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Volume 5- Issue 4: 2018
1/6
ISSN: 2574-1241
DOI: 10.26717/BJSTR.2018.10.001896
Töysa T.
Biomed J Sci & Tech Res
Research Article
Biomedical Journal of
Scientific & Technical Research (BJSTR)
Open Access
Introduction
Higher cardiac morbidity in eastern regions of Finland than
in the west, has been decades without satisfactory explanations
[1]. This east-west difference has been reported to have been
decreased by men from 1.36 to 1.26 in 1973-2002, but not by
women [2]. In period 1993-97 this risk ratio by men was still 1.33
[2]. High number of annual rainy days (RD) in East Finland has
been suggested to reduce vitamin D synthesis and affect on CHD
and general mortality [3]. In 1980 highly signicantly lower vitamin
D values have been reported from East Finland relative to South
Finland [4] (Table 2): [N cases; S-25(OH)D; standard deviation)]:
with 0.5 mcg vitamin D/100 g and fat spreads with 10 mcg/100
recommendation was doubled [5]. Dependence of S-25(OH)D on
moderate Mg and Se level is often passed [3]. The aim of this study
is to clarify CHD associations with Lat, Long, Alt, RD and Si.gw and
discuss the participating factors.
Material and Methods
Area units in this study are principally Finnish continental Rural
Centers (N 20) as follows: Provincial CHD mortality data of Finnish
middle-aged men in 1964-84 are from Valkonen and Martikainen
(1990) [6] as in [7,8]. Approximate male CHD data by Rural
Center (RC) - earlier Agricultural Advisory Centers - are attained
Rainy Days, Geographic Coordinates, Vitamin D,
Silicon, Selenium and CHD in Finland in 1962-2014
Töysä T*
Licentiate of Medicine, Specialty General Practice, Rehabilitation Hospital Vetrea Terveys Oy, Finland
Received: : September 25, 2018; published: : October 15, 2018
*Corresponding author: Töysa T, Licentiate of Medicine, Specialty General Practice, Rehabilitation Hospital Vetrea Terveys Oy,
Pohjolankatu 15, FI-74100 Iisalmi, Finland
Abstract
Background: Higher cardiac as also general mortality in eastern regions of Finland than in the west, has been decades without satisfactory
explanation. High number of annual rainy days (RD) and lower serum vitamin D values has been associated with East Finland relative to South
Finland. Enrichment of dairy products was begun in 2002. In this study has been assessed regional CHD mortality (a sign of CHD morbidity) from
1964-84 [CHD. (64-84)] and CHD morbidity from 2012-14 [CHD. (12-14)], their association strength and stability with latitude (Lat), longitude
(Long), altitude (Alt), RD and groundwater silicon (Si.gw). Areal parts of Uusimaa were combined to one unit, as respectively by Varsinais-Suomi.
Number of area units was 18.
Results (R square %´s): [CHD. (64-84)]/ [CHD. (12-14)] associations: Long: 86/52.7%; RD: 61.3/44.2 %; Si.gw: 41.8/38.2 %; Alt: 33.5/32.3 %;
Lat 15.8/42.6 %. Alt explained best Si.gw (50.2 %). Long explained best RD. Changes in CHD associations were highest with Lat and Long, smallest
Conclusion:
of RD in both periods and suggested on CHD association with serum vitamin D content. Anyhow decrease in CHD E/W ratio until period 2012-14
regulating factors, as Se, too. Changes in CHD E/W ratio during 1962-2002 associated with allowance or fertilization of Se. A new CHD risk factor Alt,
CHD mortality.
