liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Östgren, Carl Johan
Alternative names
Publications (10 of 90) Show all publications
Carlsson, A. C., Östgren, C. J., Nyström, F. H., Länne, T., Jennersjö, P., Larsson, A. & Arnlov, J. (2016). Association of soluble tumor necrosis factor receptors 1 and 2 with nephropathy, cardiovascular events, and total mortality in type 2 diabetes. Cardiovascular Diabetology, 15(1), 40.
Open this publication in new window or tab >>Association of soluble tumor necrosis factor receptors 1 and 2 with nephropathy, cardiovascular events, and total mortality in type 2 diabetes
Show others...
2016 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 15, no 1, 40- p.Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2) contribute to experimental diabetic kidney disease, a condition with substantially increased cardiovascular risk when present in patients. Therefore, we aimed to explore the levels of sTNFRs, and their association with prevalent kidney disease, incident cardiovascular disease, and risk of mortality independently of baseline kidney function and microalbuminuria in a cohort of patients with type 2 diabetes. In pre-defined secondary analyses we also investigated whether the sTNFRs predict adverse outcome in the absence of diabetic kidney disease. Methods: The CARDIPP study, a cohort study of 607 diabetes patients [mean age 61 years, 44 % women, 45 cardiovascular events (fatal/non-fatal myocardial infarction or stroke) and 44 deaths during follow-up (mean 7.6 years)] was used. Results: Higher sTNFR1 and sTNFR2 were associated with higher odds of prevalent kidney disease [odd ratio (OR) per standard deviation (SD) increase 1.60, 95 % confidence interval (CI) 1.32-1.93, p < 0.001 and OR 1.54, 95 % CI 1.21-1.97, p = 0.001, respectively]. In Cox regression models adjusting for age, sex, glomerular filtration rate and urinary albumin/creatinine ratio, higher sTNFR1 and sTNFR2 predicted incident cardiovascular events [hazard ratio (HR) per SD increase, 1.66, 95 % CI 1.29-2.174, p < 0.001 and HR 1.47, 95 % CI 1.13-1.91, p = 0.004, respectively]. Results were similar in separate models with adjustments for inflammatory markers, HbA1c, or established cardiovascular risk factors, or when participants with diabetic kidney disease at baseline were excluded (p < 0.01 for all). Both sTNFRs were associated with mortality. Conclusions/Interpretations: Higher circulating sTNFR1 and sTNFR2 are associated with diabetic kidney disease, and predicts incident cardiovascular disease and mortality independently of microalbuminuria and kidney function, even in those without kidney disease. Our findings support the clinical utility of sTNFRs as prognostic markers in type 2 diabetes.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
Keyword
Type 2 diabetes; TNF; Laplace regression; Incident cardiovascular disease; Mortality; Inflammation
National Category
Cardiac and Cardiovascular Systems General Practice
Identifiers
urn:nbn:se:liu:diva-126836 (URN)10.1186/s12933-016-0359-8 (DOI)000371581000001 ()26928194 (PubMedID)
Note

Funding Agencies|Swedish Research Council; Swedish Heart-Lung foundation; Thureus foundation; Marianne and Marcus Wallenberg Foundation; Dalarna University; Uppsala University

Available from: 2016-04-05 Created: 2016-04-05 Last updated: 2018-01-10
Rådholm, K., Festin, K., Falk, M., Midlöv, P., Mölstad, S. & Östgren, C. J. (2016). Blood pressure and all-cause mortality: a prospective study of nursing home residents. Age and Ageing, 45(6), 826-832.
Open this publication in new window or tab >>Blood pressure and all-cause mortality: a prospective study of nursing home residents
Show others...
2016 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 45, no 6, 826-832 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To explore the natural course of blood pressure development and its relation to mortality in a nursing home cohort.

Methods: A cohort of 406 nursing home residents in south east Sweden was followed prospectively for 30 months. Participants were divided into four groups based on systolic blood pressure (SBP) at baseline. Data were analysed using a Cox regression model with all-cause mortality as the outcome measurement; paired Student t-tests were used to evaluate blood pressure development over time.

