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Dow C, Galera C, Charles MA, Heude B. Maternal pre-pregnancy BMI and offspring hyperactivity-inattention trajectories from 3 to 8 years in the EDEN birth cohort study. Eur Child Adolesc Psychiatry 2023; 32:2057-2065. [PMID: 35851811 DOI: 10.1007/s00787-022-02047-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 07/06/2022] [Indexed: 12/15/2022]
Abstract
Evidence suggests obesity during pregnancy is associated with offspring attention-deficit hyperactivity disorder. However, studies have been limited to evaluating the association at a single age with inadequate data on important maternal lifestyle confounders and unmeasured familial confounding. The objective of this study was to examine the association between maternal pre-pregnancy body mass index (BMI) and child hyperactivity-inattention symptoms (HIS) at 3, 5 and 8 years. Data came from the EDEN mother-child cohort. Maternal pre-pregnancy BMI status (kg/m2) was calculated using pre-pregnancy weight and height (self-reported by mothers or measured by midwives). HIS were assessed by parental-report on the Strengths and Difficulties Questionnaire at 3, 5 and 8 years of age and used to derive developmental trajectories of HIS (n = 1428). Multivariate models were adjusted for confounders including socioeconomic status, maternal lifestyle behaviours (exercise, diet, smoking, alcohol), childcare and a stimulating home environment. Paternal BMI was used as a negative control. Compared to a normal pre-pregnancy BMI, pre-pregnancy maternal obesity was positively associated with increased odds of a high HIS trajectory between 3 and 8 years old in both unadjusted and adjusted logistic regression (adjusted odds ratio [aOR] 1.87 [95% CI 1.12, 3.12]). Pre-pregnancy overweight was not significantly associated after adjustment for confounders (aOR 1.32 [0.87, 2.01]). Maternal pre-pregnancy obesity, but not overweight, was associated with increased likelihood of a high HIS trajectory in children from 3 to 8 years old. This association persisted despite controlling for many important maternal lifestyle factors and paternal BMI. Further research is warranted to identify possible mediators involved.
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Affiliation(s)
- Courtney Dow
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France.
| | - Cédric Galera
- Univ. Bordeaux, Inserm, Bordeaux Population Health Center, UMR 1219, 33000, Bordeaux, France
- Centre Hospitalier Perrens, Bordeaux, France
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Paris, France
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2
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Dow C, Lorthe E, Marchand-Martin L, Galera C, Tafflet M, Ancel PY, Charles MA, Heude B. Maternal pre-pregnancy obesity and offspring hyperactivity-inattention symptoms at 5 years in preterm and term children: a multi-cohort analysis. Sci Rep 2022; 12:18190. [PMID: 36307528 PMCID: PMC9616941 DOI: 10.1038/s41598-022-22750-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/19/2022] [Indexed: 12/31/2022] Open
Abstract
The objective of this study was to determine the relationship between maternal pre-pregnancy body mass index (BMI) and child hyperactivity-inattention symptoms (HIS) at 5 years, including preterm and term-born children, and to determine whether this association varied with gestational age. Maternal pre-pregnancy BMI and offspring HIS were assessed in 10,898 participants born ≥ 33 weeks of gestation from the ELFE cohort and 2646 children born between 23 and 34 weeks from the EPIPAGE 2 cohort. Reported pre-pregnancy weight (kg) and measured height (m) were collected from mothers at inclusion and used to classify BMI (kg/m2). Child HIS were evaluated using the Strengths and Difficulties Questionnaire around 5 years of age. Logistic regression estimated odds ratios (OR) of a high HIS score (≥ 90th percentile) in the ELFE cohort and generalized estimated equations were used in EPIPAGE 2 to account for non-independence of multiple births. As a negative control, paternal BMI was also considered as an exposure of interest in sensitivity analyses. Maternal pre-pregnancy obesity and overweight were associated with child HIS at 5 years in ELFE (adjusted OR [aOR] for obesity 1.27 [1.06, 1.53]; overweight aOR 1.16 [1.00, 1.36]) and pre-pregnancy obesity was associated with high HIS scores in preterm infants of EPIPAGE 2 (aOR 1.48 [1.06, 2.08]). In ELFE, the magnitude of the association increased with decreasing gestational age (interaction p = 0.02). High maternal pre-pregnancy BMI is associated with greater likelihood of high HIS scores in both at-term and preterm children at 5 years of age.
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Affiliation(s)
- Courtney Dow
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France
| | - Elsa Lorthe
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France ,grid.150338.c0000 0001 0721 9812Unit of Population Epidemiology, Department of Primary Care Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Laetitia Marchand-Martin
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France
| | - Cédric Galera
- grid.412041.20000 0001 2106 639XInserm, Bordeaux Population Health Center, UMR 1219, Univ. Bordeaux, 33000 Bordeaux, France ,Centre Hospitalier Perrens, Bordeaux, France ,Unit on Children’s Psychosocial Maladjustment, Montreal, QC Canada
| | - Muriel Tafflet
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France
| | - Pierre-Yves Ancel
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France
| | - Marie-Aline Charles
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France
| | - Barbara Heude
- grid.508487.60000 0004 7885 7602Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, 75004 Paris, France
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Tatulashvili S, Fagherazzi G, Dow C, Cohen R, Fosse S, Bihan H. Socioeconomic inequalities and type 2 diabetes complications: A systematic review. Diabetes Metab 2019; 46:89-99. [PMID: 31759171 DOI: 10.1016/j.diabet.2019.11.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/19/2019] [Accepted: 11/06/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVES A socioeconomic gradient related to type 2 diabetes (T2D) prevalence has been demonstrated in high-income countries. However, there is no evidence of such a socioeconomic gradient regarding diabetes complications. Thus, the aim of this systematic review was to collect data on risk of complications according to socioeconomic status in patients with T2D. METHODS PubMed and EMBASE were searched for English-language observational studies evaluating the prevalence or incidence of micro- and macrovascular complications according to individual and geographical socioeconomic status (SES). Observational studies reporting the prevalence and risk of micro- and macrovascular diabetes complications, according to an individual or geographical index of deprivation, were selected, and estimated crude and adjusted risks for each complication were reported. RESULTS Among the 28 included studies, most described a clear relationship between SES and diabetes complications, especially retinopathy (in 9 of 14 studies) and cardiopathy (in 8 of 9 studies). Both individual and area-based low SES was associated with an increased risk of complications. However, very few studies adjusted their analyses according to HbA1c level. CONCLUSION Evaluation of SES is necessary for every T2D patient, as it appears to be a risk factor for diabetes complications. However, the available studies are insufficient for gradation of the impact of low socioeconomic level on each of these complications. Regardless, strategies for the improved screening, follow-up and care of high-risk patients should now be implemented.
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Affiliation(s)
- S Tatulashvili
- Department of Endocrinology, Diabetology, Metabolic Disease, Avicenne Hospital, Sorbonne Paris Cité, CRNH-IdF, Paris 13 University, AP-HP, 93000 Bobigny, France
| | - G Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Paris-Sud Paris-Saclay University, 94800 Villejuif, France
| | - C Dow
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Paris-Sud Paris-Saclay University, 94800 Villejuif, France
| | - R Cohen
- Department of Endocrinology, Diabetology, Delafontaine Hospital, 93205 Saint-Denis, France
| | - S Fosse
- French National Public Health Agency, 94410 Saint-Maurice, France
| | - H Bihan
- Department of Endocrinology, Diabetology, Metabolic Disease, Avicenne Hospital, Sorbonne Paris Cité, CRNH-IdF, Paris 13 University, AP-HP, 93000 Bobigny, France; Health Education and Practice Laboratory, EA 3412, UFR SMBH Léonard de Vinci, Paris 13 University, 93017 Bobigny, France.
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Imamura F, Schulze MB, Sharp SJ, Guevara M, Romaguera D, Bendinelli B, Salamanca-Fernández E, Ardanaz E, Arriola L, Aune D, Boeing H, Dow C, Fagherazzi G, Franks PW, Freisling H, Jakszyn P, Kaaks R, Khaw KT, Kühn T, Mancini FR, Masala G, Chirlaque MD, Nilsson PM, Overvad K, Pala VM, Panico S, Perez-Cornago A, Quirós JR, Ricceri F, Rodríguez-Barranco M, Rolandsson O, Sluijs I, Stepien M, Spijkerman AMW, Tjønneland A, Tong TYN, Tumino R, Vissers LET, Ward HA, Langenberg C, Riboli E, Forouhi NG, Wareham NJ. Estimated Substitution of Tea or Coffee for Sugar-Sweetened Beverages Was Associated with Lower Type 2 Diabetes Incidence in Case-Cohort Analysis across 8 European Countries in the EPIC-InterAct Study. J Nutr 2019; 149:1985-1993. [PMID: 31396627 PMCID: PMC6825826 DOI: 10.1093/jn/nxz156] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/01/2019] [Accepted: 06/11/2019] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Beverage consumption is a modifiable risk factor for type 2 diabetes (T2D), but there is insufficient evidence to inform the suitability of substituting 1 type of beverage for another. OBJECTIVE The aim of this study was to estimate the risk of T2D when consumption of sugar-sweetened beverages (SSBs) was replaced with consumption of fruit juice, milk, coffee, or tea. METHODS In the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study of 8 European countries (n = 27,662, with 12,333 cases of incident T2D, 1992-2007), beverage consumption was estimated at baseline by dietary questionnaires. Using Prentice-weighted Cox regression adjusting for other beverages and potential confounders, we estimated associations of substituting 1 type of beverage for another on incident T2D. RESULTS Mean ± SD of estimated consumption of SSB was 55 ± 105 g/d. Means ± SDs for the other beverages were as follows: fruit juice, 59 ± 101 g/d; milk, 209 ± 203 g/d; coffee, 381 ± 372 g/d; and tea, 152 ± 282 g/d. Substituting coffee for SSBs by 250 g/d was associated with a 21% lower incidence of T2D (95% CI: 12%, 29%). The rate difference was -12.0 (95% CI: -20.0, -5.0) per 10,000 person-years among adults consuming SSBs ≥250 g/d (absolute rate = 48.3/10,000). Substituting tea for SSBs was estimated to lower T2D incidence by 22% (95% CI: 15%, 28%) or -11.0 (95% CI: -20.0, -2.6) per 10,000 person-years, whereas substituting fruit juice or milk was estimated not to alter T2D risk significantly. CONCLUSIONS These findings indicate a potential benefit of substituting coffee or tea for SSBs for the primary prevention of T2D and may help formulate public health recommendations on beverage consumption in different populations.
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Affiliation(s)
- Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Matthias B Schulze
- Department of Molecular Epidemiology, Germen Institute of Human Nutrition, Potsdam, Germany
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Marcela Guevara
- IDISNA Navarra Health Research Institute, Pamplona, Spain
- CIBER Epidemiology and Public Health, Madrid, Spain
| | - Dora Romaguera
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition, Madrid, Spain
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Elena Salamanca-Fernández
- CIBER Epidemiology and Public Health, Madrid, Spain
- Andalusian School of Public Health, Institute of Investigation Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain
| | - Eva Ardanaz
- IDISNA Navarra Health Research Institute, Pamplona, Spain
- CIBER Epidemiology and Public Health, Madrid, Spain
| | - Larraitz Arriola
- Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, CIBERESP, Gipuzkoa, Spain
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Heiner Boeing
- Department of Molecular Epidemiology, Germen Institute of Human Nutrition, Potsdam, Germany
| | - Courtney Dow
- Gustave Roussy Institute, Villejuif, France
- University Paris–South, Faculty of Medicine, University Versailles–St Quentin, University Paris-Saclay, Villejuif, France
- National Institute for Health and Medical Research (INSERM), Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Guy Fagherazzi
- Gustave Roussy Institute, Villejuif, France
- University Paris–South, Faculty of Medicine, University Versailles–St Quentin, University Paris-Saclay, Villejuif, France
- National Institute for Health and Medical Research (INSERM), Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Paul W Franks
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC–WHO), Lyon, France
| | - Paula Jakszyn
- Catalan Institute of Oncology, Barcelona, Spain
- FCS Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Francesca R Mancini
- Gustave Roussy Institute, Villejuif, France
- University Paris–South, Faculty of Medicine, University Versailles–St Quentin, University Paris-Saclay, Villejuif, France
- National Institute for Health and Medical Research (INSERM), Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Maria-Dolores Chirlaque
- CIBER Epidemiology and Public Health, Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
| | - Kim Overvad
- Department of Cardiology, Aalborg University Hospital, Aarhus, Denmark
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Valeria M Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | | | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Miguel Rodríguez-Barranco
- CIBER Epidemiology and Public Health, Madrid, Spain
- Andalusian School of Public Health, Institute of Investigation Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, Cardiovascular Epidemiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Magdalena Stepien
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC–WHO), Lyon, France
| | | | | | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, “Civic-M.P. Arezzo” Hospital, Ragusa, Italy
| | - Linda E T Vissers
- Julius Center for Health Sciences and Primary Care, Cardiovascular Epidemiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Heather A Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nick J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Fagherazzi G, Chambraud C, Dow C, Mancini FR, Affret A, Balkau B, Magliano DJ, Boutron-Ruault MC, Bonnet F. What are the determinants of a concerned vision of the future when living with type 2 diabetes? Results from the E3N-AfterDiab study. Chronic Illn 2019; 15:236-241. [PMID: 30282463 DOI: 10.1177/1742395318801934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Identification of characteristics associated with a negative experience with type 2 diabetes may help to develop novel intervention to improve the outlook of people with the disease. Our aim was to identify determinants of a self-reported concerned vision about the future when living with type 2 diabetes. Methods In 2630 women with type 2 diabetes from the E3N-AfterDiab study, we used multivariable logistic regression models to derive odds-ratios and 95% confidence intervals. Results Women with elevated HbA1c levels (OR = 2.42 (1.67–3.49) for ≥7.2% when compared to <6.2%), or treated with injected glucose lowering treatments (OR = 1.37 [1.05–1.81]) had a higher risk of a concerned vision of the future. Age and obesity were associated with a decreased risk. Hypertension, duration of diabetes, smoking, fasting glucose levels, and years of education were not associated with a concerned vision of the future. Discussion Our findings highlight the importance of both glycemic control and the type of treatment on the perception of the future when living with type 2 diabetes. Subgroups of patients based on these characteristics may receive a specific attention from healthcare professionals to address potential concerns related with diabetes management or the fear of complications.
