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Kühn T, Stepien M, López-Nogueroles M, Damms-Machado A, Sookthai D, Johnson T, Roca M, Hüsing A, Maldonado SG, Cross AJ, Murphy N, Freisling H, Rinaldi S, Scalbert A, Fedirko V, Severi G, Boutron-Ruault MC, Mancini FR, Sowah SA, Boeing H, Jakszyn P, Sánchez MJ, Merino S, Colorado-Yohar S, Barricarte A, Khaw KT, Schmidt JA, Perez-Cornago A, Trichopoulou A, Karakatsani A, Thriskos P, Palli D, Agnoli C, Tumino R, Sacerdote C, Panico S, Bueno-de-Mesquita B, van Gils CH, Heath AK, Gunter MJ, Riboli E, Lahoz A, Jenab M, Kaaks R. Prediagnostic Plasma Bile Acid Levels and Colon Cancer Risk: A Prospective Study. J Natl Cancer Inst 2020; 112:516-524. [PMID: 31435679 PMCID: PMC7225675 DOI: 10.1093/jnci/djz166] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/24/2019] [Accepted: 08/14/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans. METHODS Associations between prediagnostic plasma levels of 17 primary, secondary, and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Bile acid levels were quantified by tandem mass spectrometry in samples from 569 incident colon cancer cases and 569 matched controls. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) for colon cancer risk across quartiles of bile acid concentrations. RESULTS Positive associations were observed between colon cancer risk and plasma levels of seven conjugated bile acid metabolites: the primary bile acids glycocholic acid (ORquartile 4 vs quartile 1= 2.22, 95% confidence interval [CI] = 1.52 to 3.26), taurocholic acid (OR = 1.78, 95% CI = 1.23 to 2.58), glycochenodeoxycholic acid (OR = 1.68, 95% CI = 1.13 to 2.48), taurochenodeoxycholic acid (OR = 1.62, 95% CI = 1.11 to 2.36), and glycohyocholic acid (OR = 1.65, 95% CI = 1.13 to 2.40), and the secondary bile acids glycodeoxycholic acid (OR = 1.68, 95% CI = 1.12 to 2.54) and taurodeoxycholic acid (OR = 1.54, 95% CI = 1.02 to 2.31). By contrast, unconjugated bile acids and tertiary bile acids were not associated with risk. CONCLUSIONS This prospective study showed that prediagnostic levels of certain conjugated primary and secondary bile acids were positively associated with risk of colon cancer. Our findings support experimental data to suggest that a high bile acid load is colon cancer promotive.
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Affiliation(s)
- Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Magdalena Stepien
- International Agency for Research on Cancer, Nutritional Epidemiology Group
| | - Marina López-Nogueroles
- Section of Nutrition and Metabolism, Lyon, France; Health Research Institute Hospital La Fe, Analytical Unit, Biomarkers and Precision Medicine Unit Valencia, Spain
| | - Antje Damms-Machado
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Disorn Sookthai
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Theron Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Marta Roca
- Section of Nutrition and Metabolism, Lyon, France; Health Research Institute Hospital La Fe, Analytical Unit, Biomarkers and Precision Medicine Unit Valencia, Spain
| | - Anika Hüsing
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | | | - Amanda J Cross
- School of Public Health, Imperial College London, St Mary's Campus, London, UK
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Neil Murphy
- International Agency for Research on Cancer, Nutritional Epidemiology Group
| | | | | | | | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta
| | - Gianluca Severi
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif
- Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif
- Gustave Roussy, Villejuif, France
| | - Francesca Romana Mancini
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif
- Gustave Roussy, Villejuif, France
| | - Solomon A Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, L'Hospitallet de Llobregat, Barcelona, Spain
- Facultat de Ciències de la Salut Blanquerna, Universitat Ramón Llull, Barcelona, Spain
| | - Maria J Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | | | - Sandra Colorado-Yohar
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research Pamplona, Spain
| | - Kay Tee Khaw
- University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University Hospital, Haidari, Greece
| | | | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P. Arezzo" Hospital, ASP, Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention, Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- School of Public Health, Imperial College London, St Mary's Campus, London, UK
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology
- University Medical Centre, Utrecht, the Netherlands; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Alicia K Heath
- School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Marc J Gunter
- International Agency for Research on Cancer, Nutritional Epidemiology Group
| | - Elio Riboli
- School of Public Health, Imperial College London, St Mary's Campus, London, UK
| | - Agustín Lahoz
- Section of Nutrition and Metabolism, Lyon, France; Health Research Institute Hospital La Fe, Analytical Unit, Biomarkers and Precision Medicine Unit Valencia, Spain
| | - Mazda Jenab
- International Agency for Research on Cancer, Nutritional Epidemiology Group
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
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Holtfreter B, Samietz S, Hertrampf K, Aarabi G, Hagenfeld D, Kim TS, Kocher T, Koos B, Schmitter M, Ahrens W, Alwers E, Becher H, Berger K, Brenner H, Damms-Machado A, Ebert N, Fischer B, Franzke CW, Frölich S, Greiser H, Gies A, Günther K, Hassan L, Hoffmann W, Jaeschke L, Keil T, Kemmling Y, Krause G, Krist L, Legath N, Lieb W, Leitzmann M, Linseisen J, Loeffler M, Meinke-Franze C, Michels KB, Mikolajczyk R, Obi N, Peters A, Pischon T, Schipf S, Schmidt B, Völzke H, Waniek S, Wigmann C, Wirkner K, Schmidt CO, Kühnisch J, Rupf S. Design und Qualitätskontrolle der zahnmedizinischen Untersuchung in der NAKO Gesundheitsstudie. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:426-438. [DOI: 10.1007/s00103-020-03107-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Zusammenfassung
Hintergrund
Karies und Parodontitis sind weltweit hoch prävalente Erkrankungen. Durch ihre Erfassung im Rahmen der NAKO Gesundheitsstudie können Assoziationen zwischen oralen und systemischen Erkrankungen untersucht werden.
Fragestellung
In einer ersten Qualitätsanalyse zur Halbzeit der NAKO-Basiserhebung wird die Plausibilität der zahnmedizinischen Ergebnisse überprüft. Es werden Maßnahmen zur Verbesserung der Datenqualität vorgeschlagen.
Material und Methoden
Ein zahnmedizinisches Interview, eine Speichelprobengewinnung und eine Befunderhebung wurden durchgeführt. Im Rahmen der Level-1-Untersuchung wurden Zahn- und Prothesenanzahl erfasst. In der Level-2-Untersuchung wurden detaillierte parodontologische, kariologische und funktionelle Befunde erhoben. Alle Untersuchungen wurden von geschultem nichtzahnmedizinischen Personal durchgeführt. Es wurden Plausibilitätsprüfungen durchgeführt sowie Verteilungen deskriptiv dargestellt.
Ergebnisse
In die Analysen gingen Daten von 57.967 Interviewteilnehmer*innen, 56.913 Level-1- und 6295 Level-2-Teilnehmer*innen ein. Der Anteil fehlender Werte lag für die einzelnen Parameter der Level-1- und Level-2-Untersuchungen zwischen 0,02 % und 3,9 %. Die Parameter zeigten eine plausible Verteilung; vereinzelt wurden unplausible Werte beobachtet, z. B. beim horizontalen und vertikalen Überbiss (Overjet und Overbite). Anhand der Intraklassenkorrelationskoeffizienten wurden für die einzelnen Parameter Unterschiede zwischen regionalen Clustern, den Studienzentren und verschiedenen Untersucher*innen nachgewiesen.
Diskussion
Die bisherigen Ergebnisse bestätigten die Umsetzbarkeit des Studienprotokolls durch nichtzahnmedizinisches Personal und die erfolgreiche Integration in das Untersuchungsprogramm der NAKO Gesundheitsstudie. Die Studienzentren benötigen eine intensive zahnmedizinische Betreuung für das Qualitätsmanagement.