Keywords: CHD; Rainy Days; Latitude; Longitude; Altitude; Vitamin D; Silicon; Selenium; Solar Energy
Abbreviations: Alt: Altitude (Elevation Above Sea Level (m); CHD: Coronary Heart Disease; [CHD.(64-84)]: CHD Mortality in 1964-84; [CHD.(12-
14)]: CHD Morbidity by THL Index in 2012-14; Geographic Coordinates: Lat, Long and Alt; Lat: Nordic Latitude (°N); Long: Eastern Longitude (°E);
RC: Rural Center (Earlier Agricultural Advisory Center); RD: The (Regional) Number of Annual Rainy Days); Se: Selenium; Si: Silicon; THL: Terveyden
Ja Hyvinvoinnin Laitos-National Institute for Health and Welfare
Cite this article: Töysä T. Rainy Days, Geographic Coordinates, Vitamin D, Silicon, Selenium and CHD in Finland in 1962-2014. Biomed J
Sci&Tech Res 10(1)-2018. BJSTR. MS.ID.001896. DOI: 10.26717/ BJSTR.2018.10.001896. 2/6
Volume 10- Issue 1: 2018
of one province (N 17), in other cases (N 3) by weighting the CHD
values of different provinces by their cropland areas, which were
inside the RC in 1988 [7]. The data on cropland areas, as map and
label numbers (with one exception: Åland does not include in RC
04, continental RC 04 is labeled as 04.a.) are from [8] as in [7] and
calculated as follows:
a) CHD.Pirkanmaan=(26.5*CHD.Turku_and_Pori+75.1*CHD.
Häme)/101.6;
b) CHD.Itä-Hämeen=(41.5*CHD.Häme+15.9*CHD.
Mikkeli+7.6*CHD.Central_Finland)/65.0;
CHD. Keski-Pohjanmaan = (45.7*CHD.Vaasa+23.7* CHD.
[9] included errors, because they were aimed for [10] with some
combined RC´s). Regional CHD morbidity indices in 2012-14
[CHD. (12-14)] from National Institute for Health and Welfare [11]
(Lat) (Figures 1 & 2) and longitude (Long) (Figure 3) of each RC
have been determined by their central commune [12]. Alt was got
via internet search: Name of central commune and “geographic
coordinates” or “elevation above sea level”. Map of annual rainy
days from Finnish Meteorological Institute [13] was combined
with the map of RC´s [8], similar with the map of Finnish Regions
[12]. Then approximate mean RD by RC was visually approximated
(in Lapland by the central commune) (Figure 1). Thereafter Parts
Uusimaa (RC 01 and and 02) and respectively parts of Varsinais-
Suomi (03, 04.a) were combined by weighting values by the part-
areas (Table 1).
Table 1: Rural centers with central communes, male CHD mortality in 1964-84, THL.CHD.index, Latitude, Longitude and annual
rainy days in 1981-2010, Altitude and groundwater silicon.
Regions (Rural Centers) Central Commune CHD. (1964-84) CHD. (2012-14) Latitude Longitude Altitude Rainy Days Si.gw
1/100,000 THL.index 0N0E m d/a mEq/L
Uusimaa (01;02) Järvenpää;Espoo 447 78.0 60.4 24.9 39 182 1.12
Varsinais-Suomi (03;04.a) Aura;Nagu/Nauvo 386 87.4 60.6 22.5 48 170 1.12
05 Satakunnan Noormarkku 386 91.4 61.6 21.9 44 165 0.98
06 Pirkanmaan Ylöjärvi 407 92.4 61.6 23.6 107 181 0.93
07 Hämeen Renko 414 89.1 60.9 24.3 107 190 1.12
08 Itä-Hämeen Asikkala 454 106.2 61.2 25.5 74 186 0.98
09 Kymenlaakson Anjalankoski 511 97.0 60.7 26.8 18 195 1.14
10 Etelä-Karjalan Jouseno 511 129.8 61.1 28.5 80 200 0.93
11 Mikkelin Juva 531 124.9 61.9 27.9 98 195 0.91
12 Kuopion Maaninka 564 135.5 63.2 27.3 88 200 0.78
13 Pohjois-Karjalan Kontiolahti 622 122.9 62.8 29.8 138 195 0.81
14 Keski-Suomen Saarijärvi 515 106.0 62.7 25.3 140 190 0.90
15 Etelä-Pohjanmaan Nurmo 370 100.6 62.8 22.9 47 183 1.07
16 Österbottens Svenska Mustasaari 370 98.3 63.1 21.7 15 160 1.78
17 Keski-Pohjanmaan Toholampi 432 117.6 63.8 24.3 94 173 0.90
18 Oulun Ylikiiminki 553 121.8 65.1 26.4 85 185 0.85
19 Kainuun Ristijärvi 553 141.0 64.5 28.2 160 210 0.65
20 Lapin Rovaniemi 529 127.8 66.5 25.7 92 195 0.70
04.b Åland Maarianhamina 265 98.6 60.2 19.9 11 165 0.68
Volume 10- Issue 1: 2018
Cite this article: Töysä T. Rainy Days, Geographic Coordinates, Vitamin D, Silicon, Selenium and CHD in Finland in 1962-2014. Biomed J
Sci&Tech Res 10(1)-2018. BJSTR. MS.ID.001896. DOI: 10.26717/ BJSTR.2018.10.001896. 3/6
Figure 1: Finnish map with Rural Centers and their approximate
number of rainy days (in the east the darkening gray is a sign of
higher number of rainy days, opposite in the west.
Figure 2: Association of latitude (Lat) with CHD in two periods.
Figure 3: Association of longitude (Long) with CHD in two pe-
riods.
Figure 4: Association of altitude (Alt) with CHD in two periods.
Discussion
This study showed CHD stability in different decades and
association. Most soil and groundwater factors and temperature
were associated nearer to south-north axis [1,7,9,10,12]. RD
“explained” CHD stronger before (66.8%) than after (43.8%)
annual solar energy in Finland on an average 35% compared with
cloudless sky [15]. So it can be expected that RD, a surrogate of
status of humans [3,4]. Anyhow after declining, CHD-Long factor
remained as the strongest environmental CHD factor during the
last period. Old school books wrote that rains are associated with
Cite this article: Töysä T. Rainy Days, Geographic Coordinates, Vitamin D, Silicon, Selenium and CHD in Finland in 1962-2014. Biomed J
Sci&Tech Res 10(1)-2018. BJSTR. MS.ID.001896. DOI: 10.26717/ BJSTR.2018.10.001896. 4/6
Volume 10- Issue 1: 2018
Long and RD were remarkably reduced between the periods, RD-
CHD association ad 44.2, which is about the same as Si.gw-CHD
association (38.2%) (Table 2). I.e. as during reduction of East
factors (i.a. vitamin D) Alt factors (i.a. Si.gw) (Figure 6) remained
losses) outwards. So it can be understood that weathering, erosion,
with CHD’s makes Alt a new CHD risk factor. Alt explained best
Si.gw by 50.2 % (Table 3).
Figure 5: Association of annual rainy days (RD) with CHD in
two periods
Figure 6: Association of ground water silicon (si.gw) with CHD
in two periods.
Table 2: Inter-regional associations between age adjusted CHD mortality of middle-aged men 1964-84, THL CHD morbidity index
2012-14 and environmental factors.
CHD.M.(1964-84) CHD.(2012-14) Latitude Altitude Longitude Rainy Days Si.gw
100*(R Square)
CHD.M.(1964-84) 56.2 15.8 33.5 86.0 61.3 41.8
CHD.(2012-14) 56.2 32.3 52.7 44.2 38.2
Latitude 15.8 42.6 14.2 3.2 4.1 16.0
Altitude 33.5 32.3 14.2 30.8 36.1 50.2
Longitude 86.0 52.7 3.2 30.8 74.7 36.4
Rainy days 61.3 44.2 4.1 36.1 45.4
Si.gw 41.8 38.2 16.0 50.2 45.4
Table 3.