Results: During follow-up, 174 (43%) people died. Participants with SBP <120 mmHg had a hazard ratio for mortality of 1.56 (95% confidence interval, 1.08–2.27) compared with those with SBP 120–139 mmHg, adjusted for age and sex. Risk of malnutrition or present malnutrition was most common in participants with SBP <120 mmHg; risk of malnutrition or present malnutrition estimated using the Mini Nutritional Assessment was found in 78 (71%). The levels of SBP decreased over time independent of changes in anti-hypertensive medication.

Conclusions: In this cohort of nursing home residents, low SBP was associated with increased all-cause mortality. SBP decreased over time; this was not associated with altered anti-hypertensive treatment. The clinical implication from this study is that there is a need for systematic drug reviews in elderly persons in nursing homes, paying special attention to those with low SBP.

Place, publisher, year, edition, pages
Oxford University Press, 2016
Keyword
older people, prospective study, nursing home, hypertension, hypotension, all-cause mortality
National Category
General Practice Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-121283 (URN)10.1093/ageing/afw122 (DOI)000392702200018 ()
Note

Funding agencies| Health Research Council in south east Sweden (FORSS-8888, FORSS-11636 and FORSS-31811); the County of Östergötland (LIO-11877, LIO-31321 and LIO-79951); the Family Janne Elgqvist Foundation; King Gustaf V and Queen Victoria Freemason Foundation.

At the time for thesis presentation publication was in status: Manuscript

Available from: 2015-09-11 Created: 2015-09-11 Last updated: 2018-01-11Bibliographically approved
Wijkman, M., Länne, T., Östgren, C. J. & Nyström, F. H. (2016). Diastolic orthostatic hypertension and cardiovascular prognosis in type 2 diabetes: a prospective cohort study. Cardiovascular Diabetology, 15(83), 1-10.
Open this publication in new window or tab >>Diastolic orthostatic hypertension and cardiovascular prognosis in type 2 diabetes: a prospective cohort study
2016 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 15, no 83, 1-10 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In patients with type 2 diabetes, the prognostic impact of an orthostatic rise in blood pressure is not known. Therefore, the aim of this study was to determine the prognostic implications of the diastolic orthostatic blood pressure response in a cohort of patients with type 2 diabetes. We also evaluated associations between different orthostatic blood pressure responses and markers of subclinical cardiovascular organ damage.

METHODS: Office blood pressures were measured in the sitting and in the standing position in 749 patients with type 2 diabetes who participated in the CARDIPP study (Cardiovascular Risk factors in Patients with Diabetes-a Prospective study in Primary care). Diastolic orthostatic hypertension was defined as a rise of diastolic blood pressure ≥10 mmHg and diastolic orthostatic hypotension was defined as a drop of diastolic blood pressure ≥10 mmHg. Recruitment took place between the years 2005-2008, and patients were followed until any of the primary outcome events (cardiovascular death or hospitalization for either myocardial infarction or stroke) occurred or until December 31st, 2014. Measurements of aortic pulse wave velocity and of carotid intima-media thickness were performed at base-line.

RESULTS: Diastolic orthostatic hypertension was found in 140 patients (18.7 %) and was associated with significantly lower risk of cardiovascular events (crude hazard ratio compared with patients with normal systolic and diastolic orthostatic blood pressure response: 0.450, 95 % C.I. 0.206-0.987, P = 0.046). Diastolic orthostatic hypotension was found in 31 patients (4.1 %) and was associated with higher values for aortic pulse wave velocity and carotid intima-media thickness, compared with patients with normal systolic and diastolic orthostatic blood pressure response.

