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Association Between Celiac Disease and Mortality Risk in a Swedish Population.

https://arctichealth.org/en/permalink/ahliterature306315
Source
JAMA. 2020 04 07; 323(13):1277-1285
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-07-2020
Author
Benjamin Lebwohl
Peter H R Green
Jonas Söderling
Bjorn Roelstraete
Jonas F Ludvigsson
Author Affiliation
Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York.
Source
JAMA. 2020 04 07; 323(13):1277-1285
Date
04-07-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Age Factors
Atrophy
Cardiovascular Diseases - mortality
Case-Control Studies
Celiac Disease - complications - mortality - pathology
Child
Educational Status
Female
Humans
Intestine, Small - pathology
Male
Middle Aged
Neoplasms - mortality
Proportional Hazards Models
Respiratory Tract Diseases - mortality
Retrospective Studies
Risk factors
Sweden - epidemiology
Young Adult
Abstract
Celiac disease may be associated with a modest but persistent increased long-term mortality risk. It is uncertain whether this risk has changed in the era of wider diagnosis rates, less severe clinical disease, and more widespread availability of gluten-free food.
To evaluate the association between celiac disease and mortality risk in a population-based cohort in Sweden.
All individuals in Sweden with celiac disease diagnosed between 1969 and 2017 were identified through the Epidemiology Strengthened by histoPathology Reports in Sweden (ESPRESSO) cohort. Participants (n?=?49?829) were observed starting on the day of the biopsy. The final date of follow-up was December 31, 2017.
Celiac disease was defined by the presence of small intestinal villus atrophy on histopathology specimens during the years 1969-2017 from Sweden's 28 pathology departments. Each individual was matched with as many as 5 control participants in the general population by age, sex, county, and calendar period.
The primary outcome was all-cause mortality, and the secondary outcome was cause-specific mortality. Patients with celiac disease were compared with controls using stratified Cox proportional modeling, stratifying by year of diagnosis.
There were 49?829 patients with celiac disease, including 24% who were diagnosed between the years 2010 and 2017. The mean (SD) age at diagnosis was 32.2 (25.2) years and 62.4% were women. During a median follow-up time of 12.5 years, 13.2% (n?=?6596) died. Compared with controls (n?=?246?426), overall mortality was increased in those with celiac disease (9.7 vs 8.6 deaths per 1000 person-years; absolute difference, 1.2 per 1000 person-years; hazard ratio [HR], 1.21 [95% CI, 1.17-1.25]). The relative increase in mortality risk was present in all age groups and was greatest in those diagnosed in the age range of 18 to 39 years (1.9 vs 1.1 per 1000 person-years; HR, 1.69 [95% CI, 1.47-1.94]; P values for heterogeneity comparing 18-39 years with 40-59 years and with =60 years were both
PubMed ID
32259229 View in PubMed
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Association of Maternal Gastric Bypass Surgery With Offspring Birth Defects.

https://arctichealth.org/en/permalink/ahliterature308643
Source
JAMA. 2019 10 15; 322(15):1515-1517
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
10-15-2019

Costs and Use of Health Care in Patients With Celiac Disease: A Population-Based Longitudinal Study.