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Wolf K, Kraus U, Dzolan M, Bolte G, Lakes T, Schikowski T, Greiser KH, Kuß O, Ahrens W, Bamberg F, Becher H, Berger K, Brenner H, Castell S, Damms-Machado A, Fischer B, Franzke CW, Gastell S, Günther K, Holleczek B, Jaeschke L, Kaaks R, Keil T, Kemmling Y, Krist L, Legath N, Leitzmann M, Lieb W, Loeffler M, Meinke-Franze C, Michels KB, Mikolajczyk R, Moebus S, Mueller U, Obi N, Pischon T, Rathmann W, Schipf S, Schmidt B, Schulze M, Thiele I, Thierry S, Waniek S, Wigmann C, Wirkner K, Zschocke J, Peters A, Schneider A. [Nighttime transportation noise annoyance in Germany: personal and regional differences in the German National Cohort Study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:332-343. [PMID: 32047975 DOI: 10.1007/s00103-020-03094-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Noise annoyance is associated with adverse health-related conditions and reduced wellbeing. Thereby, subjective noise annoyance depends on the objective noise exposure and is modified by personal and regional factors. OBJECTIVE How many participants of the German National Cohort Study (GNC; NAKO Gesundheitsstudie) were annoyed by transportation noise during nighttime and what factors were associated with noise annoyance? MATERIALS AND METHODS This cross-sectional analysis included 86,080 participants from 18 study centers, examined from 2014 to 2017. We used multinomial logistic regression to investigate associations of personal and regional factors to noise annoyance (slightly/moderately or strongly/extremely annoyed vs. not annoyed) mutually adjusting for all factors in the model. RESULTS Two thirds of participants were not annoyed by transportation noise during nighttime and one in ten reported strong/extreme annoyance with highest percentages for the study centers Berlin-Mitte and Leipzig. The strongest associations were seen for factors related to the individual housing situation like the bedroom being positioned towards a major road (OR of being slightly/moderately annoyed: 4.26 [95% CI: 4.01;4.52]; OR of being strongly/extremely annoyed: 13.36 [95% CI: 12.47;14.32]) compared to a garden/inner courtyard. Participants aged 40-60 years and those in low- and medium-income groups reported greater noise annoyance compared to younger or older ones and those in the high-income group. CONCLUSION In this study from Germany, transportation noise annoyance during nighttime varied by personal and regional factors.
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Affiliation(s)
- Kathrin Wolf
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland.
| | - Ute Kraus
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland
| | - Mihovil Dzolan
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland
- Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, München, Deutschland
| | - Gabriele Bolte
- Institut für Public Health und Pflegeforschung, Abteilung Sozialepidemiologie, Universität Bremen, Bremen, Deutschland
| | - Tobia Lakes
- Geographisches Institut, Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Tamara Schikowski
- IUF - Leibniz-Institut für Umweltmedizinische Forschung, Düsseldorf, Deutschland
| | - Karin Halina Greiser
- Abteilung Epidemiologie von Krebserkrankungen, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Oliver Kuß
- Deutsches Diabetes-Zentrum (DDZ), Institut für Biometrie und Epidemiologie, Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - Wolfgang Ahrens
- Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Bremen, Deutschland
- Institut für Statistik, Fachbereich Mathematik und Informatik, Universität Bremen, Bremen, Deutschland
| | - Fabian Bamberg
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Heiko Becher
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Klaus Berger
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - Hermann Brenner
- Abteilung Klinische Epidemiologie und Alternsforschung, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Stefanie Castell
- Abteilung für Epidemiologie, Helmholtz-Zentrum für Infektionsforschung (HZI), Braunschweig, Deutschland
| | - Antje Damms-Machado
- Abteilung Epidemiologie von Krebserkrankungen, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Beate Fischer
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Claus-Werner Franzke
- Institut für Prävention und Tumorepidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Sylvia Gastell
- Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke, NAKO Studienzentrum, Nuthetal, Deutschland
| | - Kathrin Günther
- Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Bremen, Deutschland
| | | | - Lina Jaeschke
- Forschergruppe Molekulare Epidemiologie, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Berlin, Deutschland
| | - Rudolf Kaaks
- Abteilung Epidemiologie von Krebserkrankungen, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Thomas Keil
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg, Deutschland
- Landesinstitut für Gesundheit, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Bad Kissingen, Deutschland
| | - Yvonne Kemmling
- Abteilung für Epidemiologie, Helmholtz-Zentrum für Infektionsforschung (HZI), Braunschweig, Deutschland
| | - Lilian Krist
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Nicole Legath