CONCLUSIONS: Diastolic orthostatic hypertension is common in patients with type 2 diabetes, and may be a novel marker for decreased cardiovascular risk in these patients.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keyword
Arterial stiffness, Blood pressure, Cardiovascular risk, Carotid intima-media thickness, Events, Orthostatic hypotension, Type 2 diabetes mellitus
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-129959 (URN)10.1186/s12933-016-0399-0 (DOI)000377852600001 ()27255168 (PubMedID)
Note

Funding agencies: FORSS; Research Council of Southeastern Sweden; King GustafV and Queen Victoria Freemason Foundation, Sweden

Available from: 2016-07-02 Created: 2016-07-02 Last updated: 2017-11-28Bibliographically approved
Lannering, C., Ernsth Bravell, M., Midlov, P., Östgren, C. J. & Molstad, S. (2016). Factors related to falls, weight-loss and pressure ulcers - more insight in risk assessment among nursing home residents. Journal of Clinical Nursing, 25(7-8), 940-950.
Open this publication in new window or tab >>Factors related to falls, weight-loss and pressure ulcers - more insight in risk assessment among nursing home residents
Show others...
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 7-8, 940-950 p.Article in journal (Refereed) Published
Abstract [en]

Aims and objectivesTo describe how the included items in three different scales, Downton Fall Risk Index, the short form of Mini Nutritional Assessment and the Modified Norton Scale are associated to severe outcomes as falls, weight loss and pressure ulcers. BackgroundFalls, malnutrition and pressure ulcers are common adverse events among nursing home residents and risk scoring are common preventive activities, mainly focusing on single risks. In Sweden the three scales are routinely used together with the purpose to improve the quality of prevention. DesignLongitudinal quantitative study. MethodsDescriptive analyses and Cox regression analyses. ResultsOnly 4% scored no risk for any of these serious events. Longitudinal risk scoring showed significant impaired mean scores indicating increased risks. This confirms the complexity of this populations status of general condition. There were no statistical significant differences between residents categorised at risk or not regarding events. Physical activity increased falls, but decreased pressure ulcers. For weight loss, cognitive decline and the status of general health were most important. ConclusionsRisk tendencies for falls, malnutrition and pressure ulcers are high in nursing homes, and when measure them at the same time the majority will have several of these risks. Items assessing mobility or items affecting mobility were of most importance. Care processes can always be improved and this study can add to the topic. Relevance to clinical practiceA more comprehensive view is needed and prevention can not only be based on total scores. Mobility is an important factor for falls and pressure ulcers, both as a risk factor and a protective factor. This involves a challenge for care - to keep the inmates physical active and at the same time prevent falls.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
Keyword
falls; frail older; malnutrition; nursing homes; pressure ulcers; risk assessment
National Category
Geriatrics Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-127422 (URN)10.1111/jocn.13154 (DOI)000372928900006 ()26813994 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS); Janne Elgqvist Foundation

Available from: 2016-05-01 Created: 2016-04-26 Last updated: 2018-01-10Bibliographically approved
Jansson, S. P., Fall, K., Brus, O., Magnuson, A., Wandell, P., Östgren, C. J. & Rolandsson, O. (2016). Letter: Response to Carlsson et al.: Prevalence and incidence of diabetes mellitus: a nationwide population-based pharmaco-epidemiological study in Sweden in DIABETIC MEDICINE, vol 33, issue 8, pp 1150-1152 [Letter to the editor]. Diabetic Medicine, 33(8), 1150-1152.
Open this publication in new window or tab >>Letter: Response to Carlsson et al.: Prevalence and incidence of diabetes mellitus: a nationwide population-based pharmaco-epidemiological study in Sweden in DIABETIC MEDICINE, vol 33, issue 8, pp 1150-1152
Show others...
2016 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 33, no 8, 1150-1152 p.Article in journal, Letter (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-130651 (URN)10.1111/dme.12983 (DOI)000379936000019 ()26444576 (PubMedID)
Available from: 2016-08-22 Created: 2016-08-19 Last updated: 2018-01-10
Jennersjö, P., Ludvigsson, J., Länne, T., Nyström, F. H. & Östgren, C. J. (2016). Pedometer-determined physical activity level and change in arterial stiffness in Type 2 diabetes over 4 years. Diabetic Medicine, 33(7), 992-997.
Open this publication in new window or tab >>Pedometer-determined physical activity level and change in arterial stiffness in Type 2 diabetes over 4 years
Show others...
2016 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 33, no 7, 992-997 p.Article in journal (Refereed) Published
Abstract [en]

Aim To explore prospectively the correlation between the level of pedometer-determined physical activity at the start of the study and the change in pulse wave velocity from baseline to 4 years later in people with Type 2 diabetes.

