0000000000180872

AUTHOR

Mirva Rottensteiner

0000-0003-1988-0952

showing 20 related works from this author

Long-Term Physical Activity May Modify Brain Structure and Function: Studies in Young Healthy Twins

2019

Background: Physical activity (PA) is said to be beneficial to many bodily functions. However, the effects of PA in the brain are still inadequately known. The authors aimed to uncover possible brain modulation linked with PA. Here, they combine 4 of their studies with monozygotic twins, who were within-pair discordant in PA for a minimum of 1 year. Methods: The authors performed brain imaging, brain electrophysiology, and cardiovascular and body composition assessments, and collected questionnaire-based data. The present synopsis elucidates the differences associated with differing PA history in conditions without genetic variability. They present new structural and electrophysiological re…

AdultMaleneurofysiologiaBrain Structure and FunctionPhysiologyHippocampal formationSomatosensory systemneuroscienceYoung Adult03 medical and health sciences0302 clinical medicineNeuroimagingHumansMedicineOrthopedics and Sports MedicineExercisehealth disparities030304 developmental biology0303 health sciencesbusiness.industryBrain morphometryBrainMotor controlNeurophysiologyneurotieteetHealthy VolunteersElectrophysiologyneurophysiologyterveyserotbusiness030217 neurology & neurosurgeryJournal of Physical Activity and Health
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Measuring psychosocial stress with heart rate variability-based methods in different health and age groups

2022

Abstract Objective. Autonomic nervous system function and thereby bodily stress and recovery reactions may be assessed by wearable devices measuring heart rate (HR) and its variability (HRV). So far, the validity of HRV-based stress assessments has been mainly studied in healthy populations. In this study, we determined how psychosocial stress affects physiological and psychological stress responses in both young (18–30 years) and middle-aged (45–64 years) healthy individuals as well as in patients with arterial hypertension and/or either prior evidence of prediabetes or type 2 diabetes. We also studied how an HRV-based stress index (Relax-Stress Intensity, RSI) relates to perceived stress …

ELDERLY ADULTSsykeHydrocortisonePhysiologyperceived stressBiomedical EngineeringBiophysicspsykososiaaliset tekijätcortisolstresswellbeingPSYCHOLOGICAL STRESSYOUNGER ADULTSHeart RateStress PhysiologicalPhysiology (medical)HumansMETABOLIC SYNDROMERISKheart rate variability1184 Genetics developmental biology physiologyMENstressiMiddle AgedRECOVERYmittausmenetelmätpsykofysiologiaTIMEDiabetes Mellitus Type 2sydän- ja verisuonitauditSHORT-TERMsykemittaritStress PsychologicalCORTISOL RESPONSESfysiologiset vaikutukset
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Persistence or Change in Leisure-Time Physical Activity Habits and Waist Gain During Early Adulthood: A Twin-Study

2014

Objective To determine the relationship between persistence or change in leisure‐time physical activity habits and waist gain among young adults. Methods Population‐based cohort study among 3383 Finnish twin individuals (1578 men) from five birth cohorts (1975‐1979), who answered questionnaires at mean ages of 24.4 y (SD 0.9) and 33.9 y (SD 1.2), with reported self‐measured waist circumference. Persistence or change in leisure‐time physical activity habits was defined based on thirds of activity metabolic equivalent h/day during follow‐up (mean 9.5 y; SD 0.7). Results Decreased activity was linked to greater waist gain compared to increased activity (3.6 cm, P < 0.001 for men; 3.1 cm, P < 0…

waist gainearly adulthoodphysical activitytwin-study
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Development of a Food-Based Diet Quality Score from a Short FFQ and Associations with Obesity Measures, Eating Styles and Nutrient Intakes in Finnish…

2019

We constructed a food-based diet quality score (DQS) and examined its association with obesity measures, eating styles and nutrient intakes. Participants were 3592 individuals (764 dizygotic [DZ] and 430 monozygotic [MZ] twin pairs) from the FinnTwin16 study. The DQS (0&ndash

