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Publications (10 of 13) Show all publications
Selin, D., Maret-Ouda, J., Oskarsson, V., Lindblad, M., Arnelo, U., Holmberg, M., . . . Sadr-Azodi, O. (2024). Exploring the association between acute pancreatitis and biliary tract cancer: a large-scale population-based matched cohort study. United European Gastroenterology journal
Open this publication in new window or tab >>Exploring the association between acute pancreatitis and biliary tract cancer: a large-scale population-based matched cohort study
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2024 (English)In: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Biliary tract cancer (BTC) often goes undetected until its advanced stages, resulting in a poor prognosis. Given the anatomical closeness of the gallbladder and bile ducts to the pancreas, the inflammatory processes triggered by acute pancreatitis might increase the risk of BTC.

Objective: To assess the association between acute pancreatitis and the risk of BTC.

Methods: Using the Swedish Pancreatitis Cohort (SwePan), we compared the BTC risk in patients with a first-time episode of acute pancreatitis during 1990–2018 to a 1:10 matched pancreatitis-free control group. Multivariable Cox regression models, stratified by follow-up duration, were used to calculate hazard ratios (HRs), adjusting for socioeconomic factors, alcohol use, and comorbidities.

Results: BTC developed in 0.94% of 85,027 acute pancreatitis patients and in 0.23% of 814,993 controls. The BTC risk notably increased within 3 months of hospital discharge (HR 82.63; 95% CI: 63.07–108.26) and remained elevated beyond 10 years of follow-up (HR 1.82; 95% CI: 1.35–2.47). However, the long-term risk of BTC subtypes did not increase with anatomical proximity to the pancreas, with a null association for gallbladder and extrahepatic tumors. Importantly, patients with acute pancreatitis had a higher occurrence of early-stage BTC within 2 years of hospital discharge than controls (13.0 vs. 3.6%; p-value <0.01).

Conclusion: Our nationwide study found an elevated BTC risk in acute pancreatitis patients; however, the risk estimates for BTC subtypes were inconsistent, thereby questioning the causality of the association. Importantly, the amplified detection of early-stage BTC within 2 years after a diagnosis of acute pancreatitis underscores the necessity for proactive BTC surveillance in these patients.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
acute pancreatitis, biliary tract cancer, cholangiocarcinoma, epidemiology, long-term outcome, population-based
National Category
Gastroenterology and Hepatology Surgery
Identifiers
urn:nbn:se:umu:diva-223502 (URN)10.1002/ueg2.12567 (DOI)2-s2.0-85189948446 (Scopus ID)
Funder
Uppsala University, DLL-941252Region Stockholm, FoUI-961115
Available from: 2024-04-26 Created: 2024-04-26 Last updated: 2024-04-26
Neumann, J. T., Twerenbold, R., Weimann, J., Ballantyne, C. M., Benjamin, E. J., Costanzo, S., . . . Ojeda, F. (2024). Prognostic value of cardiovascular biomarkers in the population. Journal of the American Medical Association (JAMA), 331(22), 1898-1909
Open this publication in new window or tab >>Prognostic value of cardiovascular biomarkers in the population
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2024 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 331, no 22, p. 1898-1909Article in journal (Refereed) Published
Abstract [en]

Importance: Identification of individuals at high risk for atherosclerotic cardiovascular disease within the population is important to inform primary prevention strategies.

Objective: To evaluate the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors.

Design, Setting, and Participants: Individual-level analysis including data on cardiovascular biomarkers from 28 general population-based cohorts from 12 countries and 4 continents with assessments by participant age. The median follow-up was 11.8 years.

Exposure: Measurement of high-sensitivity cardiac troponin I, high-sensitivity cardiac troponin T, N-terminal pro-B-type natriuretic peptide, B-type natriuretic peptide, or high-sensitivity C-reactive protein.

Main Outcomes and Measures: The primary outcome was incident atherosclerotic cardiovascular disease, which included all fatal and nonfatal events. The secondary outcomes were all-cause mortality, heart failure, ischemic stroke, and myocardial infarction. Subdistribution hazard ratios (HRs) for the association of biomarkers and outcomes were calculated after adjustment for established risk factors. The additional predictive value of the biomarkers was assessed using the C statistic and reclassification analyses.