https://arctichealth.org/en/permalink/ahliterature306026
Source
Am J Gastroenterol. 2020 08; 115(8):1253-1263
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-2020
Author
Karl Mårild
Jonas Söderling
Soran R Bozorg
Åsa H Everhov
Benjamin Lebwohl
Peter H R Green
Martin Neovius
Jonas F Ludvigsson
Author Affiliation
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
Source
Am J Gastroenterol. 2020 08; 115(8):1253-1263
Date
08-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Case-Control Studies
Celiac Disease - economics - epidemiology - therapy
Female
Health Care Costs - statistics & numerical data
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Sweden - epidemiology
Young Adult
Abstract
Celiac disease (CD) affects 1% of the population. Its effect on healthcare cost, however, is barely understood. We estimated healthcare use and cost in CD, including their temporal relationship to diagnosis.
Through biopsy reports from Sweden's 28 pathology departments, we identified 40,951 prevalent patients with CD (villous atrophy) as of January 1, 2015, and 15,086 incident patients with CD diagnosed in 2008-2015, including 2,663 who underwent a follow-up biopsy to document mucosal healing. Each patient was compared with age- and sex-matched general population comparators (n = 187,542). Using nationwide health registers, we retrieved data on all inpatient and nonprimary outpatient care, prescribed diets, and drugs.
Compared with comparators, healthcare costs in 2015 were, on average, $1,075 (95% confidence interval, $864-1,278) higher in prevalent patients with CD aged
PubMed ID
32349030 View in PubMed
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Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.

https://arctichealth.org/en/permalink/ahliterature299137
Source
Scand J Med Sci Sports. 2019 Feb; 29(2):232-239
Publication Type
Journal Article
Date
Feb-2019
Author
Elin Ekblom-Bak
Örjan Ekblom
Gunnar Andersson
Peter Wallin
Jonas Söderling
Erik Hemmingsson
Björn Ekblom
Author Affiliation
Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
Source
Scand J Med Sci Sports. 2019 Feb; 29(2):232-239
Date
Feb-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Anthropometry
Cardiorespiratory fitness
Educational Status
Employment
Exercise Test
Female
Humans
Longitudinal Studies
Male
Middle Aged
Occupational Health - trends
Oxygen consumption
Sweden - epidemiology
Young Adult
Abstract
Long-term trend analyses of cardiorespiratory fitness (VO2 max) in the general population are limited.
To describe trends in VO2 max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.
A total of 354 277 participants (44% women, 18-74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L/min) and relative (mL/min/kg) VO2 max, and the proportion with low (
PubMed ID
30351472 View in PubMed
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Delivery outcomes in term births after bariatric surgery: Population-based matched cohort study.

https://arctichealth.org/en/permalink/ahliterature299324
Source
PLoS Med. 2018 09; 15(9):e1002656
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Olof Stephansson
Kari Johansson
Jonas Söderling
Ingmar Näslund
Martin Neovius
Author Affiliation
Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
Source
PLoS Med. 2018 09; 15(9):e1002656
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adult
Bariatric Surgery
Body mass index
Cesarean Section
Cohort Studies
Delivery, Obstetric
Female
Humans
Infant, Newborn
Male
Obesity - complications - pathology - surgery
Pregnancy
Pregnancy Complications - pathology
Pregnancy outcome
Prospective Studies
Sweden
Term Birth
Weight Loss
Abstract
Obesity increases the risk of adverse delivery outcomes. Whether weight loss induced by bariatric surgery influences these risks remains to be determined. The objective was to investigate the risk of adverse delivery outcomes among post-surgery women compared with women without bariatric surgery history but with similar characteristics.
We identified 801,443 singleton live-born term births (=37 gestational weeks) in the Swedish Medical Birth Register between 1 January 2006 and 31 December 2013, of which 1,929 were in women with a history of bariatric surgery and a pre-surgery weight available from the Scandinavian Obesity Surgery Registry. For each post-surgery delivery, up to 5 control deliveries were matched by maternal pre-surgery BMI (early-pregnancy BMI used for controls), age, parity, smoking, education, height, country of birth, and delivery year (N post-surgery deliveries:matched controls = 1,431:4,476). The main outcome measures were mode of delivery, induction of labor, post-term pregnancy (=42 + 0 gestational weeks), epidural analgesia, fetal distress, labor dystocia, peripartum infection, obstetric anal sphincter injury (perineal tear grade III-IV), and postpartum hemorrhage. Among the women with a history of bariatric surgery, the mean pre-surgery BMI was 42.6 kg/m2, the median surgery-to-conception interval was 1.4 years, and the mean BMI loss between surgery and early pregnancy was 13.5 kg/m2 (38 kg). Compared to matched control women, post-surgery women were less likely to have cesarean delivery (18.2% versus 25.0%, risk ratio [RR] 0.70, 95% CI 0.60-0.80), especially emergency cesarean (6.8% versus 15.1%, RR 0.40, 95% CI 0.31-0.51). Post-surgery women also had lower risks of instrumental delivery (5.0% versus 6.5%, RR 0.73, 95% CI 0.53-0.98), induction of labor (23.4% versus 34.0%, RR 0.68, 95% CI 0.59-0.78), post-term pregnancy (4.2% versus 10.3%, RR 0.40, 95% CI 0.30-0.53), obstetric anal sphincter injury (1.5% versus 2.9%, RR 0.46, 95% CI 0.25-0.81), and postpartum hemorrhage (4.6% versus 8.0%, RR 0.58, 95% CI 0.44-0.76). Since this study was not randomized, a limitation is the possibility of selection bias, despite our efforts using careful matching.
Bariatric-surgery-induced weight loss was associated with lower risks for adverse delivery outcomes in term births.
PubMed ID
30256796 View in PubMed
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Healthcare use, work loss and total costs in incident and prevalent Crohn's disease and ulcerative colitis: results from a nationwide study in Sweden.