Methods We analysed data from 135 men and 53 women with Type 2 diabetes, aged 54–66 years. Physical activity was measured with waist-mounted pedometers on 3 consecutive days and the numbers of steps/day at baseline were classified into four groups: <5000 steps/day, 5000–7499 steps/day, 7500–9999 steps/day and ≥10 000 steps/day. Pulse wave velocity was measured using applanation tonometry over the carotid and femoral arteries at baseline and after 4 years.

Results The mean (±sd; range) number of steps/day was 8022 (±3765; 956–20 921). The participants with the lowest level of physical activity had a more pronounced increase in the change in pulse wave velocity compared with the participants with the highest. When change in pulse wave velocity was analysed as a continuous variable and adjusted for sex, age, diabetes duration, HbA1c, BMI, systolic blood pressure, pulse wave velocity at baseline, β-blocker use, statin use, unemployment, smoking and diabetes medication, the number of steps/day at baseline was significantly associated with a less steep increase in change in pulse wave velocity (P=0.005). Every 1000 extra steps at baseline corresponded to a lower increase in change in pulse wave velocity of 0.103 m/s.

Conclusions We found that a high level of pedometer-determined physical activity was associated with a slower progression of arterial stiffness over 4 years in middle-aged people with Type 2 diabetes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
National Category
Endocrinology and Diabetes General Practice Geriatrics Sport and Fitness Sciences Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-125910 (URN)10.1111/dme.12873 (DOI)000379930900018 ()26227869 (PubMedID)
Note

Funding agencies: Medical Research Council of Southeast Sweden; Centre for Medical Image Science and Visualization (CMIV), Linkoping University; GE Healthcare; Swedish Heart-Lung Foundation; Swedish Research Council [12661]; King Gustaf V and Queen Victoria Freemason Found

Available from: 2016-03-08 Created: 2016-03-08 Last updated: 2018-01-10Bibliographically approved
Carlsson, A. C., Östgren, C. J., Länne, T., Larsson, A., Nyström, F. H. & Ärnlöv, J. (2016). The association between endostatin and kidney disease and mortality in patients with type 2 diabetes. Diabetes & Metabolism, 42(5), 351-357.
Open this publication in new window or tab >>The association between endostatin and kidney disease and mortality in patients with type 2 diabetes
Show others...
2016 (English)In: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 42, no 5, 351-357 p.Article in journal (Refereed) Published
Abstract [en]

AIM: Circulating endostatin, a biologically active derivate of collagen XVIII, is considered to be a marker of kidney disease and a risk factor for its related mortality. However, less is known of the role of endostatin in diabetes and the development of diabetic nephropathy. For this reason, our study investigated the associations between circulating endostatin and the prevalence and progression of kidney disease, and its mortality risk in patients with type 2 diabetes (T2D).

METHODS: This was a cohort study of 607 patients with T2D (mean age: 61 years, 44% women). Estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation, was used to assess the patients' kidney function decline and mortality.

RESULTS: Of the total study cohort, 20 patients declined by ≥20% in eGFR over 4 years, and 44 died during the follow-up (mean duration: 6.7 years). At baseline, participants with diabetic nephropathy (defined as eGFR<60mL/min/1.73m(2)) and/or microalbuminuria [defined as a urinary albumin-to-creatinine ratio (ACR)>3g/mol] had higher median levels of endostatin than those without nephropathy (62.7μg/L vs 57.4μg/L, respectively; P=0.031). In longitudinal analyses adjusted for age, gender, baseline eGFR and ACR, higher endostatin levels were associated with a higher risk of decline (≥20% in eGFR, OR per 1 SD increase: 1.73, 95% CI: 1.13-2.65) and a higher risk of mortality (HR per 1 SD increase: 1.57, 95% CI: 1.19-2.07).

CONCLUSION: In patients with T2D, circulating endostatin levels can predict the progression of kidney disease and mortality independently of established kidney disease markers. The clinical usefulness of endostatin as a risk marker in such patients merits further studies.

