title: Global region of birth is an independent risk factor for type 2 diabetes in Stockholm, Sweden.
abstract: In Stockholm, type 2 diabetes (T2D) is a public health concern and much more prevalent in areas with a high proportion of foreign-born individuals. One in five individuals in Stockholm County are born outside of Sweden, and we therefore investigated if global region of birth was associated with diabetes risk, adjusting for established risk factors. Cross-sectional data from the population-based Stockholm Public Health Survey 2010 ( N = 69 115) was combined with registry-based information on country of birth grouped into eight global geographical regions. Cases of T2D were identified through self-reported physician-diagnosed diabetes and age at diagnosis. Region of birth was the independent risk factor and multivariable logistic regression analysis was performed adjusting for the risk factors age, sex, weight status, educational level, multiple dietary factors, tobacco, alcohol and physical activity. T2D prevalence was 5.1% in the sample. Relative to Swedish-born participants, higher odds ratio (OR) were found in those born in Asia [OR 3.2, 95% confidence interval (CI) 2.2-4.7], Sub-Saharan Africa (OR 2.5, 95% CI 1.5-4.1) and North Africa/the Middle East (OR 2.1, 95% CI 1.6-2.8), after adjustment for established risk factors. Participants from Eastern Europe and Latin America had an elevated risk but this did not remain after adjustment for other risk factors. Region of birth was found to be an independent risk factor for T2D for participants born in Asia, Africa and the Middle East. This increased risk should be taken into consideration when allocating resources for prevention, detection and care.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
authors.forename: Liselotte Schäfer
authors.initials: LS
authors.lastname: Elinder
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Shawn
authors.initials: S
authors.lastname: Hakimi
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
authors.forename: Anton
authors.initials: A
authors.lastname: Lager
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Patterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult