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Siliac-acid and incidence of hospitalization for diabetes and its complications during 40-years of follow-up in a large cohort: the Värmland survey
Örebro University, School of Health and Medical Sciences.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Örebro University, School of Health and Medical Sciences.
Department of Medicine , Clinical Epidemiological Unit, Karolinsta Institute, Stockholm, Sweden.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aim To examine the association of sialic acid (SA) with first recorded diabetes mellitus-related hospitalization.

Methods From a population-based study in Värmland, Sweden, between 1962 and 1965, 87,035 men and women were selected and followed for first recorded diabetesrelated hospitalization until 2005. The association of SA was calculated and stratified for gender by Cox´s proportional hazards models. Adjustments were made for conventional risk factors and socioeconomic status. Association analyses were made for comparisons between SA-levels above and below median.

Results The mean age was 47.2 (SD 13.0) years and the total numbers of incident diabetes-related hospitalizations in men and women were 3445 and 3273, respectively. Hazard ratios per one standard deviation of SA were 1.12 (95% CI: 1.08 to 1.17, p<0.0001) in men and 1.17 (95% CI: 1.13 to 1.22, p<0.0001) in women. Interaction analyses indicated a relatively higher SA-associated risk in women than in men with above median SA levels.

Conclusions In this large population-based cohort followed for more than 40 years, elevated SA, as a marker of systemic inflammation, was independently associated with risk of diabetes and diabetes-related hospitalizations.

Keywords [en]
epidemiology, diabetes, hospitalization, inflammation, risk
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-26694OAI: oai:DiVA.org:oru-26694DiVA, id: diva2:578445
Note

Payam Khalili is also affiliated to Department od Cardiology and Acute Internal Medicine , Central Hospital , Karlstad, Sweden

Johan Jendle is also affiliated to Endocrine and Diabetes Center, Central Hospital, Karlstad, Sweden

Peter M. Nilsson is also affiliated to Department of Clinical Sciences, Lunds University, University Hospital, Malmö, Sweden

Available from: 2012-12-18 Created: 2012-12-18 Last updated: 2017-10-17Bibliographically approved
In thesis
1. Risk factors for cardiovascular events and incident hospital-treated diabetes in the population
Open this publication in new window or tab >>Risk factors for cardiovascular events and incident hospital-treated diabetes in the population
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Well-established risk factors for CVD include increasing age, male sex, sedentary lifestyle, obesity, smoking, diabetes, hypertension, dyslipidaemia and low socio-economic status. Traditional risk factors do, however, not fully explain cardiovascular risk in general. In this thesis we focused on two conventional risk factors (smoking, blood pressure), and two unconventional risk markers (adiponectin, an adipocyte derived protein; and sialic acid (SA), a marker of systemic inflammation) for prediction of CVD events.

Aims: In Paper I we examined to what degree smoking habits modify the risk of CVD in relation to systolic blood pressure levels in middle-aged men. In Paper II we investigated the predictive role of adiponectin for risk of CVD as well as the cross-sectional associations between adiponectin and markers of glucose metabolism, also in men. In Paper III we examined if increasing pulse pressure (PP) and increasing levels of SA both increase the risk of CVD and whether their effects act in synergism. In Paper IV the association of SA with risk of incident diabetes mellitus and related complications, resulting in hospitalization, was studied.

Subjects and Methods: Two large-scale, population-based, screening studies with long follow-up periods have been used. The Malmö Preventive Project (MPP) was used with 22,444 individuals in Paper I and a sub cohort of 3,885 individuals in Paper II. The Värmland Health Survey (VHS) was used in Papers III and IV with 37,843 and 87,035 individuals, respectively.

Results: CVD risk increases with increasing systolic blood pressure levels and this risk is almost doubled in smokers. Total adiponectin level is not associated with increased risk of future CVD but it is inversely associated with markers of glucose metabolism. PP and SA both contribute to risk of future CVD. Adjustment for mean arterial pressure reduces the risk induced by PP. Elevated SA contributes to increased risk of incident diabetes and related complications leading to hospitalization.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 73
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 79
Keywords
Adiponectin, blood pressure, cardiovascular risk, diabetes, inflammation, pulse pressure, sialic acid, smoking
National Category
Medical and Health Sciences Cardiac and Cardiovascular Systems
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-24173 (URN)978-91-7668-905-9 (ISBN)
Public defence
2012-12-14, Hörsal P1, Prismahuset, Örebro universitet, Fakultetsgatan 1, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-07-30 Created: 2012-07-30 Last updated: 2017-10-17Bibliographically approved

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Citation style
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