Endocrine Abstracts

Background: Immigrants from the Middle East to Sweden have a twice as high prevalence of type 2 diabetes (T2D) and obesity as native-born Swedes. Both obesity and T2D have been linked to increased incidence of cancer, cardiovascular disease (CVD) and all-cause mortality (ACM); however, data on differences between ethnicities are scarce.

Aims: In a population-based cohort we aimed to study the impact of Middle Eastern and European ethnicity on ACM, cancer- and CVD related mortality, incidence of cancer and CVD in an eight-year follow-up study. Methods: People born in Iraq or Sweden, who were 30-75 years of age, were invited from 2010-2012 to participate in the population based MEDIM study. A total of 1398 Iraqi- and 757 Swedish-born residents participated in the study, which consisted of a health exam, fasting blood sampling, assessment of insulin secretion and action (through oral glucose tolerance test) and questionnaires assessing history of CVD, cancer and T2D. Register data were retrieved until the 31st of December 2018 from the Swedish National Patient Register and Cause of Death register regarding CVD diagnosis, cancer diagnosis and cause of death. Information regarding diabetes (DM) diagnosis was retrieved from the National Diabetes Register. Individuals with a history of cancer or CVD at baseline were excluded. Cox regression analysis was assessed to study the adjusted hazard ratios (HR) for the relationships between ethnicity and ACM, cancer events, CVD events, death from cancer, and death from CVD, with adjustments for age, sex, anthropometrical measures, DM, and lifestyle.

Results: The HR for ACM was 0.35 (95% CI .14-.86) (p0.05) were observed for CVD related morbidity and mortality between Iraqi- and Swedish-born.

Conclusion: In this 8-year follow-up study, our data show that despite the high burden of cardiovascular (CV) risk factors and T2D, ACM, cancer morbidity and mortality rates were lower in Iraqi-born immigrants compared to native Swedes.

Keywords: Immigrants · Cancer · Middle East · Mortality · CVD · Type 2 diabetes

Abbreviations: ACM, all-cause mortality; CV, cardiovascular; CVD, cardiovascular disease; T2D, type 2 diabetes; DM, diabetes mellitus; PA, physical activity; ICD, International Classification of Disease; BMI, body mass index; LD, low-density lipoprotein; HDL, high-density lipoprotein; ISI, insulin sensitivity index; DIO, oral disposition index; SD, standard deviation; IQR, interquartile range

Funding: This study was funded by grants from Lund University (ALF funding: 20101641, 20101837 and 162641), Region Skåne (226661 and 121811).