1.
Nilsson, Peter M., et al.
(författare)
Sibling rank and sibling number in relation to cardiovascular disease and mortality risk : A nationwide cohort study
2021
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:6
Tidskriftsartikel (refereegranskat) abstract
Background The number and rank order of siblings could be of importance for risk of cardiovascular disease and mortality. Previous studies have used only fatal events for risk prediction. We, therefore, aimed to use also non-fatal coronary and cardiovascular events in fully adjusted models. Methods From the Multiple-Generation Register in Sweden, data were used from 1.36 million men and 1.32 million women (born 1932-1960), aged 30-58 years at baseline and with follow-up from 1990 to 2015. Mean age at follow-up was 67 years (range 55-83 years). Fatal and non-fatal events were retrieved from national registers. Results Compared with men with no siblings, those with 1-2 siblings had a lower, and those with four or more siblings had a higher adjusted risk of cardiovascular events. Again, compared with men with no siblings, those with more than one sibling had a lower total mortality risk, and those with three or more siblings had an increased risk of coronary events. Correspondingly, compared with women with no siblings those women with three siblings or more had an increased risk of cardiovascular events, and those with two siblings or more had an increased risk of coronary events. Women with one sibling or more were at lower total mortality risk, following full adjustment. Conclusion Being first born is associated with a favourable effect on non-fatal cardiovascular and coronary events for both men and women. The underlying biological mechanisms for this should be studied in a sociocultural context.
2.
van den Berg, Gerard, et al.
(författare)
Mortality and the Business Cycle : Evidence from Individual and Aggregated Data
2017
Ingår i: Journal of Health Economics. - : Elsevier BV. - 0167-6296 .- 1879-1646. ; 56, s. 61-70
Annan publikation (övrigt vetenskapligt/konstnärligt) abstract
There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical, while others find the opposite. Some suggest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20-64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality.
3.
Lindgren, Magnus P., et al.
(författare)
Mortality risks associated with sibling heart failure
2020
Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 307, s. 114-118
Tidskriftsartikel (refereegranskat) abstract
Background The mortality in individuals with a family history of heart failure (HF) has not been determined. This nationwide sib-pair study aimed to determine mortality in individuals with a sibling affected with HF. Methods Sib-pairs were linked using the Swedish Multi-Generation Register, the Hospital Discharge Register and the Cause of Death Register for the period 1987–2012. Families with cardiomyopathy or congenital heart disease were excluded. Mortality hazard ratios (HRs) were calculated for siblings of individuals who had been diagnosed with HF compared with siblings of individuals unaffected by HF as the reference group. Similar analyses were made for spouses. HRs were determined for overall mortality, cardiovascular mortality, and death of unknown cause. Results Among siblings, the adjusted HR for overall mortality was 1.21 (95% CI 1.18–1.25). This risk remained (HR = 1.19, 95% CI 1.15–1.23) also among subjects without HF themselves. The adjusted HRs for cardiovascular mortality and death of unknown cause were 1.39 (95% CI 1.32–1.45) and 1.58 (95% CI 1.29–1.95), respectively. The mortality risk associations with spousal HF were all minimal, with an overall mortality HR of 1.02 (1.01–1.02). Early sibling age of onset of HF
4.
Frank, Christoph, et al.
(författare)
The population impact of familial cancer, a major cause of cancer
2014
Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 134:8, s. 906-1899
Tidskriftsartikel (refereegranskat) abstract
The population attributable fraction (PAF) defines the proportion of a disease that would be prevented if the exposure to a particular risk factor was avoided. Familial risk is a known risk factor for many cancers, but an unbiased estimation of the PAF for familial risk requires a large study population to include rare cancers. PAFs and their corresponding standardized incidence ratios (SIRs) were calculated for familial relative risk among first-degree relatives (FDRs) and second-degree relatives (SDRs) diagnosed with the same (concordant) invasive or in situ cancers. Calculations were based on the Swedish Family-Cancer Database considering 8,148,737 individuals. To assess environmental effects, PAFs were also calculated for concordant cancers among spouses. Almost all cancers showed a significant familial risk. The highest PAFs were found for the common cancers of the prostate (13.94%), breast (7.46%) and colorectum (6.78%) among the FDRs. In the FDRs, the overall PAF for any concordant cancer was 4.20%, but in the SDRs, it was only 0.34%. The overall PAFs for in situ cancers were 0.86% and 0.56% for the FDRs and SDRs, respectively. The overall independent familial PAF was 5.96% for the invasive and in situ cancers in the FDRs and SDRs. The cancers between spouses yielded an overall PAF of 0.14%. For esophageal cancer, the risk among spouses was higher than the familial risk. Our study shows that the overall familial PAF of 5.96%, although underestimated for sex-specific cancers, ranks as the third most common population burden after tobacco smoking and unhealthy diet.
5.
Borné, Yan, et al.