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Affiliation(s)
- Guy Fagherazzi
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Clélia Chambraud
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Courtney Dow
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Francesca Romana Mancini
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Aurélie Affret
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Beverley Balkau
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France.,3 University Versailles, Saint Quentin, University Paris-Sud, Villejuif, France
| | - Dianna J Magliano
- 4 Baker IDI, Clinical Diabetes and Epidemiology Laboratory, Melbourne, Australia
| | - Marie-Christine Boutron-Ruault
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Fabrice Bonnet
- 1 INSERM U1018, Gustave Roussy Institute, CESP, Villejuif, France.,2 University Paris-Saclay, University Paris-Sud, Villejuif, France.,5 CHU Rennes, Rennes 1 University, France
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Dow C, Balkau B, Bonnet F, Mancini F, Rajaobelina K, Shaw J, Magliano DJ, Fagherazzi G. Strong adherence to dietary and lifestyle recommendations is associated with decreased type 2 diabetes risk in the AusDiab cohort study. Prev Med 2019; 123:208-216. [PMID: 30851294 DOI: 10.1016/j.ypmed.2019.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 02/24/2019] [Accepted: 03/05/2019] [Indexed: 11/18/2022]
Abstract
We aimed to determine whether adherence to the Australian dietary guidelines and an index of healthy behavior was associated with a lower risk of type 2 diabetes (T2D) and to provide estimates of the proportion of preventable cases. Participants of the AusDiab cohort study were followed for 12 years (n = 6242), starting from May 1999, during which T2D cases were identified. The associations between T2D risk and a score of adherence to the dietary guidelines, its components, and a score of adherence to an index of healthy behaviors, (which included smoking, recreational physical activity, waist circumference and adherence to the dietary guidelines), were estimated using Cox proportional hazards ratios (HR) and 95% confidence intervals. The proportion of preventable cases was estimated using the population attributable fraction (PAF). Strong adherence to the dietary guidelines was not associated with T2D risk (HR = 0.64 [95% CI 0.39-1.06]), unless moderate alcohol consumption was considered as beneficial instead of no alcohol consumption (HR = 0.59 [0.36-0.96]). However, strong adherence to the guidelines regarding fruit and dairy intake were both associated with decreased risk of T2D (HR = 0.68 [0.51-0.91]; 0.56 [0.38-0.84], respectively) and could have prevented 23-37% of cases (PAF = 23.3% [7.3-38.2]; 37.1% [14.6-56.0], respectively). Strong adherence to the index of healthy behaviors was associated with decreased risk of T2D (HR = 0.30 [0.17-0.51]) and estimated to prevent almost 60% of T2D (PAF = 59.4% [34.3-76.6]). More than half of T2D cases could be preventable in Australia through modifying health behavior. These results could serve as a basis for prevention programs based on lifestyle modification.
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Affiliation(s)
- Courtney Dow
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France.
| | - Beverley Balkau
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France; University Versailles, Saint Quentin, University Paris-Sud, Villejuif, France
| | - Fabrice Bonnet
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France; CHU Rennes, Université de Rennes 1, France
| | - Francesca Mancini
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Kalina Rajaobelina
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Jonathan Shaw
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dianna J Magliano
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Guy Fagherazzi
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Villejuif, France
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7
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Jannasch F, Kröger J, Agnoli C, Barricarte A, Boeing H, Cayssials V, Colorado-Yohar S, Dahm CC, Dow C, Fagherazzi G, Franks PW, Freisling H, Gunter MJ, Kerrison ND, Key TJ, Khaw KT, Kühn T, Kyro C, Mancini FR, Mokoroa O, Nilsson P, Overvad K, Palli D, Panico S, García JRQ, Rolandsson O, Sacerdote C, Sánchez MJ, Sahrai MS, Schübel R, Sluijs I, Spijkerman AMW, Tjonneland A, Tong TYN, Tumino R, Riboli E, Langenberg C, Sharp SJ, Forouhi NG, Schulze MB, Wareham NJ. Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations. J Nutr 2019; 149:1047-1055. [PMID: 31149710 PMCID: PMC6543295 DOI: 10.1093/jn/nxz031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/02/2019] [Accepted: 02/06/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. OBJECTIVE The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. METHODS Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. RESULTS Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. CONCLUSIONS Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.
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Affiliation(s)
- Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- NutriAct–Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Claudia Agnoli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Valerie Cayssials
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sandra Colorado-Yohar
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Health Council, IMIB-Arrixaca, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Christina C Dahm
- Section for Epidemiology, Department of Public Health, Aarhus University, Denmark
| | - Courtney Dow
- Inserm, Centre for Research in Epidemiology and Population Health [CESP], Villejuif, France; Université Paris-Sud, Villejuif, France
| | - Guy Fagherazzi
- Inserm, Centre for Research in Epidemiology and Population Health [CESP], Villejuif, France; Université Paris-Sud, Villejuif, France
| | - Paul W Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | | | - Timothy J Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Tilman Kühn
- German Cancer Research Center [DKFZ], Heidelberg, Germany
| | - Cecilie Kyro
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Francesca Romana Mancini
- Inserm, Centre for Research in Epidemiology and Population Health [CESP], Villejuif, France; Université Paris-Sud, Villejuif, France
| | - Olatz Mokoroa
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Peter Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Denmark
- Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network—ISPRO, Florence, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | | | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Citta’della Salute e della Scienza Hospital-University of Turin and Center for Cancer Prevention (CPO), Torino, Italy
- Human Genetics Foundation (HuGeF), Torino, Italy
| | - Mariá-José Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Mohammad Sediq Sahrai
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Ruth Schübel
- German Cancer Research Center [DKFZ], Heidelberg, Germany
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | | | - Tammy Y N Tong
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, ‘Civile – M.P. Arezzo’ Hospital, Ragusa, Italy
- Associazone Iblea per la Ricerca Epidemiologica—Onlus, Ragusa, Italy
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | | | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
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8
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Zheng JS, Imamura F, Sharp SJ, van der Schouw YT, Sluijs I, Gundersen TE, Ardanaz E, Boeing H, Bonet C, Gómez JH, Dow C, Fagherazzi G, Franks PW, Jenab M, Kühn T, Kaaks R, Key TJ, Khaw KT, Lasheras C, Mokoroa O, Mancini FR, Nilsson PM, Overvad K, Panico S, Palli D, Rolandsson O, Sieri S, Salamanca-Fernández E, Sacerdote C, Spijkerman AMW, Stepien M, Tjonneland A, Tumino R, Butterworth AS, Riboli E, Danesh J, Langenberg C, Forouhi NG, Wareham NJ. Association of Plasma Vitamin D Metabolites With Incident Type 2 Diabetes: EPIC-InterAct Case-Cohort Study. J Clin Endocrinol Metab 2019; 104:1293-1303. [PMID: 30418614 PMCID: PMC6397435 DOI: 10.1210/jc.2018-01522] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/06/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Existing evidence for the prospective association of vitamin D status with type 2 diabetes (T2D) is focused almost exclusively on circulating total 25-hydroxyvitamin D [25(OH)D] without distinction between its subtypes: nonepimeric and epimeric 25(OH)D3 stereoisomers, and 25(OH)D2, the minor component of 25(OH)D. We aimed to investigate the prospective associations of circulating levels of the sum and each of these three metabolites with incident T2D. METHODS This analysis in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study for T2D included 9671 incident T2D cases and 13,562 subcohort members. Plasma vitamin D metabolites were quantified by liquid chromatography-mass spectrometry. We used a multivariable Prentice-weighted Cox regression to estimate hazard ratios (HRs) of T2D for each metabolite. Analyses were performed separately within country, and estimates were combined across countries using random-effects meta-analysis. RESULTS The mean concentrations (SD) of total 25(OH)D, nonepimeric 25(OH)D3, epimeric 25(OH)D3, and 25(OH)D2 were 41.1 (17.2), 40.7 (17.3), 2.13 (1.31), and 8.16 (6.52) nmol/L, respectively. Plasma total 25(OH)D and nonepimeric 25(OH)D3 were inversely associated with incident T2D [multivariable-adjusted HR per 1 SD = 0.81 (95% CI, 0.77, 0.86) for both variables], whereas epimeric 25(OH)D3 was positively associated [per 1 SD HR = 1.16 (1.09, 1.25)]. There was no statistically significant association with T2D for 25(OH)D2 [per 1 SD HR = 0.94 (0.76, 1.18)]. CONCLUSIONS Plasma nonepimeric 25(OH)D3 was inversely associated with incident T2D, consistent with it being the major metabolite contributing to total 25(OH)D. The positive association of the epimeric form of 25(OH)D3 with incident T2D provides novel information to assess the biological relevance of vitamin D epimerization and vitamin D subtypes in diabetes etiology.
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Affiliation(s)
- Ju-Sheng Zheng
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Ivonne Sluijs
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Eva Ardanaz
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
- Biomedical Research Center Network of Epidemiology and Public Health, Madrid, Spain
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Catalina Bonet
- Catalan Institute of Oncology–Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - Jesus Humberto Gómez
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Courtney Dow
- Center for Research in Epidemiology and Population Health, Faculty of Medicine - University Paris-South, Faculty of Medicine INSERM U1018, University Paris-Saclay, Villejuif, France
- Gustave Roussy, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Guy Fagherazzi
- Center for Research in Epidemiology and Population Health, Faculty of Medicine - University Paris-South, Faculty of Medicine INSERM U1018, University Paris-Saclay, Villejuif, France
- Gustave Roussy, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Paul W Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Mazda Jenab
- International Agency for Research on Cancer, Lyon, France
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Cristina Lasheras
- Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Olatz Mokoroa
- Biomedical Research Center Network of Epidemiology and Public Health, Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Francesca Romana Mancini
- Center for Research in Epidemiology and Population Health, Faculty of Medicine - University Paris-South, Faculty of Medicine INSERM U1018, University Paris-Saclay, Villejuif, France
- Gustave Roussy, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | | | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Salamanca-Fernández
- Biomedical Research Center Network of Epidemiology and Public Health, Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs and Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza Hospital-University of Turin and Center for Cancer Prevention, Torino, Italy
| | | | | | | | | | - Adam S Butterworth
- Medical Research Council/ British Heart Foundation Cardiovascular Epidemiology Unit and NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - John Danesh
- Medical Research Council/ British Heart Foundation Cardiovascular Epidemiology Unit and NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- British Heart Foundation Cambridge Centre of Excellence, Division of Cardiovascular Medicine, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Rajaobelina K, Dow C, Romana Mancini F, Dartois L, Boutron-Ruault MC, Balkau B, Bonnet F, Fagherazzi G. Population attributable fractions of the main type 2 diabetes mellitus risk factors in women: Findings from the French E3N cohort. J Diabetes 2019; 11:242-253. [PMID: 30098121 DOI: 10.1111/1753-0407.12839] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/18/2018] [Accepted: 08/07/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although many type 2 diabetes mellitus (T2DM) risk factors have been identified, little is known regarding their contributions to the diabetes burden at the population level. METHODS The study included 72 655 French women from the Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort followed between 1993 and 2011. Cox multivariable models including the main T2DM risk factors (metabolic, dietary, clinical, socioeconomic and hormonal) and a healthy lifestyle index combining five characteristics (smoking, body mass index [BMI], alcohol consumption, fruit and vegetable consumption, and physical activity) were used to estimate hazard ratios and population attributable fractions (PAFs) for T2DM. RESULTS In multivariate models, factors with the strongest effect on T2DM risk were, in decreasing order, BMI ≥ 30 kg/m2 (PAF = 43%; 95% confidence interval [CI] 37-47), high adherence to a Western dietary pattern (PAF = 30%; 95% CI 20-40), hypertension (PAF = 26%; 95% CI 20-32), an acidogenic diet (PAF = 24%; 95% CI 16-32), a family history of diabetes (PAF = 20%; 95% CI 17-22), and, with a negative correlation, moderate alcohol consumption (PAF-19%; 95% CI -34, -4). The PAF for an unhealthy lifestyle was 57% (95% CI 50-63). CONCLUSIONS We have been able to sort out and quantify the effect of various dietary and biological T2DM risk factors simultaneously in a single population, and to highlight the importance of a healthy lifestyle for primary prevention: more than half the T2DM cases could have been prevented through a healthier lifestyle.