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - Michael Leitzmann
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Wolfgang Lieb
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - Markus Loeffler
- Leipziger Forschungszentrum für Zivilisationserkrankungen (LIFE), Universität Leipzig, Leipzig, Deutschland
- Institut für Medizinische Informatik, Statistik, und Epidemiologie (IMISE), Universität Leipzig, Leipzig, Deutschland
| | - Claudia Meinke-Franze
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Karin B Michels
- Institut für Prävention und Tumorepidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Rafael Mikolajczyk
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Susanne Moebus
- Institut für medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Deutschland
| | - Ulrich Mueller
- Bundesinstitut für Bevölkerungsforschung, Wiesbaden, Deutschland
| | - Nadia Obi
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Tobias Pischon
- Forschergruppe Molekulare Epidemiologie, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Berlin, Deutschland
- Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partnerstandort Berlin, Berlin, Deutschland
- MDC/BIH Biobank, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC) und Berlin Institute of Health (BIH), Berlin, Deutschland
| | - Wolfgang Rathmann
- Deutsches Diabetes-Zentrum (DDZ), Institut für Biometrie und Epidemiologie, Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - Sabine Schipf
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Börge Schmidt
- Institut für medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Deutschland
| | - Matthias Schulze
- Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke, Nuthetal, Deutschland
| | - Inke Thiele
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland
| | - Sigrid Thierry
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland
- NAKO Studienzentrum, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Sabina Waniek
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - Claudia Wigmann
- IUF - Leibniz-Institut für Umweltmedizinische Forschung, Düsseldorf, Deutschland
| | - Kerstin Wirkner
- Leipziger Forschungszentrum für Zivilisationserkrankungen (LIFE), Universität Leipzig, Leipzig, Deutschland
- Institut für Medizinische Informatik, Statistik, und Epidemiologie (IMISE), Universität Leipzig, Leipzig, Deutschland
| | - Johannes Zschocke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Annette Peters
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität München, München, Deutschland
| | - Alexandra Schneider
- Institut für Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland
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4
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Sowah SA, Riedl L, Damms-Machado A, Johnson TS, Schübel R, Graf M, Kartal E, Zeller G, Schwingshackl L, Stangl GI, Kaaks R, Kühn T. Effects of Weight-Loss Interventions on Short-Chain Fatty Acid Concentrations in Blood and Feces of Adults: A Systematic Review. Adv Nutr 2019; 10:673-684. [PMID: 31075175 PMCID: PMC6628843 DOI: 10.1093/advances/nmy125] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/30/2018] [Accepted: 12/06/2018] [Indexed: 01/11/2023] Open
Abstract
Short-chain fatty acids (SCFAs, mainly acetate, propionate, and butyrate), which are primarily derived from the gut microbiome, may exert anti-inflammatory and immunomodulatory effects, and regulate energy homeostasis. It has been suggested that weight loss may affect SCFA metabolism, but a systematic review of intervention studies is lacking. We aimed to systematically assess the effects of dietary, physical activity-based, and surgical weight-loss interventions among overweight [body mass index (BMI) 25-29.9 kg/m2)] or obese (BMI ≥30 kg/m2) adults (≥18 y) on concentrations of acetate, propionate, butyrate, and total SCFAs in blood, urine, or feces. We conducted a systematic literature search in PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to April 30, 2018 for randomized and nonrandomized weight-loss trials among overweight or obese adults, in which the concentrations of individual and total SCFAs were assessed. A total of 9 studies consisting of 2 randomized parallel-arm trials, 4 crossover trials, and 3 nonrandomized clinical or surgical trials were included. In the majority of studies, changes in fecal SCFA concentrations were assessed, whereas changes in serum SCFAs were reported from 1 trial. Individual and total SCFA concentrations either remained unchanged or decreased significantly following weight loss. Three of the dietary interventions that resulted in decreased SCFA concentrations were low (≤5% of energy) in total carbohydrates. Most of the studies had a high risk of bias. Decreases in SCFA concentrations may accompany weight loss induced by bariatric surgery or dietary restriction among overweight or obese adults, particularly when carbohydrate intake is reduced. However, findings were inconsistent and based on studies with high to unclear risk of bias, and small sample sizes. Because measurements of fecal SCFAs may not be ideal due to limited sample standardization, well-powered trials with repeated blood measurements of SCFAs are required. This review was registered at PROSPERO as CRD42018088716.