(författare)
Country of birth and risk of hospitalization due to heart failure : a Swedish population-based cohort study
2011
Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 26:4, s. 275-283
Tidskriftsartikel (refereegranskat) abstract
To explore the relation between country of birth and risk of hospitalization due to heart failure (HF). All 40-89 year-old inhabitants in the city of Malmö, Sweden (n = 114,917, of whom 15.2% were born outside Sweden) were followed from November 1st, 1990 until December 31st, 2007. During a mean follow-up of 13.5 ± 5.3 years, a total of 7,640 individuals (47.4% men) were discharged from hospital with first-ever HF as primary diagnosis. Of them, 1,243 individuals had myocardial infarction (MI) before or concurrent with the HF hospitalization. The risk of HF was compared between immigrants from selected countries and Swedish natives. The overall analysis showed substantial differences among immigrant groups (P < 0.001). Compared to Swedish natives, significantly increased HF risk was found among immigrants from Finland (HR (hazard ratio): 1.40; 95% CI, 1.10-1.81), Former Yugoslavia (1.45: 1.23-1.72) and Hungary (1.48: 1.16-1.89), taking age, sex, marital status, annual income and housing condition into account. Analysis results were similar when cases with MI before or concurrent with the HF hospitalization were included in the analysis. In general, the risk of HF was significantly higher among immigrants from high-income and middle-income countries. Marital status, annual income and housing condition were also significant independent risk factors for HF in this population. There are substantial differences in risk of hospitalization due to HF among immigrants from different countries that can not be explained by socioeconomic factors. To what extent these differences could be explained by biological risk factors remains to be explored.
6.
Wändell, Per, et al.
(författare)
Urolithiasis in immigrant groups : a nationwide cohort study in Sweden
2019
Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 53:1, s. 69-76
Tidskriftsartikel (refereegranskat) abstract
Objective: To study the association between country of birth and incident urolithiasis in immigrant groups in Sweden, using individuals born in Sweden (or with Swedish-born parents in the second-generation study) as referents. Methods: This nationwide follow-up study included first- and second-generation immigrants residing in Sweden between 1 January 1998 and 31 December 2012. Urolithiasis was defined as having at least one registered diagnosis of urolithiasis in the National Patient Register. Cox regression analysis was used to estimate the risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident urolithiasis. The models were stratified by sex and adjusted for age, sociodemographic status and co-morbidity. Results: Compared to referents, slightly higher incidence rates and HRs of urolithiasis (HR; 95% CI) were observed among first-generation men (1.06; 1.04–1.09) and women (1.12; 1.08–1.16) but not among second-generation immigrants (persons born in Sweden with foreign-born parents). Among first-generation immigrants, higher HRs were noted among men and women from Central and Eastern Europe, Russia, Latin America, Africa and Asia. Lower HRs were seen among men and women from the Nordic countries, most Western European countries and North America. Among second-generation immigrants, higher HRs were noted among men and women from Denmark, Germany and Hungary, in men from Austria, and in women from the Netherlands and Poland. Lower HRs were seen in second generation immigrants from Latin America, Africa and Asia (men and women). Conclusions: We observed substantial differences in incidence of urolithiasis between certain immigrant groups and the Swedish-born population, of importance in the clinical situation.
7.
Kendler, Kenneth S., et al.
(författare)
Parent-offspring transmission of drug abuse and alcohol use disorder : Application of the multiple parenting relationships design
2019
Ingår i: American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics. - : Wiley. - 1552-4841 .- 1552-485X. ; 180:4, s. 249-257
Tidskriftsartikel (refereegranskat) abstract
With complete genealogical and cohabitation information, new genetic-epidemiological designs can be developed to clarify causes of parent-offspring transmission. We propose the Multiple Parenting Relationships (MPR) Design and apply it to drug abuse (DA) and alcohol use disorder (AUD). Using national Swedish registries, we identified four kinds of informative parents with multiple children with whom they had different genetic and/or rearing relationships. These types had children for whom they provided: (a) genes (G) plus rearing (R), G only and R only; (b) G + R and G only; (c) G only and R only; and (d) G + R and R only. We identified DA and AUD cases from national registries in over 475,000 informative parent-offspring pairs. Controlling for parental resemblance for DA or AUD, all estimates were statistically homogeneous across family types. The weighted average tetrachoric correlation (SE) for DA for G + R, R only and G only relationships were, respectively, +0.21 (0.01), +0.10 (0.02), and +0.16 (0.02). Parallel results for AUD were +0.16 (0.01), +0.04 (0.02), and +0.14 (0.01). Analyses within families with affected parents showed significantly higher disorder risks in offspring with a G + R versus an R only relationship. The MPR design is complementary to other methods, especially adoption and triparental designs, in clarifying the sources of cross-generational transmission. Consistent with results from these other designs applied to the Swedish population, we find that for DA and AUD, parent-offspring resemblance was strongest for G + R relationships, intermediate for G only relationships and weakest but significant for R only relationships.
8.
Wändell, Per, et al.