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Affiliation(s)
- Kalina Rajaobelina
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Courtney Dow
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Francesca Romana Mancini
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Laureen Dartois
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Beverley Balkau
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- University Versailles, Saint Quentin, Université Paris-Sud, Villejuif, France
| | - Fabrice Bonnet
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Rennes University Hospital, Rennes, France
| | - Guy Fagherazzi
- Inserm U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
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10
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Ongono JS, Dow C, Gambaretti J, Severi G, Boutron-Ruault MC, Bonnet F, Fagherazzi G, Mancini FR. Dietary exposure to brominated flame retardants and risk of type 2 diabetes in the French E3N cohort. Environ Int 2019; 123:54-60. [PMID: 30496982 DOI: 10.1016/j.envint.2018.11.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/13/2018] [Accepted: 11/16/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) is increasing worldwide. Recent studies have suggested that environmental factors, such as exposure to brominated flame retardants (BFRs), could play a role in the epidemic of T2D. The aim of this study was to analyze the association between the dietary exposure to BFRs (Hexabromocyclododecane (HBCD) and Polybromodiphenylether (PBDE)) and T2D risk in the E3N prospective cohort of French women. RESEARCH DESIGN AND METHODS Overall, 71,415 women followed for 19 years were included in the study. We performed Cox regression models to analyze the association between dietary exposure to BFRs and T2D risk. RESULTS Overall 71,415 women were included and 3667 (5.13%) developed a T2D during follow-up. The mean dietary exposure to HBCD and to PBDE was 0.22 ng/kg body weight (BW)/day and 1.21 ng/kg bw/day, respectively. There was a positive linear association between dietary exposure to HBCD and T2D risk starting from the 2nd quintile group (HR: 1.18; 95% CI: 1.06-1.30) to the 5th quintile group (HR: 1.47; 95% CI: 1.29-1.67) when compared to the 1st quintile group. We also found positive although non-linear associations between dietary exposure to PBDE and T2D risk, with an increased HR only for the 2nd and 4th vs. 1st quintile groups (HR: 1.12; 95% CI: 1.02-1.24, and HR: 1.20; 95% CI: 1.08-1.34, respectively). CONCLUSION The findings suggest an association between dietary exposure to BFRs and T2D risk, highlighting the importance of further investigating this association the long-term health effects of endocrine disruptors in the general population. Additional studies are needed to reproduce these findings in other populations and clarify the underlying biological mechanisms.
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Affiliation(s)
- Jeanne Sandrine Ongono
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Courtney Dow
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Juliette Gambaretti
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Gianluca Severi
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Fabrice Bonnet
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; CHU Rennes, Université de Rennes 1, Department of Endocrinology, Diabetology and Nutrition, Rennes, France
| | - Guy Fagherazzi
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France
| | - Francesca Romana Mancini
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France.
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11
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Fagherazzi G, Gusto G, Mancini FR, Dow C, Rajaobelina K, Balkau B, Boutron-Ruault MC, Bonnet F. Determinants of 20-year non-progression to Type 2 diabetes in women at very high risk: the E3N cohort study. Diabet Med 2018; 35:1716-1721. [PMID: 29978499 DOI: 10.1111/dme.13774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2018] [Indexed: 01/20/2023]
Abstract
AIMS To identify the most important determinants associated with not developing Type 2 diabetes in women considered to be at very high risk. METHODS Between 1995 and 2014, we followed 402 women from the E3N cohort study who were considered to be at very high risk of Type 2 diabetes based on the D.E.S.I.R. score. We then computed a classification and regression tree model to identify, among a large set of risk factors, the top risk factors associated with not having Type 2 diabetes at the end of the follow-up. RESULTS During follow-up, 117 women (29%) were diagnosed with Type 2 diabetes, while 285 (71%) were still free of the disease in 2014. A low Western dietary pattern score was the top characteristic associated with not developing Type 2 diabetes, as only 20% of the women at very high risk in the E3N study with that characteristic developed Type 2 diabetes (compared with 29% overall). In women with a moderate or high Western dietary pattern score, the most important characteristic associated with not developing Type 2 diabetes was a high total dietary antioxidant capacity, as only 26% of these women ultimately developed Type 2 diabetes. CONCLUSIONS We showed that the top characteristic associated with not developing Type 2 diabetes, despite being at very high risk, was a healthy diet, characterized by limiting Western dietary habits, but with a high intake of antioxidant-rich foods. This underscores the importance of diet in the prevention of Type 2 diabetes in people at high risk.
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Affiliation(s)
- G Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
| | - G Gusto
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
| | - F R Mancini
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
| | - C Dow
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
| | - K Rajaobelina
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
| | - B Balkau
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
- Versailles-Saint Quentin University, Villejuif, France
| | - M-C Boutron-Ruault
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
| | - F Bonnet
- Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Paris-South Paris Saclay University, Villejuif, France
- CHU Rennes, Rennes 1 University, Rennes, France
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12
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Mancini FR, Rajaobelina K, Dow C, Habbal T, Affret A, Balkau B, Bonnet F, Boutron-Ruault MC, Fagherazzi G. High iodine dietary intake is associated with type 2 diabetes among women of the E3N-EPIC cohort study. Clin Nutr 2018; 38:1651-1656. [PMID: 30193875 DOI: 10.1016/j.clnu.2018.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 12/18/2017] [Revised: 07/24/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Iodine is an essential micronutrient needed for the production of thyroid hormones. Consequently, iodine insufficient and excessive intakes are associated with thyroid disorders. Despite the increase in diabetes prevalence worldwide and the close relationship between thyroid function and the risk of diabetes, the relationship between iodine intake and diabetes has been overlooked. The objective of the present study is to investigate the link between iodine intake and the risk of type 2 diabetes. METHODS Cox proportional hazards regression models adjusted on potential confounders were used to calculate the hazard ratios and 95% confidence intervals for the associations between dietary iodine intake and type 2 diabetes risk among 71,264 women of the E3N-EPIC cohort. RESULTS The average iodine intake in the study population was 155.6 μg/day (±47.1 μg/day). After adjusting for the main risk factors for diabetes, for hypo/hyperthyroidism, as well as for phosphorus intakes and consumption of dairy products and seafood, the hazard ratios (95% CI) for type 2 diabetes of women in the 4th (160.7-190.5 μg/day) and 5th (190.6-596.8 μg/day) quintiles groups of iodine intake were 1.27 (1.10-1.47) and 1.28 (1.07-1.53), respectively, compared to women with iodine intake below the 1st quintile (29.3-116.9 μg/day). CONCLUSION This is the first study to investigate the relationship between dietary iodine intake and the risk of developing type 2 diabetes. More studies are warranted to further investigate the health effects of chronic high iodine intake, and in particular to investigate the biological mechanisms that underlie the association between iodine intake and type 2 diabetes.
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Affiliation(s)
- Francesca Romana Mancini
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France
| | - Kalina Rajaobelina
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France
| | - Courtney Dow
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France
| | - Tina Habbal
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France
| | - Aurélie Affret
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France
| | - Beverley Balkau
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; University Versailles, Saint Quentin, University Paris-Sud, Villejuif, France
| | - Fabrice Bonnet
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; CHU Rennes, Université de Rennes 1, France
| | - Marie-Christine Boutron-Ruault
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France
| | - Guy Fagherazzi
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, F-94805, France; Gustave Roussy, Villejuif, F-94805, France.
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13
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Mancini FR, Dow C, Affret A, Rajaobelina K, Dartois L, Balkau B, Bonnet F, Boutron-Ruault MC, Fagherazzi G. Micronutrient dietary patterns associated with type 2 diabetes mellitus among women of the E3N-EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort study. J Diabetes 2018; 10:665-674. [PMID: 29457678 DOI: 10.1111/1753-0407.12654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Micronutrients play a key role in type 2 diabetes mellitus (T2DM), but methodological difficulties arise from their collinearity and interdependencies with foods. The aim of the present study was to identify micronutrient dietary patterns in the E3N-EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort and to investigate their association with risk of T2DM. METHODS Principal component analysis was used to identify micronutrient patterns among 71 270 women from the E3N-EPIC cohort. Associations between micronutrient patterns and risk of T2DM were quantified by hazard ratios (HRs) and 95% confidence intervals (CIs) from Cox proportional hazards regression models, adjusted for potential confounders. RESULTS Six micronutrient patterns were identified explaining 78% of the total variance in micronutrient intake. A positive association was found between T2DM and a pattern highly correlated with intake of vitamins B2 and B5 (HR 1.34; 95% CI 1.16-1.56). Similarly, a positive association was found with a pattern characterized by high intakes of vitamin B12 and retinol, and a low intake of vitamin C (HR 1.30; 95% CI 1.15-1.48). An inverse association was observed between T2DM and another two patterns: one correlated with magnesium and vitamin B3 (HR 0.75; 95% CI 0.66-0.86), and the other correlated with manganese intake (HR 0.82; 95% CI 0.72-0.94). CONCLUSIONS The findings of the present study identify micronutrients that have an effect on the risk of T2DM, and enable better understanding of the complexity of the diet when investigating the association between micronutrients and T2DM.
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Affiliation(s)
- Francesca Romana Mancini
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Courtney Dow
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Aurélie Affret
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Kalina Rajaobelina
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Laureen Dartois
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Beverley Balkau
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- University Versailles-St Quentin, University Paris-Sud, Paris, France
| | - Fabrice Bonnet
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Rennes University Hospital, Rennes, France
| | - Marie-Christine Boutron-Ruault
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
| | - Guy Fagherazzi
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Paris, France
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14
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Affret A, El Fatouhi D, Dow C, Correia E, Boutron-Ruault MC, Fagherazzi G. Relative Validity and Reproducibility of a New 44-Item Diet and Food Frequency Questionnaire Among Adults: Online Assessment. J Med Internet Res 2018; 20:e227. [PMID: 29980502 PMCID: PMC6053608 DOI: 10.2196/jmir.9113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/01/2018] [Accepted: 02/18/2018] [Indexed: 12/29/2022] Open
Abstract
Background Dietary questionnaires currently available which can assess the habitual diet are timely, costly, or not adapted well to the modern diet; thus, there is a need for a shorter food frequency e-Questionnaire (FFeQ) adapted to Western diets, in order to properly estimate energy and macronutrient intakes or rank individuals according to food and nutrient intakes. Objective The aim of this study was to evaluate the relative validity and reproducibility of a 30-minute and 44-item FFeQ in a sample of adults obtained from the general population. Methods A sample of French adults was recruited through social media and an advertising campaign. A total of 223 volunteers completed the FFeQ twice at one-year intervals and were included in the reproducibility study. During that interval, 92 participants completed three-to-six 24-hour recalls and were included in the validity study. Nutrient and dietary intakes were computed for all validity and reproducibility participants. The level of agreement between the two methods was evaluated for nutrient and food group intakes using classification into quintiles of daily intake, correlation coefficients and Bland-Altman plots. Results For relative validity, correlation coefficients ranged from 0.09 to 0.88 (unadjusted correlation coefficients, median: 0.48) and 0.02 to 0.68 (deattenuated and energy adjusted correlation coefficients, median: 0.50) for food group and nutrient intakes, respectively. The median proportion of subjects classified into the same or adjacent quintile was 73% and 66% for food and nutrient intakes, respectively. Bland-Altman plots showed good agreement across the range of intakes. Regarding reproducibility, intraclass correlation coefficients ranged from 0.33 to 0.72 (median: 0.60) and 0.55 to 0.73 (median: 0.64), for food and nutrient intakes, respectively. Conclusions The FFeQ showed acceptable validity and reproducibility in a sample of adults based on their food and nutrient intakes. The FFeQ is a promising and low-cost tool that can be used in large-scale online epidemiological studies or clinical routines and could be integrated into evidence-based smartphone apps for assessing diet components.
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Affiliation(s)
- Aurélie Affret
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Douae El Fatouhi
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Courtney Dow
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Emmanuelle Correia
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Guy Fagherazzi
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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15
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Kröger J, Meidtner K, Stefan N, Guevara M, Kerrison ND, Ardanaz E, Aune D, Boeing H, Dorronsoro M, Dow C, Fagherazzi G, Franks PW, Freisling H, Gunter MJ, Huerta JM, Kaaks R, Key TJ, Khaw KT, Krogh V, Kühn T, Mancini FR, Mattiello A, Nilsson PM, Olsen A, Overvad K, Palli D, Quirós JR, Rolandsson O, Sacerdote C, Sala N, Salamanca-Fernández E, Sluijs I, Spijkerman AMW, Tjonneland A, Tsilidis KK, Tumino R, van der Schouw YT, Forouhi NG, Sharp SJ, Langenberg C, Riboli E, Schulze MB, Wareham NJ. Circulating Fetuin-A and Risk of Type 2 Diabetes: A Mendelian Randomization Analysis. Diabetes 2018; 67:1200-1205. [PMID: 29523632 PMCID: PMC6278908 DOI: 10.2337/db17-1268] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 02/27/2018] [Indexed: 12/11/2022]
Abstract
Fetuin-A, a hepatic-origin protein, is strongly positively associated with risk of type 2 diabetes in human observational studies, but it is unknown whether this association is causal. We aimed to study the potential causal relation of circulating fetuin-A to risk of type 2 diabetes in a Mendelian randomization study with single nucleotide polymorphisms located in the fetuin-A-encoding AHSG gene. We used data from eight European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study including 10,020 incident cases. Plasma fetuin-A concentration was measured in a subset of 965 subcohort participants and 654 case subjects. A genetic score of the AHSG single nucleotide polymorphisms was strongly associated with fetuin-A (28% explained variation). Using the genetic score as instrumental variable of fetuin-A, we observed no significant association of a 50 µg/mL higher fetuin-A concentration with diabetes risk (hazard ratio 1.02 [95% CI 0.97, 1.07]). Combining our results with those from the DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) consortium (12,171 case subjects) also did not suggest a clear significant relation of fetuin-A with diabetes risk. In conclusion, although there is mechanistic evidence for an effect of fetuin-A on insulin sensitivity and secretion, this study does not support a strong, relevant relationship between circulating fetuin-A and diabetes risk in the general population.