AdultMaleobesityRELATIVE VALIDITYeating behaviorsdiet quality scorelcsh:TX341-641ruokavaliotVALIDATIONArticleSNACKING BEHAVIORSBMIADHERENCEsyöminenHumansravintoaineetSOCIAL DESIRABILITYFREQUENCY QUESTIONNAIREObesity ; Waist ; Short FFQ ; Eating behaviors ; Nutrient intake ; Twins ; Diet quality score ; BMIFinlandkaksostutkimusnutrient intakedigestive oral and skin physiologyylipainoFeeding Behaviortwins3142 Public health care science environmental and occupational healthDietBODY-MASS INDEXruokatottumuksetPHYSICAL-ACTIVITYFood3121 General medicine internal medicine and other clinical medicinelihavuusFemaleravintoarvoHEALTHY NORDIC DIET3143 NutritionEnergy Intakelcsh:Nutrition. Foods and food supplyshort FFQWEIGHT CHANGEwaist
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Associations of physical activity, fitness, and body composition with heart rate variability–based indicators of stress and recovery on workdays: a c…

2014

Background. The purpose of this study was to investigate how physical activity (PA), cardiorespiratory fitness (CRF), and body composition are associated with heart rate variability (HRV)-based indicators of stress and recovery on workdays. Additionally, we evaluated the association of objectively measured stress with self-reported burnout symptoms. Methods. Participants of this cross-sectional study were 81 healthy males (age range 26–40 y). Stress and recovery on workdays were measured objectively based on HRV recordings. CRF and anthropometry were assessed in laboratory conditions. The level of PA was based on a detailed PA interview (MET index [MET-h/d]) and self-reported activity class…

medicine.medical_specialtyWorking hoursCross-sectional studyPSYCHOSOCIAL STRESSHRVPhysical activityphysical activityRATE DYNAMICSEXERCISEBurnoutToxicologyBody compositionBody fat percentagerecoveryBMIRecoveryInternal medicinemedicineHeart rate variabilityBody fat percentageCardiorespiratory fitnesskehonkoostumusWork stress2. Zero hungercardiorespiratory fitnessPhysical activitybusiness.industryResearchPublic Health Environmental and Occupational HealthFAT DISTRIBUTIONMENCardiorespiratory fitnesswork stressAnthropometrybody fat percentage3142 Public health care science environmental and occupational healthtyöaikaRISK-FACTORSBURNOUTPhysical therapyWEIGHTbusinessOBESE WOMENSafety ResearchBody mass indexAUTONOMIC ACTIVITYJournal of Occupational Medicine and Toxicology
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Long-term physical activity modulates brain processing of somatosensory stimuli: Evidence from young male twins.

2016

Leisure-time physical activity is a key contributor to physical and mental health. Yet the role of physical activity in modulating cortical function is poorly known. We investigated whether precognitive sensory brain functions are associated with the level of physical activity. Physical activity history (3-yr-LTMET), physiological measures and somatosensory mismatch response (sMMR) in EEG were recorded in 32 young healthy twins. In all participants, 3-yr-LTMET correlated negatively with body fat%, r = −0.77 and positively with VO2max, r = 0.82. The fat% and VO2max differed between 15 physically active and 17 inactive participants. Trend toward larger sMMR was seen in inactive compared to ac…

0301 basic medicineAdultMalehuman electrophysiologyFITNESSMISMATCH NEGATIVITY MMN515 PsychologyPhysical activityMonozygotic twinprecognitive brain functionPhysical exerciseSensory systemCHILDRENGatingElectroencephalographyMotor ActivitySomatosensory system03 medical and health sciences0302 clinical medicinephysical exercisemedicineEVOKED-POTENTIALSHumansHealthy Lifestyleta315Evoked PotentialsExerciseYoung malemedicine.diagnostic_testLATENCYGeneral NeuroscienceMEMORYta3141ADULTSSomatosensory Cortex16. Peace & justice3142 Public health care science environmental and occupational healthta3124030104 developmental biologyNeuropsychology and Physiological PsychologyDISCRIMINATIONFemalePsychologyNeurosciencesomatosensory mismatch response030217 neurology & neurosurgeryRESPONSESBiological psychology
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Physical activity and health: Findings from Finnish monozygotic twin pairs discordant for physical activity.