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Affiliation(s)
- Solomon A Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany,Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Lena Riedl
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Antje Damms-Machado
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Theron S Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Mirja Graf
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Ece Kartal
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany,European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Georg Zeller
- European Molecular Biology Laboratory (EMBL), Structural and Computational Biology Unit, Heidelberg, Germany
| | - Lukas Schwingshackl
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, Heidelberg, Germany,Address correspondence to TK (e-mail: )
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Fortner RT, Damms-Machado A, Kaaks R. Systematic review: Tumor-associated antigen autoantibodies and ovarian cancer early detection. Gynecol Oncol 2017; 147:465-480. [PMID: 28800944 DOI: 10.1016/j.ygyno.2017.07.138] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Tumor-associated autoantibodies (AAbs), produced as an immune response to tumor-associated antigens (TAAs), are a novel pathway of early detection markers. METHODS We conducted a systematic review on AAbs and ovarian cancer to summarize the diagnostic performance of individual AAbs and AAb panels. A total of 29 studies including 85 AAbs were included; 27 of the studies were conducted in prevalent cases and cancer-free controls and 2 investigations included pre-diagnosis samples. The majority of studies were hypothesis-driven, evaluating AAbs to target TAAs; 10 studies used screening approaches such as serological expression cloning (SEREX) and nucleic acid-programmable protein arrays (NAPPA). RESULTS The highest sensitivities for individual AAbs were reported for RhoGDI-AAbs (89.5%) and TUBA1C-AAbs (89%); however, specificity levels were relatively low (80% and 75%, respectively). High sensitivities at high specificities were reported for HOXA7-AAbs for detection of moderately differentiated ovarian tumors (66.7% sensitivity at 100% specificity) and IL8-AAbs in stage I-II ovarian cancer (65.5% sensitivity at 98% specificity). A panel of 11 AAbs (ICAM3, CTAG2, p53, STYXL1, PVR, POMC, NUDT11, TRIM39, UHMK1, KSR1, and NXF3) provided 45% sensitivity at 98% specificity for serous ovarian cancer, when at least 2 AAbs were above a threshold of 95% specificity. Twelve of the AAbs identified in this review were investigated in more than one study. Data on diagnostic discrimination by tumor histology and stage at diagnosis are sparse. Limited data suggest select AAb markers improve diagnostic discrimination when combined with markers such as CA125 and HE4. CONCLUSIONS AAbs for ovarian cancer early detection is an emerging area, and large-scale, prospective investigations considering histology and stage are required for discovery and validation. However, data to date suggests panels of AAbs may eventually reach sufficient diagnostic discrimination to allow earlier detection of disease as a complement to existing markers and transvaginal ultrasound.
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Affiliation(s)
| | - Antje Damms-Machado
- Division of Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany.
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Ertaylan G, Le Cornet C, van Roekel EH, Jung AY, Bours MJL, Damms-Machado A, van den Brandt PA, Schock H, de Kok TM, Theys J, Arts ICW, Kaaks R, Weijenberg MP, Fortner RT. A Comparative Study on the WCRF International/University of Bristol Methodology for Systematic Reviews of Mechanisms Underpinning Exposure-Cancer Associations. Cancer Epidemiol Biomarkers Prev 2017; 26:1583-1594. [PMID: 28754794 DOI: 10.1158/1055-9965.epi-17-0230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/22/2017] [Accepted: 07/19/2017] [Indexed: 12/09/2022] Open
Abstract
The World Cancer Research Fund (WCRF) International and the University of Bristol have developed a novel framework for providing an overview of mechanistic pathways and conducting a systematic literature review of the biologically plausible mechanisms underlying exposure-cancer associations. Two teams independently applied the two-stage framework on mechanisms underpinning the association between body fatness and breast cancer to test the framework feasibility and reproducibility as part of a WCRF-commissioned validation study. In stage I, a "hypothesis-free" approach was used to provide an overview of potential intermediate mechanisms between body fatness and breast cancer. Dissimilar rankings of potential mechanisms were observed between the two teams due to different applications of the framework. In stage II, a systematic review was conducted on the insulin-like growth factor 1 receptor (IGF1R) chosen as an intermediate mechanism. Although the studies included differed, both teams found inconclusive evidence for the body fatness-IGF1R association and modest evidence linking IGF1R to breast cancer, and therefore concluded that there is currently weak evidence for IGF1R as mechanism linking body fatness to breast cancer. The framework is a good starting point for conducting systematic reviews by integrating evidence from mechanistic studies on exposure-cancer associations. On the basis of our experience, we provide recommendations for future users. Cancer Epidemiol Biomarkers Prev; 26(11); 1583-94. ©2017 AACR.