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Affiliation(s)
- Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Karina Meidtner
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Norbert Stefan
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre München, University of Tübingen, Tübingen, Germany
| | - Marcela Guevara
- Navarre Public Health Institute, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (Navarra Institute for Health Research), Pamplona, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | | | - Eva Ardanaz
- Navarre Public Health Institute, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (Navarra Institute for Health Research), Pamplona, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
- Bjørknes University College, Oslo, Norway
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Miren Dorronsoro
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Instituto BioDonostia, Basque Government, San Sebastian, Spain
| | - Courtney Dow
- Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France
- Paris-Sud, Paris-Saclay University, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Guy Fagherazzi
- Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France
- Paris-Sud, Paris-Saclay University, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Paul W Franks
- Lund University, Malmö, Sweden
- Umeå University, Umeå, Sweden
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - José María Huerta
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, Murcia, Spain
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | | | - Vittorio Krogh
- Istituto Nazionale dei Tumori, Fondazione IRCCS, Milan, Italy
| | - Tilman Kühn
- German Cancer Research Center, Heidelberg, Germany
| | - Francesca Romana Mancini
- Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France
- Paris-Sud, Paris-Saclay University, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | | | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Aalborg University Hospital, Aalborg, Denmark
| | - Domenico Palli
- Cancer Research and Prevention Institute, Florence, Italy
| | | | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza Hospital-University of Torino, Center for Cancer Prevention, Torino, Italy
- Human Genetics Foundation, Torino, Italy
| | - Núria Sala
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, and Translational Research Laboratory, Catalan Institute of Oncology, Barcelona, Spain
| | - Elena Salamanca-Fernández
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | | | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Rosario Tumino
- Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy
- L'Associazione Iblea per la Ricerca Epidemiologica-Un'organizzazione Non Lucrativa di Utilità Sociale, Ragusa, Italy
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K
| | | | - Elio Riboli
- School of Public Health, Imperial College London, London, U.K
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
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16
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Li SX, Imamura F, Schulze MB, Zheng J, Ye Z, Agudo A, Ardanaz E, Aune D, Boeing H, Dorronsoro M, Dow C, Fagherazzi G, Grioni S, Gunter MJ, Huerta JM, Ibsen DB, Jakobsen MU, Kaaks R, Key TJ, Khaw KT, Kyrø C, Mancini FR, Molina-Portillo E, Murphy N, Nilsson PM, Onland-Moret NC, Palli D, Panico S, Poveda A, Quirós JR, Ricceri F, Sluijs I, Spijkerman AMW, Tjonneland A, Tumino R, Winkvist A, Langenberg C, Sharp SJ, Riboli E, Scott RA, Forouhi NG, Wareham NJ. Interplay between genetic predisposition, macronutrient intake and type 2 diabetes incidence: analysis within EPIC-InterAct across eight European countries. Diabetologia 2018; 61:1325-1332. [PMID: 29549418 PMCID: PMC6445347 DOI: 10.1007/s00125-018-4586-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/08/2018] [Indexed: 01/25/2023]
Abstract
AIMS/HYPOTHESIS Gene-macronutrient interactions may contribute to the development of type 2 diabetes but research evidence to date is inconclusive. We aimed to increase our understanding of the aetiology of type 2 diabetes by investigating potential interactions between genes and macronutrient intake and their association with the incidence of type 2 diabetes. METHODS We investigated the influence of interactions between genetic risk scores (GRSs) for type 2 diabetes, insulin resistance and BMI and macronutrient intake on the development of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct, a prospective case-cohort study across eight European countries (N = 21,900 with 9742 incident type 2 diabetes cases). Macronutrient intake was estimated from diets reported in questionnaires, including proportion of energy derived from total carbohydrate, protein, fat, plant and animal protein, saturated, monounsaturated and polyunsaturated fat and dietary fibre. Using multivariable-adjusted Cox regression, we estimated country-specific interaction results on the multiplicative scale, using random-effects meta-analysis. Secondary analysis used isocaloric macronutrient substitution. RESULTS No interactions were identified between any of the three GRSs and any macronutrient intake, with low-to-moderate heterogeneity between countries (I2 range 0-51.6%). Results were similar using isocaloric macronutrient substitution analyses and when weighted and unweighted GRSs and individual SNPs were examined. CONCLUSIONS/INTERPRETATION Genetic susceptibility to type 2 diabetes, insulin resistance and BMI did not modify the association between macronutrient intake and incident type 2 diabetes. This suggests that macronutrient intake recommendations to prevent type 2 diabetes do not need to account for differences in genetic predisposition to these three metabolic conditions.
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Affiliation(s)
- Sherly X Li
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Jusheng Zheng
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Zheng Ye
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Department of Medical Genetics, Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
| | - Antonio Agudo
- Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Eva Ardanaz
- Navarre Public Health Institute (ISPN), Pamplona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Bjørknes University College, Oslo, Norway
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Miren Dorronsoro
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Instituto BIO-Donostia, Basque Government, San Sebastian, Spain
| | - Courtney Dow
- CESP, Faculty of Medicine, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, Inserm U1018, University Paris-Saclay, Villejuif, France
| | - Guy Fagherazzi
- CESP, Faculty of Medicine, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, Inserm U1018, University Paris-Saclay, Villejuif, France
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Marc J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - José María Huerta
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Daniel B Ibsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Marianne Uhre Jakobsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
- National Food Institute, Division for Diet, Disease Prevention and Toxicology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Timothy J Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Francesca Romana Mancini
- CESP, Faculty of Medicine, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, Inserm U1018, University Paris-Saclay, Villejuif, France
| | - Elena Molina-Portillo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Neil Murphy
- International Agency for Research on Cancer, Lyon, France
| | - Peter M Nilsson
- Department of History of Medicine, Lund University, Malmö, Sweden
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Alaitz Poveda
- Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden
- Department of Nutritional Research, Umeå University, Umeå, Sweden
| | | | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, (TO), Italy
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | - Rosario Tumino
- Azienda Sanitaria Provinciale di Ragusa (ASP), Ragusa, Italy
- Associazione Iblea per la Ricerca Epidemiologica (AIRE-ONLUS), Ragusa, Italy
| | - Anna Winkvist
- The Sahlgrenska Academy, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Göteborg, Sweden
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Elio Riboli
- School of Public Health, Imperial College London, London, UK
| | - Robert A Scott
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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17
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Mancini FR, Affret A, Dow C, Balkau B, Bonnet F, Boutron-Ruault MC, Fagherazzi G. Dietary antioxidant capacity and risk of type 2 diabetes in the large prospective E3N-EPIC cohort. Diabetologia 2018; 61:308-316. [PMID: 29119242 DOI: 10.1007/s00125-017-4489-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/28/2017] [Indexed: 01/04/2023]
Abstract
AIMS/HYPOTHESIS Recent evidence suggests that oxidative stress may contribute to the pathogenesis of type 2 diabetes. The diet, and especially fruit and vegetables, contains a variety of compounds with antioxidant activity, which may have cumulative/synergistic antioxidant effects. The total antioxidant capacity, an index derived from dietary intake, is a single estimate of antioxidant capacity from all dietary antioxidants. The main aim of this study was to investigate the relationship between total antioxidant capacity and risk of type 2 diabetes. METHODS Among 64,223 women (mean age 52 ± 7 years) from the French E3N-European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, 1751 women had validated type 2 diabetes during 15 years of follow-up. The total antioxidant capacity was estimated with the ferric ion-reducing antioxidant power (FRAP) method. Adjusted Cox proportional hazards regression models were used to calculate HRs and 95% CIs for the associations between total antioxidant capacity and type 2 diabetes risk, adjusted for potential confounders. RESULTS In multivariable models, higher levels of total antioxidant capacity were associated with a lower risk of type 2 diabetes. Compared with women in the lowest quintile, women in the third, fourth and fifth quintiles for total antioxidant capacity had HRs of 0.74 (95% CI 0.63, 0.86), 0.70 (95% CI 0.59, 0.83) and 0.73 (95% CI 0.60, 0.89), respectively. The inverse association between total antioxidant capacity and risk of type 2 diabetes was linear up to values of 15 mmol/day, after which the effect reached a plateau. CONCLUSIONS/INTERPRETATION Our findings suggest that the total antioxidant capacity may play an important role in reducing the risk of type 2 diabetes in middle-aged women. More studies are warranted to better understand the biological mechanisms underlying this inverse association.
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Affiliation(s)
- Francesca Romana Mancini
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Aurélie Affret
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Courtney Dow
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Beverley Balkau
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Renal and cardiovascular Epidemiology' Team, University Versailles, Saint Quentin, University Paris-Sud, Villejuif, France
| | - Fabrice Bonnet
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
- CHU Rennes, Université de Rennes 1, Department of Endocrinology, Diabetology and Nutrition, Rennes, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
| | - Guy Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) 'Health across Generations' Team, University Paris-Saclay, University Paris-Sud, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
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18
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Meidtner K, Podmore C, Kröger J, van der Schouw YT, Bendinelli B, Agnoli C, Arriola L, Barricarte A, Boeing H, Cross AJ, Dow C, Ekblom K, Fagherazzi G, Franks PW, Gunter MJ, Huerta JM, Jakszyn P, Jenab M, Katzke VA, Key TJ, Khaw KT, Kühn T, Kyrø C, Mancini FR, Melander O, Nilsson PM, Overvad K, Palli D, Panico S, Quirós JR, Rodríguez-Barranco M, Sacerdote C, Sluijs I, Stepien M, Tjonneland A, Tumino R, Forouhi NG, Sharp SJ, Langenberg C, Schulze MB, Riboli E, Wareham NJ. Interaction of Dietary and Genetic Factors Influencing Body Iron Status and Risk of Type 2 Diabetes Within the EPIC-InterAct Study. Diabetes Care 2018; 41:277-285. [PMID: 29167213 PMCID: PMC6130703 DOI: 10.2337/dc17-1080] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/20/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Meat intake has been consistently shown to be positively associated with incident type 2 diabetes. Part of that association may be mediated by body iron status, which is influenced by genetic factors. We aimed to test for interactions of genetic and dietary factors influencing body iron status in relation to the risk of incident type 2 diabetes. RESEARCH DESIGN AND METHODS The case-cohort comprised 9,347 case subjects and 12,301 subcohort participants from eight European countries. Single nucleotide polymorphisms (SNPs) were selected from genome-wide association studies on iron status biomarkers and candidate gene studies. A ferritin-related gene score was constructed. Multiplicative and additive interactions of heme iron and SNPs as well as the gene score were evaluated using Cox proportional hazards regression. RESULTS Higher heme iron intake (per 1 SD) was associated with higher ferritin levels (β = 0.113 [95% CI 0.082; 0.144]), but not with transferrin (-0.019 [-0.043; 0.006]) or transferrin saturation (0.016 [-0.006; 0.037]). Five SNPs located in four genes (rs1799945 [HFE H63D], rs1800562 [HFE C282Y], rs236918 [PCK7], rs744653 [SLC40A1], and rs855791 [TMPRSS6 V736A]) were associated with ferritin. We did not detect an interaction of heme iron and the gene score on the risk of diabetes in the overall study population (Padd = 0.16, Pmult = 0.21) but did detect a trend toward a negative interaction in men (Padd = 0.04, Pmult = 0.03). CONCLUSIONS We found no convincing evidence that the interplay of dietary and genetic factors related to body iron status associates with type 2 diabetes risk above the level expected from the sum or product of the two individual exposures.
