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Wennberg P, Rolandsson O, van der A DL, et al. Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study. BMJ Open. 2013;3(3)doi: 10.1136/bmjopen-2012-002436.
Wennberg, P., Rolandsson, O., van der A, D. L., Spijkerman, A. M., Kaaks, R., Boeing, H., Feller, S., Bergmann, M. M., Langenberg, C., Sharp, S. J., Forouhi, N., Riboli, E., & Wareham, N. (2013). Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study. BMJ open, 3(3), . https://doi.org/10.1136/bmjopen-2012-002436
Wennberg, Patrik, et al. "Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study." BMJ open vol. 3,3 (2013). doi: https://doi.org/10.1136/bmjopen-2012-002436
Wennberg P, Rolandsson O, van der A DL, Spijkerman AM, Kaaks R, Boeing H, Feller S, Bergmann MM, Langenberg C, Sharp SJ, Forouhi N, Riboli E, Wareham N. Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study. BMJ Open. 2013 Mar 06;3(3). doi: 10.1136/bmjopen-2012-002436. PMID: 23471609; PMCID: PMC3612773.
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BMJ Open. 2013 Mar 06;3(3). doi: 10.1136/bmjopen-2012-002436.

Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study.

BMJ open

Patrik Wennberg, Olov Rolandsson, Daphne L van der A, Annemieke M W Spijkerman, Rudolf Kaaks, Heiner Boeing, Silke Feller, Manuela M Bergmann, Claudia Langenberg, Stephen J Sharp, Nita Forouhi, Elio Riboli, Nicholas Wareham

Affiliations

  1. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

PMID: 23471609 PMCID: PMC3612773 DOI: 10.1136/bmjopen-2012-002436

Abstract

OBJECTIVES: To investigate the association between self-rated health and risk of type 2 diabetes and whether the strength of this association is consistent across five European centres.

DESIGN: Population-based prospective case-cohort study.

SETTING: Enrolment took place between 1992 and 2000 in five European centres (Bilthoven, Cambridge, Heidelberg, Potsdam and Umeå).

PARTICIPANTS: Self-rated health was assessed by a baseline questionnaire in 3399 incident type 2 diabetic case participants and a centre-stratified subcohort of 4619 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study which was drawn from a total cohort of 340 234 participants in the EPIC.

PRIMARY OUTCOME MEASURE: Prentice-weighted Cox regression was used to estimate centre-specific HRs and 95% CIs for incident type 2 diabetes controlling for age, sex, centre, education, body mass index (BMI), smoking, alcohol consumption, energy intake, physical activity and hypertension. The centre-specific HRs were pooled across centres by random effects meta-analysis.

RESULTS: Low self-rated health was associated with a higher hazard of type 2 diabetes after adjusting for age and sex (pooled HR 1.67, 95% CI 1.48 to 1.88). After additional adjustment for health-related variables including BMI, the association was attenuated but remained statistically significant (pooled HR 1.29, 95% CI 1.09 to 1.53). I(2) index for heterogeneity across centres was 13.3% (p=0.33).

CONCLUSIONS: Low self-rated health was associated with a higher risk of type 2 diabetes. The association could be only partly explained by other health-related variables, of which obesity was the strongest. We found no indication of heterogeneity in the association between self-rated health and type 2 diabetes mellitus across the European centres.

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