2022

Genetic and early environmental differences including early health habits associate with future health. To provide insight on the causal nature of these associations, monozygotic (MZ) twin pairs discordant for health habits provide an interesting natural experiment. Twin pairs discordant for leisure-time physical activity (LTPA) in early adult life are thus a powerful study design to investigate the associations between long-term LTPA and indicators of health and wellbeing. We have identified 17 LTPA discordant twin pairs from two Finnish twin cohorts and summarize key findings of these studies in this paper. The carefully characterized rare long-term LTPA discordant MZ twin pairs have part…

kaksostutkimusAdulthyvinvointi (terveydellinen)elintavatgeenitrasvaprosenttiPhysical Therapy Sports Therapy and RehabilitationTwins MonozygoticliikuntaMotor ActivitykaksosetPhysical FitnessterveyskäyttäytyminenperimäliikuntatottumuksetHumansOrthopedics and Sports MedicineterveysExercisefyysinen aktiivisuusFinlandScandinavian journal of medicinescience in sports
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Leisure-time physical activity and intra-abdominal fat in young adulthood: A monozygotic co-twin control study

2016

Objective To investigate differences in abdominal fat compartments between young adult monozygotic twin pairs discordant for leisure-time physical activity. Methods Ten young adult male monozygotic twin pairs (age range 32-36 years) discordant for leisure-time physical activity during the past 3 years were systematically selected from a population-based Finnish twin cohort. Magnetic resonance image at the level of the L2-L3 intervertebral disc was used to predict intra-abdominal and subcutaneous abdominal fat masses. Dietary intake was assessed with a 4-day food diary. Results Inactive twins had 31% more intra-abdominal fat than their active co-twins (mean difference 0.52 kg, 95% CI 0.12 to…

medicine.medical_specialtyIntra-Abdominal FatEndocrinology Diabetes and MetabolismPopulationMedicine (miscellaneous)Monozygotic twin030209 endocrinology & metabolismDiet Records03 medical and health sciences0302 clinical medicineEndocrinologyInternal medicineMedicineYoung adulteducation2. Zero hungereducation.field_of_studyNutrition and Dieteticsbusiness.industry030229 sport sciencesmedicine.diseaseObesityEndocrinologyCohortbusinessBody mass indexObesity
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FinnTwin16 : A Longitudinal Study from Age 16 of a Population-Based Finnish Twin Cohort

2019

The purpose of this review is to provide a detailed and updated description of the FinnTwin16 (FT16) study and its future directions. The Finnish Twin Cohort comprises three different cohorts: the Older Twin Cohort established in the 1970s and the FinnTwin12 and FT16 initiated in the 1990s. FT16 was initiated in 1991 to identify the genetic and environmental precursors of alcoholism, but later the scope of the project expanded to studying the determinants of various health-related behaviors and diseases in different stages of life. The main areas addressed are alcohol use and its consequences, smoking, physical activity, overall physical health, eating behaviors and eating disorders, weight…

kaksostutkimusobesityalcohollongitudinal twin-family studyphysical activityweightylipainotwinspitkittäistutkimusruokavaliotsmokingdiverse phenotypesmielenterveystupakointigeneticsdietalkoholi (päihteet)kohorttitutkimusmental health
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Sports and exercise medicine clinic in public hospital settings: A real-life concept and experiences of the treatment of the first 1151 patients

2022

AbstractExercise has been shown to have a multitude of health-promoting effects, including improvements in cardiorespiratory and muscular fitness, function, symptoms and risk factors. Furthermore, exercise may slow down, stop or even reverse the progression of various non-communicable diseases (NCDs). Despite the overwhelming evidence, exercise is still not comprehensively used as a treatment component either in primary care or in hospital settings. The outpatient Sports and Exercise Medicine Clinic (SEMC) is the first specialized clinic in Finland to use exercise as part of patient protocols in the public health care system. Patients needing specialist attention due to NCDs, usually combin…

perusterveydenhuoltobody compositioncardiorespiratory fitnessexercisehoitoonohjauskuntoliikuntaphysical activityGeneral Medicineehkäisevä lääketiedefyysinen kuntopreventionsydän- ja verisuonitaudityksilöllistäminenfyysinen aktiivisuuskehonkoostumusliikuntahoito
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Fat oxidation at rest and during exercise in male monozygotic twins

