title: Sialic acid and incidence of hospitalization for diabetes and its complications during 40-years of follow-up in a large cohort: the Värmland survey.
abstract: OBJECTIVE
  To examine the association of sialic acid (SA) with first recorded diabetes mellitus-related hospitalization.
  
  
  METHODS
  From a population-based study in Värmland, Sweden, between 1962 and 1965, 87,035 men and women were selected and followed for first recorded diabetes-related hospitalization until 2005. The association of SA was calculated and stratified for gender by Cox's proportional hazards models. Adjustments were made for conventional risk factors and socioeconomic status. Association analyses were made for comparisons between SA-levels above and below median.
  
  
  RESULTS
  The mean age was 47.2 (SD 13.0) years and the total numbers of incident diabetes-related hospitalizations in men and women were 3445 and 3273, respectively. Hazard ratios per one standard deviation of SA were 1.12 (95% CI: 1.08-1.17, p<0.0001) in men and 1.17 (95% CI: 1.13-1.22, p<0.0001) in women. Interaction analyses indicated a relatively higher SA-associated risk in women than in men with above median SA levels.
  
  
  CONCLUSIONS
  In this large population-based cohort followed for more than 40 years, elevated SA, as a marker of systemic inflammation, was independently associated with risk of diabetes and diabetes-related hospitalizations.
authors.affiliation: Department of Cardiology and Acute Internal Medicine, Central Hospital, Karlstad, Sweden; Faculty of Health Sciences and Medicine, Örebro University, Örebro, Sweden. Electronic address: payam.khalili@liv.se.
authors.forename: Payam
authors.initials: P
authors.lastname: Khalili
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
authors.affiliation: Faculty of Health Sciences and Medicine, Örebro University, Örebro, Sweden; Endocrine and Diabetes Center, Central Hospital, Karlstad, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Jendle
authors.affiliation: Statistical Unit, Värmland County Council, Karlstad, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Lundin
authors.affiliation: Department of Medicine, Clinical Epidemiological Unit, Karolinska Institute, Stockholm, Sweden.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Jungner
authors.affiliation: Faculty of Health Sciences and Medicine, Örebro University, Örebro, Sweden; Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019158:N-Acetylneuraminic Acid / Q000097:blood*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D019158:N-Acetylneuraminic Acid
keywords: Diabetes mellitus; Epidemiology; Inflammation; Population; Sialic acid