Results: The analyses included 164054 individuals (median age, 53.1 years [IQR, 42.7-62.9 years] and 52.4% were women). There were 17211 incident atherosclerotic cardiovascular disease events. All biomarkers were significantly associated with incident atherosclerotic cardiovascular disease (subdistribution HR per 1-SD change, 1.13 [95% CI, 1.11-1.16] for high-sensitivity cardiac troponin I; 1.18 [95% CI, 1.12-1.23] for high-sensitivity cardiac troponin T; 1.21 [95% CI, 1.18-1.24] for N-terminal pro-B-type natriuretic peptide; 1.14 [95% CI, 1.08-1.22] for B-type natriuretic peptide; and 1.14 [95% CI, 1.12-1.16] for high-sensitivity C-reactive protein) and all secondary outcomes. The addition of each single biomarker to a model that included established risk factors improved the C statistic. For 10-year incident atherosclerotic cardiovascular disease in younger people (aged <65 years), the combination of high-sensitivity cardiac troponin I, N-terminal pro-B-type natriuretic peptide, and high-sensitivity C-reactive protein resulted in a C statistic improvement from 0.812 (95% CI, 0.8021-0.8208) to 0.8194 (95% CI, 0.8089-0.8277). The combination of these biomarkers also improved reclassification compared with the conventional model. Improvements in risk prediction were most pronounced for the secondary outcomes of heart failure and all-cause mortality. The incremental value of biomarkers was greater in people aged 65 years or older vs younger people.

Conclusions and Relevance: Cardiovascular biomarkers were strongly associated with fatal and nonfatal cardiovascular events and mortality. The addition of biomarkers to established risk factors led to only a small improvement in risk prediction metrics for atherosclerotic cardiovascular disease, but was more favorable for heart failure and mortality..

Place, publisher, year, edition, pages
American Medical Association (AMA), 2024
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-224931 (URN)10.1001/jama.2024.5596 (DOI)001225478900001 ()38739396 (PubMedID)2-s2.0-85193277267 (Scopus ID)
Funder
EU, Horizon 2020, 847770Lund University, STYR 2019/2046EU, Horizon 2020, 825903Umeå UniversityNorrbotten County CouncilRegion VästerbottenKonung Gustaf V:s och Drottning Victorias FrimurarestiftelseGerman Research Foundation (DFG)NIH (National Institutes of Health), HHSN268201500001INIH (National Institutes of Health), 75N92019D00031NIH (National Institutes of Health), R01 HL092577NIH (National Institutes of Health), R01 HL64753NIH (National Institutes of Health), R01 AG028321Academy of Finland, 321351Academy of Finland, 354447
Available from: 2024-05-31 Created: 2024-05-31 Last updated: 2024-06-26Bibliographically approved
Reinikainen, J., Kuulasmaa, K., Oskarsson, V., Amouyel, P., Biasch, K., Brenner, H., . . . Niiranen, T. (2024). Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: an analysis of 49 cohorts from 11 European countries. European Journal of Preventive Cardiology, 31(5), 569-577
Open this publication in new window or tab >>Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: an analysis of 49 cohorts from 11 European countries
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2024 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 31, no 5, p. 569-577Article in journal (Refereed) Published
Abstract [en]

Aims: The regional and temporal differences in the associations between cardiovascular disease (CVD) and its classic risk factors are unknown. The current study examined these associations in different European regions over a 30-year period.

Methods and results: The study sample comprised 553 818 individuals from 49 cohorts in 11 European countries (baseline: 1982-2012) who were followed up for a maximum of 10 years. Risk factors [sex, smoking, diabetes, non-HDL cholesterol, systolic blood pressure (BP), and body mass index (BMI)] and CVD events (coronary heart disease or stroke) were harmonized across cohorts. Risk factor-outcome associations were analysed using multivariable-adjusted Cox regression models, and differences in associations were assessed using meta-regression. The differences in the risk factor-CVD associations between central Europe, northern Europe, southern Europe, and the UK were generally small. Men had a slightly higher hazard ratio (HR) in southern Europe (P = 0.043 for overall difference), and those with diabetes had a slightly lower HR in central Europe (P = 0.022 for overall difference) compared with the other regions. Of the six CVD risk factors, minor HR decreases per decade were observed for non-HDL cholesterol [7% per mmol/L; 95% confidence interval (CI), 3-10%] and systolic BP (4% per 20 mmHg; 95% CI, 1-8%), while a minor HR increase per decade was observed for BMI (7% per 10 kg/m2; 95% CI, 1-13%).

Conclusion: The results demonstrate that all classic CVD risk factors are still relevant in Europe, irrespective of regional area. Preventive strategies should focus on risk factors with the greatest population attributable risk.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
Cardiovascular disease, Coronary heart disease, Europe, Risk factor, Stroke
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-223090 (URN)10.1093/eurjpc/zwad359 (DOI)001117280000001 ()37976098 (PubMedID)2-s2.0-85186508558 (Scopus ID)
Available from: 2024-04-11 Created: 2024-04-11 Last updated: 2024-04-11Bibliographically approved
Sadr-Azodi, O., Ljung, R., Lindblad, M. & Oskarsson, V. (2023). Antipsychotic drugs and risk of acute pancreatitis: a nationwide case–control study. Acta Psychiatrica Scandinavica, 148(2), 199-207
Open this publication in new window or tab >>Antipsychotic drugs and risk of acute pancreatitis: a nationwide case–control study
2023 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 148, no 2, p. 199-207Article in journal (Refereed) Published
Abstract [en]

Introduction: Use of antipsychotic drugs, especially second-generation agents, has been suggested to cause acute pancreatitis in multiple case reports; however, such an association has not been corroborated by larger studies. This study examined the association of antipsychotic drugs with risk of acute pancreatitis.

Methods: Nationwide case–control study, based on data from several Swedish registers and including all 52,006 cases of acute pancreatitis diagnosed in Sweden between 2006 and 2019 (with up to 10 controls per case; n = 518,081). Conditional logistic regression models were used to calculate odds ratios (ORs) in current and past users of first-generation and second-generation antipsychotic drugs (dispensed prescription <91 and ≥91 days of the index date, respectively) compared with never users of such drugs.

Results: In the crude model, first-generation and second-generation antipsychotic drugs were associated with increased risk of acute pancreatitis, with slightly higher ORs for past use (1.58 [95% confidence interval 1.48–1.69] and 1.39 [1.29–1.49], respectively) than for current use (1.34 [1.21–1.48] and 1.24 [1.15–1.34], respectively). The ORs were largely attenuated in the multivariable model—which included, among others, alcohol abuse and the Charlson comorbidity index—up to the point where only a statistically significant association remained for past use of first-generation agents (OR 1.18 [1.10–1.26]).

Conclusion: There was no clear association between use of antipsychotic drugs and risk of acute pancreatitis in this very large case–control study, indicating that previous case report data are most likely explained by confounding.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
antipsychotic agents, case–control studies, incidence, pancreatitis, population-based
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-207879 (URN)10.1111/acps.13561 (DOI)000979545100001 ()37100434 (PubMedID)2-s2.0-85153773924 (Scopus ID)
Funder
Stockholm County Council, FoUI‐961115Uppsala University, DLL‐941252
Available from: 2023-05-09 Created: 2023-05-09 Last updated: 2023-09-27Bibliographically approved
Byhamre, M. L., Eliasson, M., Söderberg, S., Wennberg, P. & Oskarsson, V. (2023). Association between snus use and lipid status in Swedish men. Scandinavian Journal of Clinical and Laboratory Investigation, 83(4), 241-250
Open this publication in new window or tab >>Association between snus use and lipid status in Swedish men
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2023 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 83, no 4, p. 241-250Article in journal (Refereed) Published
Abstract [en]

Snus is a common tobacco product in Sweden, but the cardiovascular risk profile for snus users is less known than for cigarette smokers. We examined the association of snus use with lipid status, particularly in comparison to non-tobacco use and cigarette smoking, using data from 5930 men in the Northern Sweden MONICA study. Tobacco use was self-reported in 1986 to 2014 (24.4% used snus) and blood samples were collected at the same time. Harmonized analyses on non-high-density lipoprotein (non-HDL) cholesterol, HDL cholesterol, and triglycerides were conducted in 2016 to 2018. Three hundred eighty-one snus users had also been examined more than once, allowing us to study the effect of discontinued use (achieved by 21.0%). In multivariable linear regression models, snus use was associated with higher HDL cholesterol and triglyceride concentrations compared to non-tobacco use (p values ≤ 0.04), and it was associated with higher HDL cholesterol concentrations and lower triglyceride concentrations compared to cigarette smoking (p values ≤ 0.02). Snus use was not associated with non-HDL cholesterol concentrations, irrespective of the comparison group (p values ≥ 0.07). There was no indication that higher intensity of snus use led to a worse lipid profile, given that high-consumers had higher HDL cholesterol concentrations than low-consumers (p value = 0.02), or that discontinuation of snus use led to a better lipid profile, given that continued users had lower triglyceride concentrations than discontinued users (p value = 0.03). Further studies are needed to confirm or refute our findings.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
apolipoproteins, cholesterol, cigarettes, lipids, smokeless tobacco, snus, Tobacco, triglycerides
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-209125 (URN)10.1080/00365513.2023.2209915 (DOI)000986159300001 ()2-s2.0-85159146553 (Scopus ID)
Funder
Norrbotten County CouncilRegion VästerbottenRegion VästernorrlandUmeå University
Available from: 2023-06-07 Created: 2023-06-07 Last updated: 2023-09-28Bibliographically approved
Berglund, F., Törmä, J., Wennberg, M., Wennberg, P. & Oskarsson, V. (2023). Dietary habits among snus users: a population-based cross-sectional study. Food & Nutrition Research, 67, Article ID 9537.
Open this publication in new window or tab >>Dietary habits among snus users: a population-based cross-sectional study
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2023 (English)In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 67, article id 9537Article in journal (Refereed) Published
Abstract [en]

