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Eichelmann F, Prada M, Sellem L, Jackson KG, Salas Salvadó J, Razquin Burillo C, Estruch R, Friedén M, Rosqvist F, Risérus U, Rexrode KM, Guasch-Ferré M, Sun Q, Willett WC, Martinez-Gonzalez MA, Lovegrove JA, Hu FB, Schulze MB, Wittenbecher C. Lipidome changes due to improved dietary fat quality inform cardiometabolic risk reduction and precision nutrition. Nat Med 2024:10.1038/s41591-024-03124-1. [PMID: 38992128 DOI: 10.1038/s41591-024-03124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/11/2024] [Indexed: 07/13/2024]
Abstract
Current cardiometabolic disease prevention guidelines recommend increasing dietary unsaturated fat intake while reducing saturated fats. Here we use lipidomics data from a randomized controlled dietary intervention trial to construct a multilipid score (MLS), summarizing the effects of replacing saturated fat with unsaturated fat on 45 lipid metabolite concentrations. In the EPIC-Potsdam cohort, a difference in the MLS, reflecting better dietary fat quality, was associated with a significant reduction in the incidence of cardiovascular disease (-32%; 95% confidence interval (95% CI): -21% to -42%) and type 2 diabetes (-26%; 95% CI: -15% to -35%). We built a closely correlated simplified score, reduced MLS (rMLS), and observed that beneficial rMLS changes, suggesting improved dietary fat quality over 10 years, were associated with lower diabetes risk (odds ratio per standard deviation of 0.76; 95% CI: 0.59 to 0.98) in the Nurses' Health Study. Furthermore, in the PREDIMED trial, an olive oil-rich Mediterranean diet intervention primarily reduced diabetes incidence among participants with unfavorable preintervention rMLS levels, suggestive of disturbed lipid metabolism before intervention. Our findings indicate that the effects of dietary fat quality on the lipidome can contribute to a more precise understanding and possible prediction of the health outcomes of specific dietary fat modifications.
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Affiliation(s)
- Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
| | - Marcela Prada
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Laury Sellem
- Hugh Sinclair Unit of Human Nutrition, Institute for Cardiovascular and Metabolic Research and Institute for Food, Nutrition and Health, Reading, UK
| | - Kim G Jackson
- Hugh Sinclair Unit of Human Nutrition, Institute for Cardiovascular and Metabolic Research and Institute for Food, Nutrition and Health, Reading, UK
| | - Jordi Salas Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Cristina Razquin Burillo
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
- Department of Preventive Medicine and Public Health, IdiSNA (Instituto de Investigación Sanitaria de Navarra), University of Navarra, Pamplona, Spain
| | - Ramon Estruch
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Michael Friedén
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Frederik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Marta Guasch-Ferré
- Department of Public Health and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Miguel Angel Martinez-Gonzalez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA (Instituto de Investigación Sanitaria de Navarra), University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Institute for Cardiovascular and Metabolic Research and Institute for Food, Nutrition and Health, Reading, UK
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Clemens Wittenbecher
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
- Department of Life Sciences, SciLifeLab, Chalmers University of Technology, Gothenburg, Sweden.
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Jannasch F, Nickel DV, Kuxhaus O, Schulze MB. Longitudinally changed diet quality scores and their association with type 2 diabetes mellitus and cardiovascular diseases in the EPIC-Potsdam study. Sci Rep 2024; 14:13907. [PMID: 38886373 PMCID: PMC11183239 DOI: 10.1038/s41598-024-63899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
Association analyses between longitudinal changes in diet quality scores (DQIs) and cardiometabolic risk remain scarce. Hence, we aimed to investigate how changes in two DQIs are associated with incident type 2 diabetes (T2D), myocardial infarction (MI) and stroke in the EPIC-Potsdam study. Changes in the Mediterranean Pyramid Score (MedPyr) and Healthy Diet Score (HDS) over 7 years from baseline (1994-1998) to follow-up 3 (2001-2005) were investigated in 23,548 middle-aged participants. Adjusted Cox Proportional Hazards Regression models were applied to investigate associations between changes in MedPyr and HDS and chronic disease incidence. More than 60% of the participants increased both DQIs more than 5%. Within a median follow-up time of 5 years 568 cases of T2D, 171 of MI, 189 of stroke were verified. An increased compared to stable MedPyr was associated with lower T2D risk (HR 0.74; 95% CI 0.59-0.92), while a decreased MedPyr was associated with higher stroke risk (HR 1.67; 95% CI 1.02-2.72). A decreased compared to stable HDS was associated with higher stroke risk (HR 1.80; 95% CI 1.02-3.20). The findings contribute further evidence on advantages of changing dietary intake towards a Mediterranean Diet. Although baseline HDS adherence was associated with T2D and stroke risk, longitudinal changes in HDS were only significantly associated with stroke risk.
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Affiliation(s)
- Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
- NutriAct Competence Cluster for Nutrition Research, Berlin-Potsdam, Germany.
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
| | - Daniela V Nickel
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- NutriAct Competence Cluster for Nutrition Research, Berlin-Potsdam, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Olga Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- NutriAct Competence Cluster for Nutrition Research, Berlin-Potsdam, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
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Peterson L, Lee H, Huybrechts I, Biessy C, Neuhouser ML, Haaland B, Krick B, Gunter M, Schulze MB, Jannasch F, Coletta AM, Hardikar S, Chaix A, Bauer CX, Xiao Q, Playdon MC. Reliability estimates for assessing meal timing derived from longitudinal repeated 24-hour dietary recalls. Am J Clin Nutr 2023; 117:964-975. [PMID: 36921904 PMCID: PMC10206325 DOI: 10.1016/j.ajcnut.2023.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies. OBJECTIVES To evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs). METHODS Intraclass correlation coefficients (ICC), Light's Kappa estimates, and 95% CIs were calculated from repeated 24HR administered in 3 epidemiologic studies: The United States-based Interactive Diet and Activity Tracking in AARP (IDATA) study (n = 996, 6 24HR collected over 12-mo), German EPIC-Potsdam Validation Study (European Prospective Investigation into Cancer and Nutrition Potsdam Germany cohort) (n = 134, 12 24HR collected over 12-mo) and EPIC-Potsdam BMBF-II Study (Federal Ministry of Education and Research, "Bundesministerium für Bildung und Forschung") (n = 725, 4 24HR collected over 36 mo). RESULTS Measurement reliability of overnight fasting duration based on a single 24HR was "poor" in all studies [ICC range: 0.27; 95% CI: 0.23, 0.32 - 0.46; 95% CI: 0.43, 0.50]. Reliability was "moderate" with 3 24HR (ICC range: 0.53; 95% CI: 0.47, 0.58 in IDATA, 0.62; 95% CI: 0.52, 0.69 in the EPIC-Potsdam Validation Study, and 0.72; 95% CI: 0.70-0.75 in the EPIC-Potsdam BMBF-II Study). Results were similar for the midpoint of overnight fasting time and the number of eating episodes. Reliability of measuring late eating was "fair" in IDATA (Light's Kappa: 0.30; 95% CI: 0.21, 0.39) and "slight" in the EPIC-Potsdam Validation study and the EPIC-Potsdam BMBF-II study (Light's Kappa: 0.19; 95% CI: 0.15, 0.25 and 0.09; 95% CI: 0.06, 0.12, respectively). Reliability estimates differed by sex, BMI, weekday, and season of 24HR administration in some studies. CONCLUSIONS Our results show that ≥ 3 24HR over a 1-3-y period are required for reliable estimates of meal timing variables.
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Affiliation(s)
- Lacie Peterson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Hyejung Lee
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Inge Huybrechts
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Benjamin Krick
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Marc Gunter
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Adriana M Coletta
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Sheetal Hardikar
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Cici X Bauer
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mary C Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States.
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4
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Prada M, Wittenbecher C, Eichelmann F, Wernitz A, Kuxhaus O, Kröger J, Weikert C, Schulze MB. Plasma Industrial and Ruminant Trans Fatty Acids and Incident Type 2 Diabetes in the EPIC-Potsdam Cohort. Diabetes Care 2022; 45:845-853. [PMID: 35129607 PMCID: PMC9016738 DOI: 10.2337/dc21-1897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/09/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although dietary intake of trans fatty acid (TFA) is a major public health concern because of the associated increase in the risk of cardiovascular events, it remains unclear whether TFAs also influence risk of type 2 diabetes (T2D) and whether industrial TFAs (iTFAs) and ruminant TFAs (rTFAs) exert the same effect on health. RESEARCH DESIGN AND METHODS To investigate the relationship of 7 rTFAs and iTFAs, including 2 conjugated linoleic acids (CLAs), plasma phospholipid TFAs were measured in a case-cohort study nested within the European Prospective Investigation Into Cancer and Nutrition-Potsdam cohort. The analytical sample was a random subsample (n = 1,248) and incident cases of T2D (n = 801) over a median follow-up of 6.5 years. Using multivariable Cox regression models, we examined associations of TFAs with incident T2D. RESULTS The TFA subtypes were intercorrelated with each other, with other fatty acids, and with different food sources. After controlling for other TFAs, the iTFAs (18:1n-6t, 18:1n-9t, 18:2n-6,9t) were not associated with diabetes risk. Some rTFA subtypes were inversely associated with diabetes risk: vaccenic acid (18:1n-7t; hazard ratio [HR] per SD 0.72; 95% CI 0.58-0.89) and t10c12-CLA (HR per SD 0.81; 95% CI 0.70-0.94), whereas c9t11-CLA was positively associated (HR per SD 1.39; 95% CI 1.19-1.62). Trans-palmitoleic acid (16:1n-7t) was not associated with diabetes risk when adjusting for the other TFAs (HR per SD 1.08; 95% CI 0.88-1.31). CONCLUSIONS The TFAs' conformation plays an essential role in their relationship to diabetes risk. rTFA subtypes may have opposing relationships to diabetes risk. Previous observations for reduced diabetes risk with higher levels of circulating trans-palmitoleic acid are likely due to confounding.
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Affiliation(s)
- Marcela Prada
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Clemens Wittenbecher
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Andreas Wernitz
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Olga Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Cornelia Weikert
- German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
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5
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Wittenbecher C, Cuadrat R, Johnston L, Eichelmann F, Jäger S, Kuxhaus O, Prada M, Del Greco M F, Hicks AA, Hoffman P, Krumsiek J, Hu FB, Schulze MB. Dihydroceramide- and ceramide-profiling provides insights into human cardiometabolic disease etiology. Nat Commun 2022; 13:936. [PMID: 35177612 PMCID: PMC8854598 DOI: 10.1038/s41467-022-28496-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/26/2022] [Indexed: 12/13/2022] Open
Abstract
Metabolic alterations precede cardiometabolic disease onset. Here we present ceramide- and dihydroceramide-profiling data from a nested case-cohort (type 2 diabetes [T2D, n = 775]; cardiovascular disease [CVD, n = 551]; random subcohort [n = 1137]) in the prospective EPIC-Potsdam study. We apply the novel NetCoupler-algorithm to link a data-driven (dihydro)ceramide network to T2D and CVD risk. Controlling for confounding by other (dihydro)ceramides, ceramides C18:0 and C22:0 and dihydroceramides C20:0 and C22:2 are associated with higher and ceramide C20:0 and dihydroceramide C26:1 with lower T2D risk. Ceramide C16:0 and dihydroceramide C22:2 are associated with higher CVD risk. Genome-wide association studies and Mendelian randomization analyses support a role of ceramide C22:0 in T2D etiology. Our results also suggest that (dh)ceramides partly mediate the putative adverse effect of high red meat consumption and benefits of coffee consumption on T2D risk. Thus, (dihydro)ceramides may play a critical role in linking genetic predisposition and dietary habits to cardiometabolic disease risk.