Significance levels (N = 18)
21.8 *
34.0 **
48.0 ***
East-west CHD mortality ratio (CHD E/W) (Figure 8) was
additionally assessed by male CHD data (3-year means) from
1962-86 [6] and Pajunen et al. [2] from 1973-2002. E/W ratio was
because of missing data. Then this ratio was adjusted to human
values [2] by subtracting 0.014 from it: E/W ratio was in 1962-
68 1.30, 1968 it increased to 1.35 and its 5-year means stayed
above 1.33 until 1998. 1968 was associated with reduction of
imported Se-rich grain [16]. After period 1978-82 it declined from
level 1.37 to 1.34 associated with the beginning of Se fertilization
[17,18]. The decreased to 1.26 after 1997 associated with the
second increase of Se-fertilization (for non-cereals) [18]. The
unexpectedly high difference in S-25(OH)D [4] between south and
east was obviously not dependent only on vitamin D intake per os
and per skin, but on proactive and counteractive factors, e.g. Mg,
Se [3] and obviously Si [19,20]. Weight of vitamin D as a CHD. East
factor seems to be much weaker than expected [3]. Silicon content
of food was obviously decreasing in the 1960´s with increasing
total fertilization and increasing with decrease of total fertilization
(after 1989), but changes were not as abrupt as in CHD E/W ratio.
Volume 10- Issue 1: 2018
Cite this article: Töysä T. Rainy Days, Geographic Coordinates, Vitamin D, Silicon, Selenium and CHD in Finland in 1962-2014. Biomed J
Sci&Tech Res 10(1)-2018. BJSTR. MS.ID.001896. DOI: 10.26717/ BJSTR.2018.10.001896. 5/6
Comparing of mortality statistics with morbidity indices includes
several problems/biases, which are passed in the assessment above
because of their complexity. Data has been treated as if they came
from the same data base. Interesting observetions: The moderate
high CHD in Uusimaa provice (RS´s 01 & 02) in 1964-84 could be
dependent on migration, lower synthesis of vitamin D (high houses,
indoor work), it is suspicious that vitamin D alone could explain it.
Causes for CHD reduction before 2014 in Uusimaa could be based
i.a. on higher vitamin D supply and possible validity problems with
THL CHD index (big private sector – part of the use of private sector
can stay out of study statistics). High CHD mortality of Kymenlaakso
(RC 09) in 1964-84 together with good soil parameters [9] and
its recovery until 2014 is in harmony with RD action in 1964-84
risk factor(s) [20] seem(s) to deserve attention and research
work. In this chapter associations are calculated after exclusion
of Åland with low and obviously misleading Si.gw values [1]. Even
preliminary data from this summer suggest that Si content of milk
from Åland (with low Si.gw and high Ca/Mg ratio in soil and gw)
could be the higher than in continental Finland (Figure 7).
Figure 7: Association of CHD from two period with each other.
Figure 8.
Conclusion
CHD morbidity showed high inter-regional stability between
of RD in both periods and suggested on CHD association with
serum vitamin D content. Anyhow decrease in CHD E/W ratio until
Serum vitamin D [S-25(OH)D] indicates not only allowance (per os
& per skin) of vitamin D, but regulating factors, as Se, too. Changes
in CHD E/W ratio during 1962-2002 associated with allowance or
fertilization of Se. A new CHD risk factor Alt, with high association
with Si.gw is presented. Calculated conclusions are based on
CHD mortality.
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Cite this article: Töysä T. Rainy Days, Geographic Coordinates, Vitamin D, Silicon, Selenium and CHD in Finland in 1962-2014. Biomed J
Sci&Tech Res 10(1)-2018. BJSTR. MS.ID.001896. DOI: 10.26717/ BJSTR.2018.10.001896. 6/6
Volume 10- Issue 1: 2018
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ISSN: 2574-1241
DOI: 10.26717/BJSTR.2018.10.001896
Töysa T. Biomed J Sci & Tech Res
