المؤلفون: Pigi Dikaiou, Jon Edqvist, Jesper Lagergren, Martin Adiels, Lena Björck, Annika Rosengren

المصدر: Scientific Reports, Vol 14, Iss 1, Pp 1-9 (2024)

مصطلحات موضوعية: Medicine, Science

الوصف: Abstract It is unclear how increasing body mass index (BMI) influences risk of cancer in young women. We used data from the Medical Birth, Patient and Cause of Death registers collected between 1982 and 2014 to determine the risk of obesity-related cancer types, breast cancer, all cancer and cancer-related death in relation to BMI in 1,386,725 women, aged between 18 and 45 years, in Sweden. During a median follow-up of 16.3 years (IQR 7.7–23.5), 9808 women developed cancer. The hazard ratio (HR) of endometrial and ovarian cancer increased with higher BMI from 1.08 (95% CI 0.93–1.24) and 1.08 (95% CI 0.96–1.21) among women with BMI 22.5–

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/018bf2e85fa44a0eb2fe81b00044a9dbTest

المؤلفون: Annika Rosengren, Mia Söderberg, Christina E. Lundberg, Martin Lindgren, Ailiana Santosa, Jon Edqvist, Maria Åberg, Magnus Gisslén, Josefina Robertson, Ottmar Cronie, Naveed Sattar, Jesper Lagergren, Maria Brandén, Jonas Björk, Martin Adiels

المصدر: Global Epidemiology, Vol 4, Iss , Pp 100095- (2022)

مصطلحات موضوعية: COVID-19, Mortality, Intensive care, Population study, Occupation, Comorbidity, Infectious and parasitic diseases, RC109-216

الوصف: Background: Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. Objectives: We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18–64. Methods: We conducted a registry-based study in Swedish citizens aged 18–64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Results: Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·13, 95%CI 2·91–3·36, and a PAF of 32·2% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35–1·6, blue-collar workers 1·18, 95%CI 1·06–1·31, school staff 1·21, 95%CI 1·01–1·46, and health and social care workers 1·89, 95%CI 1·67–2·135) compared with people able to work from home, with altogether about 13% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·79, 95%CI 1·34–2·38 and 1·37, 95%CI 1·04–1·81, with adjusted PAFs of altogether 9%. Conclusion: Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2590113322000256Test; https://doaj.org/toc/2590-1133Test

الوصول الحر: https://doaj.org/article/7697d2f0877b4288b5428094ce3300edTest

المؤلفون: Naveed Sattar, Marcus Lind, Stefan Franzén, Ann-Marie Svensson, Araz Rawshani, Jon Edqvist, Aidin Rawshani

المصدر: BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021)

مصطلحات موضوعية: Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: Introduction In type 1 diabetes, potential loss of life-years is greatest in those who are youngest at the time of onset. Using data from a nationwide cohort of patients with type 1 diabetes, we aimed to study risk factor trajectories by age at diagnosis.Research design and methods We stratified 30 005 patients with type 1 diabetes aged 18–75 years into categories based on age at onset: 0–10, 11–15, 16–20, 21–25, and 26–30 years. HbA1c, albuminuria, estimated glomerular filtration rate (eGFR), body mass index (BMI), low-denisty lipoprotein (LDL)-cholesterol, systolic blood pressure (SBP), and diastolic blood pressure trends were analyzed using mixed models. Variable importance for baseline HbA1c was analyzed using conditional random forest and gradient boosting machine approaches.Results Individuals aged ≥16 years at onset displayed a relatively low mean HbA1c level (~55–57 mmol/mol) that gradually increased. In contrast, individuals diagnosed at ≤15 years old entered adulthood with a mean HbA1c of approximately 70 mmol/mol. For all groups, HbA1c levels stabilized at a mean of approximately 65 mmol/mol by about 40 years old. In patients who were young at the time of onset, albuminuria appeared at an earlier age, suggesting a more rapid decrease in eGFR, while there were no distinct differences in BMI, SBP, and LDL-cholesterol trajectories between groups. Low education, higher age, and poor risk factor control were associated with higher HbA1c levels.Conclusions Young age at the diabetes onset plays a substantial role in subsequent glycemic control and the presence of albuminuria, where patients with early onset may accrue a substantial glycemic load during this period.