2019

Abstract Purpose We aimed to investigate if hereditary factors, leisure-time physical activity (LTPA) and metabolic health interact with resting fat oxidation (RFO) and peak fat oxidation (PFO) during ergometer cycling. Methods We recruited 23 male monozygotic twin pairs (aged 32–37 years) and determined their RFO and PFO with indirect calorimetry for 21 and 19 twin pairs and for 43 and 41 twin individuals, respectively. Using physical activity interviews and the Baecke questionnaire, we identified 10 twin pairs as LTPA discordant for the past 3 years. Of the twin pairs, 8 pairs participated in both RFO and PFO measurements, and 2 pairs participated in either of the measurements. We quantif…

MaleSports medicinePhysiologyIntraclass correlationTwinsMonozygotic twinDETERMINANTSlipiditliikuntaglukoosiFats0302 clinical medicineFat oxidationlipid metabolismSUBSTRATE OXIDATIONOrthopedics and Sports MedicineOral glucose tolerance315 Sport and fitness sciencesaineenvaihduntaAdiposityexerciseINSULIN SENSITIVITYhapettuminenArea under the curve1184 Genetics developmental biology physiologytwinsGeneral MedicineVARIABILITYCardiologyOriginal ArticleOxidation-Reductionfyysinen aktiivisuusAdultmedicine.medical_specialtyRest030209 endocrinology & metabolismMotor ActivityDIETARY-FATCAPACITYYoung Adult03 medical and health sciencesTIME PHYSICAL-ACTIVITYPhysiology (medical)Internal medicineCARBOHYDRATEmedicineHumansExerciseOral glucose toleranceMetabolic healthkaksostutkimusbusiness.industryINTENSITYPublic Health Environmental and Occupational HealthCalorimetry IndirectTwins Monozygotic030229 sport sciencesGlucose Tolerance TestConfidence intervalLipid metabolismoral glucose toleranceYOUNGbusiness
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Effects of aerobic and strength training on aerobic capacity, muscle strength, and gene expression of lymphomonocytes in patients with stable CAD

2020

This study examined the effectiveness, suitability, and safety of a mixed interval-type aerobic and strength training program (MIAST) on physical fitness in patients with stable coronary artery disease (CAD) without history of myocardial infarction (MI). Twenty-three patients with stable CAD were randomly assigned to a MIAST (n = 12; mean age 58.6 years) or control (n = 11; 63.3 years) group. The MIAST group participated in the progressive training program twice a week for 21 weeks. Peak oxygen uptake (VO2peak), workload, and exercise time were measured as were maximal muscle strength, serum lipids, glucose concentration, and the cross-sectional area (CSA) of knee extensors. The safety and …

kestävyysharjoitteluoxygen consumptionpotilaatfyysinen kuntoendurance trainingsepelvaltimotautiphysical fitnessmaksimaalinen hapenottoOriginal Articlevoimaharjoittelucoronary heart diseaseresistance trainingliikuntahoitolihasvoimahapenotto
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FinnTwin16: A Longitudinal Study from Age 16 of a Population-Based Finnish Twin Cohort

2019

AbstractThe purpose of this review is to provide a detailed and updated description of the FinnTwin16 (FT16) study and its future directions. The Finnish Twin Cohort comprises three different cohorts: the Older Twin Cohort established in the 1970s and the FinnTwin12 and FT16 initiated in the 1990s. FT16 was initiated in 1991 to identify the genetic and environmental precursors of alcoholism, but later the scope of the project expanded to studying the determinants of various health-related behaviors and diseases in different stages of life. The main areas addressed are alcohol use and its consequences, smoking, physical activity, overall physical health, eating behaviors and eating disorders…

GerontologyLongitudinal studyAlcohol Drinkingmedia_common.quotation_subjectTwins030209 endocrinology & metabolismPopulation based03 medical and health sciences0302 clinical medicineDiseases in TwinsmedicineHumansPersonalityLongitudinal StudiesRegistriesFinlandGenetics (clinical)media_commonData collectionIncidenceMental DisordersSmokingObstetrics and GynecologyLife satisfaction030229 sport sciencesmedicine.diseaseObesity3. Good healthAlcoholismEating disordersPediatrics Perinatology and Child HealthCohortTwin Studies as TopicPsychologyTwin Research and Human Genetics
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Physical activity and health: Findings from Finnish monozygotic twin pairs discordant for physical activity

