Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Ups J Med Sci. 2024 Aug 9;129. doi: 10.48101/ujms.v129.10376. eCollection 2024.
We aimed to analyze the risk of hereditary hemochromatosis (HH) among first-generation and second-generation immigrants in Sweden using Swedish-born individuals and Swedish-born individuals with Swedish-born parents as referents, respectively.
All individuals aged 18 years of age and older, = 6,180,500 in the first-generation study, and = 4,589,930 in the second-generation study were included in the analyses. HH was defined as at least one registered diagnosis International Classification of Diseases 10th edition (E83.1) in the National Patient Register between January 1, 1998 and December 31, 2018. Cox regression was used to estimate the hazard ratios (HRs) with 99% confidence intervals (CI) owing to multiple testing, of incident HH with adjustments for age, cancer, other comorbidities, and socio-demographics.
In the first-generation study, there were 5,112 cases of HH, and in the second-generation study 4,626 cases of HH. The adjusted HRs for first-generation men and women overall were 0.72 (99% CI: 0.63-0.82) and 0.61 (99% CI: 0.52-0.72), respectively, and for the second-generation men and women 0.72 (99% CI: 0.62-0.83) and 0.97 (99% CI: 0.83-1.14), respectively, with a higher risk found only among first-generation men from Western Europe, HR 1.47 (99% CI: 1.05-2.06), compared to the control group.
Our findings indicate that the overall risk of HH was lower among both first-generation and second-generation immigrants when compared to individuals born in Sweden or with Swedish-born parents. An elevated risk for HH was observed exclusively among first-generation men originating from Western Europe. These findings represent new knowledge and should be of global interest.
本研究旨在分别以在瑞典出生的个体和在瑞典出生且父母均为在瑞典出生的个体作为参照，分析瑞典第一代和第二代移民中遗传性血色素沉着症（HH）的发病风险。
本研究纳入了第一代研究中年龄≥18 岁的 6180500 名个体和第二代研究中年龄≥18 岁的 4589930 名个体。HH 的定义为在 1998 年 1 月 1 日至 2018 年 12 月 31 日期间，国家患者登记处至少有一次国际疾病分类第 10 版（E83.1）登记的诊断。由于存在多次检验，本研究采用 Cox 回归来估计 HH 的发病风险比（HR）及其 99%置信区间（CI），调整因素包括年龄、癌症、其他合并症和社会人口统计学因素。
在第一代研究中，共有 5112 例 HH 患者，在第二代研究中，共有 4626 例 HH 患者。总体而言，第一代男性和女性的调整后 HR 分别为 0.72（99%CI：0.63-0.82）和 0.61（99%CI：0.52-0.72），第二代男性和女性的调整后 HR 分别为 0.72（99%CI：0.62-0.83）和 0.97（99%CI：0.83-1.14），仅在第一代来自西欧的男性中发现风险较高，HR 为 1.47（99%CI：1.05-2.06），与对照组相比。
与在瑞典出生或父母均为在瑞典出生的个体相比，本研究中第一代和第二代移民的 HH 总体发病风险较低。仅在第一代来自西欧的男性中观察到 HH 发病风险升高。这些发现代表了新的知识，应该引起全球关注。