وصف الملف: electronic resource

العلاقة: https://drc.bmj.com/content/9/1/e002187.fullTest; https://doaj.org/toc/2052-4897Test

الوصول الحر: https://doaj.org/article/653bd5908adb4e118c84ed09f1bdf451Test

المؤلفون: Jon Edqvist, Araz Rawshani, Martin Adiels, Lena Björck, Marcus Lind, Ann‐Marie Svensson, Sofia Gudbjörnsdottir, Naveed Sattar, Annika Rosengren

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 8, Iss 24 (2019)

مصطلحات موضوعية: body mass index, glucose, heart failure, myocardial infarction, type 2 diabetes mellitus, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background Body mass index (BMI) may be a stronger risk factor for heart failure than for coronary heart disease in type 2 diabetes mellitus, but prior studies have not been powered to investigate the relative and absolute risks for acute myocardial infarction and heart failure in type 2 diabetes mellitus by BMI and glycemic level combined as compared with age‐ and sex‐matched general population comparators. Methods and Results We identified 181 045 patients from The Swedish National Diabetes Registry, registered during 1998 to 2012 and 1538 434 general population comparators without diabetes mellitus, matched for age, sex, and county, all without prior major cardiovascular disease. Cases and comparators were followed with respect to the outcomes through linkage to the Swedish Inpatient Registry. Over a median follow‐up time of 5.7 years, there were 28 855 acute myocardial infarction and 33 060 heart failure cases among patients and comparators. Excess risk (above that of comparators in whom no data on hemoglobin A1c and BMI was available), incidence rates and hazard ratios for heart failure were substantially higher among the obese patients compared with those with low BMI, where very obese patients (BMI ≥40 kg/m2) who also had poor glycemic control, suffered a 7‐fold risk of heart failure versus comparators (reference level). By contrast, for acute myocardial infarction, the highest absolute and relative risks were found among patients with poor glycemic control, with no additional risk conferred by increasing BMI. Conclusions BMI is a strong independent risk factor for heart failure but not for acute myocardial infarction among patients with type 2 diabetes mellitus.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-9980Test

الوصول الحر: https://doaj.org/article/973f3b1b81c249079bc35e9c4c7dd7cbTest

المؤلفون: Annika Rosengren, Christina E. Lundberg, Mia Söderberg, Ailiana Santosa, Jon Edqvist, Martin Lindgren, Maria Åberg, Magnus Gisslén, Josefina Robertson, Ottmar Cronie, Naveed Sattar, Jesper Lagergren, Maria Brandén, Jonas Björk, Martin Adiels

المصدر: Journal of Internal Medicine. 292:641-653

مصطلحات موضوعية: Aged, 80 and over, Sweden, SARS-CoV-2, comorbidity, COVID-19, demographics, mortality, population study, severe illness, Comorbidity, Hospitalization, Risk Factors, Internal Medicine, Humans, Gerontologi, medicinsk/hälsovetenskaplig inriktning, Gerontology, specialising in Medical and Health Sciences, Pandemics, Aged

الوصف: Background Exposure to many contacts is the main risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while risk of serious disease and death is chiefly determined by old age and comorbidities. Relative and population-attributable fractions (PAFs) of multiple medical and social exposures for COVID-19 outcomes have not been evaluated among older adults. Objectives We describe the effect of multiple exposures on the odds of testing positive for the virus and of severe disease (hospital care or death) and PAFs in Swedish citizens aged 55 years and above. Methods We used national registers to follow all citizens aged 55 years and above with respect to (1) testing positive, (2) hospitalization, and (3) death between 31 January 2020 and 1 February 2021. Results Of 3,410,241 persons, 156,017 (4.6%, mean age 68.3 years) tested positive for SARS-CoV-2, while 35,999 (1.1%, mean age 76.7 years) were hospitalized or died (12,384 deaths, 0.4%, mean age 84.0 years). Among the total cohort, the proportion living without home care or long-term care was 98.8% among persons aged 55-64 and 22.1% of those aged 95 and above. After multiple adjustment, home care and long-term care were associated with odds ratios of 7.9 (95% confidence interval [CI] 6.8-9.1) and 22.5 (95% CI 19.6-25.7) for mortality, with PAFs of 21.9% (95% CI 20.9-22.9) and 33.3% (95% CI 32.4-34.3), respectively. Conclusion Among Swedish residents aged 55 years and above, those with home care or long-term care had markedly increased risk for COVID-19 death during the first year of the pandemic, with over 50% of deaths attributable to these factors. Funding Agencies|Swedish Heart and Lung Foundation [2018-0366]; Swedish Research Council [2018-0366, 2020-05792, 2021-06545]; Swedish state [ALFGBG717211, AFGBG-965885]; VRREG [2019-00193, 2019-00198, 201900245, 2019-00209]; Science for Life Laboratory from the Knut and Alice Wallenberg Foundation [2020.0241]; Swedish Research Council for Health, Working Life and Welfare [2021-00304]

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::974b41a5f123d97afd0d866808513be0Test
https://doi.org/10.1111/joim.13522Test

المؤلفون: Annika Rosengren, Martin Adiels, Marcus Lind, Johnny Ludvigsson, Pigi Dikaiou, Lena Björck, Karin Andreasson, Christina Lundberg, Jon Edqvist

الوصف: Objective Type 2 diabetes is an established risk factor for hospitalization and death in COVID-19 infection while findings with respect to type 1 diabetes have been diverging. Research Design and Methods Using nationwide health registries, we identified all patients aged ≥18 years with type 1 and type 2 diabetes in Sweden. Odds ratios (ORs) describe general- and age specific risk of being hospitalized, in need of intensive care, or dying, adjusted for age, socioeconomic factors and coexisting conditions, compared to individuals without diabetes. Machine learning models were used to find predictors of outcomes among COVID-19-positive individuals with diabetes. Results Until June 30, 2021, we identified 365 (0.71%) and 11,684 (2.31%) hospitalizations in 51,402 and 504,337 patients with type 1 and 2 diabetes, respectively, with 67 (0.13%) and 2,848 (0.56%) cases requiring ICU care, while there were 68 (0.13%) and 4,020 (0.80%) deaths, which we compared with 7,824,181 individuals without diabetes (41,810 hospitalizations (0.53%), 8,753 (0.11%) needing ICU care, and 10,160 (0.13%) deaths). Although those with type 1 diabetes had moderately raised odds of being hospitalized, multiple-adjusted OR 1.38(95% CI 1.24-1.53), there was no independent effect on ICU care or death (ORs of 1.21(95% CI 0.94-1.52) and 1.13(95% CI 0.88-1.48)). Age and socioeconomic factors were the dominating features for predicting hospitalization and death in both types of diabetes. Conclusions Type 2 diabetes were associated with increased odds for all of the outcomes, whereas patients with type 1 diabetes had moderately increased odds of hospitalization but not ICU care and death.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::368e4ba85f89009270ec4c1ad187f919Test
https://doi.org/10.2337/figshare.21685727.v1Test

المؤلفون: Jon Edqvist (14228899), Christina Lundberg (14228900), Karin Andreasson (14228903), Lena Björck (77400), Pigi Dikaiou (14228908), Johnny Ludvigsson (167260), Marcus Lind (267226), Martin Adiels (157502), Annika Rosengren (68988)

مصطلحات موضوعية: Other health sciences not elsewhere classified, type 2 diabetes, Type 1 diabetes, Adult Onset Diabetes, Coronavirus (COVID-19), COVID-19

الوصف: Objective Type 2 diabetes is an established risk factor for hospitalization and death in COVID-19 infection while findings with respect to type 1 diabetes have been diverging. Research Design and Methods Using nationwide health registries, we identified all patients aged ≥18 years with type 1 and type 2 diabetes in Sweden. Odds ratios (ORs) describe general- and age specific risk of being hospitalized, in need of intensive care, or dying, adjusted for age, socioeconomic factors and coexisting conditions, compared to individuals without diabetes. Machine learning models were used to find predictors of outcomes among COVID-19-positive individuals with diabetes. Results Until June 30, 2021, we identified 365 (0.71%) and 11,684 (2.31%) hospitalizations in 51,402 and 504,337 patients with type 1 and 2 diabetes, respectively, with 67 (0.13%) and 2,848 (0.56%) cases requiring ICU care, while there were 68 (0.13%) and 4,020 (0.80%) deaths, which we compared with 7,824,181 individuals without diabetes (41,810 hospitalizations (0.53%), 8,753 (0.11%) needing ICU care, and 10,160 (0.13%) deaths). Although those with type 1 diabetes had moderately raised odds of being hospitalized, multiple-adjusted OR 1.38(95% CI 1.24-1.53), there was no independent effect on ICU care or death (ORs of 1.21(95% CI 0.94-1.52) and 1.13(95% CI 0.88-1.48)). Age and socioeconomic factors were the dominating features for predicting hospitalization and death in both types of diabetes. Conclusions Type 2 diabetes were associated with increased odds for all of the outcomes, whereas patients with type 1 diabetes had moderately increased odds of hospitalization but not ICU care and death.