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Affiliation(s)
- Karina Meidtner
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Clara Podmore
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | | | | | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Larraitz Arriola
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Instituto BIO-Donostia, Basque Government, San Sebastian, Spain
- Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Aurelio Barricarte
- Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Public Health Institute (ISPN), Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
| | - Courtney Dow
- INSERM U1018, Centre de recherche en Épidémiologie et Santé des Populations, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Kim Ekblom
- Clinical Chemistry, Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Guy Fagherazzi
- INSERM U1018, Centre de recherche en Épidémiologie et Santé des Populations, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Paul W Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Marc J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - José María Huerta
- Instituto BIO-Donostia, Basque Government, San Sebastian, Spain
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
| | - Paula Jakszyn
- Nutrition and Cancer Unit, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain
- Blanquerna Health Sciences Faculty, Universitat Ramon Llull, Barcelona, Spain
| | - Mazda Jenab
- International Agency for Research on Cancer, Lyon, France
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Francesca Romana Mancini
- INSERM U1018, Centre de recherche en Épidémiologie et Santé des Populations, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Aalborg University Hospital, Aalborg, Denmark
| | - Domenico Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University of Naples, Naples, Italy
| | | | - Miguel Rodríguez-Barranco
- Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza Hospital-University of Turin and Center for Cancer Prevention (CPO), Torino, Italy
- Human Genetics Foundation (HuGeF), Torino, Italy
| | - Ivonne Sluijs
- University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | - Rosario Tumino
- Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy
- L'Associazione Iblea per la Ricerca Epidemiologica-Organizazione Non Lucrativa di Utilità Sociale, Ragusa, Italy
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
| | - Nicholas J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, U.K
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19
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Zheng JS, Sharp SJ, Imamura F, Koulman A, Schulze MB, Ye Z, Griffin J, Guevara M, Huerta JM, Kröger J, Sluijs I, Agudo A, Barricarte A, Boeing H, Colorado-Yohar S, Dow C, Dorronsoro M, Dinesen PT, Fagherazzi G, Franks PW, Feskens EJM, Kühn T, Katzke VA, Key TJ, Khaw KT, de Magistris MS, Mancini FR, Molina-Portillo E, Nilsson PM, Olsen A, Overvad K, Palli D, Quirós JR, Rolandsson O, Ricceri F, Spijkerman AMW, Slimani N, Tagliabue G, Tjonneland A, Tumino R, van der Schouw YT, Langenberg C, Riboli E, Forouhi NG, Wareham NJ. Association between plasma phospholipid saturated fatty acids and metabolic markers of lipid, hepatic, inflammation and glycaemic pathways in eight European countries: a cross-sectional analysis in the EPIC-InterAct study. BMC Med 2017; 15:203. [PMID: 29145892 PMCID: PMC5691386 DOI: 10.1186/s12916-017-0968-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that individual circulating saturated fatty acids (SFAs) are heterogeneous in their associations with cardio-metabolic diseases, but evidence about associations of SFAs with metabolic markers of different pathogenic pathways is limited. We aimed to examine the associations between plasma phospholipid SFAs and the metabolic markers of lipid, hepatic, glycaemic and inflammation pathways. METHODS We measured nine individual plasma phospholipid SFAs and derived three SFA groups (odd-chain: C15:0 + C17:0, even-chain: C14:0 + C16:0 + C18:0, and very-long-chain: C20:0 + C22:0 + C23:0 + C24:0) in individuals from the subcohort of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study across eight European countries. Using linear regression in 15,919 subcohort members, adjusted for potential confounders and corrected for multiple testing, we examined cross-sectional associations of SFAs with 13 metabolic markers. Multiplicative interactions of the three SFA groups with pre-specified factors, including body mass index (BMI) and alcohol consumption, were tested. RESULTS Higher levels of odd-chain SFA group were associated with lower levels of major lipids (total cholesterol (TC), triglycerides, apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB)) and hepatic markers (alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT)). Higher even-chain SFA group levels were associated with higher levels of low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, ApoB, ApoB/A1 ratio, ALT, AST, GGT and CRP, and lower levels of HDL-C and ApoA1. Very-long-chain SFA group levels showed inverse associations with triglycerides, ApoA1 and GGT, and positive associations with TC, LDL-C, TC/HDL-C, ApoB and ApoB/A1. Associations were generally stronger at higher levels of BMI or alcohol consumption. CONCLUSIONS Subtypes of SFAs are associated in a differential way with metabolic markers of lipid metabolism, liver function and chronic inflammation, suggesting that odd-chain SFAs are associated with lower metabolic risk and even-chain SFAs with adverse metabolic risk, whereas mixed findings were obtained for very-long-chain SFAs. The clinical and biochemical implications of these findings may vary by adiposity and alcohol intake.
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Affiliation(s)
- Ju-Sheng Zheng
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Albert Koulman
- MRC Elsie Widdowson Laboratory, Cambridge, UK
- NIHR BRC Nutritional Biomarker Laboratory, Cambridge, UK
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Zheng Ye
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jules Griffin
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Marcela Guevara
- Navarra Public Health Institute (ISPN), Pamplona, Spain
- Navarra Institute for Health Research (ldiSNA), Pamplona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José María Huerta
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Ivonne Sluijs
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Aurelio Barricarte
- Navarra Public Health Institute (ISPN), Pamplona, Spain
- Navarra Institute for Health Research (ldiSNA), Pamplona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Sandra Colorado-Yohar
- Navarra Institute for Health Research (ldiSNA), Pamplona, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Courtney Dow
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | | | - Pia T Dinesen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Guy Fagherazzi
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Paul W Franks
- Lund University, Malmö, Sweden
- Umeå University, Umeå, Sweden
| | | | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Verena Andrea Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Francesca Romana Mancini
- INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Elena Molina-Portillo
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | | | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Domenico Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | | | | | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Turin, Italy
| | | | - Nadia Slimani
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic M.P. Arezzo" Hospital, ASP, Ragusa, Italy
| | | | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Elio Riboli
- School of Public Health, Imperial College London, London, UK
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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Fagherazzi G, El Fatouhi D, Bellicha A, El Gareh A, Affret A, Dow C, Delrieu L, Vegreville M, Normand A, Oppert JM, Severi G. An International Study on the Determinants of Poor Sleep Amongst 15,000 Users of Connected Devices. J Med Internet Res 2017; 19:e363. [PMID: 29061551 PMCID: PMC5673882 DOI: 10.2196/jmir.7930] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 05/02/2017] [Revised: 08/23/2017] [Accepted: 09/06/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sleep is a modifiable lifestyle factor that can be a target for efficient intervention studies to improve the quality of life and decrease the risk or burden of some chronic conditions. Knowing the profiles of individuals with poor sleep patterns is therefore a prerequisite. Wearable devices have recently opened new areas in medical research as potential efficient tools to measure lifestyle factors such as sleep quantity and quality. OBJECTIVES The goal of our research is to identify the determinants of poor sleep based on data from a large population of users of connected devices. METHODS We analyzed data from 15,839 individuals (13,658 males and 2181 females) considered highly connected customers having purchased and used at least 3 connected devices from the consumer electronics company Withings (now Nokia). Total and deep sleep durations as well as the ratio of deep/total sleep as a proxy of sleep quality were analyzed in association with available data on age, sex, weight, heart rate, steps, and diastolic and systolic blood pressures. RESULTS With respect to the deep/total sleep duration ratio used as a proxy of sleep quality, we have observed that those at risk of having a poor ratio (≤0.40) were more frequently males (odds ratio [OR]female vs male=0.45, 95% CI 0.38-0.54), younger individuals (OR>60 years vs 18-30 years=0.47, 95% CI 0.35-0.63), and those with elevated heart rate (OR>78 bpm vs ≤61 bpm=1.18, 95% CI 1.04-1.34) and high systolic blood pressure (OR>133 mm Hg vs ≤116 mm Hg=1.22, 95% CI 1.04-1.43). A direct association with weight was observed for total sleep duration exclusively. CONCLUSIONS Wearables can provide useful information to target individuals at risk of poor sleep. Future alert or mobile phone notification systems based on poor sleep determinants measured with wearables could be tested in intervention studies to evaluate the benefits.
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Affiliation(s)
- Guy Fagherazzi
- Centre de Recherche en Epidémiologie et Santé des Populations U1018, Inserm, Villejuif, France
| | - Douae El Fatouhi
- Centre de Recherche en Epidémiologie et Santé des Populations U1018, Inserm, Villejuif, France
| | - Alice Bellicha
- Bioingénierie, Tissus et Neuroplasticité, Université Paris-Est Créteil, Creteil, France
| | - Amin El Gareh
- Centre de Recherche en Epidémiologie et Santé des Populations U1018, Inserm, Villejuif, France
| | - Aurélie Affret
- Centre de Recherche en Epidémiologie et Santé des Populations U1018, Inserm, Villejuif, France
| | - Courtney Dow
- Centre de Recherche en Epidémiologie et Santé des Populations U1018, Inserm, Villejuif, France
| | | | | | | | - Jean-Michel Oppert
- Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitie-Salpetriere University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,University Pierre et Marie Curie-Paris, Paris, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations U1018, Inserm, Villejuif, France
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21
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Imamura F, Sharp SJ, Koulman A, Schulze MB, Kröger J, Griffin JL, Huerta JM, Guevara M, Sluijs I, Agudo A, Ardanaz E, Balkau B, Boeing H, Chajes V, Dahm CC, Dow C, Fagherazzi G, Feskens EJM, Franks PW, Gavrila D, Gunter M, Kaaks R, Key TJ, Khaw KT, Kühn T, Melander O, Molina-Portillo E, Nilsson PM, Olsen A, Overvad K, Palli D, Panico S, Rolandsson O, Sieri S, Sacerdote C, Slimani N, Spijkerman AMW, Tjønneland A, Tumino R, van der Schouw YT, Langenberg C, Riboli E, Forouhi NG, Wareham NJ. A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study. PLoS Med 2017; 14:e1002409. [PMID: 29020051 PMCID: PMC5636062 DOI: 10.1371/journal.pmed.1002409] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/14/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Combinations of multiple fatty acids may influence cardiometabolic risk more than single fatty acids. The association of a combination of fatty acids with incident type 2 diabetes (T2D) has not been evaluated. METHODS AND FINDINGS We measured plasma phospholipid fatty acids by gas chromatography in 27,296 adults, including 12,132 incident cases of T2D, over the follow-up period between baseline (1991-1998) and 31 December 2007 in 8 European countries in EPIC-InterAct, a nested case-cohort study. The first principal component derived by principal component analysis of 27 individual fatty acids (mole percentage) was the main exposure (subsequently called the fatty acid pattern score [FA-pattern score]). The FA-pattern score was partly characterised by high concentrations of linoleic acid, stearic acid, odd-chain fatty acids, and very-long-chain saturated fatty acids and low concentrations of γ-linolenic acid, palmitic acid, and long-chain monounsaturated fatty acids, and it explained 16.1% of the overall variability of the 27 fatty acids. Based on country-specific Prentice-weighted Cox regression and random-effects meta-analysis, the FA-pattern score was associated with lower incident T2D. Comparing the top to the bottom fifth of the score, the hazard ratio of incident T2D was 0.23 (95% CI 0.19-0.29) adjusted for potential confounders and 0.37 (95% CI 0.27-0.50) further adjusted for metabolic risk factors. The association changed little after adjustment for individual fatty acids or fatty acid subclasses. In cross-sectional analyses relating the FA-pattern score to metabolic, genetic, and dietary factors, the FA-pattern score was inversely associated with adiposity, triglycerides, liver enzymes, C-reactive protein, a genetic score representing insulin resistance, and dietary intakes of soft drinks and alcohol and was positively associated with high-density-lipoprotein cholesterol and intakes of polyunsaturated fat, dietary fibre, and coffee (p < 0.05 each). Limitations include potential measurement error in the fatty acids and other model covariates and possible residual confounding. CONCLUSIONS A combination of individual fatty acids, characterised by high concentrations of linoleic acid, odd-chain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D. The specific fatty acid pattern may be influenced by metabolic, genetic, and dietary factors.
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Affiliation(s)
- Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J. Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Albert Koulman
- National Institute for Health Research Biomedical Research Centres Core Nutritional Biomarker Laboratory, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
- National Institute for Health Research Biomedical Research Centres Core Metabolomics and Lipidomics Laboratory, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Medical Research Council Epidemiology Unit Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam, Germany
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam, Germany
| | - Julian L. Griffin
- Medical Research Council Epidemiology Unit Elsie Widdowson Laboratory, Cambridge, United Kingdom
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - José M. Huerta
- Department of Epidemiology, Consejería de Sanidad y Política Social, CIBER de Epidemiología y Salud Pública, Murcia, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Marcela Guevara
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Navarre Public Health Institute, Pamplona, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Navarre Public Health Institute, Pamplona, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Beverley Balkau
- Center for Research in Epidemiology and Population Health, Inserm U1018, Paris-Sud University, University Versailles Saint-Quentin-en-Yvelines, Paris Saclay University, Villejuif, France
| | - Heiner Boeing
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam, Germany
| | | | - Christina C. Dahm
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Courtney Dow
- Center for Research in Epidemiology and Population Health, Inserm U1018, Paris-Sud University, University Versailles Saint-Quentin-en-Yvelines, Paris Saclay University, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Guy Fagherazzi
- Center for Research in Epidemiology and Population Health, Inserm U1018, Paris-Sud University, University Versailles Saint-Quentin-en-Yvelines, Paris Saclay University, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Edith J. M. Feskens
- Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, Netherlands
| | - Paul W. Franks
- Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
| | - Diana Gavrila
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
- Murcia BioHealth Research Institute–Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Marc Gunter
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
| | - Elena Molina-Portillo
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Peter M. Nilsson
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aalborg University Hospital, Aarhus, Denmark
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Federico II University, Naples, Italy
| | - Olov Rolandsson
- Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza Hospital–University of Turin and Center for Cancer Prevention, Torino, Italy
| | - Nadia Slimani
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Rosario Tumino
- Affiliation Cancer Registry, Department of Prevention, Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - Nita G. Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nick J. Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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22
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Affret A, Wagner S, El Fatouhi D, Dow C, Correia E, Niravong M, Clavel-Chapelon F, De Chefdebien J, Fouque D, Stengel B, Boutron-Ruault MC, Fagherazzi G. Validity and reproducibility of a short food frequency questionnaire among patients with chronic kidney disease. BMC Nephrol 2017; 18:297. [PMID: 28915857 PMCID: PMC5599889 DOI: 10.1186/s12882-017-0695-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/22/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND A balanced diet is essential to slowing the progression of chronic kidney disease (CKD) and managing the symptoms. Currently, no tool is available to easily and quickly assess energy and macronutrient intake in patients with non end-stage CKD. We aimed to develop and evaluate the validity and reproducibility of a new short 49-item food frequency questionnaire (SFFQ) adapted to patients with CKD. METHODS The CKD-REIN study is a prospective cohort that enrolled 3033 patients with moderate or advanced CKD from a national sample of nephrology clinics. A sub-sample of 201 patients completed the SFFQ twice, at a one-year interval and were included in the reproducibility study. During this interval, 127 patients also completed six 24-h recalls and were included in the validity study. Main nutrient and dietary intakes were computed. Validity was evaluated by calculating crude, energy-adjusted and de-attenuated correlation coefficients (CC) between FFQ and the mean of the 24-h recall results. Bland-Altman plots were performed and cross-classification into quintiles of consumption of each nutrient and food group was computed. Reproducibility between the two SFFQs was evaluated by intraclass CC (ICC). RESULTS Regarding validity, CC ranged from 0.05 to 0.79 (unadjusted CC, median: 0.40) and 0.10 to 0.59 (de-attenuated CC, median: 0.35) for food group and nutrient intakes, respectively. Five of the most important nutrients of interest in CKD, i.e. protein, calcium, phosphorus, potassium, and sodium had de-attenuated CC of 0.46, 0.43, 0.39, 0.32, and 0.12, respectively. The median of classification into the same or adjacent quintiles was 68% and 65% for food and nutrient intakes, respectively, and ranged from 63% to 69% for the five nutrients mentioned before. Bland-Altman plots showed good agreement across the range of intakes. ICC ranged from 0.18 to 0.66 (median: 0.46). CONCLUSIONS The CKD-REIN SFFQ showed acceptable validity and reproducibility in a sample of patients with CKD, notably for CKD nutrients of importance. It can now be used in large-scale epidemiological studies to easily assess the relations between diet and CKD outcomes as well as in clinical routine. It may also serve as a basis for the development of FFQs in international CKD cohort networks.
