title: Gout in immigrant groups: a cohort study in Sweden.
abstract: Our aim was to study the association between country of birth and incidence of gout in different immigrant groups in Sweden. The study population included the whole population of Sweden. Gout was defined as having at least one registered diagnosis in the National Patient Register. The association between incidence of gout and country of birth was assessed by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (95% CI), using Swedish-born individuals as referents. All models were conducted in both men and women, and the full model was adjusted for age, place of residence in Sweden, educational level, marital status, neighbourhood socio-economic status and co-morbidities. The risk of gout varied by country of origin, with highest estimates, compared to Swedish born, in fully adjusted models among men from Iraq (HR 1.82, 95% CI 1.54-2.16), and Russia (HR 1.69, 95% CI 1.26-2.27), and also high among men from Austria, Poland, Africa and Asian countries outside the Middle East; and among women from Africa (HR 2.23, 95% CI 1.50-3.31), Hungary (HR 1.98, 95% CI 1.45-2.71), Iraq (HR 1.76, 95% CI 1.13-2.74) and Austria (HR 1.70, 95% CI 1.07-2.70), and also high among women from Poland. The risk of gout was lower among men from Greece, Spain, Nordic countries (except Finland) and Latin America and among women from Southern Europe, compared to their Swedish counterparts. The increased risk of gout among several immigrant groups is likely explained by a high cardio-metabolic risk factor pattern needing attention.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden. per.wandell@ki.se.
authors.forename: Per
authors.identifier: http://orcid.org/0000-0001-5169-2965
authors.initials: P
authors.lastname: Wändell
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden.|Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors.forename: Xinjun
authors.initials: X
authors.lastname: Li
authors.affiliation: Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
authors.forename: Danijela
authors.initials: D
authors.lastname: Gasevic
authors.affiliation: Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Ärnlöv
authors.affiliation: Department of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden.|Department of Internal Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Holzmann
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D006073:Gout / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: First-generation immigrants; Gender; Gout; Neighbourhood; Second-generation immigrants; Socio-economic status