Women In Gothenburg Research Articles

Sick-leave among women and the role of psychiatric disorder.

The aim was to assess sick-leave among women in relation to psychiatric disorder. A stratified population-based sample of women in Gothenburg were interviewed and diagnoses were made according to DSM-III-R. Sick-leave data was obtained for a ten year period. Women with psychiatric disorder had higher rates of sick-leave, compared to women without such disorders, in analyses taking into account age, socio-economic status, physical health, marital status and motherhood. Presence of psychiatric and physical illness were both independently associated with higher sick-leave. Highest sick-leave was found among those with a combination of psychiatric and physical morbidity. Psychiatric disorder is an important factor in sick-leave among women, especially regarding length of absence.

The Prospective Population Study of Women in Gothenburg, Sweden, 1968-69 to 1992-93 A 24-year follow-up study with special reference to participation, representativeness, and mortality

Objective - To describe the fourth phase of the Prospective Population Study of Women in Gothenburg, Sweden, with special reference to participation and survival.Design - Prospective population study.Setting - City of Gothenburg with about 430000 inhabitants. Participants - 1462 participants and 128 refusers aged 38-60 years at the time of the initial study in 1968-69, 282 women who were sampled but not invited to the study in 1968-69, and 266 women participating since 1980-81 and 32 women for the first time in 1992-93.Main outcome measures - Participation rate, survival, anthropometric and metabolic characteristics.Results - The participation rate throughout the study period was high. The participants were mainly characteristic of women of the same ages in the general population even after 24 years. The mortality after 24 years was higher in non-participants than in participants, while mere was no difference in survival between women who were invited and women who were not invited to the study.Conclusions - The initial participants were mainly characteristic of the general population, also after a long follow-up period. The long-term survival was lower in initial refusers than in initial participants.

Low-fat diets may prevent weight gain in sedentary women: prospective observations from the population study of women in Gothenburg, Sweden.

The Population Study of Women in Gothenburg, Sweden is an ongoing prospective study of female residents who were recruited from the local registry in 1968-1969 when they were 38-60 years old. The data presented here were collected from 361 healthy women who underwent a baseline physical examination including a supplementary dietary history interview and returned for a second general health examination 6 years later. This report identifies a subgroup of 57 women who were sedentary during their leisure time and appear to have been particularly susceptible to gaining weight as a function of the fat content of their diets. Specifically, longitudinal analysis of body weights in the whole sample revealed a statistical interaction between leisure-time physical activity and habitual dietary fat intake (energy%), as reported at the baseline examination, in the prediction of subsequent weight change. Further stratified analysis suggested that weight changes were significantly dependent on dietary fat intake among the sedentary women only. High energy intake also predicted weight gain in the sedentary group, although the predictive value for a high-fat diet was of marginal significance after adjusting for total energy consumption. These results suggest that sedentary recreational activity plus a low-fat diet may have a combined contribution to weight change that is not equivalent to the sum of the separate effects. Such a synergy between two modifiable lifestyle factors seems highly relevant for prevention of obesity.

The Interrelationships between Fasting Serum Insulin Level, Obesity and Blood Pressure in Women: Results from a Cross-Sectional Population Study of Women in Gothenburg, Sweden.

This study is based on a representative population sample of women in Gothenburg, Sweden. Three hundred and thirty-six 50-year-old nondiabetic women, not taking any antihypertensive medication, were included in the study. They underwent a comprehensive examination programme, where body weight, body height, waist and hip circumferences, systolic and diastolic blood pressures and fasting serum insulin concentration were measured. Fasting serum insulin concentration was significantly correlated with systolic and diastolic blood pressures. After controlling for both body mass index (BMI) and waist to hip circumference ratio (WHR), fasting serum insulin concentration remained independently associated with blood pressure (P=0.001 for systolic blood pressure, P=0.06 for diastolic blood pressure). When stratified for BMI or WHR the correlations between fasting serum insulin concentration and blood pressure remained significant only in the upper 50th precentiles of BMI and WHR. When relating pressure to different levels of fasting serum insulin concentration there seems to be a threshold at an insulin concentration corresponding to the upper quartile limit (at approximately 17μU/ml), above which level the blood pressure rises more obviously. The same phenomenon was seen for systolic and diastolic blood pressures. (Hypertens Res 1993; 16: 197-201)

Diabetes incidence in users and non-users of antihypertensive drugs in relation to serum insulin, glucose tolerance and degree of adiposity: a 12-year prospective population study of women in Gothenburg, Sweden.

As part of a prospective population study in Gothenburg, Sweden, women aged 50 years were subjected to an intravenous glucose tolerance test on entry to the study and followed up for 12 years. Manifest diabetes was the only end-point registered in this part of the study. Of 352 initially non-diabetic women, 17 (4.8%) subjects developed diabetes, with a fourfold increased risk in women taking antihypertensive drugs (diuretics or beta-blockers, or both) compared with women who were not taking such medication. The increased risk was observed independently of initially measured glucose metabolism variables and degree of adiposity, although the incidences were higher overall if the use of antihypertensive drugs was combined with fasting hyperinsulinaemia and adiposity. This study provides further evidence to support the view that diuretics and beta-blockers are precipitators of type 2 diabetes mellitus.

Social factors and tooth loss in a 12‐year follow‐up study of women in Gothenburg, Sweden

Representative samples of women in different age groups in Gothenburg, Sweden, were examined by means of panoramic radiography in 1968-69 and in 1980-81. Edentulousness and number of remaining teeth were assessed from the radiographs. Data on socioeconomic conditions, educational background and dental care attendance were obtained from a questionnaire. Cross-sectional results showed that improvements in dental status had occurred irrespective of socioeconomic conditions and educational levels and that differences between groups had decreased over the 12-yr period. Dental care attendance was high in all socioeconomic groups, but differences noted in 1968-69 remained in 1980-81.

Low Sex-Hormone-Binding Globulin Concentration as Independent Risk Factor for Development of NIDDM: 12-Yr Follow-Up of Population Study of Women in Gothenburg, Sweden

Serum sex-hormone-binding globulin (SHBG) and corticosteroid-binding globulin (CBG) concentrations were evaluated as risk factors for the development of non-insulin-dependent diabetes mellitus (NIDDM), myocardial infarction, stroke, and premature death in a prospective study of 1462 randomly selected women, aged 38-60 yr, over 12 yr of observation. In multivariate analysis, taking only age into consideration as a confounding factor, low initial concentration of SHBG was significantly correlated to the incidence of NIDDM and stroke, and high initial concentration of CBG was correlated to the incidence of NIDDM. There were also significant correlations between SHBG and CBG concentrations on one hand and possible risk factors for the end points studied, such as serum triglycerides, serum cholesterol, fasting blood glucose, body mass, body mass index, waist/hip ratio, smoking habits, and systolic blood pressure, on the other. When these possible confounders, in addition to age, were taken into consideration in multivariate analyses, only the inverse significant correlation between SHBG and NIDDM remained. The increased incidence of diabetes was confined to the lowest quintile of SHBG values, where it was 5-fold higher than in the remaining group. This incidence was further increased to 8- and 11-fold in the lowest 10 and 5% of the values, respectively. We conclude that SHBG is a uniquely strong independent risk factor for the development of NIDDM in women.

Low sex-hormone-binding globulin concentration as independent risk factor for development of NIDDM. 12-yr follow-up of population study of women in Gothenburg, Sweden

Low sex-hormone-binding globulin concentration as independent risk factor for development of NIDDM. 12-yr follow-up of population study of women in Gothenburg, Sweden

Changes in women's sexual desire in middle life: The longitudinal study of women in Gothenburg

In a general population survey, 677 urban middle-aged women were interviewed about their sexual desire at two occasions 6 years apart. Data from 497 subjects, who were married at both occasions or were cohabiting with a male partner, were analyzed. Twenty-seven percent reported a decrease in sexual desire between interviews, and 10% experienced an increased desire. There were no clear cohort differences. A decrease in sexual desire was predicted by age, high sexual desire at first interview, lack of a confiding relationship, insufficient support from spouse, alcoholism in spouse, and major depression. Predictors of an increase of sexual desire were weak desire at first interview, negative marital relations before first interview, and mental disorder at first interview. Although sexual desire showed considerable stability over time, a substantial proportion of married middle-aged women experienced major changes, mostly as a decrease. Age, psychosocial factors associated with quality of marital relationship, and mental health were major contributors towards change in sexual desire.

Symptoms by Age and Sex: The Population Studies of Men and Women in Gothenburg, Sweden

Symptoms by age and sex were studied in two population studies from Gothenburg, Sweden. In general, men and women showed the same age-related pattern. The prevalence of the following symptoms increased with age--sleeping disturbances, pain in the joints, pain in the legs, breathlessness, and impaired hearing. Six symptoms decreased with age--general fatigue, abdominal pain, nausea, diarrhoea, cough, and headache. A group of symptoms showed a curvilinear shape with a peak at the age of 50. In general, women presented more symptoms than men. This was especially true for symptoms of depression and tension. A possible explanation is that women are more attentive to their internal state. A more probable explanation, supported by our study, is that the mental symptoms are related to the woman's situation in life with double work (responsible for both work and family).

Distribution of adipose tissue in relation to cardiovascular and total mortality as observed during 20 years in a prospective population study of women in Gothenburg, Sweden

The relation between obesity and cardiovascular disease has been the subject of great controversy. Several studies have shown that the deposition of fat predominantly in the abdomen and upper body has been associated with abnormalities of blood pressure, glucose tolerance, and serum lipid levels [ 1,2] and with an increased risk of coronary heart disease and overall mortality in men as well as in women [3,4]. Our cohort of 1462 women has now been followed up for 20 years and in the present study we have related initial anthropometric variables to the cardiovascular and overall mortality during 20 years of follow up.

The population study of women in Gothenburg 1980-81--the third phase of a longitudinal study. Comparison between participants and non-participants.

A representative population sample comprising 1,462 women was studied in Gothenburg, Sweden in 1968-69, and a third follow-up study was carried out in 1980-81. The participation rates in the baseline study and during the follow-up studies were high. In 1980-81 women in two new age strata, aged 26 and 38, were added. Women who had moved to or from Gothenburg during the study period were not found to differ from those who were living in Gothenburg during the total study period, while there were a few differences of statistical significance between refusers and participants in 1980-81. The mortality among initial refusers was about doubled compared to that of those who participated in the baseline study.

Dietary habits and incidence of noninsulin-dependent diabetes mellitus in a population study of women in Gothenburg, Sweden

Dietary intake as initially estimated in a cross-sectional study has been related to the 12-y incidence of diabetes mellitus in a prospective study of 1462 women. In addition, all 50-y-old women (n = 352) were subjected to an intravenous glucose tolerance test. Because of the sampling procedure and a high participation rate the participants were representative of middle-aged women in the general population. No differences of statistical significance were observed concerning intake of energy and different nutrients. Neither did the number of meals nor the longest time between meals differ between women who developed diabetes and those who did not. Women with impaired glucose tolerance who developed diabetes did not differ from those who did not develop diabetes, concerning dietary intake. Body mass index was significantly higher in women who developed diabetes compared with other women. No specific dietary recommendations can be based on the results of this study.

Number of amalgam tooth fillings in relation to subjectively experienced symptoms in a study of Swedish women

There has been a lot of discussion concerning the possible influence of amalgam tooth fillings on different symptoms and complaints. Information on this topic could be obtained from 1024 dentulous women aged 38-72, participants in a population study of women in Gothenburg, Sweden, who answered a questionnaire with 30 specific questions concerning different symptoms and complaints. The answers were related to number of tooth surfaces restored with amalgam. Due to the sampling method and the high participation rate, the participants were representative of dentulous women of the same age in the general population. No positive correlations were found between number of amalgam fillings and number of symptoms, nor between number of amalgam fillings and prevalence of specified single symptoms or complaints. On the contrary there were a number of age-matched significant correlations in the opposite direction, which means that women with a high number of amalgam fillings reported a lower number of symptoms and complaints than women with a low number of amalgam fillings. These inverse relationships between number of amalgam fillings and different symptoms and complaints usually disappeared, when number of teeth was taken into consideration as a background variable. The inverse relationships with abdominal pain and poor appetite were, however, independent of both number of teeth and socioeconomic status as based on multivariate analysis. This study does not support the view of a correlation between amalgam fillings and symptoms and complaints, at least not on a population level.

A 12-year cross-sectional and longitudinal radiographic study of dental restorations in women in Gothenburg, Sweden.

A dental examination was included in a mainly medically oriented population study of women in Gothenburg, Sweden. From panoramic radiographs the numbers of remaining teeth, restored teeth (fillings and crowns), pontics, and endodontically treated teeth were assessed in 1968-69 and in a 12-yr follow-up study in 1980-81. Women aged 38, 46, 50, 54 and 60 yr were initially studied. In the follow-up study, a group of 38-yr-old women was added. A comparison between cross-sectional data in 1968-69 and in 1980-81 in women aged 38 and 50 yr showed some marked differences. Dentulous women of the same age had in 1980-81 a larger mean number of teeth and a larger number of restored teeth (including crowns). The number of restored teeth in relation to remaining teeth was the same in the 38-yr-old women in 1980-81 but had increased in the 50-yr-olds. The absolute and relative numbers (in relation to remaining teeth) of crowns (also studied separately), pontics, and endodontically treated teeth were about the same in 1968-69 and 1980-81 both for the 38-yr-olds and the 50-yr-olds. There was a slight but statistically significant increase only in the absolute number of crowns for the 50-yr-olds. The follow-up study showed a moderate decrease of remaining teeth in all age groups. Related to remaining teeth, the number of restored teeth (including crowns), crowns, pontics, and endodontically treated teeth showed a statistically significant increase for all age groups except for the oldest, in which group a significant increase was only observed for crowns.

Peak expiratory flow and risk of cardiovascular disease and death. A 12-year follow-up of participants in the population study of women in Gothenburg, Sweden.

A longitudinal population study of 1,462 women, aged 38-60 years at entry, was begun in Gothenburg, Sweden, in 1968-1969. This paper deals with the first 12-year follow-up period. In univariate analysis, peak expiratory flow showed a significant negative correlation with the 12-year incidences of myocardial infarction, electrocardiographic changes suggesting ischemic heart disease, stroke, and death. The association with incidence of myocardial infarction, stroke, and death remained in multivariate analysis, and was independent of age, body height, body mass index, adipose tissue distribution, chest deformity, history of pulmonary disease, smoking habit, serum cholesterol concentration, serum triglyceride concentration, systolic blood pressure, diabetes, and physical activity. The findings indicate that measuring peak expiratory flow is a simple procedure to identify women with an increased risk of cardiovascular disease or death. It seems urgent to find out what preventive measures might be taken as a consequence of these observations.

Dietary habits in relation to incidence of cardiovascular disease and death in women: a 12-year follow-up of participants in the population study of women in Gothenburg, Sweden

Dietary intake as initially estimated by means of a 24-h recall has been related to the incidence of ischemic heart disease, stroke, and overall mortality during a 12-yr follow-up period in a prospective study of 1462 women representative of the general population. Energy intake was inversely correlated to the 12-yr incidence of myocardial infarction. The correlation was independent of age, indices of obesity, smoking habits, serum cholesterol, serum triglycerides, diabetes, systolic blood pressure, and physical activity. No correlation was found between dietary intake and incidence of stroke or overall mortality, nor was any correlation found between end-points and intake of fish, energy percentage of fat, protein, and carbohydrates. These observations suggest that suboptimal intake of nutrients may be an important factor in the pathogenesis of ischemic heart disease.

Socioeconomic factors and physical activity in relation to cardiovascular disease and death. A 12 year follow up of participants in a population study of women in Gothenburg, Sweden.

In a prospective population study of middle aged women socioeconomic factors and physical activity as initially reported were related to the 12 year incidence of ischaemic heart disease and to total mortality. There was a significant age specific correlation between low socioeconomic status according to the husband's occupation and myocardial infarction. No such association was seen between the socioeconomic status of the women themselves and myocardial infarction. Women with a low educational level had a significantly increased age specific incidence of angina pectoris. There was no significant correlation between marital status or number of children and incidence of ischaemic heart disease or overall mortality. Women who initially reported low physical activity at work during the last year had a significantly increased age specific 12 year incidence of stroke and death, as did those who reported low physical activity during leisure hours in whom the incidence of myocardial infarction and electrocardiographic changes indicating ischaemic heart disease were also increased. Multivariate analyses showed that the association between low educational level and incidence of angina pectoris was independent of socioeconomic group, smoking habits, systolic blood pressure, indices of obesity, serum triglycerides, and serum cholesterol. Similarly, low physical activity during leisure hours seemed to be an independent risk factor for stroke, and low physical activity at work was an independent risk factor for overall mortality.

Psychosocial factors and risk of ischaemic heart disease and death in women: A twelve-year follow-up of participants in the population study of women in Gothenburg, Sweden

A community sample of 795 women of the ages 38, 46, 50 and 54 yr was subjected to comprehensive medical and psychiatric examinations and was followed up for 12 yr. The 12-yr incidence of angina pectoris was 3.2% and of electrocardiographic changes indicating ischaemic heart disease 5.8%. The corresponding incidence of myocardial infarction was 1.4% and death rate 4.2%. High initial ratings of passive dependency, neuroticism, experience of strain, grade of mental disorder and severity of major or minor depression were predictive of angina pectoris. A low rating of aggression was predictive of the development of electrocardiographic changes indicating ischaemic heart disease. Low ratings of guilt feelings and neurotic self-assertiveness were predictive of myocardial infarction. Death rate was not related to any of the psychosocial factors studied. These associations remained significant after adjustments for age, social class, marital status or confounding conventional risk factors for ischaemic heart disease. The results show that the different clinical manifestations of ischaemic heart disease are related to different sets of psychosocial predictors.

Smoking--a risk factor for cardiovascular disease in women? Considerations based on a prospective population study of women in Gothenburg, Sweden.

A longitudinal population study of 1462 women aged 38-60 was carried out in Gothenburg, Sweden during 1968-69. The participants have been followed up for 12 years. The relationships between smoking and cardiovascular disease and between smoking and mortality have been evaluated. No significant increased risk was observed for smoking women concerning the 12-year incidence of myocardial infarction, angina pectoris, electrocardiographic changes suggesting ischaemic heart disease, stroke or death from all causes. Multivariate analysis could not demonstrate an independent effect of the cigarette smoking habit in women on these end-points. In agreement with the results from the Framingham prospective study we could not in our prospective study verify the markedly increased risk of myocardial infarction in smoking women, which has been observed in a number of cross-sectional studies of women and also in prospective studies of men.