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移民群体中的尿路结石病:瑞典的一项全国性队列研究。

Urolithiasis in immigrant groups: a nationwide cohort study in Sweden.

作者信息

Wändell Per, Carlsson Axel C, Li Xinjun, Gasevic Danijela, Sundquist Jan, Sundquist Kristina

机构信息

a Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Huddinge , Sweden.

b Center for Primary Health Care Research , Lund University , Malmö , Sweden.

出版信息

Scand J Urol. 2019 Feb;53(1):69-76. doi: 10.1080/21681805.2019.1593241. Epub 2019 Apr 8.

Abstract

To study the association between country of birth and incident urolithiasis in immigrant groups in Sweden, using individuals born in Sweden (or with Swedish-born parents in the second-generation study) as referents. This nationwide follow-up study included first- and second-generation immigrants residing in Sweden between 1 January 1998 and 31 December 2012. Urolithiasis was defined as having at least one registered diagnosis of urolithiasis in the National Patient Register. Cox regression analysis was used to estimate the risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident urolithiasis. The models were stratified by sex and adjusted for age, sociodemographic status and co-morbidity. Compared to referents, slightly higher incidence rates and HRs of urolithiasis (HR; 95% CI) were observed among first-generation men (1.06; 1.04-1.09) and women (1.12; 1.08-1.16) but not among second-generation immigrants (persons born in Sweden with foreign-born parents). Among first-generation immigrants, higher HRs were noted among men and women from Central and Eastern Europe, Russia, Latin America, Africa and Asia. Lower HRs were seen among men and women from the Nordic countries, most Western European countries and North America. Among second-generation immigrants, higher HRs were noted among men and women from Denmark, Germany and Hungary, in men from Austria, and in women from the Netherlands and Poland. Lower HRs were seen in second generation immigrants from Latin America, Africa and Asia (men and women). : We observed substantial differences in incidence of urolithiasis between certain immigrant groups and the Swedish-born population, of importance in the clinical situation.

摘要

为研究瑞典移民群体中出生国与新发尿路结石之间的关联,以出生在瑞典的个体(或在第二代研究中有瑞典出生父母的个体)作为对照。这项全国性的随访研究纳入了1998年1月1日至2012年12月31日期间居住在瑞典的第一代和第二代移民。尿路结石定义为在国家患者登记册中至少有一次登记的尿路结石诊断。采用Cox回归分析来估计新发尿路结石的风险(风险比(HR)及95%置信区间(CI))。模型按性别分层,并对年龄、社会人口学状况和合并症进行了调整。与对照相比,第一代男性(1.06;1.04 - 1.09)和女性(1.12;1.08 - 1.16)的尿路结石发病率和HR略高,但第二代移民(出生在瑞典但父母为外国出生的人)中未出现这种情况。在第一代移民中,来自中欧和东欧、俄罗斯、拉丁美洲、非洲和亚洲的男性和女性的HR较高。来自北欧国家、大多数西欧国家和北美的男性和女性的HR较低。在第二代移民中,来自丹麦、德国和匈牙利的男性和女性、来自奥地利的男性以及来自荷兰和波兰的女性的HR较高。来自拉丁美洲、非洲和亚洲的第二代移民(男性和女性)的HR较低。我们观察到某些移民群体与瑞典出生人口之间尿路结石发病率存在显著差异,这在临床情况中具有重要意义。

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