Diabetes and obesity in Northern Sweden: occurrence and risk factors for stroke and myocardial infarction.
OBJECTIVE
The authors describe the occurrence of diabetes and obesity in the population of Northern Sweden and the role of diabetes in cardiovascular disease.


METHODS
Four surveys of the population aged 25 to 64 years were undertaken during a 14-year time span. Stroke events in subjects 35-74 years during 1985-92 and myocardial infarction in subjects 25-64 years 1989-93 were registered.


RESULTS
The prevalence of diagnosed diabetes was 3.1 and 2.0% in men and women, respectively, and 2.6 and 2.7% for previously undiagnosed diabetes. During the 13-year observation period, BMI increased 0.96 kg/m(2) in men and 0.87 in women. The proportion of subjects with obesity (BMI>or=30) increased from 10.3% to 14.6% in men and from 12.5% to 15.7% in women. Hip circumference increased substantially more than waist circumference, leading to a decreasing waits-to-hip ratio (WHR). The relative risk for stroke or myocardial infarction was four to six times higher in a person with diabetes than in those without diabetes. The 28-day case fatality for myocardial infarction, but not for stroke, was significantly higher in both men and women with diabetes. Population-attributable risk for diabetes and stroke was 18% in men and 22% in women and for myocardial infarction it was 11% in men and 17% in women.


CONCLUSIONS
Obesity is becoming more common, although of a more distal than central distribution. The burden of diabetes in cardiovascular diseases in Northern Sweden is high.
Eliasson
Mats
M
Medicine, Department of Medicine, Sunderby Hospital, Luleå, Sweden. mats.eliasson@nll.se
Lindahl
Bernt
B
Lundberg
Vivan
V
Stegmayr
Birgitta
B
D000328:Adult; D000368:Aged; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology*; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology