| 31. |
- Calling, Susanna, et al.
(författare)
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Preterm birth and unintentional injuries: risks to children, adolescents and young adults show no consistent pattern.
- 2012
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253.
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Preterm birth is associated with a number of physical and mental health issues. The aim of this study was to find out if there was also any association between individuals born preterm in Sweden between 1984 and 2006 and the risk of unintentional injuries during childhood, adolescence and young adulthood METHODS: The study followed 2,297,134 individuals, including 5.9% born preterm, from 1985 to 2007 for unintentional injuries leading to hospitalisation or death (n=244,021). The males and females were divided into four age groups: 1-5 years, 6-12 years, 13-18 years and 19-23 years. Hazard ratios were calculated for falls, transport injuries and other injuries RESULTS: After adjusting for a comprehensive set of covariates, some of the preterm subgroups demonstrated slightly increased risks of unintentional injuries, while others showed slightly decreased risks. However, most of the estimates were borderline or non-significant in both males and females. In addition, the absolute risk differences between individuals born preterm and full term were small CONCLUSION: Despite the association between preterm birth and a variety of physical and mental health consequences, this study shows that there is no consistent risk pattern between preterm birth and unintentional injuries in childhood, adolescence and young adulthood. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.
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| 32. |
- Calling, Susanna, et al.
(författare)
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Shared and non-shared familial susceptibility of coronary heart disease, ischemic stroke, peripheral artery disease and aortic disease.
- 2013
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 168:3, s. 2844-2850
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about whether the four main manifestations of arterial vascular disease (coronary heart disease=CHD, ischemic stroke, peripheral artery disease=PAD, and aortic (i.e. atherosclerosis/aneurysm) disease=AD) share familial susceptibility. The aim of this nationwide study was to determine the familial risks of concordant (same disease in proband and exposed relative) and discordant (different disease in proband and exposed relative) cardiovascular disease (CVD). METHODS: Data from the Swedish Multigeneration Register on individuals aged 0-76years were linked to Swedish Hospital Discharge Register data for the period 1964-2008. Standardized incidence ratios (SIRs) for CHD (n=140,708 cases), ischemic stroke (n=73,771), PAD (n=18,982) and AD (n=7879) were calculated for siblings of individuals hospitalized due to CHD, stroke, PAD or AD compared to those of unaffected siblings. The procedure was repeated for parent-offspring and spouses. RESULTS: All concordant and discordant sibling risks were increased for both males and females. Concordant risks were generally higher than discordant risks. The highest sibling risks were observed for premature concordant disease (<55years for males and <65years for females): SIR for CHD=1.93 (95% CI: 1.90-1.96), SIR for ischemic stroke=1.45 (1.39-1.50), SIR for PAD=2.76 (2.54-3.00), and SIR for AD=6.36 (5.28-7.59). Premature parent-offspring transmission followed the same pattern. The disease risk was modestly increased in spouses, highest for AD (SIR=1.48 (1.28-1.69)) and PAD (SIR=1.27 (1.21-1.32)). CONCLUSIONS: The four main manifestations of CVD share familial susceptibility, but unique site-specific familial factors may exist.
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| 33. |
- Calling, Susanna, et al.
(författare)
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Socioeconomic inequalities and infant mortality of 46 470 preterm infants born in Sweden between 1992 and 2006
- 2011
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Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 25:4, s. 357-365
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Tidskriftsartikel (refereegranskat)abstract
- Socioeconomic inequalities and infant mortality of 46 470 preterm infants born in Sweden between 1992 and 2006. Paediatric and Perinatal Epidemiology 2011; 25: 357-365. Studies on possible sociodemographic inequities in the survival of preterm infants are scarce. Individual and neighbourhood sociodemographic factors are related to preterm birth and to infant mortality in full-term infants. The aim here was to examine whether infant mortality in Swedish preterm infants is related to individual and neighbourhood sociodemographic factors, and to study whether the hypothesised association between neighbourhood deprivation and infant mortality persists after accounting for individual sociodemographic factors. The study included 46 470 infants with a gestational length of < 37 weeks, born in Sweden between 1992 and 2006. Neighbourhood deprivation was assessed by an index (education, income, unemployment, welfare assistance) in small geographical units, and categorised into low, moderate and high deprivation. Adjusted odds ratios for infant mortality were examined in relation to individual and neighbourhood sociodemographic factors. After adjusting for maternal age, infant mortality was associated with the following sociodemographic variables: maternal non-married/non-cohabiting status, low family income, low maternal education and rural status. After full adjustment, the odds ratio [95% confidence interval] was 2.98 [2.42, 3.67] for low family income compared with high family income. An increase in infant mortality was also associated with high neighbourhood deprivation; however, this increased risk no longer remained statistically significant after adjusting for individual sociodemographic factors. In conclusion, this study showed an increased infant mortality in preterm infants born to women with a less favourable sociodemographic profile.
