The main finding of this study is the differences between ethnic Swedes and Assyrians/Syrians with type 2 diabetes in increased levels of serum triglycerides and hypertension. Ethnic Swedes had twice higher odds of increased serum triglycerides than Assyrian/Syrians. The same pattern was observed regarding hypertension.
The prevalence of type 2 diabetes in Assyrians/Syrians in the present study agrees with a number of studies in immigrant populations in general  and in particular with studies from the Middle East that have shown than these subjects have a higher prevalence of diabetes than the native population [6, 8, 11, 19–21]. A review of 18 studies on Turkish and Moroccan immigrants in Northwestern Europe found a two to four times higher prevalence of type 2 diabetes in both groups compared to a Dutch population  and lower cardiovascular mortality rates in Turkish immigrants, and the absolute risk for a coronary event in this group was similar to the risk in native Dutch diabetes patients . Because of a lack of valid studies on blood pressure and lipids in this review, we cannot compare our results. In the present study we have contributory findings on higher risks for a coronary event in Assyrians/Syrians than in native Swedes because of elevated triglycerides levels.
It is also a well-known fact that elevated triglyceride levels contribute to an increased risk of cardiovascular disease independently and, in combination with, among other factors, obesity, metabolic syndrome and type 2 diabetes affect the cardiovascular disease risk [23, 24]. Elevated triglyceride levels have been shown to be more prevalent in urban populations [25, 26]. The population in the present study is an urban one with more disadvantaged socioeconomic conditions in Assyrians/Syrians than in native Swedes, but despite this fact we found higher increased triglyceride levels in the indigenous population than in immigrants.
Available data from 2007 on the general Swedish population in the National Diabetes Register (NDR)  make it possible to compare our results with countrywide results: the prevalence of normal HbA1c levels in the Swedish-born subjects in the present study is slightly higher than in the Swedish population in general (59.4% vs 58.1%). The prevalence of normal HbA1c in Assyrians/Syrians is somewhat lower than in the general population (50.6% vs 58.1%). The normal level of total cholesterol in the sample in this study is lower than in the general Swedish population according to the NDR (33.5% vs 43.1%), but it is almost on the same level in Assyrian/Syrian subjects (41.2% vs 43.1%). According to the NDR, 55.5% of the general population reach the target for an acceptable level of triglycerides (< 1.7 mmol/L), which is quite similar to our results in Swedish-born subjects (49.5%) and lower than in Assyrian/Syrian ethnic group (61.3%). The number of individuals with a normal blood pressure (≤ 130/80 mmHg) in the general population is higher than in the Swedish sample in the present study (35% vs 23.2%) and lower than in Assyrians/Syrians (35% vs 42.1%).
Our findings of ethnic differences in lipids are in accord with the results of other studies, e.g. high cholesterol levels were examined in an Swedish study and were found to be associated with younger older and longer education in a primary-health-care-based programme for cardiovascular prevention in both native-born and foreign-born individuals. However, no significant predictor was detected for the reduction of high triglyceride levels .
Our finding of an increased prevalence of hypertension in Swedish-born subjects contrasts with a large number of studies comparing immigrant groups with the host population. For example, in a meta-analysis of 125 studies investigating an association between acculturation and blood pressure, the investigators concluded that there were changes in blood pressure due to acculturation to Western society and that this was not related to body mass index (BMI) or cholesterol. It was concluded that the higher blood pressure in immigrants was associated with acculturation, with the stress of cultural change being the major component. Despite a lack of information as to whether the participants in those studies had diabetes or no, it is interesting to compare to the results in the present study, with the host population having a significantly higher prevalence of hypertension than Assyrian/Syrian patients with type 2 diabetes.
Studies done in Sweden have shown that immigrants perceived their health to be poorer, and they have onsets of disease earlier and are more overweight than native Swedish individuals with type 2 diabetes [6, 28]. The following factors pertaining to migration itself and to the lifestyle after migration have been cited as explanations: low levels of employment and education and a higher prevalence of overweight and obesity among immigrants in general and in women from Turkey in particular . The focus of the present study was not on investigating the onset of diabetes or the prevalence of overweight, but the results do not agree with the findings of studies documenting poor health in immigrants as compared to native-born populations [29–32].
It is a known fact that food intake, especially increased carbohydrate intake, is a common reason for elevated triglycerides . It is possible that the Mediterranean diet  of Assyrians/Syrians decreased the risk for higher levels of lipids, but we have no data concerning this in the present study and the matter should be investigated in prospective studies.
The major strength of this study is that this is the first survey describing a somewhat homogeneous Assyrian/Syrian ethnic group identifying themselves in terms of their actual ethnicity and not of a classification based on country of birth or regional and geographic affiliations. Despite the small sample size, the study may be considered to be representative of Assyrians/Syrians from four countries living in Sweden. Even if we cannot generalise our findings to all Assyrian/Syrian and Swedish-born patients, the results of the study provide a reliable baseline for future studies.
A major limitation of the study is its cross-sectional nature and that the small number of participants precludes the possibility of drawing extensive causal conclusions. We are not able to estimate the number of Assyrians/Syrians ethnic group in Sweden because they are registered as citizens of the countries from which they come, but they originate predominantly from Turkey and so is their representation in our study with 33.5% coming from that country.