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- Henricsson, M., et al.
(författare)
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Mortality in diabetic patients participating in an ophthalmological control and screening programme
- 1997
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Ingår i: Diabetic Medicine. - 0742-3071. ; 14:7, s. 576-583
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this follow-up study has been to assess retinopathy and change of treatment to insulin therapy as risk factors for mortality in diabetic patients participating in a control and screening programme for retinopathy. A total of 3220 diabetic patients, 483 with an age at diagnosis <30 years, and 2737 with an age at diagnosis ≤30 years, were included. Retinopathy was graded on fundus photographs using the Wisconsin Scale, and the visual acuity was assessed. The average HbA(1c) value was calculated for each patient for the previous 8 years to estimate long-term glycaemic control. Mortality data were obtained from death certificates. Two hundred and sixty-three diabetic patients (8.2 %) died during the mean follow-up time of 3.4 years, 13 (2.7 %) of those with younger-onset (<30 years) and 250 (9.1%) of those with older-onset (≤30 years) diabetes. Of them, 148 (56.3 %) died from cardiovascular and 23 (8.7 %) from cerebrovascular disorders. After adjusting for differences in age and sex, more severe retinopathy and the use of antihypertensive drugs were associated with a decreased overall survival rate as well as an increased mortality from cardiovascular and cerebrovascular diseases. A statistically significant association between HbA(tc) values in the highest quartile, i.e. ≤8.4 %, and cardiovascular and all cause mortality did not remain when retinopathy was entered into the multivariate analyses. Duration of diabetes, but not change of treatment to insulin therapy, was associated with higher cardiovascular mortality in patients whose diabetes was diagnosed after the age of 30 years. We conclude that severe retinopathy, use of antihypertensive drugs, and poor glycaemic control predicted death from cardiovascular disease in diabetic patients participating in an ophthalmological screening programme.
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- Elmståhl, S., et al.
(författare)
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Increased incidence of fractures in middle-aged and elderly men with low intakes of phosphorus and zinc
- 1998
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 8:4, s. 333-340
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to determine dietary risk factors for fracture in men aged 46-68 years. Six thousand five hundred and seventy-six men were randomly invited using the Municipal Registry to a diet and health study. The diet was assessed using a combined 7-day menu book for hot meals, beverages and dietary supplements and a quantitative food frequency questionnaire for other foods. The fracture incidence was 103/10,000 person-years during a mean follow-up of 2.4 years. Zinc and phosphorus intake were associated with fracture risk and showed a threshold effect. The zinc intake in the lowest decentile, 10 mg daily, was associated with almost a doubled risk of fracture compared with the fourth and fifth quintiles (RR = 0.47; 95% confidence interval, 27-82) of zinc intake adjusted for energy, previous fractures, lifestyle factors and co-morbidity. Energy-adjusted phosporus intake in the lowest quintile, mean level 1357 mg, was associated with an increased fracture risk compared with subjects in the second quintile. Smoking, martial status and physical activity were independently associated with fracture risk. Calcium, retinol and vitamin D showed no associations with fracture risk. We conclude that inadequate intakes of zinc and phosporus are important risk factors for fracture.
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- Elmståhl, S., et al.
(författare)
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The prevalence of anaemia and mineral supplement use in a Swedish middle-aged population. Results from the Malmo Diet and Cancer Study
- 1996
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Ingår i: European Journal of Clinical Nutrition. - 0954-3007. ; 50:7, s. 450-455
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe dietary habits and use of mineral supplements in relation to nutrient recommendations and anaemia. Design: a population-based cohort study. Subjects: 2665 men and 3878 women, born between 1926 and 1945, randomly invited and participating in the prospective 'Malmo Diet and Cancer study' during 1991-1992. Methods: The diet was assessed using a combined 7-day menu book for hot meals, beverages and supplements and a quantitative food frequency questionnaire for other foods. Anaemia was defined as haemoglobin ≤131 g/l for men and ≤115 g/l for women. Results: Intake of mineral supplements were reported by 19% of the men and 31% of the women. Less than 0.2% had intakes of iron and selenium above highest recommended Swedish long-term intakes. The percentage of women with intake below nutrient recommendations were: zinc and selenium (60%); magnesium (35%); calcium (21%) and iron (70%, premenopausal). The corresponding values for men were: zinc, selenium and magnesium (33-47%); calcium and iron (5%). The median contribution of calcium from supplements was less than 110 mg. Supplement users had higher intakes of fish, fruits, vegetables and tea and lower intakes of coffee and meat. The iron intake was correlated to haemoglobin levels, and iron supplementation constituted about 45% of the intake. Three per cent of premenopausal women had anaemia as did less than 2% of postmenopausal women. Conclusion: A substantial number had mineral intake below present recommendations despite supplement use. The nutrient content of some supplements could be improved, especially calcium. Iron supplementation among postmenopausal women and men are questionable.
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