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| 34. |
- Calling, Susanna, et al.
(författare)
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Socioeconomic status and alcohol use disorders across the lifespan : A co-relative control study
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:10, s. 0224127-0224127
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Alcohol use disorders (AUD) is well known to aggregate in families and is associated with socioeconomic status (SES). The objective was to study the effect of education, income and neighborhood SES in adulthood on AUD, and to explore whether the potential associations were confounded by shared familial factors, by using a co-relative control design. METHODS: Data on AUD was drawn from the Swedish inpatient and outpatient care registers; prescription drug register; and crime data. Through national population registers we collected information on income, education and neighborhood SES at age 25, 30, 35 and 40 years in all individuals born in Sweden between 1950 and 1980. Each sex-specific stratum consisted of approximately 750,000-1,200,000 individuals, who were followed for AUD for a mean follow-up time ranging between 10 and 15 years until the end of 2013. Cox proportional hazards models were used to investigate the risk of AUD as a function of income, education and neighborhood SES in the general population and in pairs of first cousins and full siblings within the same sex, who differed in their exposure to the SES measure. RESULTS: Higher educational level, higher income and higher neighborhood SES were all associated with a reduced risk for AUD for both males and females in all ages. The potentially protective effect remained but was attenuated when comparing pairs of first cousins and full siblings. CONCLUSIONS: High educational level and income in adulthood, as well as high neighborhood socioeconomic status, may represent protective factors against alcohol use disorders, even when shared familial factors, e.g. childhood socioeconomic status and genetic factors, have been taken into account.
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| 35. |
- Calling, Susanna, et al.
(författare)
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The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women's health in the Lund area (WHILA) : a 17-year follow-up cohort study
- 2019
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Identifying variables predictive of acute myocardial infarction (AMI) in women is important. The use of the ratio of total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) is often overlooked. The aim was to study TC/HDL-C in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist-hip ratio, blood pressure, and neighbourhood socioeconomic status. The hypothesis was that increasing TC/HDL-C is associated with an increased risk of later AMI.METHODS: From December 1995 to February 2000, 6147 women aged 50-59 years from the Womens' Health in Lund area (WHILA) study in southern Sweden underwent a physical examination, laboratory tests and filled in a questionnaire. The women were followed through national registers for incidence of AMI during a mean follow up of 17 years.RESULTS: An increasing TC/HDL-C showed a strong relationship with AMI, with the lowest hazard ratio (HR = 1) in women with a ratio of ≤3.5. The HR for AMI was 1.14 (95% CI: 0.73-1.78) for those with a ratio between 3.5 and 4.0; in those with a ratio between 4.0 and 5.0 the HR for AMI was 1.46 (95% CI: 1.00-2.13) and in those with a ratio > 5.0 the HR was 1.89 (95% CI 1.26-2.82), after adjusting for potential confounding factors.CONCLUSIONS: TC/HDL-C ratio is a powerful predictor of AMI in middle-aged women. The results indicate that this variable should be used in clinical practice and is important for early identification of individuals at risk of AMI.
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| 36. |
- Calling, Susanna, et al.