العلاقة: https://figshare.com/articles/figure/Severe_Covid-19_infection_in_type_1_and_type_2_diabetes_mellitus_during_the_first_three_waves_in_Sweden/21685727Test

الإتاحة: https://doi.org/10.2337/figshare.21685727.v1Test

المؤلفون: Jon Edqvist, Christina Lundberg, Karin Andreasson, Lena Björck, Pigi Dikaiou, Johnny Ludvigsson, Marcus Lind, Martin Adiels, Annika Rosengren

المصدر: Diabetes care.

مصطلحات موضوعية: Advanced and Specialized Nursing, Endocrinology, Diabetes and Metabolism, Internal Medicine

الوصف: OBJECTIVEType 2 diabetes is an established risk factor for hospitalization and death in COVID-19 infection, while findings with respect to type 1 diabetes have been diverging.RESEARCH DESIGN AND METHODSUsing nationwide health registries, we identified all patients aged ≥18 years with type 1 and type 2 diabetes in Sweden. Odds ratios (ORs) describe the general and age-specific risk of being hospitalized, need for intensive care, or dying, adjusted for age, socioeconomic factors, and coexisting conditions, compared with individuals without diabetes. Machine learning models were used to find predictors of outcomes among individuals with diabetes positive for COVID-19.RESULTSUntil 30 June 2021, we identified 365 (0.71%) and 11,684 (2.31%) hospitalizations in 51,402 and 504,337 patients with type 1 and 2 diabetes, respectively, with 67 (0.13%) and 2,848 (0.56%) requiring intensive care unit (ICU) care and 68 (0.13%) and 4,020 (0.80%) dying (vs 7,824,181 individuals without diabetes [41,810 hospitalizations (0.53%), 8,753 (0.11%) needing ICU care, and 10,160 (0.13%) deaths). Although those with type 1 diabetes had moderately raised odds of being hospitalized (multiple-adjusted OR 1.38 [95% CI 1.24–1.53]), there was no independent effect on ICU care or death (OR of 1.21 [95% CI 0.94–1.52] and 1.13 [95% CI 0.88–1.48], respectively). Age and socioeconomic factors were the dominating features for predicting hospitalization and death in both types of diabetes.CONCLUSIONSType 2 diabetes was associated with increased odds for all outcomes, whereas patients with type 1 diabetes had moderately increased odds of hospitalization but not ICU care and death.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b32eddd935717219bc6f22a0905b9cb5Test
https://pubmed.ncbi.nlm.nih.gov/36607219Test

المؤلفون: Martin Adiels, Araz Rawshani, Annika Rosengren, Lena Björck, Marcus Lind, Ann-Marie Svensson, Naveed Sattar, Jon Edqvist, Stefan Franzén, Aidin Rawshani

المصدر: BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021)

مصطلحات موضوعية: Adult, Pediatrics, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, Diseases of the endocrine glands. Clinical endocrinology, albuminuria, Risk Factors, Diabetes mellitus, Glycemic load, medicine, Humans, Risk factor, Age of Onset, Glycemic, Glycated Hemoglobin, Type 1 diabetes, business.industry, medicine.disease, RC648-665, Diabetes Mellitus, Type 1, type 1, Cohort, diabetes mellitus, glycated hemoglobin A, Albuminuria, cardiovascular system, Epidemiology/Health services research, medicine.symptom, business, Body mass index