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Affiliation(s)
- C Wittenbecher
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - R Cuadrat
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - L Johnston
- Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - F Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - S Jäger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - O Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - M Prada
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - F Del Greco M
- Institute for Biomedicine, Eurac Research, Bolzano/Bozen, Italy, affiliated with the University of Lübeck, Lübeck, Germany
| | - A A Hicks
- Institute for Biomedicine, Eurac Research, Bolzano/Bozen, Italy, affiliated with the University of Lübeck, Lübeck, Germany
| | - P Hoffman
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - J Krumsiek
- Institute for Computational Biomedicine, Englander Institute for Precision Medicine, Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - F B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - M B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
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6
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Larnyo E, Dai B, Larnyo A, Nutakor JA, Ampon-Wireko S, Nkrumah ENK, Appiah R. Impact of Actual Use Behavior of Healthcare Wearable Devices on Quality of Life: A Cross-Sectional Survey of People with Dementia and Their Caregivers in Ghana. Healthcare (Basel) 2022; 10:275. [PMID: 35206890 PMCID: PMC8872618 DOI: 10.3390/healthcare10020275] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 12/17/2022] Open
Abstract
The increasing prevalence of dementia has necessitated the introduction and use of healthcare wearable devices to augment the healthcare services delivered to people with dementia (PWDs). Unfortunately, evidence on user feedback and the real impact of the actual use of these devices on the quality of life of PWDs has not been fully explored, especially in the context of developing countries. This study, therefore, seeks to evaluate the impact of actual use behavior (AUB) of healthcare wearable devices on the quality of life (QoL) of PWDs in Ghana by using constructs from the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) model and the SF-36 quality of life instrument. Data were collected from people with dementia and, in some cases, caregivers (acting as proxies) in three administrative regions of Ghana using structured questionnaires. Of the 420 questionnaires distributed, 356 were returned, giving a response rate of (356/420, 84.8%). Three hundred and twenty (320) responses were used for further analysis, employing the Partial Least Squares based on Structural Equation Modeling. The results showed a significant positive relationship between AUB and QoL (p < 0.001). Other predictors such as behavioral intention, facilitating conditions, effort expectancy and social influence were also found to significantly impact the actual use behavior of healthcare wearable devices among PWDs. The study also revealed that 4% (14) of patients rated their reported health transition associated with the use of healthcare wearable devices as excellent, 42.5% (136) as very good, and 39.4% (126) as good, respectively at the time of the study compared to a year ago. This study provided empirical evidence of the positive impact of the actual use of healthcare wearable devices on the quality of life of PWDs and further highlighted the factors that drive actual use behavior among PWDs in Ghana. Based on the findings of this study, stakeholders need to create the necessary conditions that will facilitate the adoption and use of healthcare wearable devices, as this will help improve the quality of life, reduce the burden of the disease on caregivers, and enable independent living of PWDs.
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Affiliation(s)
- Ebenezer Larnyo
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (E.L.); (J.A.N.); (S.A.-W.); (R.A.)
| | - Baozhen Dai
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (E.L.); (J.A.N.); (S.A.-W.); (R.A.)
| | - Abigail Larnyo
- School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (A.L.); (E.N.K.N.)
| | - Jonathan Aseye Nutakor
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (E.L.); (J.A.N.); (S.A.-W.); (R.A.)
| | - Sabina Ampon-Wireko
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (E.L.); (J.A.N.); (S.A.-W.); (R.A.)
| | - Edmund Nana Kwame Nkrumah
- School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (A.L.); (E.N.K.N.)
| | - Ruth Appiah
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China; (E.L.); (J.A.N.); (S.A.-W.); (R.A.)
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Abdelmajed SS, El-Dessouky MA, SalahElDin DS, Hassan NAM, Zaki ME, Ismail S. Assessing the association of rs7574865 STAT4 gene variant and type 1 diabetes mellitus among Egyptian patients. J Genet Eng Biotechnol 2021; 19:112. [PMID: 34342790 PMCID: PMC8333174 DOI: 10.1186/s43141-021-00214-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022]
Abstract
Background Variants in the signal transducer and activator of transcription 4 (STAT4) gene have an important role in the incident of multiple autoimmune diseases including type 1 diabetes mellitus (T1D). It is a genetically related auto-immune disorder that resulted from T cell-mediated destruction of pancreatic cells that are in control for the production of insulin in the blood. The current study aimed to clarify the role of STAT4 (rs7574865) variant allelic and genotypic variations in the susceptibility to type 1 diabetes among Egyptians by using the real-time PCR. Results A total of 100 patients and 100 controls were genotyped for rs7574865, and the biochemical and anthropometric parameters were measured to show that type 1 diabetic patients had significantly higher levels of HbA1c and triglycerides compared to non-diabetic individuals (P < 0.05). And genetically, the T allele and GT genotype have a significant correlation with diabetes type 1. Conclusion It was confirmed by this study that the rs7574865 T allele and GT genotype have a significant correlation with diabetes type 1 incidence among Egyptian patients.
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Affiliation(s)
| | - Mohamed A El-Dessouky
- Chemistry Department (Biochemistry Division), Faculty of Science, Cairo University, Giza, Egypt
| | - Doaa S SalahElDin
- Chemistry Department (Biochemistry Division), Faculty of Science, Cairo University, Giza, Egypt
| | - Naglaa Abu-Mandil Hassan
- Biological Anthropology Department, Medical Research Division, National Research Centre, Giza, Egypt
| | - Moushira Erfan Zaki
- Biological Anthropology Department, Medical Research Division, National Research Centre, Giza, Egypt
| | - Somaia Ismail
- Medical Molecular Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Giza, Egypt
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Prada M, Wittenbecher C, Eichelmann F, Wernitz A, Drouin-Chartier JP, Schulze MB. Association of the odd-chain fatty acid content in lipid groups with type 2 diabetes risk: A targeted analysis of lipidomics data in the EPIC-Potsdam cohort. Clin Nutr 2021; 40:4988-4999. [PMID: 34364238 DOI: 10.1016/j.clnu.2021.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Plasma odd-chain saturated fatty acids (OCFA) are inversely associated with type 2 diabetes (T2D) risk and may serve as biomarkers for dairy fat intake. Their distribution across different lipid classes and consequences for diabetes risk remain unknown. AIM To investigate the prospective associations of OCFA-containing lipid species with T2D risk and their dietary determinants. METHODS Within the European Prospective Investigation into Cancer and Nutrition-Potsdam study (n = 27,548), we applied a nested case-cohort design (subcohort: n = 1,248; T2D cases: n = 820; median follow-up 6.5 years). OCFA-containing lipids included triacylglycerols, free fatty acids (FFA), cholesteryl esters (CE), phosphatidylcholines, phosphatidylethanolamines, lysophosphatidylcholines, lysophosphatidylethanolamines, monoacylglycerols, and diacylglycerols. We estimated lipid class-specific associations between OCFA-containing lipids and T2D in sex-stratified Cox proportional-hazards models. We investigated correlations between lipids and dietary intakes derived from food-frequency questionnaires. RESULTS We observed heterogeneous integration of OCFA in different lipid classes: triacylglycerols, FFA, CE, and phosphatidylcholines contributed most to the total OCFA-plasma abundance. The relative concentration of OCFA was particularly high in monoacylglycerols, and the contribution of C15:0 versus C17:0 to the total OCFA-abundance differed across lipid classes. In women, several OCFA-containing phospholipids were inversely associated with T2D risk [phosphatidylcholine(C15:0), HR Q5 vs Q1: 0.56, 95% CI 0.32-0.97; phosphatidylcholine(C17:0), HR per SD: 0.59, 95% CI 0.48-0.71; lysophosphatidylcholine(C17:0), HR Q5 vs Q1: 0.42, 95% CI 0.23-0.76]. In men, we did not detect statistically significant inverse associations in phospholipids, and lysophosphatidylcholine(C15:0) was associated with higher T2D risk (HR Q5 vs. Q1: 1.96, 95% CI 1.06-3.63). Besides, CE(C17:0), monoacylglycerols(C15:0), and diacylglycerols(C15:0) were inversely associated with T2D risk; FFA(C17:0) was positively associated with T2D risk in women. Consumption of fat-rich dairy and fiber-rich foods were positively and red meat inversely correlated to OCFA-containing lipid plasma levels. CONCLUSIONS OCFA-containing lipids are linked to T2D risk in a lipid class and sex-specific manner, and they are correlated with several foods.
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Affiliation(s)
- Marcela Prada
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Clemens Wittenbecher
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Andreas Wernitz
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Jean-Philippe Drouin-Chartier
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, Canada
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
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9
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Polemiti E, Baudry J, Kuxhaus O, Jäger S, Bergmann MM, Weikert C, Schulze MB. BMI and BMI change following incident type 2 diabetes and risk of microvascular and macrovascular complications: the EPIC-Potsdam study. Diabetologia 2021; 64:814-825. [PMID: 33452586 PMCID: PMC7940263 DOI: 10.1007/s00125-020-05362-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS Studies suggest decreased mortality risk among people who are overweight or obese compared with individuals with normal weight in type 2 diabetes (obesity paradox). However, the relationship between body weight or weight change and microvascular vs macrovascular complications of type 2 diabetes remains unresolved. We investigated the association between BMI and BMI change with long-term risk of microvascular and macrovascular complications in type 2 diabetes in a prospective cohort study. METHODS We studied participants with incident type 2 diabetes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, who were free of cancer, cardiovascular disease and microvascular disease at diagnosis (n = 1083). Pre-diagnosis BMI and relative annual change between pre- and post-diagnosis BMI were evaluated in multivariable-adjusted Cox models. RESULTS There were 85 macrovascular (myocardial infarction and stroke) and 347 microvascular events (kidney disease, neuropathy and retinopathy) over a median follow-up of 10.8 years. Median pre-diagnosis BMI was 29.9 kg/m2 (IQR 27.4-33.2), and the median relative annual BMI change was -0.4% (IQR -2.1 to 0.9). Higher pre-diagnosis BMI was positively associated with total microvascular complications (multivariable-adjusted HR per 5 kg/m2 [95% CI]: 1.21 [1.07, 1.36], kidney disease 1.39 [1.21, 1.60] and neuropathy 1.12 [0.96, 1.31]) but not with macrovascular complications (HR 1.05 [95% CI 0.81, 1.36]). Analyses according to BMI categories corroborated these findings. Effect modification was not evident by sex, smoking status or age groups. In analyses according to BMI change categories, BMI loss of more than 1% indicated a decreased risk of total microvascular complications (HR 0.62 [95% CI 0.47, 0.80]), kidney disease (HR 0.57 [95% CI 0.40, 0.81]) and neuropathy (HR 0.73 [95% CI 0.52, 1.03]), compared with participants with a stable BMI; no clear association was observed for macrovascular complications (HR 1.04 [95% CI 0.62, 1.74]). The associations between BMI gain compared with stable BMI and diabetes-related vascular complications were less apparent. Associations were consistent across strata of sex, age, pre-diagnosis BMI or medication but appeared to be stronger among never-smokers compared with current or former smokers. CONCLUSIONS/INTERPRETATION Among people with incident type 2 diabetes, pre-diagnosis BMI was positively associated with microvascular complications, while a reduced risk was observed with weight loss when compared with stable weight. The relationships with macrovascular disease were less clear.
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Affiliation(s)
- Elli Polemiti
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Julia Baudry
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Olga Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Susanne Jäger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Manuela M Bergmann
- Human Study Center, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Cornelia Weikert
- German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
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Trace element profile and incidence of type 2 diabetes, cardiovascular disease and colorectal cancer: results from the EPIC-Potsdam cohort study. Eur J Nutr 2021; 60:3267-3278. [PMID: 33590281 PMCID: PMC8354864 DOI: 10.1007/s00394-021-02494-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/13/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE We aimed to examine the prospective association between manganese, iron, copper, zinc, iodine, selenium, selenoprotein P, free zinc, and their interplay, with incident type 2 diabetes (T2D), cardiovascular disease (CVD) and colorectal cancer (CRC). METHODS Serum trace element (TE) concentrations were measured in a case-cohort study embedded within the EPIC-Potsdam cohort, consisting of a random sub-cohort (n = 2500) and incident cases of T2D (n = 705), CVD (n = 414), and CRC (n = 219). TE patterns were investigated using principal component analysis. Cox proportional hazard models were fitted to examine the association between TEs with T2D, CVD and CRC incidence. RESULTS Higher manganese, zinc, iodine and selenium were associated with an increased risk of developing T2D (HR Q5 vs Q1: 1.56, 1.09-2.22; HR per SD, 95% CI 1.18, 1.05-1.33; 1.09, 1.01-1.17; 1.19, 1.06-1.34, respectively). Regarding CVD, manganese, copper and copper-to-zinc ratio were associated with an increased risk (HR per SD, 95% CI 1.13, 1.00-1.29; 1.22, 1.02-1.44; 1.18, 1.02-1.37, respectively). The opposite was observed for higher selenium-to-copper ratio (HR Q5 vs Q1, 95% CI 0.60, 0.39-0.93). Higher copper and zinc were associated with increasing risk of developing CRC (HR per SD, 95% CI 1.29, 1.05-1.59 and 1.14, 1.00-1.30, respectively). Selenium, selenoprotein P and selenium-to-copper-ratio were associated to decreased risk (HR per SD, 95% CI 0.82, 0.69-0.98; 0.81, 0.72-0.93; 0.77, 0.65-0.92, respectively). Two TE patterns were identified: manganese-iron-zinc and copper-iodine-selenium. CONCLUSION Different TEs were associated with the risk of developing T2D, CVD and CRC. The contrasting associations found for selenium with T2D and CRC point towards differential disease-related pathways.