(författare)
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Total cholesterol/HDL-C ratio versus non-HDL-C as predictors for ischemic heart disease : a 17-year follow-up study of women in southern Sweden
- 2021
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: A distorted blood lipid profile is an important risk factor for ischemic heart disease (IHD) but the predictive ability of the different lipid measures has rarely been studied. Our aim was to examine and compare, in a large sample of women, the predictive ability of total cholesterol/HDL cholesterol ratio (TC/HDL-C) and non-HDL-C in relation to IHD, adjusted for age, exercise, smoking, waist-hip ratio, blood pressure, and diabetes mellitus. Methods: Between 1995 and 2000, a total of 6537 women aged 50–59 years from the Women’s Health in Lund area (WHILA) study in southern Sweden were included and underwent a baseline examination. The women were followed through national registers for incidence of IHD during a mean follow-up of 17 years. The prediction accuracy was estimated through Harrell’s C and Akaike Information Criterion (AIC). Results: Increasing TC/HDL-C as well as non-HDL-C showed strong associations with IHD, with the highest risk in the 5th quintile, where the HR was 2.30 (95% CI: 1.70–3.11) for TC/HDL-C and 1.67 (95% CI: 1.25–2.24) for non-HDL-C, after adjustments. Comparisons using Harrell’s C and AIC indicated that TC/HDL-C has a slightly higher predictive ability than that of non-HDL-C (Harrell’s C 0.62 and 0.59 respectively, p = 0.003 for difference, age-adjusted model; AIC for TC/HDL-C < AIC for non-HDL-C). Conclusions: TC/HDL-C ratio and non-HDL-C are both clinical predictors for IHD in middle-aged women. The results indicate that the predictive ability of TC/HDL-C was higher than that of non-HDL-C; however, non-HDL-C was linearly related to IHD (p = 0.58) and may be easier to calculate and interpret in clinical practice, for early identification of future IHD in women.
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| 37. |
- Calling, Susanna, et al.
(författare)
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Trajectories of body mass index and risk for coronary heart disease : A 38-year follow-up study
- 2021
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:10 October 2021
-
Tidskriftsartikel (refereegranskat)abstract
- Objective Obesity is a well-known risk factor for coronary heart disease (CHD), but there is little evidence on the effect of long-term trajectories of body mass index (BMI) over the life course. By using repeated assessments, the aim was to study the risk of CHD in adults during 38 years in different trajectories of BMI. Methods A sample of 2129 men and women, aged 20-59 years at baseline, took part in four repeated interviews between 1980 and 2005. Data on BMI, medical history, lifestyle and socioeconomy were collected. Based on the World Health Organization categories of BMI, life course trajectories of stable normal weight, stable overweight, stable obesity, increasing BMI and fluctuating BMI were created. The individuals were followed through national registers for first hospitalization of CHD (389 events) until the end of 2017, and Hazard Ratios (HRs) were calculated, adjusted for age, sex, socioeconomic factors, lifestyle factors and metabolic comorbidities. Results Stable normal weight in all assessments was the reference group. Those who had an increase in BMI from normal weight in the first assessment to overweight or obesity in later assessments had no increased risk of CHD, HR 1.04 (95% CI: 0.70-1.53). The HR for individuals with fluctuating BMI was 1.25 (0.97-1.61), for stable overweight 1.43 (1.03-1.98), for stable obesity 1.50 (0.92-2.55), and for stable overweight or obesity 1.45 (1.07-1.97), after full adjustments. Conclusion Having a stable overweight or obesity throughout adult life was associated with increased CHD risk but changing from normal weight at baseline to overweight or obesity was not associated with increased CHD risk. Prevention of obesity early in life may be particularly important to reduce CHD risk.
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| 38. |
- Calling, Susanna, et al.
(författare)
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Women's Health in the Lund Area (WHILA) study. Health problems and acute myocardial infarction in women – A 17-year follow-up study
- 2018
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Ingår i: Maturitas. - : Elsevier BV. - 0378-5122. ; 115, s. 45-50
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The literature has highlighted the importance of identifying symptoms predictive of acute myocardial infarction (AMI) in women, in addition to traditional cardiovascular risk factors. The objective was to study subjective health problems, in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist/hip ratio, blood pressure, total cholesterol/HDL ratio, diabetes and neighbourhood socioeconomic status. Study design: From December 1995 to February 2000 a cohort of 6711 women aged 50–59 years in southern Sweden underwent a physical examination and answered a questionnaire that had 18 items on health problems such as stress symptoms, tiredness and pain. Main outcome measures: Incidence of AMI during a mean follow-up of 17 years, drawn from national registers. Results: The number of health problems showed a J-shaped relationship with AMI, with the lowest hazard ratio (HR) in women with a median of 4 health problems. The HR for AMI in women with 0 health problems was 1.58 (95% CI: 0.95–2.63) and in those with 13 problems HR 1.65 (95% CI 1.16–2.36), after adjusting for potential confounding factors. Conclusions: The presence of several health problems, including pain and stress symptoms, is associated with an increased risk of later AMI in middle-aged women. Awareness among clinicians of predictive risk factors for AMI is important for the early identification of individuals at higher risk.
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| 39. |
- Cardoso, Rafael, et al.