Background: The dietary habits among snus users are largely unknown and have not been accounted for in observational studies on the health effects of snus use.

Aim: To examine whether snus users eat unhealthier than never tobacco users.

Methods: A total of 3,397 male participants, examined between 1994 and 2014 in the Northern Sweden Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, were included. Snus use and dietary habits were self-reported using questionnaires, from which intakes of different food groups, macronutrients, and a healthy diet score (HDS) were calculated (the latter as a proxy for overall diet quality). The association between snus use and dietary habits was examined by quantile regression models.

Results: In the multivariable-adjusted model, current snus users had a lower HDS (median difference: −0.86 [95% confidence interval: −1.32, −0.40]) than never tobacco users. Snus users also consumed fewer weekly servings of fruits and berries (median difference: −1.03 [−1.65, −0.40]), and their estimated percentage of energy intake con-sisted of less carbohydrates (median difference: −1.43 [−2.12, −0.74]) and of more total fat (median difference: 0.99 [0.30, 1.67]), saturated fat (median difference: 0.67 [0.29, 1.05]), monounsaturated fat (median difference: 0.44 [0.20, 0.68]), trans fat (median difference: 0.03 [0.01, 0.06]), and alcohol (median difference: 0.21 [0.02, 0.40]).

Conclusion: We observed that snus users had an unhealthier diet than never tobacco users. Future studies on the association between snus use and health outcomes should, therefore, consider diet as a potential confounder.

Place, publisher, year, edition, pages
Swedish Nutrition Foundation, 2023
Keywords
beverages, diet, food, smokeless tobacco, snus, tobacco
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-214061 (URN)10.29219/fnr.v67.9537 (DOI)2-s2.0-85168989019 (Scopus ID)
Funder
Norrbotten County Council
Available from: 2023-09-06 Created: 2023-09-06 Last updated: 2023-09-06Bibliographically approved
Törmä, J., Lundqvist, R., Eliasson, M., Nilsson, L. M., Oskarsson, V. & Wennberg, M. (2022). Comparison of dietary trends between two counties with and without a cardiovascular prevention program: a population-based cross-sectional study in northern Sweden. Public Health Nutrition, 25(7), 1835-1843
Open this publication in new window or tab >>Comparison of dietary trends between two counties with and without a cardiovascular prevention program: a population-based cross-sectional study in northern Sweden
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2022 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 25, no 7, p. 1835-1843Article in journal (Refereed) Published
Abstract [en]

Objective: To compare temporal trends, over a 20-year period, in dietary habits between a county (Västerbotten) with a cardiovascular disease (CVD) prevention program and a county (Norrbotten) without such a program.

Design: Cross-sectional data from the Northern Sweden MONICA study (survey period 1994, 1999, 2004, 2009, 2014). Dietary habits were assessed by a semi-quantitative food frequency questionnaire.

Setting: Counties of Norrbotten and Västerbotten, Northern Sweden.

Participants: Five thousand four hundred Swedish adults (mean age 56.9 years; 51.2% women) from Västerbotten (47%) and Norrbotten (53%).