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The reliability and relative validity of predefined dietary patterns were higher than that of exploratory dietary patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam population. Br J Nutr 2020; 125:1270-1280. [DOI: 10.1017/s0007114520003517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe aim of this study was to assess the ability of the FFQ to describe reliable and valid dietary pattern (DP) scores. In a total of 134 participants of the European Prospective Investigation into Cancer and Nutrition-Potsdam study aged 35–67 years, the FFQ was applied twice (baseline and after 1 year) to assess its reliability. Between November 1995 and March 1997, twelve 24-h dietary recalls (24HDR) as reference instrument were applied to assess the validity of the FFQ. Exploratory DP were derived by principal component analyses. Investigated predefined DP were the Alternative Healthy Eating Index (AHEI) and two Mediterranean diet indices. From dietary data of each FFQ, two exploratory DP were retained, but differed in highly loading food groups, resulting in moderate correlations (r 0·45–0·58). The predefined indices showed higher correlations between the FFQ (r(AHEI) 0·62, r(Mediterranean Diet Pyramid Index (MedPyr)) 0·62 and r(traditional Mediterranean Diet Score (tMDS)) 0·51). From 24HDR dietary data, one exploratory DP retained differed in composition to the first FFQ-based DP, but showed similarities to the second DP, reflected by a good correlation (r 0·70). The predefined DP correlated moderately (r 0·40–0·60). To conclude, long-term analyses on exploratory DP should be interpreted with caution, due to only moderate reliability. The validity differed extensively for the two exploratory DP. The investigated predefined DP showed a better reliability and a moderate validity, comparable to other studies. Within the two Mediterranean diet indices, the MedPyr performed better than the tMDs in this middle-aged, semi-urban German study population.
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12
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Wittenbecher C, Kuxhaus O, Boeing H, Stefan N, Schulze MB. Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors. Diabetologia 2019; 62:2211-2221. [PMID: 31501920 PMCID: PMC6861343 DOI: 10.1007/s00125-019-04978-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/16/2019] [Indexed: 01/30/2023]
Abstract
AIMS/HYPOTHESIS This study aimed to evaluate associations of height as well as components of height (sitting height and leg length) with risk of type 2 diabetes and to explore to what extent associations are explainable by liver fat and cardiometabolic risk markers. METHODS A case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study comprising 26,437 participants who provided blood samples was designed. We randomly selected a subcohort of 2500 individuals (2029 diabetes-free at baseline and with anamnestic, anthropometrical and metabolic data for analysis). Of the 820 incident diabetes cases identified in the full cohort during 7 years of follow-up, 698 remained for analyses after similar exclusions. RESULTS After adjustment for age, potential lifestyle confounders, education and waist circumference, greater height was related to lower diabetes risk (HR per 10 cm, men 0.59 [95% CI 0.47, 0.75] and women 0.67 [0.51, 0.88], respectively). Leg length was related to lower risk among men and women, but only among men if adjusted for total height. Adjustment for liver fat and triacylglycerols, adiponectin and C-reactive protein substantially attenuated associations between height and diabetes risk, particularly among women. CONCLUSIONS/INTERPRETATION We observed inverse associations between height and risk of type 2 diabetes, which was largely related to leg length among men. The inverse associations may be partly driven by lower liver fat content and a more favourable cardiometabolic profile.
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Affiliation(s)
- Clemens Wittenbecher
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Olga Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Norbert Stefan
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Nephrology, University of Tübingen, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, Tübingen, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany.
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Lachmann R, Stelmach-Mardas M, Bergmann MM, Bernigau W, Weber D, Pischon T, Boeing H. The accumulation of deficits approach to describe frailty. PLoS One 2019; 14:e0223449. [PMID: 31613904 PMCID: PMC6793873 DOI: 10.1371/journal.pone.0223449] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/20/2019] [Indexed: 01/10/2023] Open
Abstract
The advancing age of the participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study was the incentive to investigate frailty as a major parameter of ageing. The aim of this study was to develop a multidimensional tool to measure frailty in an ageing, free-living study population. The "accumulation of deficits approach" was used to develop a frailty index (FI) to characterize a sub-sample (N = 815) of the EPIC-Potsdam (EPIC-P) study population regarding the aging phenomenon. The EPIC-P frailty index (EPIC-P-FI) included 32 variables from the following domains: health, physical ability, psychosocial and physiological aspects. P-values were calculated for the linear trend between sociodemographic and life style variables and the EPIC-P-FI was calculated using regression analysis adjusted for age. The relationship between the EPIC-P-FI and age was investigated using fractional polynomials. Some characteristics such as age, education, time spent watching TV, cycling and a biomarker of inflammation (C-reactive protein) were associated with frailty in men and women. Interestingly, living alone, having no partner and smoking status were only associated with frailty in men, and alcohol use and physical fitness (VO2max) only in women. The generated, multidimensional FI, adapted to the EPIC-P study, showed that this cohort is a valuable source for further exploration of factors that promote healthy ageing.
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Affiliation(s)
- Raskit Lachmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
- Department of Biophysics, Poznan University of Medical Sciences, Poznan, Poland
- * E-mail:
| | - Manuela M. Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
| | - Wolfgang Bernigau
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
| | - Daniela Weber
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin-Buch, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
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Andriolo V, Dietrich S, Knüppel S, Bernigau W, Boeing H. Traditional risk factors for essential hypertension: analysis of their specific combinations in the EPIC-Potsdam cohort. Sci Rep 2019; 9:1501. [PMID: 30728434 PMCID: PMC6365562 DOI: 10.1038/s41598-019-38783-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022] Open
Abstract
Appropriate interventions might improve the prevention of essential hypertension. This requires a comprehensive view of modifiable lifestyle factors (MLFs) distribution and effect. To determine how six MLFs (general adiposity, abdominal adiposity, alcohol consumption, smoking, diet, physical inactivity) for risk of hypertension are distributed and how their combinations affect the risk, a prospective study cohort of 11,923 healthy participants from the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study was used. Of these, 1,635 developed hypertension during a mean follow-up of 10.3 years. Mutually exclusive combinations, clustering and interactions of MLFs were then investigated stratifying by sex, Hazard Ratios (HRs) and Population Attributable Risks (PARs%) were calculated. General adiposity alone was sufficient to increase the risk of hypertension (HR = 1.86, PAR% 3.36), and in this cohort it played a major role in enhancing the risk of hypertension, together with smoking and physical inactivity. MLFs had a different impact and a different modulation of risk in women and men, and they showed a remarkable tendency to occur in specific patterns with higher prevalence than expected. This indication can help to promote a holistic approach through multifactorial preventive strategies addressing more than a factor at a time. For prevention of hypertension addressing adiposity together with smoking, promoting at the same time physical activity should be the first choice.
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Affiliation(s)
- Violetta Andriolo
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany.
| | - Stefan Dietrich
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Sven Knüppel
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Wolfgang Bernigau
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Germany
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Genetic variants including markers from the exome chip and metabolite traits of type 2 diabetes. Sci Rep 2017; 7:6037. [PMID: 28729637 PMCID: PMC5519666 DOI: 10.1038/s41598-017-06158-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 06/08/2017] [Indexed: 01/19/2023] Open
Abstract
Diabetes-associated metabolites may aid the identification of new risk variants for type 2 diabetes. Using targeted metabolomics within a subsample of the German EPIC-Potsdam study (n = 2500), we tested previously published SNPs for their association with diabetes-associated metabolites and conducted an additional exploratory analysis using data from the exome chip including replication within 2,692 individuals from the German KORA F4 study. We identified a total of 16 loci associated with diabetes-related metabolite traits, including one novel association between rs499974 (MOGAT2) and a diacyl-phosphatidylcholine ratio (PC aa C40:5/PC aa C38:5). Gene-based tests on all exome chip variants revealed associations between GFRAL and PC aa C42:1/PC aa C42:0, BIN1 and SM (OH) C22:2/SM C18:0 and TFRC and SM (OH) C22:2/SM C16:1). Selecting variants for gene-based tests based on functional annotation identified one additional association between OR51Q1 and hexoses. Among single genetic variants consistently associated with diabetes-related metabolites, two (rs174550 (FADS1), rs3204953 (REV3L)) were significantly associated with type 2 diabetes in large-scale meta-analysis for type 2 diabetes. In conclusion, we identified a novel metabolite locus in single variant analyses and four genes within gene-based tests and confirmed two previously known mGWAS loci which might be relevant for the risk of type 2 diabetes.
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16
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Bachlechner U, Floegel A, Steffen A, Prehn C, Adamski J, Pischon T, Boeing H. Associations of anthropometric markers with serum metabolites using a targeted metabolomics approach: results of the EPIC-potsdam study. Nutr Diabetes 2016; 6:e215. [PMID: 27348203 PMCID: PMC4931315 DOI: 10.1038/nutd.2016.23] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/07/2016] [Accepted: 05/29/2016] [Indexed: 12/13/2022] Open
Abstract
Background/Objectives: The metabolic consequences of type of body shape need further exploration. Whereas accumulation of body mass in the abdominal area is a well-established metabolic risk factor, accumulation in the gluteofemoral area is controversially debated. We evaluated the associations of anthropometric markers of overall body mass and body shape with 127 serum metabolites within a sub-sample of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort. Subjects/Methods: The cross-sectional analysis was conducted in 2270 participants, randomly drawn from the EPIC-Potsdam cohort. Metabolites were measured by targeted metabolomics. To select metabolites related with both waist circumference (WC) (abdominal subcutaneous and visceral fat) and hip circumference (HC) (gluteofemoral fat, muscles and bone structure) correlations (r) with body mass index (BMI) as aggregating marker of body mass (lean and fat mass) were calculated. Relations with body shape were assessed by median metabolite concentrations across tertiles of WC and HC, mutually adjusted to each other. Results: Correlations revealed 23 metabolites related to BMI (r⩾I0.20 I). Metabolites showing relations with BMI were showing similar relations with HC adjusted WC (WCHC). In contrast, relations with WC adjusted HC (HCWC) were less concordant with relations of BMI and WCHC. In both sexes, metabolites with concordant relations regarding WCHC and HCWC included tyrosine, diacyl-phosphatidylcholine C38:3, C38:4, lyso-phosphatidylcholine C18:1, C18:2 and sphingomyelin C18:1; metabolites with opposite relations included isoleucine, diacyl-phosphatidylcholine C42:0, acyl–alkyl-phosphatidylcholine C34:3, C42:4, C42:5, C44:4 and C44:6. Metabolites specifically related to HCWC included acyl–alkyl-phosphatidylcholine C34:2, C36:2, C38:2 and C40:4, and were solely observed in men. Other metabolites were related to WCHC only. Conclusions: The study revealed specific metabolic profiles for HCWC as marker of gluteofemoral body mass differing from those for BMI and WCHC as markers of overall body mass and abdominal fat, respectively. Thus, the study suggests that gluteofemoral mass may have less-adverse metabolic implications than abdominal fat.
