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Diabetes and obesity in Northern Sweden: occurrence and risk factors for stroke and myocardial infarction

Department of Medicine, Sunderby Hospital, LuleÅ, Sweden, mats.eliasson{at}nll.se, Medicine, Department of Public Health and Clinical Medicine, UmeÅ University, UmeÅ, Sweden

Bernt Lindahl

Behavioral Medicine, Department of Public Health and Clinical Medicine, UmeÅ University

Vivan Lundberg

Department of Internal Medicine, Kalix Hospital, Kalix, Sweden

Birgitta Stegmayr

Medicine, Department of Public Health and Clinical Medicine, UmeÅ University, UmeÅ, Sweden

Aims: 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/m² in men and 0.87 in women. The proportion of subjects with obesity (BMI30) 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. Conclusion: 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.

Key Words: diabetes mellitus • myocardial infarction • obesity • prevalence • stroke • time trends • women.

Scandinavian Journal of Public Health, Vol. 31, No. 61 suppl, 70-77 (2003)
DOI: 10.1080/14034950310001360


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