(författare)
End-stage kidney diseases in immigrant groups : a nationwide cohort study in Sweden
2019
Ingår i: American Journal of Nephrology. - : S. Karger AG. - 0250-8095 .- 1421-9670. ; 49:3, s. 186-192
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: Our aim was to study the association between the country of birth and incident end-stage kidney disease (ESKD) in several immigrant groups in Sweden, using individuals born in Sweden or with Swedish-born parents as referents.METHODS: A cohort study of first- and second-generation immigrants residing in Sweden between January 1, 1998 and December 31, 2012 was performed. Outcomes were defined as having at least one registered diagnosis of ESKD in the National Patient Register. The incidence of ESKD in different immigrant groups was used in the Cox regression models to estimate hazard ratios (HRs) and 95% CIs. All models were stratified by sex and adjusted for age, geographical residence, educational level, marital status, and neighbourhood socioeconomic status.RESULTS: Compared to their referents, higher incidence rates and HRs of ESKD (HR; 95% CI) were observed in general among foreign-born men (1.10; 1.04-1.16) and women (1.12; 1.04-1.21) but not among second-generation immigrants (persons born in Sweden with foreign-born parents). A particularly high -incidence was noted among men and women from -East-European countries, as well as from non-European regions. A lower incidence of ESKD was noted among men from Finland.CONCLUSIONS: We observed substantial differences in incidence of ESKD between immigrant groups and the Swedish-born population, which may be clinically relevant when monitoring preventive measures in patient subgroups with a higher risk of deteriorating kidney disease, and suggest higher attention to hypertension and diabetes control in immigrants. Mechanisms attributable to the migration process or ethnic differences may lead to an increased risk of ESKD.
9.
Blomstedt, Yulia, et al.
(författare)
Mental health of immigrants from the former Soviet Bloc : a future problem for primary health care in the enlarged European Union? A cross-sectional study
2007
Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 7, s. Article nr 27-
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: Enlargement of the European Union has caused worries about the possibility of increased migration from its new members, the former Soviet countries, and consequently increased demands on the health care systems of the host countries. This study investigated whether or not earlier immigrants from the former Soviet Bloc have poorer self-reported mental health, measured as self-reported psychiatric illness and psychosomatic complaints, than the host population in Sweden. It also examined the particular factors which might determine the self-reported mental health of these immigrants. METHODS: The cross-sectional national sample included 25-84-year-old Swedish-born persons (n = 35,459) and immigrants from Poland (n = 161), other East European countries (n = 164), and the former Soviet Union (n = 60) who arrived in Sweden after 1944 and were interviewed during 1994-2001. Unconditional multivariate logistic regression was used in the analyses. RESULTS: The findings indicated that the country of birth had a profound influence on self-reported mental health. Polish and other East European immigrants in general had a twofold higher odds ratio of reporting psychiatric illness and psychosomatic complaints, which fact could not be explained by adjustments for the demographic and socioeconomic variables. However, immigrants from the former Soviet Union had odds similar to those of the Swedish-born reference group. Adjustments for migration-related variables (language spoken at home and years in Sweden) changed the association between the country of birth and the outcomes only to a limited extent. CONCLUSION: Since poor mental health may hinder acculturation, the mental health of immigrants from Poland and other East European countries should be acknowledged, particularly with the expansion of the European Union and inclusion of nine former Soviet Bloc countries by 2007.
10.
Kendler, Kenneth S., et al.
(författare)
The impact of parenthood on risk of registration for alcohol use disorder in married individuals : A Swedish population-based analysis
2019
Ingår i: Psychological Medicine. - 0033-2917. ; 49:13, s. 2141-2148
Tidskriftsartikel (refereegranskat) abstract
BackgroundAlthough being married with children is associated with a reduced rate of alcohol use disorder (AUD), is this finding independent of a marital effect, different in mothers and fathers and potentially causal in effect.MethodsUsing Cox proportional hazards, we examined, in 1 252 237 married individuals, the association between a resident younger and older child and risk for AUD registration in national medical, criminal, and pharmacy registers. Using logistic regression, we analyzed, in 600 219 parents, within-person models comparing risk for AUD prior to first pregnancy v. with young children. We examined whether risk for AUD in 1302 parents after a first spousal AUD registration was reduced by having a young resident child.ResultsCompared with childless married individuals, resident younger children were associated with a reduced risk for AUD in mothers [hazard ratio (HR) 0.36, 95% confidence interval 0.31-0.41] and fathers (HR 0.66, 0.60-0.73). The reduced risk was attenuated but still significant for older children. Within-person models confirmed the protective effect of young children in mothers [odds ratio (OR) 0.49, 0.30-0.80] but yielded inconclusive results in fathers (OR 0.85, 0.58-1.25). After a first spousal registration for AUD, a resident young child was associated with a substantial reduction in risk for mothers and a weaker marginal effect in fathers.ConclusionIn married individuals, resident children are associated with a reduction in basal risk for AUD which is stronger in mothers than fathers and with younger v. older children. This effect is also evident during high-risk periods. In mothers, our results are consistent with a largely causal effect.