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Affiliation(s)
- U Bachlechner
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - A Floegel
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - A Steffen
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - C Prehn
- Institute of Experimental Genetics, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - J Adamski
- Institute of Experimental Genetics, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research, Neuherberg, Germany.,Institute of Experimental Genetics, Technical University of Munich, Freising-Weihenstephan, Germany
| | - T Pischon
- Molecular Epidemiology Group, Max Delbrück Center for Molecular Medicine (MDC), Berlin-Buch, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
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Circulating Omentin as a Novel Biomarker for Colorectal Cancer Risk: Data from the EPIC–Potsdam Cohort Study. Cancer Res 2016; 76:3862-71. [DOI: 10.1158/0008-5472.can-15-3464] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 03/28/2016] [Indexed: 11/16/2022]
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Drogan D, Schulze MB, Boeing H, Pischon T. Insulin-Like Growth Factor 1 and Insulin-Like Growth Factor-Binding Protein 3 in Relation to the Risk of Type 2 Diabetes Mellitus: Results From the EPIC-Potsdam Study. Am J Epidemiol 2016; 183:553-60. [PMID: 26880678 DOI: 10.1093/aje/kwv188] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 07/10/2015] [Indexed: 12/27/2022] Open
Abstract
Higher levels of insulin-like growth factor-binding protein 3 (IGFBP-3) might raise the risk of type 2 diabetes mellitus (T2DM) via binding of insulin-like growth factor 1 (IGF-1), an insulin-like hormone that is involved in glucose homeostasis. We investigated serum concentrations of IGF-1 and IGFBP-3 and their molar ratio in relation to T2DM incidence in a nested case-cohort study within the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study. We included a randomly selected subcohort of persons without T2DM at the time of blood sampling (n = 2,269) and 776 individuals with incident T2DM identified between 1994 and 2005. For the highest quartile versus lowest, the multivariable-adjusted hazard rate ratios were 0.91 (95% confidence interval (CI): 0.68, 1.23; P for trend = 0.31) for IGF-1, 1.33 (95% CI: 1.00, 1.76; P for trend = 0.04) for IGFBP-3, and 0.77 (95% CI: 0.57, 1.03; P for trend = 0.03) for IGF-1:IGFBP-3 ratio. IGFBP-3 level remained positively associated with T2DM incidence-and the ratio of IGF-1 to IGFBP-3 was inversely related with T2DM incidence--in models that included adjustment for IGF-1 concentrations (P for trend < 0.05). Therefore, our findings do not confirm an association between total IGF-1 concentrations and risk of T2DM in the general study population, although higher IGFBP-3 levels might raise T2DM risk independent of IGF-1 levels.
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Jäger S, Jacobs S, Kröger J, Stefan N, Fritsche A, Weikert C, Boeing H, Schulze MB. Association between the Fatty Liver Index and Risk of Type 2 Diabetes in the EPIC-Potsdam Study. PLoS One 2015; 10:e0124749. [PMID: 25902304 PMCID: PMC4406732 DOI: 10.1371/journal.pone.0124749] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/05/2015] [Indexed: 12/14/2022] Open
Abstract
The fatty liver index (FLI) predicts fatty liver by using BMI, waist circumference, γ-glutamyltransferase and triglycerides. We investigated the association between the FLI and the risk of type 2 diabetes and evaluated to what extent single FLI components contribute to the diabetes risk. We analysed a case-cohort study (random sub-cohort: 1922; incident cases: 563) nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. The proportion of exposure effect (PEE) explained by single FLI components was evaluated and effect decomposition using inverse probability weighting (IPW) was applied. Women and men with a FLI ≥60 compared to those with a FLI <30 had a multivariable-adjusted Hazard Ratio (HR) of 17.6; 95% confidence interval (CI) 11.1-28.0 and HR: 10.9; 95% CI 6.22-19.2, respectively. Adjustment for BMI or waist circumference attenuated this association in men [PEEBMI (95% CI) = 53.8% (43.9%-65.8%); PEEwaist (95% CI) = 54.8% (44.2%-68.8%)]. In women, adjustment for waist circumference attenuated the association to a lesser degree than in men [PEEwaist (95% CI) = 31.1%; (21.9%-43.1%)] while BMI had no appreciable effect [PEEBMI (95% CI) = 11.0% (2.68%-21.0%)]. γ-glutamyltransferase and triglycerides showed only a small attenuation in women [PEEGGT(95% CI) = 3.11% (-0.72%-4.48%); PEETG (95% CI) = 6.36% (3.81%-9.92%)] and in men [PEEGGT = 0%; PEETG (95% CI) = 6.23% (2.03%-11.8%)]. In women, the total effect was decomposed into a direct effect and 4 indirect effects (HRBMI = 1.10; HRwaist = 1.28; HRGGT = 0.97 and HRTG = 1.03). In men, the 4 indirect effects were HRBMI = 1.25; HRwaist = 1.29; HRGGT = 0.97 and HRTG = 0.99. These data suggest that the FLI, as a proxy for fatty liver, is associated with risk of type 2 diabetes. This association is only partly explained by standard estimates of overall and abdominal body fatness, particularly among women.
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Affiliation(s)
- Susanne Jäger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Simone Jacobs
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Norbert Stefan
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Fritsche
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University Hospital Tübingen, Tübingen, Germany
| | - Cornelia Weikert
- Research Group Cardiovascular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- * E-mail:
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20
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Wirth J, Giuseppe RD, Wientzek A, Katzke VA, Kloss M, Kaaks R, Boeing H, Weikert C. Presence of gallstones and the risk of cardiovascular diseases: The EPIC-Germany cohort study. Eur J Prev Cardiol 2015; 22:326-334. [DOI: 10.1177/2047487313512218] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Janine Wirth
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | - Romina di Giuseppe
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | - Angelika Wientzek
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center Heidelberg, Germany
| | - Manja Kloss
- Department of Neurology, University of Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | - Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité University, Medical Center, Berlin, Germany
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21
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Drogan D, Dunn WB, Lin W, Buijsse B, Schulze MB, Langenberg C, Brown M, Floegel A, Dietrich S, Rolandsson O, Wedge DC, Goodacre R, Forouhi NG, Sharp SJ, Spranger J, Wareham NJ, Boeing H. Untargeted metabolic profiling identifies altered serum metabolites of type 2 diabetes mellitus in a prospective, nested case control study. Clin Chem 2014; 61:487-97. [PMID: 25524438 DOI: 10.1373/clinchem.2014.228965] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Application of metabolite profiling could expand the etiological knowledge of type 2 diabetes mellitus (T2D). However, few prospective studies apply broad untargeted metabolite profiling to reveal the comprehensive metabolic alterations preceding the onset of T2D. METHODS We applied untargeted metabolite profiling in serum samples obtained from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort comprising 300 individuals who developed T2D after a median follow-up time of 6 years and 300 matched controls. For that purpose, we used ultraperformance LC-MS with a protocol specifically designed for large-scale metabolomics studies with regard to robustness and repeatability. After multivariate classification to select metabolites with the strongest contribution to disease classification, we applied multivariable-adjusted conditional logistic regression to assess the association of these metabolites with T2D. RESULTS Among several alterations in lipid metabolism, there was an inverse association with T2D for metabolites chemically annotated as lysophosphatidylcholine(dm16:0) and phosphatidylcholine(O-20:0/O-20:0). Hexose sugars were positively associated with T2D, whereas higher concentrations of a sugar alcohol and a deoxyhexose sugar reduced the odds of diabetes by approximately 60% and 70%, respectively. Furthermore, there was suggestive evidence for a positive association of the circulating purine nucleotide isopentenyladenosine-5'-monophosphate with incident T2D. CONCLUSIONS This study constitutes one of the largest metabolite profiling approaches of T2D biomarkers in a prospective study population. The findings might help generate new hypotheses about diabetes etiology and develop further targeted studies of a smaller number of potentially important metabolites.
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Affiliation(s)
| | - Warwick B Dunn
- Centre for Endocrinology and Diabetes, Institute of Human Development, and Centre for Advanced Discovery and Experimental Therapeutics (CADET), Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK; School of Chemistry and Manchester Centre for Integrative Systems Biology, University of Manchester, Manchester, UK; School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Wanchang Lin
- Centre for Endocrinology and Diabetes, Institute of Human Development, and Centre for Advanced Discovery and Experimental Therapeutics (CADET), Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK; School of Chemistry and Manchester Centre for Integrative Systems Biology, University of Manchester, Manchester, UK
| | | | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Marie Brown
- Centre for Endocrinology and Diabetes, Institute of Human Development, and Centre for Advanced Discovery and Experimental Therapeutics (CADET), Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK; School of Chemistry and Manchester Centre for Integrative Systems Biology, University of Manchester, Manchester, UK
| | | | | | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - David C Wedge
- School of Chemistry and Manchester Centre for Integrative Systems Biology, University of Manchester, Manchester, UK; Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Royston Goodacre
- School of Chemistry and Manchester Centre for Integrative Systems Biology, University of Manchester, Manchester, UK
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Joachim Spranger
- Department of Endocrinology, Diabetes and Nutrition, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nick J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
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Knüppel S, Rohde K, Meidtner K, Drogan D, Holzhütter HG, Boeing H, Fisher E. Evaluation of 41 candidate gene variants for obesity in the EPIC-Potsdam cohort by multi-locus stepwise regression. PLoS One 2013; 8:e68941. [PMID: 23874820 PMCID: PMC3709896 DOI: 10.1371/journal.pone.0068941] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 06/04/2013] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Obesity has become a leading preventable cause of morbidity and mortality in many parts of the world. It is thought to originate from multiple genetic and environmental determinants. The aim of the current study was to introduce haplotype-based multi-locus stepwise regression (MSR) as a method to investigate combinations of unlinked single nucleotide polymorphisms (SNPs) for obesity phenotypes. METHODS In 2,122 healthy randomly selected men and women of the EPIC-Potsdam cohort, the association between 41 SNPs from 18 obesity-candidate genes and either body mass index (BMI, mean=25.9 kg/m(2), SD=4.1) or waist circumference (WC, mean=85.2 cm, SD=12.6) was assessed. Single SNP analyses were done by using linear regression adjusted for age, sex, and other covariates. Subsequently, MSR was applied to search for the 'best' SNP combinations. Combinations were selected according to specific AICc and p-value criteria. Model uncertainty was accounted for by a permutation test. RESULTS The strongest single SNP effects on BMI were found for TBC1D1 rs637797 (β = -0.33, SE=0.13), FTO rs9939609 (β=0.28, SE=0.13), MC4R rs17700144 (β=0.41, SE=0.15), and MC4R rs10871777 (β=0.34, SE=0.14). All these SNPs showed similar effects on waist circumference. The two 'best' six-SNP combinations for BMI (global p-value= 3.45⋅10(-6) and 6.82⋅10(-6)) showed effects ranging from -1.70 (SE=0.34) to 0.74 kg/m(2) (SE=0.21) per allele combination. We selected two six-SNP combinations on waist circumference (global p-value = 7.80⋅10(-6) and 9.76⋅10(-6)) with an allele combination effect of -2.96 cm (SE=0.76) at maximum. Additional adjustment for BMI revealed 15 three-SNP combinations (global p-values ranged from 3.09⋅10(-4) to 1.02⋅10(-2)). However, after carrying out the permutation test all SNP combinations lost significance indicating that the statistical associations might have occurred by chance. CONCLUSION MSR provides a tool to search for risk-related SNP combinations of common traits or diseases. However, the search process does not always find meaningful SNP combinations in a dataset.
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Affiliation(s)
- Sven Knüppel
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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Floegel A, Stefan N, Yu Z, Mühlenbruch K, Drogan D, Joost HG, Fritsche A, Häring HU, Hrabě de Angelis M, Peters A, Roden M, Prehn C, Wang-Sattler R, Illig T, Schulze MB, Adamski J, Boeing H, Pischon T. Identification of serum metabolites associated with risk of type 2 diabetes using a targeted metabolomic approach. Diabetes 2013; 62:639-48. [PMID: 23043162 PMCID: PMC3554384 DOI: 10.2337/db12-0495] [Citation(s) in RCA: 737] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Metabolomic discovery of biomarkers of type 2 diabetes (T2D) risk may reveal etiological pathways and help to identify individuals at risk for disease. We prospectively investigated the association between serum metabolites measured by targeted metabolomics and risk of T2D in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam (27,548 adults) among all incident cases of T2D (n = 800, mean follow-up 7 years) and a randomly drawn subcohort (n = 2,282). Flow injection analysis tandem mass spectrometry was used to quantify 163 metabolites, including acylcarnitines, amino acids, hexose, and phospholipids, in baseline serum samples. Serum hexose; phenylalanine; and diacyl-phosphatidylcholines C32:1, C36:1, C38:3, and C40:5 were independently associated with increased risk of T2D and serum glycine; sphingomyelin C16:1; acyl-alkyl-phosphatidylcholines C34:3, C40:6, C42:5, C44:4, and C44:5; and lysophosphatidylcholine C18:2 with decreased risk. Variance of the metabolites was largely explained by two metabolite factors with opposing risk associations (factor 1 relative risk in extreme quintiles 0.31 [95% CI 0.21-0.44], factor 2 3.82 [2.64-5.52]). The metabolites significantly improved T2D prediction compared with established risk factors. They were further linked to insulin sensitivity and secretion in the Tübingen Family study and were partly replicated in the independent KORA (Cooperative Health Research in the Region of Augsburg) cohort. The data indicate that metabolic alterations, including sugar metabolites, amino acids, and choline-containing phospholipids, are associated early on with a higher risk of T2D.