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Affiliation(s)
- Aurélie Affret
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Sandra Wagner
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
- FCRIN INI-CRCT, Lyon, France
| | - Douae El Fatouhi
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Courtney Dow
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Emmanuelle Correia
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Maryvonne Niravong
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Françoise Clavel-Chapelon
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Julie De Chefdebien
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Denis Fouque
- FCRIN INI-CRCT, Lyon, France
- Centre Hospitalier Lyon Sud, Lyon, F-69495 Pierre-Bénite, France
- CarMeN, Inserm UMRS 1060, Inserm, Univ Lyon-Sud, Lyon, 69921 Oullins, France
| | - Bénédicte Stengel
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
- Center for Research in Epidemiology and Population Health (CESP), INSERM (Institut National de la Santé et de la Recherche Médicale) U1018, Team 9, Health across generations, Gustave Roussy Institute, 114 rue Edouard Vaillant, 94805 Villejuif Cedex, France
| | - Guy Fagherazzi
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- Univ Paris-Sud, Villejuif, France
- UVSQ, Villejuif, France
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23
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Li SX, Imamura F, Ye Z, Schulze MB, Zheng J, Ardanaz E, Arriola L, Boeing H, Dow C, Fagherazzi G, Franks PW, Agudo A, Grioni S, Kaaks R, Katzke VA, Key TJ, Khaw KT, Mancini FR, Navarro C, Nilsson PM, Onland-Moret NC, Overvad K, Palli D, Panico S, Quirós JR, Rolandsson O, Sacerdote C, Sánchez MJ, Slimani N, Sluijs I, Spijkerman AM, Tjonneland A, Tumino R, Sharp SJ, Riboli E, Langenberg C, Scott RA, Forouhi NG, Wareham NJ. Interaction between genes and macronutrient intake on the risk of developing type 2 diabetes: systematic review and findings from European Prospective Investigation into Cancer (EPIC)-InterAct. Am J Clin Nutr 2017; 106:263-275. [PMID: 28592605 PMCID: PMC5486199 DOI: 10.3945/ajcn.116.150094] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 04/26/2017] [Indexed: 12/12/2022] Open
Abstract
Background: Gene-diet interactions have been reported to contribute to the development of type 2 diabetes (T2D). However, to our knowledge, few examples have been consistently replicated to date.Objective: We aimed to identify existing evidence for gene-macronutrient interactions and T2D and to examine the reported interactions in a large-scale study.Design: We systematically reviewed studies reporting gene-macronutrient interactions and T2D. We searched the MEDLINE, Human Genome Epidemiology Network, and WHO International Clinical Trials Registry Platform electronic databases to identify studies published up to October 2015. Eligibility criteria included assessment of macronutrient quantity (e.g., total carbohydrate) or indicators of quality (e.g., dietary fiber) by use of self-report or objective biomarkers of intake. Interactions identified in the review were subsequently examined in the EPIC (European Prospective Investigation into Cancer)-InterAct case-cohort study (n = 21,148, with 9403 T2D cases; 8 European countries). Prentice-weighted Cox regression was used to estimate country-specific HRs, 95% CIs, and P-interaction values, which were then pooled by random-effects meta-analysis. A primary model was fitted by using the same covariates as reported in the published studies, and a second model adjusted for additional covariates and estimated the effects of isocaloric macronutrient substitution.Results: Thirteen observational studies met the eligibility criteria (n < 1700 cases). Eight unique interactions were reported to be significant between macronutrients [carbohydrate, fat, saturated fat, dietary fiber, and glycemic load derived from self-report of dietary intake and circulating n-3 (ω-3) polyunsaturated fatty acids] and genetic variants in or near transcription factor 7-like 2 (TCF7L2), gastric inhibitory polypeptide receptor (GIPR), caveolin 2 (CAV2), and peptidase D (PEPD) (P-interaction < 0.05). We found no evidence of interaction when we tried to replicate previously reported interactions. In addition, no interactions were detected in models with additional covariates.Conclusions: Eight gene-macronutrient interactions were identified for the risk of T2D from the literature. These interactions were not replicated in the EPIC-InterAct study, which mirrored the analyses undertaken in the original reports. Our findings highlight the importance of independent replication of reported interactions.
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Affiliation(s)
- Sherly X Li
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Fumiaki Imamura
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Zheng Ye
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Düsseldorf, Germany
| | - Jusheng Zheng
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Eva Ardanaz
- Navarre Public Health Institute (ISPN), Pamplona, Spain
- Center for Biomedical Research in Network Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Larraitz Arriola
- Center for Biomedical Research in Network Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Bio-Donostia Institute, Basque Government, San Sebastian, Spain
| | - Heiner Boeing
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Courtney Dow
- French National Institute of Health and Medical Research (INSERM) U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Guy Fagherazzi
- French National Institute of Health and Medical Research (INSERM) U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Paul W Franks
- Lund University, Malmö, Sweden
- Umeå University, Umeå, Sweden
| | - Antonio Agudo
- Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Sara Grioni
- Epidemiology and Prevention Unit, Milan, Italy
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Kay Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Francesca R Mancini
- French National Institute of Health and Medical Research (INSERM) U1018, Institut Gustave Roussy, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Carmen Navarro
- Center for Biomedical Research in Network Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Biomedical Research Institute of Murcia (IMIB)-Arrixaca, Murcia, Spain
- Unit of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Murcia, Spain
| | | | | | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Aalborg University Hospital, Aalborg, Denmark
| | - Domenico Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, City of Health and Science Hospital, University of Turin, Torino, Italy
- Center for Cancer Prevention (CPO), Torino, Italy
- Human Genetics Foundation (HuGeF), Torino, Italy
| | - María-José Sánchez
- Center for Biomedical Research in Network Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
- Biosanitary Research Institute of Granada (Granada.ibs), Granada, Spain
| | - Nadia Slimani
- International Agency for Research on Cancer, Lyon, France
| | - Ivonne Sluijs
- University Medical Center Utrecht, Utrecht, Netherlands
| | | | | | - Rosario Tumino
- Provincial Healthcare Company (ASP) Ragusa, Vittoria, Italy; and
| | - Stephen J Sharp
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - Claudia Langenberg
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Robert A Scott
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nita G Forouhi
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom;
| | - Nicholas J Wareham
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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24
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Fagherazzi G, Gusto G, Affret A, Mancini FR, Dow C, Balkau B, Clavel-Chapelon F, Bonnet F, Boutron-Ruault MC. Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study. Ann Nutr Metab 2017; 70:51-58. [PMID: 28214853 DOI: 10.1159/000458769] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 01/23/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND The influence of artificial sweeteners on metabolic diseases is controversial. Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes (T2D) but biases and reverse causation have been suspected to have influenced the observed association. In addition, it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary. METHODS We used data from 61,440 women in the prospective E3N-European Prospective Investigation into Cancer and Nutrition study, conducted between 1993 and 2011. We estimated hazards ratios (HRs) and 95% CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets. RESULTS Compared to "never or rare" consumers of artificial sweeteners, those using them "always or almost always" had an increased risk of T2D (HR = 1.83 [95% CI 1.66-2.02] in the multivariate model [MM], HR = 1.33 [95% CI 1.20-1.47] when further adjusted for body mass index, BMI). Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users (HR = 2.10 [95% CI 1.83-2.40] in the MM and HR = 1.15 [95% CI 1.00-1.33] when adjusted for BMI, respectively). CONCLUSIONS Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk, independently of major T2D risk factors, but partially mediated by adiposity. A precautionary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes.
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Affiliation(s)
- Guy Fagherazzi
- Inserm U1018, Gustave Roussy Institute, CESP, Villejuif, France
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25
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Yu ZX, Qi S, Lasaro MA, Bouchard K, Dow C, Moore K, Wu Z, Barama A, Xu J, Johnson K, Marozsan AJ, Wang Y. Targeting Complement Pathways During Cold Ischemia and Reperfusion Prevents Delayed Graft Function. Am J Transplant 2016; 16:2589-97. [PMID: 27003920 DOI: 10.1111/ajt.13797] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 01/15/2016] [Accepted: 03/11/2016] [Indexed: 01/25/2023]
Abstract
The complement system plays a critical role in ischemia-reperfusion injury (IRI)-mediated delayed graft function (DGF). To better understand the roles of complement activation pathways in IRI in kidney transplantation, donor kidneys were treated ex vivo with terminal complement pathway (TP) inhibitor, anti-rat C5 mAb 18A10, or complement alternative pathway (AP) inhibitor TT30 for 28 h at 4°C pretransplantation in a syngeneic kidney transplantation rat model. All 18A10- and 67% of TT30-pretreated grafts, but only 16.7% of isotype control-pretreated grafts, survived beyond day 21 (p < 0.01). Inhibitor treatment in the final 45 min of 28-h cold ischemia (CI) similarly improved graft survival. Systemic posttransplant treatment with 18A10 resulted in 60% increased graft survival beyond day 21 (p < 0.01), while no TT30-treated rat survived > 6 days. Our results demonstrate that AP plays a prominent role during CI and that blocking either the AP or, more effectively the TP prevents ischemic injury and subsequent DGF. Multiple complement pathways may be activated and contribute to reperfusion injury; blocking the TP, but not the AP, posttransplant is effective in preventing reperfusion injury and increasing graft survival. These results demonstrate the feasibility of using complement inhibitors for prevention of DGF in humans.
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Affiliation(s)
- Z X Yu
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - S Qi
- Research Centre, Centre Hospitalier de l'Université de Montréal, Department of Surgery, Hôpital Notre Dame and Université de Montréal, Montréal, Quebec, Canada
| | - M A Lasaro
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - K Bouchard
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - C Dow
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - K Moore
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - Z Wu
- Research Centre, Centre Hospitalier de l'Université de Montréal, Department of Surgery, Hôpital Notre Dame and Université de Montréal, Montréal, Quebec, Canada
| | - A Barama
- Research Centre, Centre Hospitalier de l'Université de Montréal, Department of Surgery, Hôpital Notre Dame and Université de Montréal, Montréal, Quebec, Canada
| | - J Xu
- Research Centre, Centre Hospitalier de l'Université de Montréal, Department of Surgery, Hôpital Notre Dame and Université de Montréal, Montréal, Quebec, Canada
| | - K Johnson
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - A J Marozsan
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
| | - Y Wang
- Pre-Clinical Sciences, Alexion Pharmaceuticals, Inc., Cheshire, CT, Canada
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Forouhi NG, Imamura F, Sharp SJ, Koulman A, Schulze MB, Zheng J, Ye Z, Sluijs I, Guevara M, Huerta JM, Kröger J, Wang LY, Summerhill K, Griffin JL, Feskens EJM, Affret A, Amiano P, Boeing H, Dow C, Fagherazzi G, Franks PW, Gonzalez C, Kaaks R, Key TJ, Khaw KT, Kühn T, Mortensen LM, Nilsson PM, Overvad K, Pala V, Palli D, Panico S, Quirós JR, Rodriguez-Barranco M, Rolandsson O, Sacerdote C, Scalbert A, Slimani N, Spijkerman AMW, Tjonneland A, Tormo MJ, Tumino R, van der A DL, van der Schouw YT, Langenberg C, Riboli E, Wareham NJ. Association of Plasma Phospholipid n-3 and n-6 Polyunsaturated Fatty Acids with Type 2 Diabetes: The EPIC-InterAct Case-Cohort Study. PLoS Med 2016; 13:e1002094. [PMID: 27434045 PMCID: PMC4951144 DOI: 10.1371/journal.pmed.1002094] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/16/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Whether and how n-3 and n-6 polyunsaturated fatty acids (PUFAs) are related to type 2 diabetes (T2D) is debated. Objectively measured plasma PUFAs can help to clarify these associations. METHODS AND FINDINGS Plasma phospholipid PUFAs were measured by gas chromatography among 12,132 incident T2D cases and 15,919 subcohort participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study across eight European countries. Country-specific hazard ratios (HRs) were estimated using Prentice-weighted Cox regression and pooled by random-effects meta-analysis. We also systematically reviewed published prospective studies on circulating PUFAs and T2D risk and pooled the quantitative evidence for comparison with results from EPIC-InterAct. In EPIC-InterAct, among long-chain n-3 PUFAs, α-linolenic acid (ALA) was inversely associated with T2D (HR per standard deviation [SD] 0.93; 95% CI 0.88-0.98), but eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were not significantly associated. Among n-6 PUFAs, linoleic acid (LA) (0.80; 95% CI 0.77-0.83) and eicosadienoic acid (EDA) (0.89; 95% CI 0.85-0.94) were inversely related, and arachidonic acid (AA) was not significantly associated, while significant positive associations were observed with γ-linolenic acid (GLA), dihomo-GLA, docosatetraenoic acid (DTA), and docosapentaenoic acid (n6-DPA), with HRs between 1.13 to 1.46 per SD. These findings from EPIC-InterAct were broadly similar to comparative findings from summary estimates from up to nine studies including between 71 to 2,499 T2D cases. Limitations included potential residual confounding and the inability to distinguish between dietary and metabolic influences on plasma phospholipid PUFAs. CONCLUSIONS These large-scale findings suggest an important inverse association of circulating plant-origin n-3 PUFA (ALA) but no convincing association of marine-derived n3 PUFAs (EPA and DHA) with T2D. Moreover, they highlight that the most abundant n6-PUFA (LA) is inversely associated with T2D. The detection of associations with previously less well-investigated PUFAs points to the importance of considering individual fatty acids rather than focusing on fatty acid class.