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Affiliation(s)
- Gökhan Ertaylan
- Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
| | - Charlotte Le Cornet
- Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Eline H van Roekel
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Audrey Y Jung
- Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Martijn J L Bours
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Antje Damms-Machado
- Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Piet A van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - Helena Schock
- Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Theo M de Kok
- Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
- Department of Toxicogenomics, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Jan Theys
- Department of Radiotherapy, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Ilja C W Arts
- Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Matty P Weijenberg
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
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Damms-Machado A, Louis S, Schnitzer A, Volynets V, Rings A, Basrai M, Bischoff SC. Gut permeability is related to body weight, fatty liver disease, and insulin resistance in obese individuals undergoing weight reduction. Am J Clin Nutr 2017; 105:127-135. [PMID: 28049662 DOI: 10.3945/ajcn.116.131110] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 10/04/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Obesity and associated metabolic disorders are related to impairments of the intestinal barrier. OBJECTIVE We examined lactulose:mannitol (Lac:Man) permeability in obese individuals with and without liver steatosis undergoing a weight-reduction program to test whether an effective weight-loss program improves gut barrier function and whether obese patients with or without liver steatosis differ in this function. DESIGN Twenty-seven adult, nondiabetic individuals [mean ± SD body mass index (BMI; in kg/m2): 43.7 ± 5.2; 78% with moderate or severe liver steatosis] were included in the follow-up intervention study (n = 13 by month 12). All patients reduced their weight to a mean ± SD BMI of 36.4 ± 5.1 within 12 mo. We assessed barrier functions by the oral Lac:Man and the fecal zonulin tests. Insulin resistance was assessed by the homeostatic model assessment index (HOMA), and liver steatosis by sonography and the fatty liver index (FLI). RESULTS The Lac:Man ratio and circulating interleukin (IL) 6 concentration decreased during intervention from 0.080 (95% CI: 0.073, 0.093) to 0.027 (95% CI: 0.024, 0.034; P < 0.001) and from 4.2 ± 1.4 to 2.8 ± 1.6 pg/mL (P < 0.01), respectively. At study start, the Lac:Man ratio was higher in patients with moderate or severe steatosis than in those without any steatosis (P < 0.001). The Lac:Man ratio tended to correlate with HOMA (ρ = 0.55, P = 0.052), which correlated with FLI (ρ = 0.75, P < 0.01). A multiple-regression analysis led to a final model explaining FLI best through BMI, waist circumference, and the Lac:Man ratio. CONCLUSIONS Intestinal permeability is increased in obese patients with steatosis compared with obese patients without. The increased permeability fell to within the previously reported normal range after weight reduction. The data suggest that a leaky gut barrier is linked with liver steatosis and could be a new target for future steatosis therapies. This trial was registered at clinicaltrials.gov as NCT01344525.
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Affiliation(s)
- Antje Damms-Machado
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Sandrine Louis
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Anna Schnitzer
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Valentina Volynets
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Andreas Rings
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Maryam Basrai
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Stephan C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Louis S, Tappu RM, Damms-Machado A, Huson DH, Bischoff SC. Characterization of the Gut Microbial Community of Obese Patients Following a Weight-Loss Intervention Using Whole Metagenome Shotgun Sequencing. PLoS One 2016; 11:e0149564. [PMID: 26919743 PMCID: PMC4769288 DOI: 10.1371/journal.pone.0149564] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/01/2016] [Indexed: 02/07/2023] Open
Abstract
Background/Objectives Cross-sectional studies suggested that obesity is promoted by the gut microbiota. However, longitudinal data on taxonomic and functional changes in the gut microbiota of obese patients are scarce. The aim of this work is to study microbiota changes in the course of weight loss therapy and the following year in obese individuals with or without co-morbidities, and to asses a possible predictive value of the gut microbiota with regard to weight loss maintenance. Subjects/Methods Sixteen adult patients, who followed a 52-week weight-loss program comprising low calorie diet, exercise and behavioral therapy, were selected according to their weight-loss course. Over two years, anthropometric and metabolic parameters were assessed and microbiota from stool samples was functionally and taxonomically analyzed using DNA shotgun sequencing. Results Overall the microbiota responded to the dietetic and lifestyle intervention but tended to return to the initial situation both at the taxonomical and functional level at the end of the intervention after one year, except for an increase in Akkermansia abundance which remained stable over two years (12.7x103 counts, 95%CI: 322–25100 at month 0; 141x103 counts, 95%CI: 49-233x103 at month 24; p = 0.005). The Firmicutes/Bacteroidetes ratio was higher in obese subjects with metabolic syndrome (0.64, 95%CI: 0.34–0.95) than in the “healthy obese” (0.27, 95%CI: 0.08–0.45, p = 0.04). Participants, who succeeded in losing their weight consistently over the two years, had at baseline a microbiota enriched in Alistipes, Pseudoflavonifractor and enzymes of the oxidative phosphorylation pathway compared to patients who were less successful in weight reduction. Conclusions Successful weight reduction in the obese is accompanied with increased Akkermansia numbers in feces. Metabolic co-morbidities are associated with a higher Firmicutes/Bacteroidetes ratio. Most interestingly, microbiota differences might allow discrimination between successful and unsuccessful weight loss prior to intervention.