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Affiliation(s)
- Anna Floegel
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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Arregui M, Buijsse B, Stefan N, Corella D, Fisher E, di Giuseppe R, Coltell O, Knüppel S, Aleksandrova K, Joost HG, Boeing H, Weikert C. Heterogeneity of the Stearoyl-CoA desaturase-1 (SCD1) gene and metabolic risk factors in the EPIC-Potsdam study. PLoS One 2012; 7:e48338. [PMID: 23139775 PMCID: PMC3491059 DOI: 10.1371/journal.pone.0048338] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 09/24/2012] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Stearoyl-CoA desaturase-1 (SCD1) is an enzyme involved in lipid metabolism. In mice and humans its activity has been associated with traits of the metabolic syndrome, but also with the prevention of saturated fatty acids accumulation and subsequent inflammation, whereas for liver fat content inconsistent results have been reported. Thus, variants of the gene encoding SCD1 (SCD1) could potentially modify metabolic risk factors, but few human studies have addressed this question. METHODS In a sample of 2157 middle-aged men and women randomly drawn from the Potsdam cohort of the European Prospective Investigation into Cancer and Nutrition, we investigated the impact of 7 SCD1 tagging-single nucleotide polymorphisms (rs1502593, rs522951, rs11190480, rs3071, rs3793767, rs10883463 and rs508384) and 5 inferred haplotypes with frequency >5% describing 90.9% of the genotype combinations in our population, on triglycerides, body mass index (BMI), waist circumference (WC), glycated haemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT) and fetuin-A. RESULTS No significant associations between any of the SNPs or haplotypes and BMI, WC, fetuin-A and hs-CRP were observed. Associations of rs10883463 with triglycerides, GGT and HbA1c as well as of rs11190480 with ALT activity, were weak and became non-significant after multiple-testing correction. Also associations of the haplotype harbouring the minor allele of rs1502593 with HbA1c levels, the haplotype harbouring the minor alleles of rs11190480 and rs508384 with activity of ALT, and the haplotype harbouring the minor alleles of rs522951, rs10883463 and rs508384 with triglyceride and HbA1C levels and GGT activities did not withstand multiple-testing correction. CONCLUSION These findings suggest that there are no associations between common variants of SCD1 or its inferred haplotypes and the investigated metabolic risk factors. However, given the results from animal models, heterogeneity of human SCD1 warrants further investigation, in particular with regard to rare variants.
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Affiliation(s)
- Maria Arregui
- Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, Nuthetal, Germany.
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Eichholzer M, Steinbrecher A, Kaaks R, Teucher B, Linseisen J, Rohrmann S. Effects of selenium status, dietary glucosinolate intake and serum glutathione S-transferase α activity on the risk of benign prostatic hyperplasia. BJU Int 2012; 110:E879-85. [PMID: 22882569 DOI: 10.1111/j.1464-410x.2012.11383.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
UNLABELLED Study Type--Prognosis (case control) Level of Evidence 2. What's known on the subject? and What does the study add? Geographical and ethnic differences in the distribution of BPH and the results of migrant studies indicate that not only age, androgens and genetics, but also modifiable factors may play a role in the aetiology of BPH. Oxidative stress induced by chronic inflammation could be a cause and antioxidants, including selenoproteins, may reduce the risk. The published data related to this topic are scarce and are mainly based on cross-sectional and case-control studies. In a nested case-control study, we observed a significant inverse association between serum selenium concentrations and the risk of BPH. These results need to be confirmed in larger, prospective epidemiological studies. Prostate enlargement is an increasing health problem as a result of an ageing population in many countries. Modifiable factors may also play a role. In the present study, before this antioxidant can be recommended as a preventive measure. OBJECTIVE • To determine whether geographical differences in the distribution of benign prostatic hyperplasia (BPH) and migrant studies indicate that modifiable factors play a role in the aetiology of BPH. Oxidative stress produced by chronic inflammation could represent one of the causes, and antioxidants, including selenoproteins, may reduce the risk. SUBJECTS AND METHODS • Conditional logistic regression was used to examine the associations of serum selenium and selenoprotein P concentrations and glutathione peroxidase activity with respect to the risk of BPH in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition-Heidelberg cohort, including 111 cases and 214 matched controls. • In addition, dietary glucosinolate intake and the serum glutathione S-transferase α concentration was investigated. RESULTS • The risk of BPH significantly decreased with an increasing serum selenium concentration; the risk estimate was 0.83 (35% CI 0.69-0.99) per 10 µg/L increase in serum selenium concentration. • However, no significant association was present for serum selenoprotein P concentration or glutathione peroxidase activity. Risk estimates for BPH decreased with a higher intake of glucosinolates, although the results were not statistically significant. CONCLUSION • A low serum selenium concentration may increase the risk of BPH, although the findings reported in the present study need to be confirmed in larger, well-designed epidemiological studies.
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Affiliation(s)
- Monika Eichholzer
- Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine University of Zurich, Z ürich, Switzerland
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26
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Schulze MB, Thorand B, Fritsche A, Häring HU, Schick F, Zierer A, Rathmann W, Kröger J, Peters A, Boeing H, Stefan N. Body adiposity index, body fat content and incidence of type 2 diabetes. Diabetologia 2012; 55:1660-7. [PMID: 22349074 DOI: 10.1007/s00125-012-2499-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 01/16/2012] [Indexed: 10/28/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to compare estimates of body fat content, i.e. body adiposity index (BAI), BMI and waist and hip circumferences, with respect to their ability to predict the percentage of body fat (PBF; confirmed by magnetic resonance tomography) and incident type 2 diabetes. METHODS Associations between anthropometric measurements and PBF were evaluated in the Tübingen Lifestyle Intervention Program (TULIP; 138 men, 222 women), and between these measurements and incident type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study (9,729 men, 15,438 women) and the Cooperative Health Research in the Region of Augsburg (KORA) study (5,573 men, 5,628 women), using correlation and multivariate Cox regression analyses. RESULTS BMI more strongly correlated with PBF (men: r = 0.81, women: r = 0.84) than BAI (r = 0.68 and 0.81, respectively), while waist circumference among men (r = 0.84) and hip circumference among women (r = 0.88) showed the strongest correlations. BAI overestimated PBF among men (mean difference -3.0%), and this error was dependent on the value of PBF. BAI was more weakly associated with diabetes risk (RRs for 1 SD, EPIC-Potsdam men: 1.62 [95% CI 1.52, 1.72], women: 1.67 [95% CI 1.55, 1.80]; KORA men: 1.62 [95% CI 1.48, 1.78], women: 1.82 [95% CI 1.65, 2.02]) compared with BMI (RRs, EPIC-Potsdam men: 1.95 [95% CI 1.83, 2.09], women 1.88 [95% CI 1.76, 2.02], KORA men 1.75 [95% CI 1.62, 1.89], women 2.00 [95% CI 1.81, 2.22]), while waist circumference showed the strongest associations (RRs: 2.17 [95% CI 2.01, 2.35], 2.33 [95% CI 2.15, 2.53], 1.81 [95% CI 1.66, 1.96] and 2.29 [95% CI 2.05, 2.57] for EPIC-Potsdam men and women and KORA men and women, respectively). CONCLUSIONS/INTERPRETATION Waist circumference in men and hip circumference in women are better predictors of PBF than BAI and BMI. BAI was not as strong a predictor of diabetes as BMI, while waist circumference was the strongest predictor.
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Affiliation(s)
- M B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
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27
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Drogan D, Sheldrick AJ, Schütze M, Knüppel S, Andersohn F, di Giuseppe R, Herrmann B, Willich SN, Garbe E, Bergmann MM, Boeing H, Weikert C. Alcohol consumption, genetic variants in alcohol deydrogenases, and risk of cardiovascular diseases: a prospective study and meta-analysis. PLoS One 2012; 7:e32176. [PMID: 22363810 PMCID: PMC3283737 DOI: 10.1371/journal.pone.0032176] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 01/23/2012] [Indexed: 01/10/2023] Open
Abstract
Objective First, to investigate and compare associations between alcohol consumption and variants in alcohol dehydrogenase (ADH) genes with incidence of cardiovascular diseases (CVD) in a large German cohort. Second, to quantitatively summarize available evidence of prospective studies on polymorphisms in ADH1B and ADH1C and CVD-risk. Methods We conducted a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a randomly drawn subcohort (n = 2175) and incident cases of myocardial infarction (MI; n = 230) or stroke (n = 208). Mean follow-up time was 8.2±2.2 years. The association between alcohol consumption, ADH1B or ADH1C genotypes, and CVD-risk was assessed using Cox proportional hazards regression. Additionally, we report results on associations of variants in ADH1B and ADH1C with ischemic heart disease and stroke in the context of a meta-analysis of previously published prospective studies published up to November 2011. Results Compared to individuals who drank >0 to 6 g alcohol/d, we observed a reduced risk of MI among females consuming >12 g alcohol/d (HR = 0.31; 95% CI: 0.10–0.97) and among males consuming >24 to 60 g/d (HR = 0.57; 95% CI: 0.33–0.98) or >60 g alcohol/d (HR = 0.30; 95% CI: 0.12–0.78). Stroke risk was not significantly related to alcohol consumption >6 g/d, but we observed an increased risk of stroke in men reporting no alcohol consumption. Individuals with the slow-coding ADH1B*1/1 genotype reported higher median alcohol consumption. Yet, polymorphisms in ADH1B or ADH1C were not significantly associated with risk of CVD in our data and after pooling results of eligible prospective studies [ADH1B*1/1: RR = 1.35 (95% CI: 0.98–1.88; p for heterogeneity: 0.364); ADH1C*2/2: RR = 1.07 (95% CI: 0.90–1.27; p for heterogeneity: 0.098)]. Conclusion The well described association between alcohol consumption and CVD-risk is not reflected by ADH polymorphisms, which modify the rate of ethanol oxidation.
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Affiliation(s)
- Dagmar Drogan
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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Kröger J, Zietemann V, Enzenbach C, Weikert C, Jansen EH, Döring F, Joost HG, Boeing H, Schulze MB. Erythrocyte membrane phospholipid fatty acids, desaturase activity, and dietary fatty acids in relation to risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Am J Clin Nutr 2011; 93:127-42. [PMID: 20980488 DOI: 10.3945/ajcn.110.005447] [Citation(s) in RCA: 200] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The long-term role of fatty acids (FAs) in the cause of diabetes remains largely unclear. OBJECTIVE We aimed to investigate erythrocyte membrane FAs, desaturase activity, and dietary FAs in relation to the incidence of type 2 diabetes. DESIGN We applied a nested case-cohort design (n = 2724, including 673 incident diabetes cases) within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study, which involves 27,548 middle-aged subjects. Thirty erythrocyte membrane FAs (percentage of total FAs) and FA intake (percentage of total fat) were measured at baseline, and physician-confirmed incident diabetes was assessed during a mean follow-up of 7.0 y. We evaluated Δ⁵ desaturase (D5D) and Δ⁶ desaturase (D6D) activity by using FA product-to-precursor ratios (traditional approach) and by investigating variants in FADS1 and FADS2 genes that encode these desaturases (Mendelian randomization approach). RESULTS As a main finding, erythrocyte 16:1n-7 and 18:3n-6 and FA ratios, which reflect stearoyl coenzyme A desaturase (SCD) and D6D activity, were directly related to diabetes risk in multivariable-adjusted models [relative risks (95% CIs) comparing extreme quintiles: 16:1n-7, 2.11 (1.46, 3.05); 18:3n-6, 2.00 (1.38, 2.88); SCD, 2.61 (1.75, 3.89); and D6D, 2.46 (1.67, 3.63)], whereas the FA ratio that reflects D5D activity was inversely associated with risk [0.46 (0.31, 0.70)]. The Mendelian randomization approach corroborated the direct relation for D6D activity and tended to support the inverse relation for D5D activity. Proportions of dietary FAs showed only modest to low correlations with erythrocyte FAs and were not significantly associated with risk. CONCLUSION The FA profile of erythrocyte membrane phospholipids and activity of desaturase enzymes are strongly linked to the incidence of type 2 diabetes.
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Affiliation(s)
- Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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Drogan D, Weikert C, Dierkes J, Klipstein-Grobusch K, Buijsse B, Möhlig M, Pfeiffer AFH, Pischon T, Spranger J, Boeing H. Plasma γ-Glutamyltransferase, Cysteinyl-Glycine, and Oxidized Low-Density Lipoprotein. Arterioscler Thromb Vasc Biol 2010; 30:2053-8. [DOI: 10.1161/atvbaha.110.209346] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objective—
To investigate the interrelation between plasma γ-glutamyltransferase (GGT) activity, cysteinyl-glycine (Cys-Gly) (ie, a thiol originating from GGT-mediated cleavage of glutathione), and oxidized low-density lipoprotein (oxLDL) with regard to myocardial infarction (MI) risk in a prospective study.
Methods and Results—
Incident cases of MI were identified among European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam participants without prior MI during 6.0 years of follow-up. Baseline levels of Cys-Gly and oxLDL and GGT activity in plasma were measured in a case-cohort study comprising 837 subjects without incident MI and 116 subjects with incident MI. The relation of GGT, Cys-Gly and oxLDL to MI risk was assessed using Cox proportional hazards regression analysis. After adjustment for established risk factors, hazard ratios associated with a 1-SD unit increase in the log-transformed biomarker were 1.63 (95% CI, 1.30 to 2.05) for GGT, 1.36 (95% CI, 1.07 to 1.72) for Cys-Gly, and 1.37 (95% CI, 1.00 to 1.86) for oxLDL. Cys-Gly and oxLDL accounted for 2.3% of the relation between GGT and MI risk.
Conclusion—
The positive association between GGT activity and MI risk appears to be independent of circulating Cys-Gly and oxLDL levels. With Cys-Gly, we found a potential new predictor of MI risk whose impact needs to be further elucidated.
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Affiliation(s)
- Dagmar Drogan
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Cornelia Weikert
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Jutta Dierkes
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Kerstin Klipstein-Grobusch
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Brian Buijsse
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Matthias Möhlig
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Andreas F. H. Pfeiffer
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Tobias Pischon
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Joachim Spranger
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
| | - Heiner Boeing
- From the Department of Epidemiology (D.D., C.W., K.K.-G., B.B., T.P., and H.B.), German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; the Department of Clinical Chemistry and Pathobiochemistry (J.D.), Otto-von-Guericke University, Magdeburg, Germany; the Institute of Medicine (J.D.), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; the Faculty of Health Sciences (K.K.-G.), School of Public Health, University of the Witwatersrand, Johannesburg, South
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Steinbrecher A, Méplan C, Hesketh J, Schomburg L, Endermann T, Jansen E, Åkesson B, Rohrmann S, Linseisen J. Effects of Selenium Status and Polymorphisms in Selenoprotein Genes on Prostate Cancer Risk in a Prospective Study of European Men. Cancer Epidemiol Biomarkers Prev 2010; 19:2958-68. [DOI: 10.1158/1055-9965.epi-10-0364] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Weikert C, Weikert S, Schulze MB, Pischon T, Fritsche A, Bergmann MM, Willich SN, Boeing H. Presence of gallstones or kidney stones and risk of type 2 diabetes. Am J Epidemiol 2010; 171:447-54. [PMID: 20089496 DOI: 10.1093/aje/kwp411] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Recent evidence suggests that gallstones and kidney stones are associated with insulin resistance, but the relation between stone diseases and the risk of developing type 2 diabetes mellitus is not clear. Participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study (Potsdam, Germany) provided information about the presence of gallstones and kidney stones at recruitment between 1994 and 1998. On biennial questionnaires, participants reported newly diagnosed type 2 diabetes mellitus, and confirmation was obtained from treating physicians. During a mean follow-up period of 7.0 years between 1994 and 2005, 849 incident cases of type 2 diabetes were identified among 25,166 participants. After adjustment for sex, age, waist circumference, and lifestyle risk factors, persons with reported gallstones (n = 3,293) had an increased risk of type 2 diabetes (relative risk = 1.42, 95% confidence interval: 1.21, 1.68). Among the 23,817 participants with information on reported kidney stones (784 cases of incident diabetes), those who developed kidney stones (n = 2,468) were not at increased risk of diabetes in multivariable-adjusted models (relative risk = 1.05, 95% confidence interval: 0.86, 1.27). These findings suggest that gallstones, but not kidney stones, may predict the risk of developing type 2 diabetes, providing physicians with an interventional opportunity to implement adequate prevention measures.
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Affiliation(s)
- Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke,Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany.
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Steinbrecher A, Nimptsch K, Hüsing A, Rohrmann S, Linseisen J. Dietary glucosinolate intake and risk of prostate cancer in the EPIC-Heidelberg cohort study. Int J Cancer 2009; 125:2179-86. [PMID: 19585501 DOI: 10.1002/ijc.24555] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Glucosinolates (GLS) are secondary plant metabolites occurring in cruciferous vegetables. Their biologically active break-down products show cancer preventive properties in animal and cell studies. So far, epidemiologic studies, using consumption of cruciferous vegetables as proxy for GLS intake, yielded inconsistent results. Here, we evaluated the association between dietary intake of GLS in comparison with consumption data of GLS-containing foods and the risk of prostate cancer. The study population comprised 11,405 male participants of the prospective EPIC-Heidelberg cohort study. During a mean follow-up time of 9.4 years, 328 incident cases of prostate cancer occurred. At recruitment, habitual food consumption was assessed by a validated food frequency questionnaire, and intake of individual GLS was estimated by means of a newly compiled database on food content of GLS. Adjusted hazard ratios (HR) for prostate cancer were calculated using the Cox proportional hazard model. Median daily intake of total GLS was 7.9 mg/day (interquartile range 5.1-11.9 mg/day). The risk of prostate cancer decreased significantly over quartiles of total GLS intake (multivariate HR [4th vs. 1st quartile] 0.68, 95% CI 0.48-0.97, p(trend) 0.03). Associations with GLS-containing food intake were weaker. Among GLS subgroups, aliphatic GLS showed the strongest inverse association with cancer risk. Analyses stratified by tumor stage and grade gave hint to inverse associations for localized and low-grade cancers. This study shows an inverse association between dietary intake of GLS and the risk of prostate cancer. Because this is the first prospective study using individual GLS intake data, confirmation in other studies is warranted.
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Affiliation(s)
- Astrid Steinbrecher
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
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Fisher E, Stefan N, Saar K, Drogan D, Schulze MB, Fritsche A, Joost HG, Häring HU, Hubner N, Boeing H, Weikert C. Association of AHSG gene polymorphisms with fetuin-A plasma levels and cardiovascular diseases in the EPIC-Potsdam study. ACTA ACUST UNITED AC 2009; 2:607-13. [PMID: 20031641 DOI: 10.1161/circgenetics.109.870410] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Elevated circulating levels of fetuin-A in blood have been associated with increased risk of cardiovascular disease. The goal of our study was to prospectively investigate the potential causal nature of the association between fetuin-A levels and myocardial infarction (MI) and ischemic stroke by applying a Mendelian randomization approach. METHODS AND RESULTS Five tagging single-nucleotide polymorphisms (rs2248690, rs2070633, rs2070635, rs4917, and rs6787344) capturing the common genetic variation of the fetuin-A coding gene alpha(2)-Heremans-Schmid glycoprotein (AHSG) were genotyped in a case-cohort comprising 214 MI cases, 154 ischemic stroke cases, and 2152 persons who remained free of cardiovascular disease events in the European Prospective Investigation into Cancer and Nutrition-Potsdam study. One single-nucleotide polymorphism (rs6787344) was discarded because of Hardy-Weinberg disequilibrium. All AHSG tagging single-nucleotide polymorphisms were associated with fetuin-A plasma levels (P<0.0001). AHSG rs4917 C>T showed the strongest association, explaining 21.2% of the phenotypic variance independent of potential confounding factors (+35.5 microg/mL increase per C-allele, P= 2 x 10(-121)). Furthermore, the rs4917 C-allele showed a significant association with MI (adjusted hazard rate ratio [RR] 1.34, 95% CI 1.05 to 1.70, P=0.02). Based on this association, the expected RR for MI corresponding to 1 SD in fetuin-A was 1.54 and, thus, strikingly matches the previously observed association between fetuin-A plasma levels and MI risk (RR 1.59). CONCLUSIONS These data provide evidence for the causal nature of the recently reported association between fetuin-A plasma levels and MI risk, thereby suggesting an involvement of fetuin-A in the pathogenesis of cardiovascular disease.
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Affiliation(s)
- Eva Fisher
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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Fisher E, Schulze MB, Stefan N, Häring HU, Döring F, Joost HG, Al-Hasani H, Boeing H, Pischon T. Association of the FTO rs9939609 single nucleotide polymorphism with C-reactive protein levels. Obesity (Silver Spring) 2009; 17:330-4. [PMID: 18948966 DOI: 10.1038/oby.2008.465] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adipose tissue is a key factor determining C-reactive protein (CRP) plasma levels. Variation at the fat-mass and obesity-associated (FTO) gene locus has been reported to be associated with increased body fat. We investigated whether the FTO rs9939609 T>A single nucleotide polymorphism might alter CRP levels in a population-based sample of 2,415 participants from a large prospective cohort study. Genotype/phenotype relationships were studied by linear trend analysis stratified by sex. The rs9939609 A-allele was significantly associated with CRP levels in both genders (men, +21%, P = 0.002; women, +14%, P = 0.01 per A-allele). The association was attenuated, but remained statistically significant after additional adjustment for BMI, waist-to-hip ratio, and other potential confounding factors (men, +14%, P = 0.03; women, +12%, P = 0.02; per A-allele). Similar results were obtained when subjects with CRP levels higher then 10 mg/l were excluded. Our data provide preliminary evidence that the FTO rs9939609 T>A polymorphism contributes to variation in plasma CRP levels independently of obesity indices.
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Affiliation(s)
- Eva Fisher
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost HG, Boeing H. Metabolic syndrome and risk of incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. Cardiovasc Diabetol 2008; 7:35. [PMID: 19077281 PMCID: PMC2627822 DOI: 10.1186/1475-2840-7-35] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 12/12/2008] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Several aspects concerning the relationship between the metabolic syndrome and incident diabetes are incompletely understood including the magnitude of the risk estimate, potential gender differences in the associations between the metabolic syndrome and incident diabetes, the associations between the components of the metabolic syndrome and incident diabetes, and whether the metabolic syndrome provides additional prediction beyond its components. To shed light on these issues, we examined the prospective association between the metabolic syndrome defined by the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) and diabetes. METHODS We used data for 2796 men and women aged 35-65 years from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study followed for an average of 6.9 years. This analysis employed a case-cohort design that included 697 participants who developed diabetes and 2099 participants who did not. Incident diabetes was identified on the basis of self-reports and verified by contacting the patient's attending physician. RESULTS The adjusted hazard ratio for the NCEP definition was 4.62 (95% confidence interval [CI]: 3.90-5.48) and that for the IDF definition was 4.59 (95% CI: 3.84-5.50). The adjusted hazard ratios for the NCEP but not IDF definition were higher for women than men. When participants who had no cardiometabolic abnormalities were used as the reference group for the NCEP definition, the adjusted hazard ratio for having 3 or more abnormalities increased to 22.50 (95% CI: 11.21-45.19). Of the five components, abdominal obesity and hyperglycemia were most strongly associated with incident diabetes. CONCLUSION In this study population, both definitions of the metabolic syndrome provided similar estimates of relative risk for incident diabetes. The increase in risk for participants with the metabolic syndrome according to the NCEP definition was very large when contrasted with the risk among those who had no cardiometabolic abnormalities.
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Affiliation(s)
- Earl S Ford
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Weikert C, Stefan N, Schulze MB, Pischon T, Berger K, Joost HG, Häring HU, Boeing H, Fritsche A. Plasma fetuin-a levels and the risk of myocardial infarction and ischemic stroke. Circulation 2008; 118:2555-62. [PMID: 19029462 DOI: 10.1161/circulationaha.108.814418] [Citation(s) in RCA: 227] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Fetuin-A, a protein almost exclusively secreted by the liver, induces insulin resistance and subclinical inflammation in rodents. Circulating fetuin-A levels are elevated in humans with metabolic syndrome and insulin resistance, conditions that are associated with increased risk of cardiovascular disease. METHODS AND RESULTS We investigated the association between fetuin-A levels and the risk of future myocardial infarction (MI) and ischemic stroke (IS) in a case-cohort study based on the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study comprising 27 548 middle-aged subjects of the general population. Fetuin-A levels were measured in plasma of 227 individuals who developed MI, in 168 who developed IS, and in 2198 individuals who remained free of cardiovascular events during a mean follow-up of 8.2+/-2.2 years. Individuals in the highest compared with the lowest quintile of plasma fetuin-A had significantly increased risks of MI (relative risk, 3.80; 95% confidence interval, 2.37 to 6.10; P for trend <0.0001) and IS (relative risk, 3.93; 95% confidence interval, 2.17 to 7.12; P for trend <0.0001) after adjustment for sex and age. Additional adjustment for smoking status, body mass index, waist circumference, alcohol consumption, educational attainment, physical activity, hypertension, diabetes mellitus, total and high-density lipoprotein cholesterol, and C-reactive protein only moderately attenuated these risks (MI: relative risk, 3.25; 95% confidence interval, 2.01 to 5.28; P for trend <0.0001; IS: relative risk, 3.78; 95% confidence interval, 2.06 to 6.94; P for trend <0.0001). CONCLUSIONS Our data provide evidence for a link between high plasma fetuin-A levels and an increased risk of MI and IS. Therefore, more research is warranted to determine the role of fetuin-A in the pathophysiology of cardiovascular disease.