https://arctichealth.org/en/permalink/ahliterature304922
Source
Aliment Pharmacol Ther. 2020 08; 52(4):655-668
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
08-2020
Author
Hamed Khalili
Åsa H Everhov
Jonas Halfvarson
Jonas F Ludvigsson
Johan Askling
Pär Myrelid
Jonas Söderling
Ola Olen
Martin Neovius
Author Affiliation
Boston, MA, USA.
Source
Aliment Pharmacol Ther. 2020 08; 52(4):655-668
Date
08-2020
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Absenteeism
Adolescent
Adult
Colitis, Ulcerative - economics - epidemiology - therapy
Crohn Disease - economics - epidemiology - therapy
Female
Health Care Costs - statistics & numerical data
Health Resources - economics - statistics & numerical data
Hospitalization - economics - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Prevalence
Sick Leave - economics - statistics & numerical data
Sweden - epidemiology
Tumor Necrosis Factor-alpha - therapeutic use
Work - economics - statistics & numerical data
Young Adult
Abstract
There are limited data on population-wide assessment of cost in Crohn's disease (CD) and ulcerative colitis (UC).
To estimate the societal cost of actively treated CD and UC in Sweden.
We identified 10 117 prevalent CD and 19 762 prevalent UC patients, aged =18 years on 1 January 2014 and 4028 adult incident CD cases and 8659 adult incident UC cases (2010-2013) from Swedish Patient Register. Each case was matched to five population comparators. Healthcare costs were calculated from medications, outpatient visits, hospitalisations and surgery. Cost of productivity losses was derived from disability pension and sick leave.
The mean annual societal costs per working-age patient (18-64 years) with CD and UC were $22 813 (vs $7533 per comparator) and $14 136 (vs $7351 per comparator), respectively. In patients aged =65 years, the mean annual costs of CD and UC were $9726 and $8072 vs $3875 and $4016 per comparator, respectively. The majority of cost for both CD (56%) and UC (59%) patients originated from productivity losses. Higher societal cost of working-age CD patients as compared to UC patients was related to greater utilisation of anti-TNF (22.2% vs 7.4%) and increased annual disability pension (44 days vs 25 days). Among incident CD and UC patients, the mean total cost over the first year per patient was over three times higher than comparators.
In Sweden, the societal cost of incident and prevalent CD and UC patients was consistently two to three times higher than the general population.
Notes
CommentIn: Aliment Pharmacol Ther. 2020 Sep;52(5):879-880 PMID 32852814
CommentIn: Aliment Pharmacol Ther. 2021 Jan;53(2):368-369 PMID 33368510
PubMed ID
32902894 View in PubMed
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Incidence and Treatment of Patients Diagnosed With Inflammatory Bowel Diseases at 60 Years or Older in Sweden.

