@article{8a1b3ab2ec124c629f3e6f1a608a8feb,
title = "Examining the causal effect of type 2 diabetes on ischemic heart disease – A longitudinal study with four measurements (1980–2017)",
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 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.",
keywords = "Causal effect, Epidemiology, Ischemic Heart Disease, Type 2 Diabetes",
author = "Filip Jans{\aa}ker and Ola Ekstr{\"o}m and Memon, {Ashfaque A.} and Ola Hansson and Johansson, {Sven Erik} and Kristina Sundquist",
note = "Funding Information: This work was supported by non-commercial governmental research funding granted to Professor Kristina Sundquist and Dr. Filip Jans{\aa}ker: i.e. Swedish Society of Medicine, Knut and Alice Wallenberg Foundation, and Alf-funding from Region Sk{\aa}ne/Lund University (FJ), and the Swedish Heart-Lung Foundation (KS). The funding sources of the study had no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; or in the decision to submit the paper for publication. We also want to thank Patrick Reilly for helping with language revision of the paper. Data sharing statement, This study made use of several national registers and, owing to legal concerns, data cannot be made openly available. Further information regarding the health registries is available from the Swedish National Board of Health and Welfare (https:// www.socialstyrelsen.se/en/statistics-and-data/registers/) and Statistics Sweden (https://www.scb.se/en/ and https://www.scb.se/en/finding-statistics/statistics-by-subject-area/living-conditions/living-conditions/living-conditions-surveys-ulfsilc/). The code used in the analysis can be provided upon request to Professor Kristina Sundquist, senior researcher on this study. Funding Information: This work was supported by non-commercial governmental research funding granted to Professor Kristina Sundquist and Dr. Filip Jans{\aa}ker: i.e., Swedish Society of Medicine, Knut and Alice Wallenberg Foundation, and Alf-funding from Region Sk{\aa}ne/Lund University (FJ), and the Swedish Heart-Lung Foundation (KS). The funding sources of the study had no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; or in the decision to submit the paper for publication. We also want to thank Patrick Reilly for helping with language revision of the paper. Publisher Copyright: {\textcopyright} 2023 The Authors",
year = "2023",
month = apr,
doi = "10.1016/j.diabres.2023.110595",
language = "English",
volume = "198",
journal = "Diabetes Research and Clinical Practice",
issn = "0168-8227",
publisher = "Elsevier Ireland Ltd",
}