(författare)
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Colorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: an international population-based study
- 2021
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Ingår i: The Lancet Oncology. - 1474-5488. ; 22:7, s. 1002-1013
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Tidskriftsartikel (refereegranskat)abstract
- Background: Colorectal cancer screening programmes and uptake vary substantially across Europe. We aimed to compare changes over time in colorectal cancer incidence, mortality, and stage distribution in relation to colorectal cancer screening implementation in European countries. Methods: Data from nearly 3·1 million patients with colorectal cancer diagnosed from 2000 onwards (up to 2016 for most countries) were obtained from 21 European countries, and were used to analyse changes over time in age-standardised colorectal cancer incidence and stage distribution. The WHO mortality database was used to analyse changes over time in age-standardised colorectal cancer mortality over the same period for the 16 countries with nationwide data. Incidence rates were calculated for all sites of the colon and rectum combined, as well as the subsites proximal colon, distal colon, and rectum. Average annual percentage changes (AAPCs) in incidence and mortality were estimated and relevant patterns were descriptively analysed. Findings: In countries with long-standing programmes of screening colonoscopy and faecal tests (ie, Austria, the Czech Republic, and Germany), colorectal cancer incidence decreased substantially over time, with AAPCs ranging from −2·5% (95% CI −2·8 to −2·2) to −1·6% (−2·0 to −1·2) in men and from −2·4% (−2·7 to −2·1) to −1·3% (−1·7 to −0·9) in women. In countries where screening programmes were implemented during the study period, age-standardised colorectal cancer incidence either remained stable or increased up to the year screening was implemented. AAPCs for these countries ranged from −0·2% (95% CI −1·4 to 1·0) to 1·5% (1·1 to 1·8) in men and from −0·5% (−1·7 to 0·6) to 1·2% (0·8 to 1·5) in women. Where high screening coverage and uptake were rapidly achieved (ie, Denmark, the Netherlands, and Slovenia), age-standardised incidence rates initially increased but then subsequently decreased. Conversely, colorectal cancer incidence increased in most countries where no large-scale screening programmes were available (eg, Bulgaria, Estonia, Norway, and Ukraine), with AAPCs ranging from 0·3% (95% CI 0·1 to 0·5) to 1·9% (1·2 to 2·6) in men and from 0·6% (0·4 to 0·8) to 1·1% (0·8 to 1·4) in women. The largest decreases in colorectal cancer mortality were seen in countries with long-standing screening programmes. Interpretation: We observed divergent trends in colorectal cancer incidence, mortality, and stage distribution across European countries, which appear to be largely explained by different levels of colorectal cancer screening implementation. Funding: German Cancer Aid (Deutsche Krebshilfe) and the German Federal Ministry of Education and Research. © 2021 Elsevier Ltd
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| 40. |
- Carlsson, Axel C., et al.
(författare)
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Differences and time trends in drug treatment of atrial fibrillation in men and women and doctors' adherence to warfarin therapy recommendations
- 2013
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Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 69:2, s. 245-253
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about prescription trends in atrial fibrillation (AF) in primary health care in Sweden. The aim was to study time trends in pharmacotherapy, in men and women with AF. We also aimed at studying doctors' adherence to CHADS2 for prescribing warfarin. CHADS2 assesses stroke risk by presence of known risk factors, i.e., congestive heart failure, hypertension, age > 75 years, diabetes, previous stroke and transient ischemic attack. Data were obtained from primary health care records that contained individual clinical data. In total, 371,036 patients were included in the sample from 2002, and 424,329 patients were included in the sample from 2007. The study population consisted of individuals aged 45+ years who were diagnosed with AF in 2002 (1,330 men and 1,096 women) and 2007 (2,748 men and 2,234 women). The pharmacotherapies prescribed in 2002 and 2007 were analyzed separately in men and women. Logistic regression was used to calculate the association between the CHADS2 score and prescribed warfarin treatment. Selective beta-blockers, anti-coagulant therapy and lipid-lowering drugs were prescribed more frequently in 2007 than in 2002. In 2007, antithrombotic and RAS-blocking agents were prescribed more frequently to men, whereas beta-1 selective beta-blockers were prescribed more frequently to women. There was no consistent association between the CHADS2 score and prescribed warfarin treatment. Pharmacotherapy of AF has improved over time, though CHADS2 guidelines need to be implemented systematically in primary health care in Sweden to decrease the risk of stroke and improve quality of life in patients with AF.
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