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Affiliation(s)
- Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany.
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Weikert C, Westphal S, Berger K, Dierkes J, Möhlig M, Spranger J, Rimm EB, Willich SN, Boeing H, Pischon T. Plasma resistin levels and risk of myocardial infarction and ischemic stroke. J Clin Endocrinol Metab 2008; 93:2647-53. [PMID: 18460562 DOI: 10.1210/jc.2007-2735] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CONTEXT Resistin is a hormone that has been linked to insulin resistance, inflammatory processes, and coronary heart disease in case-control studies; however, prospective data on the association between plasma resistin levels and future risk of cardiovascular disease are lacking. OBJECTIVE The objective of the study was to investigate the association between plasma resistin levels and risk of future myocardial infarction (MI) and ischemic stroke (IS) in a large prospective cohort. METHODS We investigated the association between plasma resistin levels and risk of MI and IS in a case-cohort design among 26,490 middle-aged subjects from the European Investigation into Cancer and Nutrition-Potsdam Study without history of MI or stroke at time of blood draw. Plasma resistin levels were measured in baseline blood samples of 139 individuals who developed MI, 97 who developed IS, and 817 individuals who remained free of cardiovascular events during a mean follow-up of 6 yr. RESULTS After multivariable adjustment for established cardiovascular risk factors including C-reactive protein, individuals in the highest compared with the lowest quartile of plasma resistin levels had a significantly increased risk of MI (relative risk 2.09; 95% confidence interval 1.01-4.31; P for trend = 0.01). In contrast, plasma resistin levels were not significantly associated with risk of IS (relative risk 0.94; 95% confidence interval 0.51-1.73; P for trend = 0.88). CONCLUSION Our data suggest that high plasma resistin levels are associated with an increased risk of MI but not with risk of IS. Further studies are needed to evaluate the predictive value of plasma resistin levels for cardiovascular disease.
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Affiliation(s)
- Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition, Arthur-Scheunert-Allee 114-116, Nuthetal, Germany.
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Nitz I, Fisher E, Weikert C, Burwinkel B, Li Y, Möhlig M, Boeing H, Schreiber S, Schrezenmeir J, Döring F. Association analyses of GIP and GIPR polymorphisms with traits of the metabolic syndrome. Mol Nutr Food Res 2007; 51:1046-52. [PMID: 17624916 DOI: 10.1002/mnfr.200700048] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Glucose-dependent insulinotropic polypeptide (GIP) stimulates insulin release via interaction with its pancreatic receptor (GIP receptor (GIPR)). GIP also acts as vasoactive protein. To investigate whether variations in GIP and GIPR genes are associated with risk factors of the metabolic syndrome we sequenced gene regions and identified two coding SNPs (GIP Ser103Gly, GIPR Glu354Gln) and one splice site SNP (GIP rs2291726) in 47 subjects. Interestingly, in silico analyses revealed that splice site SNP rs2291726 results in a truncated protein and classified GIPR variant Glu354Gln as a functional amino acid change. Association analyses were performed in a case-cohort study of incident cardiovascular disease (CVD) nested in the EPIC-Potsdam cohort. No significant associations between incident CVD and GIP Ser103Gly and rs2291726 were found. For GIPR Glu354Gln, we obtained a nominal association of heterozygous minor allele carrier with CVD in a codominant model adjusted for BMI, sex, and age (OR: 0.67, CI: 0.50-0.91, p = 0.01) or additional covariates of CVD (OR: 0.72, CI: 0.52-0.97, p = 0.03). In conclusion, we identified a common splice site mutation (rs2291726) of the GIP gene which results in a truncated protein and provide preliminary evidence for an association of the heterozygous GIPR Glu354Gln genotype with CVD.
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Affiliation(s)
- Inke Nitz
- Department of Molecular Nutrition, Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
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Carbohydrate intake and incidence of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Br J Nutr 2007; 99:1107-16. [PMID: 17988431 DOI: 10.1017/s0007114507853360] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It remains unclear what long-term effects of substituting carbohydrates at the expense of protein or fat may have with regard to diabetes risk. Our objective was to evaluate carbohydrate intake in predicting type 2 diabetes using substitution models for fat and protein. We conducted a prospective cohort study of 9,702 men and 15,365 women aged 35-65 years and free of diabetes at baseline (1994-8) who were followed for incident type 2 diabetes until 2005. Dietary intake of macronutrients was estimated with a validated FFQ. We estimated the relative risk (RR) using Cox proportional hazards analysis. During 176,117 person-years of follow-up we observed 844 incident cases of physician-confirmed type 2 diabetes. After adjustment for age, BMI, waist circumference, potential lifestyle and dietary confounders, substituting 5 % of energy intake from total, saturated, or monounsaturated fat with carbohydrates was not associated with diabetes risk. In contrast, substituting carbohydrates for protein or PUFA was inversely related to diabetes risk (RR for 5 % energy substitution of protein 0.77 (95 % CI 0.64, 0.91); RR for PUFA 0.83 (95 % CI 0.70, 0.98)). These associations appeared to be similar for men and women, but gained statistical significance only among men for protein (RR 0.78 (95 % CI 0.61, 0.99)). Restricted cubic spline regression did not indicate non-linearity of these associations (P for non-linearity in full cohort was 0.353 and 0.349). In conclusion, a higher carbohydrate intake at the expense of protein and PUFA might be associated with decreased diabetes risk.
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Weikert C, Dierkes J, Hoffmann K, Berger K, Drogan D, Klipstein-Grobusch K, Spranger J, Möhlig M, Luley C, Boeing H. B Vitamin Plasma Levels and the Risk of Ischemic Stroke and Transient Ischemic Attack in a German Cohort. Stroke 2007; 38:2912-8. [PMID: 17885260 DOI: 10.1161/strokeaha.107.486068] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background and Purpose—
Data from prospective studies on the associations between B vitamin plasma levels and the risk of stroke are limited. We investigated the individual and combined effects of plasma folate, vitamin B12, and pyridoxal 5-phophate (PLP) levels on the risk of ischemic stroke and transient ischemic attack (TIA) in a large, prospective German cohort.
Methods—
Incident cases of ischemic stroke or TIA were identified among 25 770 participants (age 35 to 65 years) of the European Prospective Investigation into Cancer and Nutrition-Potsdam Study during 6.0±1.5 years of follow-up. The present analysis is based on a case-cohort study comprising 779 subjects free from cardiovascular disease and 188 incident cases of cerebral ischemia (ischemic stroke or TIA). Multivariable Cox proportional-hazard models were applied to evaluate the association between B vitamin levels and risk of cerebral ischemia.
Results—
Participants in the lowest tertile of vitamin B12 values were at increased risk of cerebral ischemia compared with subjects in the highest tertile; this was not observed, however, for either folate or PLP. In subgroup analyses, the relative risks were similar in magnitude for stroke and TIA. When various combinations of B vitamin tertile levels were analyzed, only combined low folate and vitamin B12 levels (relative risk, 2.24; 95% CI, 1.10 to 4.54) were significantly related to an increased risk of cerebrovascular ischemia.
Conclusions—
Our data suggest that low vitamin B12 plasma levels, particularly in combination with low folate levels, increase the risk of cerebral ischemia. This effect may be mediated at least partly through elevations of homocysteine levels.
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Affiliation(s)
- Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany.
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Nitz I, Fisher E, Grallert H, Li Y, Gieger C, Rubin D, Boeing H, Spranger J, Lindner I, Schreiber S, Rathmann W, Gohlke H, Döring A, Wichmann HE, Schrezenmeir J, Döring F, Illig T. Association of prostaglandin E synthase 2 (PTGES2) Arg298His polymorphism with type 2 diabetes in two German study populations. J Clin Endocrinol Metab 2007; 92:3183-8. [PMID: 17566096 DOI: 10.1210/jc.2006-2550] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT On the basis of its chromosomal localization and its role in the synthesis of the antilipolytic compound prostaglandin E(2), the prostaglandin E synthase 2 (PTGES2) is a candidate gene for type 2 diabetes. OBJECTIVE The aim of the present study was to investigate whether genetic variants in the PTGES2 gene are associated with type 2 diabetes. RESULTS Sequencing of the PTGES2 gene revealed one nonsynonymous coding single-nucleotide polymorphism (SNP) (Arg298His, rs13283456) and a previously unknown promoter SNP g.-417G>T. Both SNPs and additional haplotype tagging SNPs (rs884115, rs10987883, rs4837240) were genotyped in a nested case-control study of 192 incident type 2 diabetes subjects and 384 controls (European Prospective Investigation into Cancer and Nutrition-Potsdam). Carriers of the minor allele of Arg298His had a lower risk to develop the disease [odds ratio (OR) 0.63, 95% confidence interval (CI) 0.41-0.97, P = 0.04], compared with homozygous individuals with the common allele. The PTGES2 Arg298His polymorphism was reinvestigated in a population-based cross-sectional study (Cooperative Health Research in the Augsburg Region) consisting of 239 individuals with impaired glucose tolerance, 226 with type 2 diabetes, and 863 normoglycemic controls. In this study population, the Arg298His polymorphism was significantly associated with impaired glucose tolerance (OR 0.68, 95% CI 0.50-0.93, P = 0.007) and type 2 diabetes (OR 0.61, 95% CI 0.43-0.86, P = 0.004). A pooled analysis of data from both study populations revealed reduced risk of type 2 diabetes (OR 0.62, 95% CI 0.47-0.81, P = 0.0005) in PTGES2 298His allele carriers. CONCLUSION We obtained evidence from two Caucasian study populations that the His298-allele of PTGES2 Arg298His confers to reduced risk of type 2 diabetes.
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Affiliation(s)
- Inke Nitz
- Molecular Nutrition, Christian-Albrechts-University of Kiel, Kiel, Germany
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Drogan D, Hoffmann K, Schulz M, Bergmann MM, Boeing H, Weikert C. A food pattern predicting prospective weight change is associated with risk of fatal but not with nonfatal cardiovascular disease. J Nutr 2007; 137:1961-7. [PMID: 17634271 DOI: 10.1093/jn/137.8.1961] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Recently, a food pattern predictive for prospective weight change was identified within the European Prospective Investigation into Cancer and Nutrition-Potsdam cohort. Given the possible impact of weight change on cardiovascular disease (CVD) risk, we examined the association between the above mentioned food pattern and risk of CVD. The analyzed food pattern was defined by a high consumption of whole-grain bread, fruits, fruit juices, grain flakes and/or cereals, and raw vegetables, and a low consumption of processed meat, butter, high-fat cheese, margarine, and meat other than poultry. The associations between quartiles of the food pattern score and CVD morbidity and mortality were examined in 26,238 subjects of the European Prospective Investigation into Cancer and Nutrition-Potsdam cohort using a Cox's Proportional Hazards model for competing risks. During 6.4 y of follow-up, 379 incident cases of CVD were identified, of which 68 were fatal events. The food pattern was not associated with risk of nonfatal CVD. After adjusting for cardiovascular risk factors, the hazard ratios for fatal CVD across increasing quartiles of the score were 1.00, 0.85, 0.31, and 0.47, respectively (P for trend = 0.016). The association of the food pattern with CVD risk differed between fatal and nonfatal events (P for difference = 0.05). These findings from a large German cohort indicate that a food pattern predicting prospective weight change may be associated with the risk of fatal CVD.
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Affiliation(s)
- Dagmar Drogan
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Nuthetal, 14558 Germany.