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Affiliation(s)
- Sandrine Louis
- Institute of Clinical Nutrition, University of Hohenheim, Stuttgart, Germany
| | | | - Antje Damms-Machado
- Institute of Clinical Nutrition, University of Hohenheim, Stuttgart, Germany
| | - Daniel H. Huson
- Algorithms in Bioinformatics, University of Tübingen, Tübingen, Germany
| | - Stephan C. Bischoff
- Institute of Clinical Nutrition, University of Hohenheim, Stuttgart, Germany
- * E-mail:
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Friedrich AE, Damms-Machado A, Meile T, Scheuing N, Stingel K, Basrai M, Küper MA, Kramer KM, Königsrainer A, Bischoff SC. Laparoscopic sleeve gastrectomy compared to a multidisciplinary weight loss program for obesity--effects on body composition and protein status. Obes Surg 2014; 23:1957-65. [PMID: 23856991 DOI: 10.1007/s11695-013-1036-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Optimal obesity therapy is a matter of debate. Besides weight reduction, other criteria such as safety and nutritional status are of relevance. Therefore, we compared a favored surgical intervention with the most effective conservative treatment regarding anthropometry and nutritional status. METHODS Fifty-four obese patients were included who underwent laparoscopic sleeve gastrectomy (LSG, n = 27) or a 52-week multidisciplinary intervention program (MIP, n = 27) for weight loss. Body weight, body composition assessed by bioelectrical impedance analysis, and serum protein levels were measured before and within 12 months after intervention. RESULTS After 1 year of observation, excess weight loss was more pronounced following LSG (65 %) compared to MIP (38 %, p < 0.001). In both groups, body fat was clearly reduced, but a higher reduction occurred in the LSG group. However, protein status deteriorated particularly in the LSG group. Within 1 year, body cell mass declined from 37.1 to 26.9 kg in the LSG group, but only from 35.7 to 32.2 kg in the MIP group. This resulted in an increased mean extracellular mass/body cell mass ratio (1.42 versus 1.00, p < 0.001), in a decreased mean phase angle (4.4° versus 6.6°, p < 0.001), and in a lower prealbumin level in serum (p < 0.02) in the LSG group compared to the MIP group. CONCLUSIONS LSG, compared to MIP, was more effective regarding excess weight loss and body fat loss within 1 year, however, induced more pronounced muscle mass and protein loss, possibly requiring particular interventions such as exercise or protein supplements.
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Affiliation(s)
- Asja E Friedrich
- Department of Nutritional Medicine, University of Hohenheim, Fruwirthstraße 12, 70593, Stuttgart, Germany,
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Mitra S, Förster-Fromme K, Damms-Machado A, Scheurenbrand T, Biskup S, Huson DH, Bischoff SC. Analysis of the intestinal microbiota using SOLiD 16S rRNA gene sequencing and SOLiD shotgun sequencing. BMC Genomics 2013; 14 Suppl 5:S16. [PMID: 24564472 PMCID: PMC3852202 DOI: 10.1186/1471-2164-14-s5-s16] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Metagenomics seeks to understand microbial communities and assemblages by DNA sequencing. Technological advances in next generation sequencing technologies are fuelling a rapid growth in the number and scope of projects aiming to analyze complex microbial environments such as marine, soil or the gut. Recent improvements in longer read lengths and paired-sequencing allow better resolution in profiling microbial communities. While both 454 sequencing and Illumina sequencing have been used in numerous metagenomic studies, SOLiD sequencing is not commonly used in this area, as it is believed to be more suitable in the context of reference-guided projects. Results To investigate the performance of SOLiD sequencing in a metagenomic context, we compared taxonomic profiles of SOLiD mate-pair sequencing reads with Sanger paired reads and 454 single reads. All sequences were obtained from the bacterial 16S rRNA gene, which was amplified from microbial DNA extracted from a human fecal sample. Additionally, from the same fecal sample, complete genomic microbial DNA was extracted and shotgun sequenced using SOLiD sequencing to study the composition of the intestinal microbiota and the existing microbial metabolism. We found that the microbiota composition of 16S rRNA gene sequences obtained using Sanger, 454 and SOLiD sequencing provide results comparable to the result based on shotgun sequencing. Moreover, with SOLiD sequences we obtained more resolution down to the species level. In addition, the shotgun data allowed us to determine a functional profile using the databases SEED and KEGG. Conclusions This study shows that SOLiD mate-pair sequencing is a viable and cost-efficient option for analyzing a complex microbiome. To the best of our knowledge, this is the first time that SOLiD sequencing has been used in a human sample.