الوصف: IntroductionIn type 1 diabetes, potential loss of life-years is greatest in those who are youngest at the time of onset. Using data from a nationwide cohort of patients with type 1 diabetes, we aimed to study risk factor trajectories by age at diagnosis.Research design and methodsWe stratified 30 005 patients with type 1 diabetes aged 18–75 years into categories based on age at onset: 0–10, 11–15, 16–20, 21–25, and 26–30 years. HbA1c, albuminuria, estimated glomerular filtration rate (eGFR), body mass index (BMI), low-denisty lipoprotein (LDL)-cholesterol, systolic blood pressure (SBP), and diastolic blood pressure trends were analyzed using mixed models. Variable importance for baseline HbA1c was analyzed using conditional random forest and gradient boosting machine approaches.ResultsIndividuals aged ≥16 years at onset displayed a relatively low mean HbA1c level (~55–57 mmol/mol) that gradually increased. In contrast, individuals diagnosed at ≤15 years old entered adulthood with a mean HbA1c of approximately 70 mmol/mol. For all groups, HbA1c levels stabilized at a mean of approximately 65 mmol/mol by about 40 years old. In patients who were young at the time of onset, albuminuria appeared at an earlier age, suggesting a more rapid decrease in eGFR, while there were no distinct differences in BMI, SBP, and LDL-cholesterol trajectories between groups. Low education, higher age, and poor risk factor control were associated with higher HbA1c levels.ConclusionsYoung age at the diabetes onset plays a substantial role in subsequent glycemic control and the presence of albuminuria, where patients with early onset may accrue a substantial glycemic load during this period.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::93f6bd17a70ce49fd2c4c945010e1643Test
https://pubmed.ncbi.nlm.nih.gov/34059526Test

المؤلفون: Martin Adiels, Soffia Gudbjörnsdottir, Stefan Franzén, Marcus Lind, Araz Rawshani, Naveed Sattar, Annika Rosengren, Jon Edqvist, Ann-Marie Svensson

المصدر: Diabetologia

مصطلحات موضوعية: medicine.medical_specialty, HbA1c, Endocrinology, Diabetes and Metabolism, Population, 030209 endocrinology & metabolism, Type 2 diabetes, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Albuminuria, Humans, Registries, Risk factor, education, Socioeconomic status, Aged, Aged, 80 and over, Glycated Hemoglobin, Heart Failure, education.field_of_study, business.industry, Absolute risk reduction, Middle Aged, medicine.disease, Diabetes Mellitus, Type 2, Socioeconomic Factors, Heart failure, Female, medicine.symptom, business

الوصف: Aims/hypothesis Type 2 diabetes is an established risk factor for heart failure, but age-specific data are sparse. We aimed to determine excess risk of heart failure, based on age, glycaemic control and kidney function in comparison with age- and sex-matched control individuals from the general population. Methods Individuals with type 2 diabetes registered in the Swedish National Diabetes Registry 1998–2012 (n = 266,305) were compared with age-, sex- and county-matched control individuals without diabetes (n = 1,323,504), and followed over a median of 5.6 years until 31 December 2013. Results We identified 266,305 individuals with type 2 diabetes (mean age 62.0 years, 45.3% women) and 1,323,504 control individuals. Of the individuals with type 2 diabetes and control individuals, 18,715 (7.0%) and 50,157 (3.8%) were hospitalised with a diagnosis of heart failure, respectively. Comparing individuals with diabetes with those in the control group, men and women with type 2 diabetes who were younger than 55 years of age had HRs for hospitalisation for heart failure of 2.07 (95% CI 1.73, 2.48) and 4.59 (95% CI 3.50, 6.02), respectively, using analyses adjusted for socioeconomic variables and associated conditions. Younger age, poorer glycaemic control and deteriorating renal function were all associated with increased excess risk of heart failure in those with type 2 diabetes compared with the control group. However, people with diabetes who were ≥75 years and without albuminuria or with good glycaemic control (HbA1c ≤52 mmol/mol [≤6.9%]) had a similar risk of hospitalisation for heart failure as control individuals in the same age group. Conclusions/interpretation Men and women aged

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::597d63c5f61cdf1c95350813f75a30aaTest
https://doi.org/10.1007/s00125-018-4700-5Test