Results: No differences in temporal trend for estimated percentage of energy intake from total carbohydrates, total fat, total protein, and alcohol were observed between the counties (p for interaction ≥0.33). There were no between-county difference in temporal trends for overall diet quality (assessed by the Healthy Diet Score; p for interaction = 0.36). Nor were there any between-county differences for intake of whole grain products, fruits, vegetables, fish, sweetened beverages or fried potatoes (p for interaction ≥ 0.09). Consumption of meat (p for interaction = 0.05) increased to a greater extent in Norrbotten from 2009 and onwards, mainly in men (sex-specific analyses, p for interaction = 0.04). Men in Västerbotten decreased their intake of sweets to a greater extent than men in Norrbotten (p for interaction <0.01).

Conclusions: Over a 20-year period in northern Sweden, only small differences in dietary habits were observed in favor of a county with a CVD prevention program compared to a county without such a program.

Place, publisher, year, edition, pages
Cambridge University Press, 2022
Keywords
alcohol, carbohydrates, cardiovascular disease, dietary patterns, fat, healthy foods, prevention program, protein, unhealthy foods
National Category
Nutrition and Dietetics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-186577 (URN)10.1017/S1368980021003050 (DOI)000781637200001 ()34296666 (PubMedID)2-s2.0-85111303993 (Scopus ID)
Funder
Region VästerbottenSwedish Research Council
Available from: 2021-08-12 Created: 2021-08-12 Last updated: 2023-03-24Bibliographically approved
Mejia Baranda, J., Ljungberg, J., Wixner, J., Anan, I. & Oskarsson, V. (2022). Epidemiology of hereditary transthyretin amyloidosis in the northernmost region of Sweden: a retrospective cohort study. Amyloid: Journal of Protein Folding Disorders, 29(2), 120-127
Open this publication in new window or tab >>Epidemiology of hereditary transthyretin amyloidosis in the northernmost region of Sweden: a retrospective cohort study
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2022 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 29, no 2, p. 120-127Article in journal (Refereed) Published
Abstract [en]

Introduction: Epidemiological data on hereditary transthyretin (ATTRv) amyloidosis from the northernmost region of Sweden (Norrbotten) are sparse.

Methods: We reviewed the medical records of all incident cases of ATTRv amyloidosis in Norrbotten between 2006 and 2018. Official population and mortality statistics were used to estimate incidence rates and standardised mortality ratios (SMRs).

Results: Ninety-three patients were diagnosed with ATTRv amyloidosis between 2006 and 2018 (median age, 72.8 years; 68.8% men; 95.7% Val30Met [p.Val50Met] mutation). The incidence rate per 100,000 persons and year increased from 1.50 (95% confidence interval [CI], 0.84–2.47) cases in 2006–2009 to 4.92 (95%CI, 3.46–6.78) cases in 2016–2018. The SMR in the ATTRv amyloidosis cohort was 2.64 times higher than in the general population in 2006–2018 (95%CI, 1.78–3.77). However, there were indications of lower SMRs over time (2006–2012, 2.96 [95%CI, 1.73–4.74]; 2013–2018, 2.32 [95%CI, 1.23–3.96]) and by use of disease-modifying drugs (no, 3.21 [95%CI, 1.87–5.13]; yes, 2.09 [95%CI, 1.08–3.64]).

Conclusion: The incidence of ATTRv amyloidosis increased 3-fold in Norrbotten between 2006 and 2018, most likely due to a previous underdiagnosis–with suggestions of lowered mortality during later years, possibly due to the introduction of disease-modifying drugs.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Amyloid, amyloidosis, epidemiology, hereditary, Sweden, transthyretin
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-191741 (URN)10.1080/13506129.2022.2026323 (DOI)000742289900001 ()35023433 (PubMedID)2-s2.0-85122894118 (Scopus ID)
Funder
Norrbotten County Council
Available from: 2022-01-24 Created: 2022-01-24 Last updated: 2023-05-22Bibliographically approved
Oskarsson, V., Eliasson, M., Salomaa, V., Reinikainen, J., Männistö, S., Palmieri, L., . . . Söderberg, S. (2022). Influence of geographical latitude on vitamin D status: cross-sectional results from the BiomarCaRE consortium. British Journal of Nutrition, 128(11), 2208-2218
Open this publication in new window or tab >>Influence of geographical latitude on vitamin D status: cross-sectional results from the BiomarCaRE consortium
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2022 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 128, no 11, p. 2208-2218Article in journal (Refereed) Published
Abstract [en]

