at 1 and 3 hours post exercise (p<0.001). There was no effect of supplementation on protein signalling. Muscular FSR analysis showed no differences between neither supplement type nor contraction mode interventions.

Conclusion: Resistance exercise and supplementation combined provided an acute stimulation of the muscular FSR and the Akt-mTORC1 signalling pathway. A contraction mode specific, but not supplement specific, effect was observed for mTORC1 phosphorylation. Muscular FSR analysis showed no differences between supplement and contraction mode interventions.

O02.05 Annesofie Lunde Jensen

OSTEOPOROSIS GROUP EDUCATION - INTERPRETING AND INDIVIDUALISING A BONE FRIENDLY RECIPE

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A.L. Jensen1,3, G. Wing2, B. Langdahl3, K. Lomborg1,4

1 Section for Nursing, Department of Public Health, Aarhus University,

2Department of Culture and Society, Aarhus University, 3Department of Endocrinology and Internal Medicine, Aarhus University Hospital,

4Department of Clinical Medicine, Aarhus University

Introduction: Osteoporosis group education is recommended as part of disease prevention and management. Characteristic for studies of

osteoporosis group education is a lack of report on the interaction between patients and health professionals.

Aim: To analyse the practice of multidisciplinary group education for patients with osteoporosis, and to identify and interpret important

characteristic of what is at stack when patients and teachers interact during group education.

Methods: An interpretive description design was utilized with 17 women and men diagnosed with osteoporosis. Data consisted of ethnographic field studies in five classes, sessions of the everyday life of the patients and semi-structured interviews before and 6-9 months after group education.

Results: The practice of group education revealed individual ways of interpreting disease specific recommendations. Two patterns formed the characteristics of group education: 1) "Interpreting a bone friendly recipe"

outlined that interaction between patients and teachers concerned understanding and interpreting how to follow recommendations; 2)

"Personal counselling" described how an inevitable part of the interaction concerned patients' personal perspective and entailed personalised advice given by the teachers directed at one patient.

Conclusion: Articulating and interpreting teachers' and patients'

experience, knowledge and skills seemed essential if patients were to gain competences and transfer "a bone friendly recipe" into daily life. Group education involved personal counselling and individual consultations.

Hence, group education may be of specific value to the unified treatment for patients with osteoporosis.

O02.06 Tue Kjølhede LONG-TERM PROGRESSIVE RESISTANCE TRAINING IMPROVES FUNCTIONAL CAPACITY FOR PEOPLE WITH MULTIPLE SCLEROSIS T. Kjølhede1, K. Vissing1, E. Stenager2, 3, T. Petersen4, U. Dalgas1

1Section for Sport Science, Department of Public Health, Aarhus University,

2Institute of Regional Health Research, University of Southern Denmark, 3 MS-clinic of Southern Jutland, Sygehus Sønderjylland, 4MS-clinic, Department of Neurology, Aarhus University Hospital

Introduction: Exercise therapy has become an important part of

rehabilitation for people with Multiple Sclerosis (PwMS), with progressive resistance training (PRT) proving to be a safe and effective way of improving maximal muscle strength (MMS). However, most conducted studies are of relatively short duration and conflicting results exist regarding the effects of PRT on functional capacity (FC). Thus, one purpose of this

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study was to elucidate the effects of long-term PRT on FC in PwMS.

Methods: 35 PwMS were randomized to perform either 24 weeks of supervised PRT (n=18) or constitute a non-training control group (n=17).

Measures of FC included; timed 25ft walk test, 2min walk test, 5-time sit-stand and stair climb test. Additionally, the 12-item MS Walking Scale (MSWS12) was completed. MMS was measured as peak torque of the knee extensors and flexors. Baseline values, within and between groups changes (post-pre) was compared between groups using Student's t-test.

Results: 32 of 35 PwMS completed the study. For all patient characteristics, MMS and FC, training and control group were similar at baseline. After 24 weeks of supervised PRT, the improvements in MMS and all measures of FC were higher for training than for control group. Within the control group no changes were observed in any measures, while the training group

improved in all measures of MMS and FC (p<0.05). No difference in changes between groups was observed for MSWS12, however within training group a tendency to improvement was observed (p=0.06).

Conclusions: This long-term study supports earlier short-term findings and further strengthens the contention that PRT is capable of improving MMS and FC for PwMS.

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