Place, publisher, year, edition, pages
Elsevier, 2016
Keyword
Albumin-to-creatinine ratio, Angiogenesis, Chronic kidney disease, Community, Extracellular matrix remodeling, NIDDM
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-129960 (URN)10.1016/j.diabet.2016.03.006 (DOI)000392262700006 ()27080454 (PubMedID)
Note

Funding agencies: Swedish Research Council; Swedish Heart-Lung Foundation; Marianne and Marcus Wallenberg Foundation; European Union [634869]

Available from: 2016-07-02 Created: 2016-07-02 Last updated: 2017-11-28Bibliographically approved
Rådholm, K., Wiréhn, A.-B., Chalmers, J. & Östgren, C. J. (2016). Use of antidiabetic and antidepressant drugs is associated with increased risk of myocardial infarction: a nationwide register study. Diabetic Medicine, 33(2), 218-223.
Open this publication in new window or tab >>Use of antidiabetic and antidepressant drugs is associated with increased risk of myocardial infarction: a nationwide register study
2016 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 33, no 2, 218-223 p.Article in journal (Refereed) Published
Abstract [en]

Aims

To explore the gender- and age-specific risk of developing a first myocardial infarction in people treated with antidiabetic and/or antidepressant drugs compared with people with no pharmaceutical treatment for diabetes or depression.

Methods

A cohort of all Swedish residents aged 45–84 years (n = 4 083 719) was followed for a period of 3 years. Data were derived from three nationwide registers. The prescription and dispensing of antidiabetic and antidepressant drugs were used as markers of disease. All study subjects were reallocated according to treatment and the treatment categories were updated every year. Data were analysed using a Cox regression model with a time-dependent variable. The outcome of interest was first fatal or non-fatal myocardial infarction.

Results

During follow-up, 42 840 people had a first myocardial infarction, 3511 of which were fatal. Women aged 45–64 years, receiving both antidiabetic and antidepressant drugs had a hazard ratio for myocardial infarction of 7.4 (95% CI 6.3–8.6) compared with women receiving neither. The corresponding hazard ratio for men was 3.1 (95% CI 2.8–3.6).

Conclusions

The combined use of antidiabetic and antidepressant drugs was associated with a higher risk of myocardial infarction compared with use of either group of drugs alone. The increase in relative risk was greater in middle-aged women than in middle-aged men.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology Other Health Sciences General Practice
Identifiers
urn:nbn:se:liu:diva-121285 (URN)10.1111/dme.12822 (DOI)000370161800011 ()26036276 (PubMedID)
Note

Funding agencies: King Gustaf V and Queen Victoria Freemason Foundation

Available from: 2015-09-11 Created: 2015-09-11 Last updated: 2018-01-11Bibliographically approved
Jennersjö, P., Guldbrand, H., Björne, S., Länne, T., Fredrikson, M., Lindström, T., . . . Nyström, F. H. (2015). A prospective observational study of all-cause mortality in relation to serum 25-OH vitamin D-3 and parathyroid hormone levels in patients with type 2 diabetes. Diabetology and Metabolic Syndrome, 7(53).
Open this publication in new window or tab >>A prospective observational study of all-cause mortality in relation to serum 25-OH vitamin D-3 and parathyroid hormone levels in patients with type 2 diabetes
Show others...
2015 (English)In: Diabetology and Metabolic Syndrome, ISSN 1758-5996, E-ISSN 1758-5996, Vol. 7, no 53Article in journal (Refereed) Published
Abstract [en]