Even though sunlight is viewed as the most important determinant of 25-hydroxyvitamin D (25[OH]D) status, several European studies have observed higher 25(OH)D concentrations among north-Europeans than south-Europeans. We studied the association between geographical latitude (derived from ecological data) and 25(OH)D status in 6 European countries by using harmonized immunoassay data from 81,084 participants in the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project (male sex 48.9%; median age 50.8 years; examination period 1984 to 2014). Quantile regression models, adjusted for age, sex, decade and calendar week of sampling, and time from sampling to analysis, were used for between-country comparisons. Up until the median percentile, the ordering of countries by 25(OH)D status (from highest to lowest) was as follows: Sweden (at 65.6 to 63.8 oN), Germany (at 48.4 oN), Finland (at 65.0 to 60.2 oN), Italy (at 45.6 to 41.5 oN), Scotland (at 58.2 to 55.1 oN), and Spain (at 41.5 oN). From the 75th percentile and upwards, Finland had higher values than Germany. As an example, using the Swedish cohort as comparator, the median 25(OH)D concentration was 3.03, 3.28, 5.41, 6.54, and 9.28 ng/mL lower in the German, Finnish, Italian, Scottish, and Spanish cohort, respectively (P-value < 0.001 for all comparisons). The ordering of countries was highly consistent in subgroup analyses by sex, age, and decade and season of sampling. In conclusion, we confirmed the previous observation of a north-to-south gradient of 25(OH)D status in Europe, with higher percentile values among north-Europeans than south-Europeans.

Place, publisher, year, edition, pages
Cambridge University Press, 2022
Keywords
25-hydroxyvitamin D, Epidemiology, Europe, Latitude, Population-based, Vitamin D
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-191009 (URN)10.1017/S0007114521005080 (DOI)000742514400001 ()34933700 (PubMedID)2-s2.0-85121916814 (Scopus ID)
Available from: 2022-01-05 Created: 2022-01-05 Last updated: 2022-12-30Bibliographically approved
Sujana, C., Salomaa, V., Kee, F., Costanzo, S., Söderberg, S., Jordan, J., . . . Thorand, B. (2021). Natriuretic Peptides and Risk of Type 2 Diabetes: Results From the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium. Diabetes Care, 44(11), 2527-2535
Open this publication in new window or tab >>Natriuretic Peptides and Risk of Type 2 Diabetes: Results From the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium
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2021 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 44, no 11, p. 2527-2535Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Natriuretic peptide (NP) concentrations are increased in cardiovascular diseases (CVDs) but are associated with a lower diabetes risk. We investigated associations of N-terminal pro-B-type NP (NT-proBNP) and midregional proatrial NP (MR-proANP) with incident type 2 diabetes stratified by the presence of CVD.

RESEARCH DESIGN AND METHODS: Based on the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium, we included 45,477 participants with NT-proBNP measurements (1,707 developed type 2 diabetes over 6.5 years of median follow-up; among these, 209 had CVD at baseline) and 11,537 participants with MR-proANP measurements (857 developed type 2 diabetes over 13.8 years of median follow-up; among these, 106 had CVD at baseline). The associations were estimated using multivariable Cox regression models.

RESULTS: Both NPs were inversely associated with incident type 2 diabetes (hazard ratios [95% CI] per 1-SD increase of log NP: 0.84 [0.79; 0.89] for NT-proBNP and 0.77 [0.71; 0.83] for MR-proANP). The inverse association between NT-proBNP and type 2 diabetes was significant in individuals without CVD but not in individuals with CVD (0.81 [0.76; 0.86] vs. 1.04 [0.90; 1.19]; P multiplicative interaction = 0.001). There was no significant difference in the association of MR-proANP with type 2 diabetes between individuals without and with CVD (0.75 [0.69; 0.82] vs. 0.81 [0.66; 0.99]; P multiplicative interaction = 0.236).

CONCLUSIONS: NT-proBNP and MR-proANP are inversely associated with incident type 2 diabetes. However, the inverse association of NT-proBNP seems to be modified by the presence of CVD. Further investigations are warranted to confirm our findings and to investigate the underlying mechanisms.

Place, publisher, year, edition, pages
American Diabetes Association (ADA), 2021
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-190114 (URN)10.2337/dc21-0811 (DOI)000743313400021 ()34521639 (PubMedID)2-s2.0-85120091849 (Scopus ID)
Funder
EU, FP7, Seventh Framework Programme, 2007–2013EU, Horizon 2020, 825903EU, Horizon 2020, 847770Norrbotten County CouncilRegion VästerbottenSwedish Heart Lung Foundation
Available from: 2021-12-10 Created: 2021-12-10 Last updated: 2023-09-05Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2936-2895

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