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Friedrich A, Meile T, Damms-Machado A, Kueper M, Kramer K, Königsrainer A, Bischoff S. PP220-SUN EFFECT OF LAPAROSCOPIC SLEEVE GASTRECTOMY ON LIPID PROFILES, INFLAMMATION MARKERS AND LIVER ENZYMES IN OBESE PATIENTS. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60265-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Galasso A, Aufderklamm S, Damms-Machado A, Miller F, Stenzl A, Bischoff S, Gakis G. 800 CHEMOPREVENTIVE PROPERTIES OF THE FLAVONOIDS GENISTEIN AND QUERCETIN IN MEN WITH RISING PSA: FIRST RESULTS OF A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED TRIAL (QUERGEN TRIAL). J Urol 2013. [DOI: 10.1016/j.juro.2013.02.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Background The prevalence of micronutrient deficiencies is higher in obese individuals compared to normal-weight people, probably because of inadequate eating habits but also due to increased demands among overweight persons, which are underestimated by dietary reference intakes (DRI) intended for the general population. We therefore evaluated the dietary micronutrient intake in obese individuals compared to a reference population and DRI recommendations. Furthermore, we determined the micronutrient status in obese subjects undergoing a standardized DRI-covering low-calorie formula diet to analyze if the DRI meet the micronutrient requirements of obese individuals. Methods In 104 subjects baseline micronutrient intake was determined by dietary record collection. A randomly assigned subgroup of subjects (n = 32) underwent a standardized DRI-covering low-calorie formula diet over a period of three months. Pre- and post-interventional intracellular micronutrient status in buccal mucosa cells (BMC) was analyzed, as well as additional micronutrient serum concentrations in 14 of the subjects. Results Prior to dietetic intervention, nutrition was calorie-rich and micronutrient-poor. Baseline deficiencies in serum concentrations were observed for 25-hydroxyvitamin-D, vitamin C, selenium, iron, as well as ß-carotene, vitamin C, and lycopene in BMC. After a three-month period of formula diet even more subjects had reduced micronutrient levels of vitamin C (serum, BMC), zinc, and lycopene. There was a significant negative correlation between lipophilic serum vitamin concentrations and body fat, as well as between iron and C-reactive protein. Conclusions The present pilot study shows that micronutrient deficiency occurring in obese individuals is not corrected by protein-rich formula diet containing vitamins and minerals according to DRI. In contrast, micronutrient levels remain low or become even lower, which might be explained by insufficient intake, increased demand and unbalanced dispersal of lipophilic compounds in the body. Trial registration The study was registered at ClinicalTrials.gov (NCT01344525). The study protocol comprises only a part of the approved trial protocol.
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Affiliation(s)
- Antje Damms-Machado
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Bischoff SC, Damms-Machado A, Betz C, Herpertz S, Legenbauer T, Löw T, Wechsler JG, Bischoff G, Austel A, Ellrott T. Multicenter evaluation of an interdisciplinary 52-week weight loss program for obesity with regard to body weight, comorbidities and quality of life--a prospective study. Int J Obes (Lond) 2011; 36:614-24. [PMID: 21673653 PMCID: PMC3322430 DOI: 10.1038/ijo.2011.107] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To determine the effectiveness of a structured multidisciplinary non-surgical obesity therapy program on the basis of a temporary low-calorie-diet for 12 weeks, and additional intervention modules to enhance nutritional education, to increase physical activity and to modify eating behavior. DESIGN Prospective multicenter observational study in obese individuals undergoing a medically supervised outpatient-based 52-week treatment in 37 centers in Germany. SUBJECTS A total of 8296 participants with a body mass index (BMI) of >30 kg m(-2) included within 8.5 years. MEASUREMENTS Main outcome measures were body weight loss, waist circumference (WC), blood pressure, quality of life and adverse events. RESULTS In females, initial body weight was reduced after the 1-year-intervention by 19.6 kg (95% confidence intervals 19.2-19.9 kg) and in males by 26.0 kg (25.2-26.8) according to per protocol analysis of 4850 individuals. Intention-to-treat (ITT) analysis revealed a weight reduction of 15.2 kg (14.9-15.6) in females and 19.4 kg (18.7-20.1) in males. Overall, the intervention resulted in mean reduction in WC of 11 cm; it reduced the prevalence of the metabolic syndrome by 50% and the frequency of hypertension from 47 to 29% of all participants (ITT, all P<0.001). The beneficial effects could be documented for up to 3 years and comprised significant improvement of health-related quality of life. The incidence of adverse effects was low; the only event repeatedly observed and possibly related to either the intervention or the underlying disease was biliary disorders. CONCLUSION The present non-surgical intervention program is a highly effective treatment of obesity grades I-III and obesity-related diseases, and therefore, could be a valuable basis for future weight maintenance strategies required for sustained success.
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Affiliation(s)
- S C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
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