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Fisher E, Weikert C, Klapper M, Lindner I, Möhlig M, Spranger J, Boeing H, Schrezenmeir J, Döring F. L-FABP T94A is associated with fasting triglycerides and LDL-cholesterol in women. Mol Genet Metab 2007; 91:278-84. [PMID: 17485234 DOI: 10.1016/j.ymgme.2007.03.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Revised: 03/08/2007] [Accepted: 03/08/2007] [Indexed: 11/22/2022]
Abstract
To determine the possible role of the common FABP1 T94A polymorphism in modulating susceptibility to traits of the metabolic syndrome, we analysed a random sample of 826 subjects from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort. Multivariate adjusted linear trend regression analysis of metabolic, anthropometric and blood pressure variables in FABP1 T94A genotypes were performed in both genders. In women, a significant trend of higher plasma triglyceride (P=0.01) and LDL-cholesterol (P=0.02) concentrations were seen for A-allele carriers after adjustment for age, menopausal status, hormone intake and Apo E genotype. Because elevated triglyceride and cholesterol levels are important risk factors of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), we additionally analysed the association of the T94A variant and disease risks in two studies enrolling 220 incident CVD and 192 incident T2DM patients of the EPIC-Potsdam cohort. After adjusting for age, sex, BMI and other covariates, we found no association between FABP1 T94A and CVD or T2DM. In conclusion, our study provides evidence for an association of the FABP1 T94A polymorphism and fasting triglycerides and LDL-cholesterol levels in females. These results support previous findings in fenofibrate-treated individuals and thereby provide some additional indication of the functional relevance of the FABP1 T94A SNP in hepatic fatty acid and lipid metabolism in humans.
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Affiliation(s)
- Eva Fisher
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
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Heidemann C, Hoffmann K, Klipstein-Grobusch K, Weikert C, Pischon T, Hense HW, Boeing H. Potentially modifiable classic risk factors and their impact on incident myocardial infarction: results from the EPIC-Potsdam study. ACTA ACUST UNITED AC 2007; 14:65-71. [PMID: 17301629 DOI: 10.1097/01.hjr.0000238392.19847.4c] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prospective data on the importance of established risk factors for myocardial infarction in Germany are sparse. DESIGN The population-based cohort study European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam with 159 incident cases of myocardial infarction (120 men, 39 women) occurring among 26 954 participants (10 463 men, 16 491 women) during an average follow-up time of 4.6 years. METHODS We examined the classic, potentially modifiable risk factors smoking, hypertension, hyperlipidemia, diabetes mellitus, abdominal obesity, and sporting inactivity, both individually and in combination, by estimating their prevalence and their relative and population-attributable risks of incident myocardial infarction. RESULTS After adjusting for age, sex, educational attainment, alcohol intake, and the respective other classic risk factors the relative risks of myocardial infarction were 3.18 for smoking [95% confidence interval (CI) 2.31, 4.38], 1.84 for hypertension (95% CI 1.27, 2.65), 1.81 for sporting inactivity (95% CI 1.04, 3.15), 1.64 for diabetes (95% CI 1.05, 2.56), 1.62 for abdominal obesity (95% CI 1.03, 2.56), and 1.15 for hyperlipidemia (95% CI 0.84, 1.59). Participants with four or all five significant risk factors had an approximately 11.5-fold higher risk of the coronary event than participants with none or one risk factor. Altogether, 84.3% of myocardial infarctions in the study population were attributable to the presence of the five risk factors smoking, hypertension, diabetes, sporting inactivity, and abdominal obesity. CONCLUSION The majority of myocardial infarctions in the EPIC-Potsdam cohort were explainable by potentially modifiable classic risk factors. Therefore, besides efforts to investigate novel coronary risk factors, the prevention of coronary disease should focus on strategies to reduce the prevalence of established risk factors.
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Affiliation(s)
- Christin Heidemann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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45
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Hoffmann K, Boeing H, Boffetta P, Nagel G, Orfanos P, Ferrari P, Bamia C. Comparison of two statistical approaches to predict all-cause mortality by dietary patterns in German elderly subjects. Br J Nutr 2007; 93:709-16. [PMID: 15975171 DOI: 10.1079/bjn20051399] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dietary patterns are comprehensive variables of dietary intake appropriate to model the complex exposure in nutritional research. The objectives of this study were to identify dietary patterns by applying two statistical methods, principal component analysis (PCA) and reduced rank regression (RRR), and to assess their ability to predict all-cause mortality. Motivated by previous studies we chose percentages of energy from different macronutrients as response variables in the RRR analysis. We used data from 9356 German elderly subject enrolled in the European Prospective Investigation into Cancer and Nutrition study. The first RRR pattern, subjects which explained 30·8 % of variation in energy sources and especially much variation in intake of saturated fat, monounsaturated fat and carbohydrates was a significant predictor of all-cause mortality. The pattern score had high positive loadings in all types of meat, butter, sauces and eggs, and was inversely associated with bread and fruits. After adjustment for other known risk factors, the relative risks from the lowest to highest quintiles of the first RRR pattern score were 1·0, 1·01, 0·96, 1·32, 1·61 (P for trend: 0·0004). In contrast, the first two PCA patterns explaining 19·7 % of food intake variation but only 7·0 % of variation in energy sources were not related to mortality. These results suggest that variation in macronutrients is meaningful for mortality and that the RRR method is more appropriate than the classic PCA method to identify dietary patterns relevant to mortality.
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Affiliation(s)
- Kurt Hoffmann
- Department of Epidemiology, German Institute of Human Nutrition, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
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Weikert C, Berger K, Heidemann C, Bergmann MM, Hoffmann K, Klipstein-Grobusch K, Boeing H. Joint effects of risk factors for stroke and transient ischemic attack in a German population. J Neurol 2007; 254:315-21. [PMID: 17345050 DOI: 10.1007/s00415-006-0358-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Accepted: 07/26/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND Single, modifiable risk factors for stroke have extensively been studied. In contrast, differences of their combined effects among stroke and transitoy ischemic attack (TIA) have been rarely investigated. The aim of the present study was to assess single and joint effects of risk factors on the incidence of stroke and TIA and to compare their magnitudes in a large population-based German cohort. METHODS Incident cases of stroke and TIA were identified among 25,538 participants (aged 35-65 at baseline) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Relative risks for stroke and TIA related to modifiable risk factors were estimated using Cox proportional hazard models. RESULTS During 4.3 years of follow-up 100 stroke cases and 112 TIA cases occurred. Incidences of stroke and TIA were 91.7 and 102.7 per 100,000 person-years, respectively. Relative risks for ischemic stroke (RR 5.12, 95% CI 1.49-17.6, p for trend<0.0001) and for TIA (RR 3.08, 95% CI 1.00-9.44, p for trend<0.024) were highest among participants having 4 or 5 modifiable risk factors. 58.5% of ischemic strokes and 26.2% of TIA cases were attributable to the 5 risk factors hypertension, diabetes mellitus, high alcohol consumption, hyperlipidemia, and smoking. CONCLUSION Our data indicate that classical risk factors may explain almost 60% of ischemic stroke but only one in four TIA cases. Analysing potential differences of known risk factors between ischemic stroke and TIAs and the identification of other determinants of ischemic attacks are important steps to better explain the burden of stroke.
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Affiliation(s)
- Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
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Drogan D, Klipstein-Grobusch K, Dierkes J, Weikert C, Boeing H. Dietary intake of folate equivalents and risk of myocardial infarction in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam study. Public Health Nutr 2007; 9:465-71. [PMID: 16870018 DOI: 10.1079/phn2005863] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectiveTo assess the relationship between intake of dietary folate equivalents and risk of myocardial infarction in a German cohort.DesignIntake of dietary folate equivalents was assessed by a validated food-frequency questionnaire. Cox proportional hazard models were used to evaluate the association between intake of dietary folate equivalents and risk of myocardial infarction.SettingThe European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam cohort, Germany.SubjectsSubjects were 22 245 apparently healthy non-users of vitamin supplements aged 35–64 years.ResultsDuring 4.6 years of follow-up, 129 incident cases of myocardial infarction were identified. Compared with intake below the median (103 μg), higher intake of dietary folate equivalents was associated with a multivariate-adjusted hazard ratio (HR) of 0.57 (95% confidence interval (CI) 0.36–0.91). The inverse association of folate intake and myocardial infarction risk was stronger in participants with an ethanol intake equal to or above the sex-specific median (HR = 0.37, 95% CI 0.18–0.79) and attenuated in those with a low ethanol intake (HR = 0.67, 95% CI 0.37–1.22).ConclusionAn increased intake of dietary folate equivalents was observed to be associated with decreased risk of myocardial infarction in a German study population, pointing towards the importance of folate intake with respect to primary prevention of myocardial infarction.
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Affiliation(s)
- Dagmar Drogan
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany
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Schulze MB, Heidemann C, Schienkiewitz A, Bergmann MM, Hoffmann K, Boeing H. Comparison of anthropometric characteristics in predicting the incidence of type 2 diabetes in the EPIC-Potsdam study. Diabetes Care 2006; 29:1921-3. [PMID: 16873804 DOI: 10.2337/dc06-0895] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Matthias B Schulze
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal.
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Schienkiewitz A, Schulze MB, Hoffmann K, Kroke A, Boeing H. Body mass index history and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study. Am J Clin Nutr 2006. [DOI: 10.1093/ajcn/84.2.427] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Anja Schienkiewitz
- From the Department of Epidemiology, German Institute of Human Nutrition Potsdam–Rehbrücke, Germany (AS, MBS, KH, and HB), and the Department of Nutrition and Health, Research Institute of Child Nutrition, Dortmund, Germany (AK)
| | - Matthias B Schulze
- From the Department of Epidemiology, German Institute of Human Nutrition Potsdam–Rehbrücke, Germany (AS, MBS, KH, and HB), and the Department of Nutrition and Health, Research Institute of Child Nutrition, Dortmund, Germany (AK)
| | - Kurt Hoffmann
- From the Department of Epidemiology, German Institute of Human Nutrition Potsdam–Rehbrücke, Germany (AS, MBS, KH, and HB), and the Department of Nutrition and Health, Research Institute of Child Nutrition, Dortmund, Germany (AK)
| | - Anja Kroke
- From the Department of Epidemiology, German Institute of Human Nutrition Potsdam–Rehbrücke, Germany (AS, MBS, KH, and HB), and the Department of Nutrition and Health, Research Institute of Child Nutrition, Dortmund, Germany (AK)
| | - Heiner Boeing
- From the Department of Epidemiology, German Institute of Human Nutrition Potsdam–Rehbrücke, Germany (AS, MBS, KH, and HB), and the Department of Nutrition and Health, Research Institute of Child Nutrition, Dortmund, Germany (AK)
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Lindner I, Helwig U, Rubin D, Li Y, Fisher E, Boeing H, Möhlig M, Spranger J, Pfeiffer A, Hampe J, Schreiber S, Döring F, Schrezenmeir J. Putative association between a new polymorphism in exon 3 (Arg109Cys) of the pancreatic colipase gene and type 2 diabetes mellitus in two independent Caucasian study populations. Mol Nutr Food Res 2005; 49:972-6. [PMID: 16189801 DOI: 10.1002/mnfr.200500087] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The protein encoded by the pancreatic colipase (CLPS) gene is an essential cofactor needed by pancreatic triglyceride lipase (PNLIP) for efficient dietary lipid hydrolysis. Since the inhibition of lipase activity was shown to reduce the incidence of type 2 diabetes mellitus, we tested the hypothesis that genetic variations in the CLPS and PNLIP genes are associated with type 2 diabetes; 47 unrelated subjects were screened for polymorphisms of the CLPS and PNLIP genes. A nested-case control study of 192 incident type 2 diabetes subjects and 384 sex- and age-matched controls taken from the European Prospective Investigation into Cancer and Nutrition Potsdam Cohort (EPIC) was employed for association studies. The Metabolic Intervention Cohort Kiel (MICK) consisting of 716 males was used for verification. A novel putative functional polymorphism (Arg109Cys) was identified in the CLPS gene. The frequencies of the Arg/Cys genotype were 2.6% in EPIC and 2.2% in MICK study subjects. No homozygotes for the Cys/Cys genotype were found in either study population. Logistic regression analysis showed a statistically significant association of the Arg/Cys genotype with an increased risk of type 2 diabetes. The odds ratios estimated by the model were 3.75 (95%CI = 1.13-12.49, p = 0.03) in EPIC and 4.86 (95%CI = 1.13-20.95, p = 0.03) in MICK. No comparable associations were found with other traits of the insulin-resistance syndrome (e. g.; body mass index, waist to hip ratio). In conclusion, we obtained evidence in two German Caucasian study populations that the variant of the rare CLPS Arg109Cys polymorphism might contribute to increased susceptibility of type 2 diabetes.
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Affiliation(s)
- Inka Lindner
- Institute for Physiology and Biochemistry of Nutrition, Federal Research Center for Nutrition and Food, Hermann-Weigmann-Strasse 1, 24103 Kiel, Germany
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