https://arctichealth.org/en/permalink/ahliterature291560
Source
Gastroenterology. 2018 02; 154(3):518-528.e15
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Åsa H Everhov
Jonas Halfvarson
Pär Myrelid
Michael C Sachs
Caroline Nordenvall
Jonas Söderling
Anders Ekbom
Martin Neovius
Jonas F Ludvigsson
Johan Askling
Ola Olén
Author Affiliation
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: asa.hallqvist-everhov@ki.se.
Source
Gastroenterology. 2018 02; 154(3):518-528.e15
Date
02-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adrenal Cortex Hormones - adverse effects - therapeutic use
Adult
Age of Onset
Aged
Aged, 80 and over
Biological Products - adverse effects - therapeutic use
Child
Child, Preschool
Colectomy - adverse effects
Colitis, Ulcerative - diagnosis - epidemiology - therapy
Crohn Disease - diagnosis - epidemiology - therapy
Female
Gastrointestinal Agents - adverse effects - therapeutic use
Healthcare Disparities
Humans
Immunologic Factors - adverse effects - therapeutic use
Incidence
Infant
Infant, Newborn
Male
Middle Aged
Registries
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Young Adult
Abstract
Diagnosis of inflammatory bowel diseases (IBD) is increasing among elderly persons (60 years or older). We performed a nationwide population-based study to estimate incidence and treatment of IBD.
We identified all incident IBD cases in Sweden from 2006 through 2013 using national registers and up to 10 matched population comparator subjects. We collected data on the patients' health care contacts and estimated incidence rates, health service burden, pharmacologic treatments, extra-intestinal manifestations, and surgeries in relation to age of IBD onset (pediatric,
PubMed ID
29102619 View in PubMed
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Inflammatory bowel disease and risk of severe COVID-19: A nationwide population-based cohort study in Sweden.

https://arctichealth.org/en/permalink/ahliterature311922
Source
United European Gastroenterol J. 2021 03; 9(2):177-192
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2021
Author
Jonas F Ludvigsson
Jordan Axelrad
Jonas Halfvarson
Hamed Khalili
Emma Larsson
Paul Lochhead
Bjorn Roelstraete
Tracey G Simon
Jonas Söderling
Ola Olén
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Source
United European Gastroenterol J. 2021 03; 9(2):177-192
Date
03-2021
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
COVID-19 - complications - diagnosis - epidemiology - mortality
Comorbidity
Cross-Sectional Studies
Female
Hospitalization - statistics & numerical data
Humans
Inflammatory Bowel Diseases - complications - epidemiology
Male
Middle Aged
Prognosis
Propensity Score
SARS-CoV-2
Sweden - epidemiology
Young Adult
Abstract
There are concerns that individuals with chronic immune-mediated diseases are at increased risk of COVID-19 and related severe adverse outcome, including intensive care admission or death. We aimed to explore the absolute and relative risk of severe COVID-19 in inflammatory bowel disease (IBD).
This population-based cohort study used nationwide registers in Sweden, with 67,292 individuals with a diagnosis of IBD 1969-2017 (Crohn's disease, n = 21,599; ulcerative colitis: n = 43,622; IBD-unclassified: n = 2071) and alive on 1 February 2020. Patients with IBD were matched to up to five controls from the general population (n = 297,910). Cox regression estimated hazard ratios (HRs) for (i) hospital admission with laboratory-confirmed COVID-19 as the primary diagnosis, and (ii) severe COVID-19 (composite outcome consisting of (a) COVID-19 intensive care admission, or (b) death from COVID-19 or (c) death within 30 days of COVID-19 hospital admission), were calculated. Analyses were conditioned on age, sex, calendar period, and county and adjusted for other comorbidities.
Between 1 February and 31 July 2020, 179 (0.27%) IBD patients and 500 (0.17%) general population controls were admitted to hospital with COVID-19 (adjusted HR [aHR] = 1.43; 95% CI = 1.19-1.72). The corresponding numbers for severe COVID-19 was 65 (0.10%) and 183 (0.06%; aHR = 1.11; 95% CI = 0.81-1.52). Adjusted HRs were similar in Crohn's disease and ulcerative colitis. In a propensity score-matched model taking comorbidity into account until 2016, the increased risk for COVID-19 hospital admission remained (aHR = 1.32; 1.12-1.56), but there was no increased risk of severe COVID-19 (aHR = 1.12; 0.85-1.47).
While individuals with IBD were more likely to be admitted to hospital for COVID-19 than the general population, the risk of severe COVID-19 was not higher.
PubMed ID
33704918 View in PubMed
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Periconception glycaemic control in women with type 1 diabetes and risk of major birth defects: population based cohort study in Sweden.