2021

AbstractGenetic and early environmental differences including early health habits associate with future health. To provide insight on the causal nature of these associations, monozygotic (MZ) twin pairs discordant for health habits provide an interesting natural experiment. Twin pairs discordant for leisure-time physical activity (LTPA) in early adult life are thus a powerful study design to investigate the associations between long-term LTPA and indicators of health and wellbeing. We have used this study design by identifying 17 LTPA discordant twin pairs from two Finnish twin cohorts and summarize key findings of these studies in this paper. The carefully characterized rare long-term LTPA…

Discordant Twinbusiness.industryPhysical fitnessPhysical activityMonozygotic twin030229 sport sciencesType 2 diabetesmedicine.disease03 medical and health sciencesAdult life0302 clinical medicineLiver fatmedicineObservational study030212 general & internal medicinebusinessDemography
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Persistence or change in leisure-time physical activity habits and waist gain during early adulthood: A twin-study

2014

Objective To determine the relationship between persistence or change in leisure-time physical activity habits and waist gain among young adults. Methods Population-based cohort study among 3383 Finnish twin individuals (1578 men) from five birth cohorts (1975-1979), who answered questionnaires at mean ages of 24.4 y (SD 0.9) and 33.9 y (SD 1.2), with reported self-measured waist circumference. Persistence or change in leisure-time physical activity habits was defined based on thirds of activity metabolic equivalent h/day during follow-up (mean 9.5 y; SD 0.7). Results Decreased activity was linked to greater waist gain compared to increased activity (3.6 cm, P < 0.001 for men; 3.1 cm, P < 0…

medicine.medical_specialtyDiscordant Twineducation.field_of_studyNutrition and DieteticsWaistbusiness.industryEndocrinology Diabetes and MetabolismPopulationMedicine (miscellaneous)Twin studyMetabolic equivalentEndocrinologyEndocrinologyInternal medicinemedicineYoung adultmedicine.symptombusinesseducationWeight gainDemographyCohort studyObesity
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Motives for physical activity among active and inactive persons in their mid-30s

2013

The purpose of this study was to examine the motives for leisure-time physical activity among active and inactive men and women in their mid-30s. We used both cross-sectional and longitudinal designs. Altogether, 2308 participants (mean age 33.9 years, 53.4% women) were identified from the population-based FinnTwin16 Cohort. Physically active and inactive individuals were identified on the basis of their leisure-time MET h/day. We evaluated participants' physical activity motivation with a modified version of the Recreational Exercise Motivation Measure. Comparisons between active and inactive individuals were analysed using the Wald test for equality of means, and effect sizes were calcula…

education.field_of_studymedicine.medical_specialtyCross-sectional studybusiness.industryPopulationPhysical fitnessPhysical activityPhysical Therapy Sports Therapy and Rehabilitation16. Peace & justiceSocial engagementMental healthCohortPhysical therapymedicineOrthopedics and Sports Medicine10. No inequalityeducationbusinessPsychologyClinical psychologySedentary lifestyleScandinavian Journal of Medicine &amp; Science in Sports
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Physical Activity, Fitness, Glucose Homeostasis, and Brain Morphology in Twins

2014

The main aim of the present study (FITFATTWIN) was to investigate how physical activity level is associated with body composition, glucose homeostasis, and brain morphology in young adult male monozygotic twin pairs discordant for physical activity.From a population-based twin cohort, we systematically selected 10 young adult male monozygotic twin pairs (age range, 32-36 yr) discordant for leisure time physical activity during the past 3 yr. On the basis of interviews, we calculated a mean sum index for leisure time and commuting activity during the past 3 yr (3-yr LTMET index expressed as MET-hours per day). We conducted extensive measurements on body composition (including fat percentage …

AdultBlood GlucoseMalemedicine.medical_specialtyPhysical fitnessPopulationMonozygotic twinPhysical Therapy Sports Therapy and RehabilitationMotor ActivityBiology03 medical and health sciencesLeisure Activities0302 clinical medicineInternal medicinemedicineHomeostasisHumansGlucose homeostasisOrthopedics and Sports Medicine030212 general & internal medicinegray matter volumeeducationta315education.field_of_studybody compositionexercisebusiness.industryBrain morphometryBrainta3141Twins MonozygoticMagnetic Resonance ImagingTwin studyPhysical activity levelfitnessEndocrinologyPhysical Fitnessglocosebusiness030217 neurology & neurosurgeryHomeostasisMedicine and Science in Sports and Exercise
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Cross-sectional associations between the diversity of sport activities and the type of low back pain in adulthood