Background: Low levels of vitamin D have been related to increased mortality and morbidity in several non-diabetic studies. We aimed to prospectively study relationships between serum 25-OH vitamin D-3 (vitamin D) and of serum parathyroid hormone (PTH) to total mortality in type 2 diabetes. We also aimed to compare the levels of these potential risk-factors in patients with and without diabetes. Methods: The main study design was prospective and observational. We used baseline data from 472 men and 245 women who participated in the "Cardiovascular Risk factors in Patients with Diabetes-a Prospective study in Primary care" study. Patients were 55-66 years old at recruitment, and an age-matched non-diabetic sample of 129 individuals constituted controls for the baseline data. Carotid-femoral pulse-wave velocity (PWV) was measured with applanation-tonometry and carotid intima-media thickness (IMT) with ultrasound. Patients with diabetes were followed for all-cause mortality using the national Swedish Cause of Death Registry. Results: Levels of vitamin D were lower in patients with diabetes than in controls, also after correction for age and obesity, while PTH levels did not differ. Nine women and 24 men died during 6 years of median follow up of the final cohort (n = 698). Vitamin D levels were negatively related to all-cause mortality in men independently of age, PTH, HbA1c, waist circumference, 24-h systolic ambulatory-blood pressure (ABP) and serum-apoB (p = 0.049). This finding was also statistically significant when PWV and IMT were added to the analyses (p = 0.028) and was not affected statistically when medications were also included in the regression-analysis (p = 0.01). In the women with type 2 diabetes, levels of PTH were positively related with all-cause mortality in the corresponding calculations (p = 0.016 without PWV and IMT, p = 0.006 with PWV and IMT, p = 0.045 when also adding medications to the analysis), while levels of vitamin D was without statistical significance (p greater than 0.9). Conclusions: Serum vitamin D in men and serum PTH in women give prognostic information in terms of total-mortality that are independent of regular risk factors in addition to levels of ABP, IMT and PWV.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keyword
Arteriosclerosis; Calcium; Mortality; Parathyroid hormone; Type 2 diabetes; Vitamin D
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-120044 (URN)10.1186/s13098-015-0049-9 (DOI)000356219100001 ()26078787 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden; Futurum; King Gustaf V and Queen Victoria Freemason Foundation; GE Healthcare; Swedish Heart-Lung Foundation; Swedish Research Council [12661]; County Council of Ostergotland; Linkoping University, Department of Medical and Health Sciences

Available from: 2015-07-06 Created: 2015-07-06 Last updated: 2017-12-04
Grundvold, I., Bodegard, J., Nilsson, P. M., Svennblad, B., Johansson, G., Östgren, C. J. & Sundström, J. (2015). Body weight and risk of atrial fibrillation in 7,169 patients with newly diagnosed type 2 diabetes; an observational study. Cardiovascular Diabetology, 14(5).
Open this publication in new window or tab >>Body weight and risk of atrial fibrillation in 7,169 patients with newly diagnosed type 2 diabetes; an observational study
Show others...
2015 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 14, no 5Article in journal (Refereed) Published
Abstract [en]

Background: Obesity, type 2 diabetes and atrial fibrillation (AF) are closely associated, but the underlying mechanisms are not fully understood. We aimed to explore associations between body mass index (BMI) or weight change with risk of AF in patients with type 2 diabetes. Methods: A total of 7,169 participations with newly diagnosed type 2 diabetes were stratified according to baseline BMI, and after a second BMI measurement within 18 months, further grouped according to relative weight change as "weight gain" (greater than 1 BMI unit), " stable weight" (+/- 1 BMI unit) and " weight loss" (less than 1 BMI unit). The mean follow-up period was 4.6 years, and the risk of AF was estimated using adjusted Cox regression models. Results: Average age at diabetes diagnosis was 60 years and the patients were slightly obese (mean BMI 30.2 kg/m(2)). During follow-up, 287 patients developed incident AF, and those with overweight or obesity at baseline had 1.9 fold and 2.9-fold higher risk of AF, respectively, than those with normal BMI. The 14% of the patients with subsequent weight gain had 1.5-fold risk of AF compared with those with stable weight or weight loss. Conclusions: In patients with newly diagnosed type 2 diabetes, baseline overweight and obesity, as well as modest weight increase during the first 18 months after diagnosis, were associated with a substantially increased risk of incident AF. Patients with type 2 diabetes may benefit from efforts to prevent weight gain in order to reduce the risk of incident AF.

Place, publisher, year, edition, pages
BioMed Central / Springer Verlag (Germany), 2015
Keyword
Epidemiology; Atrial fibrillation; Type 2 diabetes; Weight control
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-114583 (URN)10.1186/s12933-014-0170-3 (DOI)000348545000001 ()25589001 (PubMedID)
Note

Funding Agencies|AstraZeneca

Available from: 2015-02-27 Created: 2015-02-26 Last updated: 2018-01-11
Organisations

Search in DiVA

Show all publications