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Affiliation(s)
- Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J. Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | - Jusheng Zheng
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Zheng Ye
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Ivonne Sluijs
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marcela Guevara
- Navarre Public Health Institute (ISPN), Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - José María Huerta
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Janine Kröger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | | | | | | | | | - Aurélie Affret
- Inserm, CESP, U1018, Villejuif, France
- Univ Paris-Sud, UMRS 1018, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Instituto BIO-Donostia, Basque Government, San Sebastian, Spain
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | - Courtney Dow
- Inserm, CESP, U1018, Villejuif, France
- Univ Paris-Sud, UMRS 1018, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Guy Fagherazzi
- Inserm, CESP, U1018, Villejuif, France
- Univ Paris-Sud, UMRS 1018, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Paul W. Franks
- Lund University, Malmö, Sweden
- Umeå University, Umeå, Sweden
| | | | - Rudolf Kaaks
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | | | - Kay Tee Khaw
- University of Cambridge, Cambridge, United Kingdom
| | - Tilman Kühn
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Lotte Maxild Mortensen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | | | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
- Aalborg University Hospital, Aalborg, Denmark
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | | | - Miguel Rodriguez-Barranco
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital-University of Turin and Center for Cancer Prevention (CPO), Turin, Italy
- Human Genetics Foundation (HuGeF), Turin, Italy
| | | | - Nadia Slimani
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Maria-Jose Tormo
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, Civic and M.P.Arezzo Hospital, ASP Ragusa, Italy
| | - Daphne L. van der A
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
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Mothé BR, Lindestam Arlehamn CS, Dow C, Dillon MBC, Wiseman RW, Bohn P, Karl J, Golden NA, Gilpin T, Foreman TW, Rodgers MA, Mehra S, Scriba TJ, Flynn JL, Kaushal D, O'Connor DH, Sette A. The TB-specific CD4(+) T cell immune repertoire in both cynomolgus and rhesus macaques largely overlap with humans. Tuberculosis (Edinb) 2015; 95:722-735. [PMID: 26526557 DOI: 10.1016/j.tube.2015.07.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 05/05/2015] [Revised: 07/23/2015] [Accepted: 07/26/2015] [Indexed: 01/05/2023]
Abstract
Non-human primate (NHP) models of tuberculosis (TB) immunity and pathogenesis, especially rhesus and cynomolgus macaques, are particularly attractive because of the high similarity of the human and macaque immune systems. However, little is known about the MHC class II epitopes recognized in macaques, thus hindering the establishment of immune correlates of immunopathology and protective vaccination. We characterized immune responses in rhesus macaques vaccinated against and/or infected with Mycobacterium tuberculosis (Mtb), to a panel of antigens currently in human vaccine trials. We defined 54 new immunodominant CD4(+) T cell epitopes, and noted that antigens immunodominant in humans are also immunodominant in rhesus macaques, including Rv3875 (ESAT-6) and Rv3874 (CFP10). Pedigree and inferred restriction analysis demonstrated that this phenomenon was not due to common ancestry or inbreeding, but rather presentation by common alleles, as well as, promiscuous binding. Experiments using a second cohort of rhesus macaques demonstrated that a pool of epitopes defined in the previous experiments can be used to detect T cell responses in over 75% of individual monkeys. Additionally, 100% of cynomolgus macaques, irrespective of their latent or active TB status, responded to rhesus and human defined epitope pools. Thus, these findings reveal an unexpected general repertoire overlap between MHC class II epitopes recognized in both species of macaques and in humans, showing that epitope pools defined in humans can also be used to characterize macaque responses, despite differences in species and antigen exposure. The results have general implications for the evaluation of new vaccines and diagnostics in NHPs, and immediate applicability in the setting of macaque models of TB.
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Affiliation(s)
- Bianca R Mothé
- Department of Biology, CSUSM, San Marcos, CA 92096, USA; La Jolla Institute for Allergy & Immunology, La Jolla, CA 92037, USA.
| | | | - Courtney Dow
- Department of Biology, CSUSM, San Marcos, CA 92096, USA
| | - Myles B C Dillon
- La Jolla Institute for Allergy & Immunology, La Jolla, CA 92037, USA
| | - Roger W Wiseman
- Wisconsin National Primate Research Center and Department of Pathology and Laboratory Medicine, UW-Madison, Madison, WI 53706, USA
| | - Patrick Bohn
- Wisconsin National Primate Research Center and Department of Pathology and Laboratory Medicine, UW-Madison, Madison, WI 53706, USA
| | - Julie Karl
- Wisconsin National Primate Research Center and Department of Pathology and Laboratory Medicine, UW-Madison, Madison, WI 53706, USA
| | - Nadia A Golden
- Tulane National Primate Research Center, Covington, LA 70433, USA
| | - Trey Gilpin
- Department of Biology, CSUSM, San Marcos, CA 92096, USA
| | - Taylor W Foreman
- Tulane National Primate Research Center, Covington, LA 70433, USA
| | - Mark A Rodgers
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15216, USA
| | - Smriti Mehra
- Tulane National Primate Research Center, Covington, LA 70433, USA; Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University Baton Rouge, LA 70803, USA
| | - Thomas J Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, and Department of Pediatrics and Child Health, University of Cape Town, Cape Town 7925, South Africa
| | - JoAnne L Flynn
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15216, USA
| | - Deepak Kaushal
- Tulane National Primate Research Center, Covington, LA 70433, USA
| | - David H O'Connor
- Wisconsin National Primate Research Center and Department of Pathology and Laboratory Medicine, UW-Madison, Madison, WI 53706, USA
| | - Alessandro Sette
- La Jolla Institute for Allergy & Immunology, La Jolla, CA 92037, USA
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Lindestam Arlehamn C, Mothe B, Dow C, Dillon M, Wiseman R, Bohn P, Karl J, Golden N, Foreman T, Mehra S, Scriba T, Kaushal D, O'Connor D, Sette A. The Mycobacterium tuberculosis-specific CD4 T cell immune repertoire in rhesus macaques overlaps with human responses (MPF2P.752). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.63.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Animal models to study the process of TB pathogenesis and vaccine development are of importance. NHP models, especially Rhesus macaques, are attractive because of available resources to evaluate their immunogenetic backgrounds and the aerosol model closely mimics the human infection route. In this study, we characterized the MHC immunogenetic background of a cohort of animals that have been vaccinated and/or infected with Mtb, defining 54 new immunodominant CD4 T cell epitopes using IFNγ ELISPOTs with antigens utilized in human clinical trials. Antigens which are immunodominant in humans are also immunodominant in rhesus macaques, including Rv3875 (ESAT-6) and Rv3874 (CFP10). Interestingly, the shared responses were not due to common ancestry or inbreeding upon identifying MHC alleles. Instead, the results indicate promiscuous binding, which is the first account of this phenomenon in the rhesus macaque TB model of infection. These results suggest that while the CD4 response of NHPs to TB is broad and heterogeneous, epitope sets can be defined to broadly follow and characterize these responses in genetically heterogeneous NHP animal cohorts. To our knowledge, this is the first comprehensive epitope identification effort for non-human primates. We reveal a profound repertoire overlap between epitopes recognized in NHPs and in humans. These findings have important implications for the evaluation of new vaccines and diagnostics in the setting of non-human primate model of TB.
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Affiliation(s)
| | - Bianca Mothe
- 1La Jolla Institute for Allergy and Immunology, La Jolla, CA
- 2Department of Biology, California State University San Marcos, San Marcos, CA
| | - Courtney Dow
- 2Department of Biology, California State University San Marcos, San Marcos, CA
| | - Myles Dillon
- 1La Jolla Institute for Allergy and Immunology, La Jolla, CA
| | - Roger Wiseman
- 3Department of Pathology and Laboratory Medicine, Wisconsin National Primate Research Center, Madison, WI
| | - Patrick Bohn
- 3Department of Pathology and Laboratory Medicine, Wisconsin National Primate Research Center, Madison, WI
| | - Julie Karl
- 3Department of Pathology and Laboratory Medicine, Wisconsin National Primate Research Center, Madison, WI
| | - Nadia Golden
- 4Tulane National Primate Research Center, Covington, LA
| | | | - Smriti Mehra
- 4Tulane National Primate Research Center, Covington, LA
- 5Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| | - Thomas Scriba
- 6Institute of Infectious Disease and Molecular Medicine and School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | - David O'Connor
- 3Department of Pathology and Laboratory Medicine, Wisconsin National Primate Research Center, Madison, WI
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Dow C, Henderson R, Sette A, Mothé BR. CD4(+) T-cell inhibitory ligands: a tool for characterizing dysfunctional CD4(+) T cells during chronic infection. Immunology 2013; 140:61-9. [PMID: 23566283 DOI: 10.1111/imm.12109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 09/26/2012] [Revised: 04/03/2013] [Accepted: 04/04/2013] [Indexed: 01/02/2023] Open
Abstract
Activation of CD4(+) T cells helps to establish and maintain immune responses. During infection with lymphocytic choriomeningitis virus (LCMV) clone 13, the CD4(+) T-cell responses are lost. In this study, we were interested in the nature of the CD4(+) T-cell responses following infection with LCMV clone 13. To pursue this question, we infected C57BL/6 mice with LCMV clone 13. We used a GP66-80 MHC Class II tetramer to determine whether the CD4(+) T cells were present following infection with LCMV clone 13. We determined that the cells were present and antigen specific, but not functional. We attributed their dysfunction to the presence of CD4(+) T-cell inhibitory ligands. We further stained for the presence of CD4(+) T-cell inhibitory ligands. We found that the during chronic infection the number of CD4(+) T cells expressing programmed death-1 and CD160 were greater over the time-course study than the other CD4(+) T-cell inhibitory ligands. These data show that using CD4(+) T-cell inhibitory ligands as a reagent for characterization can help in understanding the complex immune responses associated with persistent infections.
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Affiliation(s)
- Courtney Dow
- Department of Biological Sciences, California State University, San Marcos, CA 92096, USA
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31
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Lipton L, Kentwell M, Li M, Williams D, Christie M, Landgren A, Dow C, Jones I, McLaughlin S, Delatycki M, Macrae F, Lynch E. Audit of routine immunohistochemistry testing for mismatch repair proteins at diagnosis of colorectal cancer under the age of 50. Hered Cancer Clin Pract 2012. [PMCID: PMC3326819 DOI: 10.1186/1897-4287-10-s2-a78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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32
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Sette A, Sidney J, Southwood S, Moore C, Berry J, Dow C, Bradley K, Hoof I, Lewis MG, Hildebrand WH, McMurtrey CP, Wilson NA, Watkins DI, Mothé BR. A shared MHC supertype motif emerges by convergent evolution in macaques and mice, but is totally absent in human MHC molecules. Immunogenetics 2012; 64:421-34. [PMID: 22322672 PMCID: PMC3349854 DOI: 10.1007/s00251-011-0598-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 12/25/2011] [Indexed: 02/07/2023]
Abstract
The SIV-infected rhesus macaque (Macaca mulatta) is the most established model of AIDS disease systems, providing insight into pathogenesis and a model system for testing novel vaccines. The understanding of cellular immune responses based on the identification and study of Major Histocompatibility Complex (MHC) molecules, including their MHC:peptide-binding motif, provides valuable information to decipher outcomes of infection and vaccine efficacy. Detailed characterization of Mamu-B*039:01, a common allele expressed in Chinese rhesus macaques, revealed a unique MHC:peptide-binding preference consisting of glycine at the second position. Peptides containing a glycine at the second position were shown to be antigenic from animals positive for Mamu-B*039:01. A similar motif was previously described for the Dd mouse MHC allele, but for none of the human HLA molecules for which a motif is known. Further investigation showed that one additional macaque allele, present in Indian rhesus macaques, Mamu-B*052:01, shares this same motif. These “G2” alleles were associated with the presence of specific residues in their B pocket. This pocket structure was found in 6% of macaque sequences but none of 950 human HLA class I alleles. Evolutionary studies using the “G2” alleles points to common ancestry for the macaque sequences, while convergent evolution is suggested when murine and macaque sequences are considered. This is the first detailed characterization of the pocket residues yielding this specific motif in nonhuman primates and mice, revealing a new supertype motif not present in humans.