2020

Leisure-time physical activity has a complex relationship with low back pain (LBP). Thus, we aimed to investigate whether the diversity of sport activities is associated with the type of LBP. In the FinnTwin16 study, 4246 (55% females) Finnish twins at mean age 34.1 years replied to a health behaviour survey in 2010-2012. Based on the participation in different sport activities, we created two measures of diversity: quantity (i.e. the number of sport activities: 1, 2, 3, 4 and >= 5) and quality (i.e. the type of sport activity: endurance, strength, body care, etc.). Based on the frequency, duration and type of LBP, we created three groups: no history of LBP lasting more than one day, radiat…

Malephysical activitylumbagoliikuntaLogistic regressionRunning0302 clinical medicineOdds RatioOrthopedics and Sports Medicinekohorttitutkimuslow back painexerciseConfoundingGeneral MedicineLow back pain3142 Public health care science environmental and occupational healthPREVALENCEpopulation characteristicsselkäFemalemedicine.symptomCohort studyfyysinen aktiivisuusSportsCohort studyAdultmedicine.medical_specialtyPhysical activity030209 endocrinology & metabolismPhysical Therapy Sports Therapy and Rehabilitationiskias03 medical and health sciencesSex FactorsDiseases in Twinsmedicinecohort studyHumanssciaticabusiness.industryDISABILITYHealth behaviourkipu030229 sport sciencesOdds ratioBicyclingnervous system diseasesLogistic ModelsPHYSICAL-ACTIVITYPhysical EndurancePhysical therapybusinesshuman activitiesDiversity (business)
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Sport disciplines, types of sports, and waist circumference in young adulthood – a population-based twin study

2017

Purpose: The benefits of physical activity (PA) in preventing abdominal obesity are well recognized, but the role of different sport disciplines remains open. We aimed, therefore, to investigate how participation in different sport disciplines, and the number and types of sports engaged in are associated with waist circumference (WC) in young adulthood. Methods: This population-based cohort study comprised 4027 Finnish twin individuals (1874 men), with a mean age of 34 y (32-37), who answered a survey, including self-measured WC. We extracted the number and identified the types (aerobic, power, and mixed) of the different sport disciplines respondents reported participating in. Results: The…

MaleliikuntaCohort Studies0302 clinical medicineOrthopedics and Sports Medicine030212 general & internal medicinetwin study315 Sport and fitness sciencesYoung adultta315Abdominal obesityRISKeducation.field_of_studyta3141General Medicinewaist circumference3142 Public health care science environmental and occupational healthsport disciplinesWEIGHT-GAINVISCERAL FATADOLESCENCEFemaleHEALTHmedicine.symptomfyysinen aktiivisuusSportsCohort studyAdultCOUNTRIESmedicine.medical_specialtyWaistDizygotic twinPopulationEXERCISE030209 endocrinology & metabolismPhysical Therapy Sports Therapy and Rehabilitationabdominal obesityTIME PHYSICAL-ACTIVITY03 medical and health sciencesmedicineHumanseducationkaksostutkimusPhysical activitybusiness.industryTwin studyBODY-MASS INDEXPhysical therapybusinesshuman activitiesBody mass indexDemographyEuropean Journal of Sport Science
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Cardiorespiratory Fitness Estimation Based on Heart Rate and Body Acceleration in Adults With Cardiovascular Risk Factors : Validation Study

2022

Publisher Copyright: © Antti-Pekka E Rissanen, Mirva Rottensteiner, Urho M Kujala, Jari L O Kurkela, Jan Wikgren, Jari A Laukkanen. Originally published in JMIR Cardio (https://cardio.jmir.org), 25.10.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited. The complete bibliographic information, a link to the original publication on https://cardio.jmir.org, as well as this copyright and license information must be included. Background: C…

cardiorespiratory fitnesshypertensiondiabetesheart rate variabilityHealth Informaticsriskitekijätwearable technology3121 General medicine internal medicine and other clinical medicineterveysvaikutuksetsydän- ja verisuonitauditkohonnut verenpainetype 2 diabetespuettava teknologiaCardiology and Cardiovascular Medicineaikuistyypin diabetesmetabolinen oireyhtymäcardiopulmonary exercise test
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