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Examining the causal effect of type 2 diabetes on ischemic heart disease : - a longitudinal study with four measurements (1980-2017)

Jansåker, Filip LU ; Ekström, Ola LU ; Memon, Ashfaque A LU orcid ; Hansson, Ola LU orcid ; Johansson, Sven-Erik LU and Sundquist, Kristina LU (2023) In Diabetes Research and Clinical Practice 198.
Abstract

OBJECTIVE: This longitudinal study examines a possible causal effect between type 2 diabetes and ischemic heart disease (IHD) by using measurements on four occasions from the Swedish Statistics on Income and Living Conditions (SILC) together with nationwide healthcare registers.

METHODS: This was a longitudinal study based on a random sample of men and women (n = 2014) from the Swedish population with four measurements in the SILC every eight years. Baseline was 1980/81 and the participants were followed for up to 37 years. The mean age and age range at baseline were 36.5 and 20-59 years, respectively. The study used Marginal Structural Modeling (MSM-Cox) to account for time-varying exposures by implementing inverse probability... (More)

OBJECTIVE: This longitudinal study examines a possible causal effect between type 2 diabetes and ischemic heart disease (IHD) by using measurements on four occasions from the Swedish Statistics on Income and Living Conditions (SILC) together with nationwide healthcare registers.

METHODS: This was a longitudinal study based on a random sample of men and women (n = 2014) from the Swedish population with four measurements in the SILC every eight years. Baseline was 1980/81 and the participants were followed for up to 37 years. The mean age and age range at baseline were 36.5 and 20-59 years, respectively. The study used Marginal Structural Modeling (MSM-Cox) to account for time-varying exposures by implementing inverse probability weighting (IPTW). MSM-Cox with IPTW was compared with Cox proportional hazard modelling.

RESULTS: The hazard ratio (HR) for IHD (369 cases) with 95% confidence interval (CI) in participants with type 2 diabetes (11.1%) compared to participants without type 2 diabetes (88.9%) was significantly higher (1.99; CI = 1.15 - 3.44) when using MSM-Cox with IPTW after adjustments for clinical and sociodemographic risk factors. When applying Cox proportional hazard models adjusted for the same variables, the HR was lower and non-significant at 1.34 (CI = 0.94 - 1.98).

CONCLUSIONS: This longitudinal study with four measurements assessed a possible causal association between type 2 diabetes and IHD by applying MSM-Cox with IPTW. Although causality cannot be determined due to the remaining risk of residual bias, the results may help to elucidate a potential causal relationship between type 2 diabetes and IHD. Further causal studies on possible underlying mechanisms are, however, needed.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Research and Clinical Practice
volume
198
article number
110595
pages
19 pages
publisher
Elsevier
external identifiers
  • scopus:85149199390
  • pmid:36842479
ISSN
1872-8227
DOI
10.1016/j.diabres.2023.110595
language
English
LU publication?
yes
id
7231eef3-efa7-4814-800f-9803e48d47dc
date added to LUP
2023-02-28 12:22:41
date last changed
2024-04-19 20:19:23
@article{7231eef3-efa7-4814-800f-9803e48d47dc,
  abstract     = {{<p>OBJECTIVE: This longitudinal study examines a possible causal effect between type 2 diabetes and ischemic heart disease (IHD) by using measurements on four occasions from the Swedish Statistics on Income and Living Conditions (SILC) together with nationwide healthcare registers.</p><p>METHODS: This was a longitudinal study based on a random sample of men and women (n = 2014) from the Swedish population with four measurements in the SILC every eight years. Baseline was 1980/81 and the participants were followed for up to 37 years. The mean age and age range at baseline were 36.5 and 20-59 years, respectively. The study used Marginal Structural Modeling (MSM-Cox) to account for time-varying exposures by implementing inverse probability weighting (IPTW). MSM-Cox with IPTW was compared with Cox proportional hazard modelling.</p><p>RESULTS: The hazard ratio (HR) for IHD (369 cases) with 95% confidence interval (CI) in participants with type 2 diabetes (11.1%) compared to participants without type 2 diabetes (88.9%) was significantly higher (1.99; CI = 1.15 - 3.44) when using MSM-Cox with IPTW after adjustments for clinical and sociodemographic risk factors. When applying Cox proportional hazard models adjusted for the same variables, the HR was lower and non-significant at 1.34 (CI = 0.94 - 1.98).</p><p>CONCLUSIONS: This longitudinal study with four measurements assessed a possible causal association between type 2 diabetes and IHD by applying MSM-Cox with IPTW. Although causality cannot be determined due to the remaining risk of residual bias, the results may help to elucidate a potential causal relationship between type 2 diabetes and IHD. Further causal studies on possible underlying mechanisms are, however, needed.</p>}},
  author       = {{Jansåker, Filip and Ekström, Ola and Memon, Ashfaque A and Hansson, Ola and Johansson, Sven-Erik and Sundquist, Kristina}},
  issn         = {{1872-8227}},
  language     = {{eng}},
  month        = {{02}},
  publisher    = {{Elsevier}},
  series       = {{Diabetes Research and Clinical Practice}},
  title        = {{Examining the causal effect of type 2 diabetes on ischemic heart disease : - a longitudinal study with four measurements (1980-2017)}},
  url          = {{http://dx.doi.org/10.1016/j.diabres.2023.110595}},
  doi          = {{10.1016/j.diabres.2023.110595}},
  volume       = {{198}},
  year         = {{2023}},
}