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Increased levels of triglycerides, BMI and blood pressure and low physical activity increase the risk of diabetes in Swedish women. A prospective 18‐year follow‐up of the BEDA *study
Author(s) -
Dotevall A.,
Johansson S.,
Wilhelmsen L.,
Rosengren A.
Publication year - 2004
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2004.01189.x
Subject(s) - medicine , diabetes mellitus , body mass index , hazard ratio , blood pressure , confidence interval , population , obesity , type 2 diabetes , risk factor , prospective cohort study , endocrinology , environmental health
Aim To investigate risk factors for the development of diabetes in middle‐aged women. Methods A random population sample of 1351 women without prior diabetes or cardiovascular disease, aged 39–65 years, took part in a screening study in 1979–1981 with questionnaires, physical examination and blood sampling. Development of diabetes up to 1998 was identified at a second examination in 1997–1998. Results Seventy‐three women (5.4%) were diagnosed with diabetes during follow‐up. As expected, obesity resulted in a rising age‐adjusted risk with hazards ratio 3.2 [95% confidence interval (CI) 1.3, 8.1] at body mass index (BMI) 24–27 kg/m 2 , and 8.3 (3.5, 19.7), at BMI ≥ 27, compared with BMI < 22 kg/m 2 . S‐triglycerides (TG) carried a steeply increasing age‐adjusted risk with hazards ratio 4.0 (95% CI 2.1, 7.6) already at s‐TG 1.0–1.4 mmol/l, 7.1 (3.6, 14.0) at s‐TG 1.5–1.9 mmol/l and 9.3 (4.3, 20.2) at s‐TG ≥ 2.0 mmol/l compared with s‐TG < 1.0 mmol/l. Increasing systolic blood pressure (SBP) to 130–144, 145–159 and ≥ 160 mmHg escalated the hazards ratio of diabetes to 1.6 (0.8, 3.3), 3.6 (1.7, 7.4) and 5.6 (2.7, 11.4), respectively, compared with SBP < 130 mmHg. Also, low physical activity predicted diabetes, with hazards ratio 2.1 (1.3, 3.3) for sedentary compared with non‐sedentary activity. Smoking was not associated with increased risk of diabetes. After adjustment for BMI, SBP and physical activity, increasing TG level remained a strong and significant risk factor for diabetes [hazards ratio 3.0 (1.6, 5.7), 3.7 (1.8, 7.7) and 4.5 (2.0, 10.0), P < 0.001]. Conclusions Among middle‐aged Swedish women even very slightly elevated s‐TG resulted in a considerably enhanced risk of developing diabetes, which was independent of age, BMI, blood pressure and physical activity.