https://arctichealth.org/en/permalink/ahliterature298590
Source
BMJ. 2018 Jul 05; 362:k2638
Publication Type
Journal Article
Date
Jul-05-2018
Author
Jonas F Ludvigsson
Martin Neovius
Jonas Söderling
Soffia Gudbjörnsdottir
Ann-Marie Svensson
Stefan Franzén
Olof Stephansson
Björn Pasternak
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden jonasludvigsson@yahoo.com.
Source
BMJ. 2018 Jul 05; 362:k2638
Date
Jul-05-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Biomarkers - metabolism
Cohort Studies
Congenital Abnormalities - epidemiology
Diabetes Mellitus, Type 1 - epidemiology - metabolism
Female
Glycated Hemoglobin A - metabolism
Humans
Infant
Infant, Newborn
Pregnancy
Pregnancy in Diabetics - epidemiology - metabolism
Risk factors
Sweden - epidemiology
Abstract
To examine the association between maternal type 1 diabetes and the risk of major birth defects according to levels of glycated haemoglobin (HbA1C) within three months before or after estimated conception.
Population based historical cohort study using nationwide health registers.
Sweden, 2003-15.
2458 singleton liveborn infants of mothers with type 1 diabetes and a glycated haemoglobin measurement within three months before or after estimated conception and 1?159?865 infants of mothers without diabetes.
Major cardiac and non-cardiac birth defects according to glycated haemoglobin levels.
122 cases of major cardiac defects were observed among 2458 infants of mothers with type 1 diabetes. Compared with 15 cases of major cardiac defects per 1000 infants of mothers without diabetes, the rates among infants of mothers with type 1 diabetes were 33 per 1000 for a glycated haemoglobin level of
PubMed ID
29976596 View in PubMed
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Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons.

https://arctichealth.org/en/permalink/ahliterature283396
Source
BMJ. 2017 Jun 14;357:j2563
Publication Type
Article
Date
Jun-14-2017
Author
Martina Persson
Sven Cnattingius
Eduardo Villamor
Jonas Söderling
Björn Pasternak
Olof Stephansson
Martin Neovius
Source
BMJ. 2017 Jun 14;357:j2563
Date
Jun-14-2017
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Cohort Studies
Congenital Abnormalities - epidemiology - etiology
Female
Humans
Infant
Infant, Newborn
Mothers
Odds Ratio
Overweight - complications - epidemiology - physiopathology
Pregnancy
Pregnancy Complications - epidemiology - etiology - physiopathology
Sentinel Surveillance
Sweden - epidemiology
Thinness - complications - epidemiology - physiopathology
Abstract
Objective To estimate the risks of major congenital malformations in the offspring of mothers who are underweight (body mass index (BMI)
Notes
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PubMed ID
28615173 View in PubMed
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13 records – page 1 of 2.