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Affiliation(s)
- Alessandro Sette
- Department of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA 92037, USA
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Philpott HL, Boussioutas A, Kronborg I, Zanatti S, Dow C. Education and imaging. Gastrointestinal: Tuberculosis of the sigmoid colon--a cautionary tale. J Gastroenterol Hepatol 2011; 26:1692. [PMID: 22011300 DOI: 10.1111/j.1440-1746.2011.06899.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- H L Philpott
- Western Health, Gastroenterology, Melbourne, Victoria, Australia
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Chen C, Dow C, Wang P, Sidney J, Read A, Harmsen A, Samuel JE, Peters B. Identification of CD4+ T cell epitopes in C. burnetii antigens targeted by antibody responses. PLoS One 2011; 6:e17712. [PMID: 21423609 PMCID: PMC3057979 DOI: 10.1371/journal.pone.0017712] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 02/11/2011] [Indexed: 02/02/2023] Open
Abstract
Coxiella burnetii is an obligate intracellular Gram-negative bacterium that causes acute Q fever and chronic infections in humans. A killed, whole cell vaccine is efficacious, but vaccination can result in severe local or systemic adverse reactions. Although T cell responses are considered pivotal for vaccine derived protective immunity, the epitope targets of CD4+ T cell responses in C. burnetii vaccination have not been elucidated. Since mapping CD4+ epitopes in a genome with over 2,000 ORFs is resource intensive, we focused on 7 antigens that were known to be targeted by antibody responses. 117 candidate peptides were selected from these antigens based on bioinformatics predictions of binding to the murine MHC class II molecule H-2 IAb. We screened these peptides for recognition by IFN-γ producing CD4+ T cell in phase I C. burnetii whole cell vaccine (PI-WCV) vaccinated C57BL/6 mice and identified 8 distinct epitopes from four different proteins. The identified epitope targets account for 8% of the total vaccination induced IFN-γ producing CD4+ T cells. Given that less than 0.4% of the antigens contained in C. burnetii were screened, this suggests that prioritizing antigens targeted by antibody responses is an efficient strategy to identify at least a subset of CD4+ targets in large pathogens. Finally, we examined the nature of linkage between CD4+ T cell and antibody responses in PI-WCV vaccinated mice. We found a surprisingly non-uniform pattern in the help provided by epitope specific CD4+ T cells for antibody production, which can be specific for the epitope source antigen as well as non-specific. This suggests that a complete map of CD4+ response targets in PI-WCV vaccinated mice will likely include antigens against which no antibody responses are made.
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Affiliation(s)
- Chen Chen
- Department of Microbial and Molecular Pathogenesis, Texas A&M Health Science Center, College Station, Texas, United States of America
| | - Courtney Dow
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology (LIAI), La Jolla, California, United States of America
| | - Peng Wang
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology (LIAI), La Jolla, California, United States of America
| | - John Sidney
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology (LIAI), La Jolla, California, United States of America
| | - Amanda Read
- Department of Veterinary Molecular Biology, Montana State University, Bozeman, Montana, United States of America
| | - Allen Harmsen
- Department of Veterinary Molecular Biology, Montana State University, Bozeman, Montana, United States of America
| | - James E. Samuel
- Department of Microbial and Molecular Pathogenesis, Texas A&M Health Science Center, College Station, Texas, United States of America
| | - Bjoern Peters
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology (LIAI), La Jolla, California, United States of America
- * E-mail:
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Wang P, Sidney J, Dow C, Mothé B, Sette A, Peters B. A systematic assessment of MHC class II peptide binding predictions and evaluation of a consensus approach. PLoS Comput Biol 2008; 4:e1000048. [PMID: 18389056 PMCID: PMC2267221 DOI: 10.1371/journal.pcbi.1000048] [Citation(s) in RCA: 598] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 02/29/2008] [Indexed: 11/23/2022] Open
Abstract
The identification of MHC class II restricted peptide epitopes is an important goal in immunological research. A number of computational tools have been developed for this purpose, but there is a lack of large-scale systematic evaluation of their performance. Herein, we used a comprehensive dataset consisting of more than 10,000 previously unpublished MHC-peptide binding affinities, 29 peptide/MHC crystal structures, and 664 peptides experimentally tested for CD4+ T cell responses to systematically evaluate the performances of publicly available MHC class II binding prediction tools. While in selected instances the best tools were associated with AUC values up to 0.86, in general, class II predictions did not perform as well as historically noted for class I predictions. It appears that the ability of MHC class II molecules to bind variable length peptides, which requires the correct assignment of peptide binding cores, is a critical factor limiting the performance of existing prediction tools. To improve performance, we implemented a consensus prediction approach that combines methods with top performances. We show that this consensus approach achieved best overall performance. Finally, we make the large datasets used publicly available as a benchmark to facilitate further development of MHC class II binding peptide prediction methods. A critical step in developing immune response against pathogens is the recognition of antigenic peptides presented by MHC class II molecules. Since experiments for MHC class II binding peptide identification are expensive and time consuming, computational tools have been developed as fast alternatives but with inferior performance. Here, we carried out a large-scale systematic evaluation of existing prediction tools with the aim of establishing a benchmark for performance comparison and to identify directions that can further improve prediction performance. We provide an unbiased ranking of the performance of publicly available MHC class II prediction tools and demonstrate that the MHC class II prediction tools did not perform as well as the MHC class I tools. In addition, we show that the size of training data and the correct identification of the binding core are the two factors limiting the performance of existing tools. Finally, we make available to the immunology community a large dataset to facilitate the evaluation and development of MHC class II binding prediction tools.
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Affiliation(s)
- Peng Wang
- La Jolla Institute for Allergy and Immunology, La Jolla, California, United States of America
| | - John Sidney
- La Jolla Institute for Allergy and Immunology, La Jolla, California, United States of America
| | - Courtney Dow
- La Jolla Institute for Allergy and Immunology, La Jolla, California, United States of America
- Department of Biological Sciences, California State University-San Marcos, San Marcos, California, United States of America
| | - Bianca Mothé
- Department of Biological Sciences, California State University-San Marcos, San Marcos, California, United States of America
| | - Alessandro Sette
- La Jolla Institute for Allergy and Immunology, La Jolla, California, United States of America
| | - Bjoern Peters
- La Jolla Institute for Allergy and Immunology, La Jolla, California, United States of America
- * E-mail:
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Jackson CB, Judd LM, Menheniott TR, Kronborg I, Dow C, Yeomans ND, Boussioutas A, Robb L, Giraud AS. Augmented gp130-mediated cytokine signalling accompanies human gastric cancer progression. J Pathol 2007; 213:140-51. [PMID: 17724739 DOI: 10.1002/path.2218] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
H. pylori infection accounts for most cases of gastric cancer, but the initiating events remain unclear. The principal H. pylori pathogenicity-associated CagA protein disrupts intracellular SHP-2 signalling pathways including those used by the IL-6 family cytokines, IL-6 and IL-11. Imbalanced IL-6 family cytokine signalling in the gp130(757FF) mouse model of gastric cancer arising from hyperactivation of oncogenic STAT3 after altered SHP-2 : ERK1/2 signalling produces dysplastic antral tumours preceded by gastritis and metaplasia. In a cohort of patient gastric biopsies with known H. pylori and CagA status, we investigated whether (i) STAT3 and ERK1/2 activation is altered in H. pylori-dependent gastritis; (ii) these profiles are more pronounced in CagA+ H. pylori infection; and (iii) the expression of pro-inflammatory cytokines that activate STAT3 and ERK 1/2 pathways is associated with progression to gastric cancer. IL-6, IL-11, and activated STAT3 and ERK1/2 were quantified in antral biopsies from gastritic stomach, metaplastic tissue, and resected gastric cancer tissues. We observed significantly increased STAT3 and ERK1/2 activation (p = 0.001) in H. pylori-dependent gastritis, which was further enhanced in the presence of CagA+ H. pylori strains. Of known gastric ligands that drive STAT3 activation, IL-6 expression was increased after H. pylori infection and both IL-6 and IL-11 were strongly up-regulated in the gastric cancer biopsies. This suggests a mechanism by which IL-11 drives STAT3 activation and proliferation during gastric cancer progression. We addressed this using an in vitro approach, demonstrating that recombinant human IL-11 activates STAT3 and concomitantly increases proliferation of MKN28 gastric epithelial cells. In summary, we show increased STAT3 and ERK1/2 activation in H. pylori-dependent gastritis that is likely driven in an IL-6-dependent fashion. IL-11 expression is associated with adenocarcinoma development, but not gastritic lesions, and we identify a novel mechanism for IL-11 as a potent inducer of proliferation in the human gastric cancer setting.
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Affiliation(s)
- C B Jackson
- Gastrointestinal Cancer Lab, Department of Medicine, The University of Melbourne at Western Hospital, Footscray, 3011, Melbourne, Australia
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Mothé BR, Stewart BS, Oseroff C, Bui HH, Stogiera S, Garcia Z, Dow C, Rodriguez-Carreno MP, Kotturi M, Pasquetto V, Botten J, Crotty S, Janssen E, Buchmeier MJ, Sette A. Chronic lymphocytic choriomeningitis virus infection actively down-regulates CD4+ T cell responses directed against a broad range of epitopes. J Immunol 2007; 179:1058-67. [PMID: 17617598 DOI: 10.4049/jimmunol.179.2.1058] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Activation of CD4(+) T cells helps establish and sustain CD8(+) T cell responses and is required for the effective clearance of acute infection. CD4-deficient mice are unable to control persistent infection and CD4(+) T cells are usually defective in chronic and persistent infections. We investigated the question of how persistent infection impacted pre-existing lymphocytic choriomeningitis virus (LCMV)-specific CD4(+) T cell responses. We identified class II-restricted epitopes from the entire set of open reading frames from LCMV Armstrong in BALB/c mice (H-2(d)) acutely infected with LCMV Armstrong. Of nine epitopes identified, six were restricted by I-A(d), one by I-E(d) and two were dually restricted by both I-A(d) and I-E(d) molecules. Additional experiments revealed that CD4(+) T cell responses specific for these epitopes were not generated following infection with the immunosuppressive clone 13 strain of LCMV. Most importantly, in peptide-immunized mice, established CD4(+) T cell responses to these LCMV CD4 epitopes as well as nonviral, OVA-specific responses were actively suppressed following infection with LCMV clone 13 and were undetectable within 12 days after infection, suggesting an active inhibition of established helper responses. To address this dysfunction, we performed transfer experiments using both the Smarta and OT-II systems. OT-II cells were not detected after clone 13 infection, indicating physical deletion, while Smarta cells proliferated but were unable to produce IFN-gamma, suggesting impairment of the production of this cytokine. Thus, multiple mechanisms may be involved in the impairment of helper responses in the setting of early persistent infection.
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Affiliation(s)
- Bianca R Mothé
- Department of Biological Sciences, California State University, San Marcos, California 92096, USA.
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Abstract
The authors examined a cognitive function mediated by the cerebellum, classical eyeblink conditioning, and its relationship to cerebellar volume in healthy controls (n = 59) and temporal lobe epilepsy subjects (n = 77). Controls demonstrated better conditioning, larger cerebellar volumes, and an association between conditioning and cerebellar volume that was not observed in epilepsy patients. These findings provide support for the hypothesis that cerebellar atrophy in epilepsy affects procedural memory.
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Affiliation(s)
- B Hermann
- Matthews Neuropsychology Lab, Department of Neurology, University of Wisconsin, 600 N. Highland, Madison, WI 53792, USA.
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Oyegbile TO, Dow C, Jones J, Bell B, Rutecki P, Sheth R, Seidenberg M, Hermann BP. The nature and course of neuropsychological morbidity in chronic temporal lobe epilepsy. Neurology 2004; 62:1736-42. [PMID: 15159470 DOI: 10.1212/01.wnl.0000125186.04867.34] [Citation(s) in RCA: 228] [Impact Index Per Article: 11.4] [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] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize the nature and degree of cognitive morbidity in patients with chronic temporal lobe epilepsy compared with healthy control subjects, determine the association between the duration of epilepsy and cognitive morbidity, and ascertain whether there are factors that moderate the association between duration of disorder and cognitive impairment. METHODS Temporal lobe epilepsy (n = 96) and healthy control (n = 82) subjects were assessed with a comprehensive neuropsychological battery. Test performances were adjusted for age, gender, and education and transformed to a common metric (z scores). Analyses included group comparisons and correlations of duration of epilepsy with cognitive morbidity. RESULTS Patients with temporal lobe epilepsy exhibited not only worse memory function (p < 0.05) but worse performance across measures of intelligence, language, executive function, and motor speed (p < 0.05). Chronicity of epilepsy was related to worsening mental status (r = 0.42, p < 0.001). This relationship was particularly evident among those individuals with less (r = 0.58, p < 0.001) compared with more (r = 0.25, NS) cerebral reserve, operationally defined by years of formal education. CONCLUSIONS Neuropsychological morbidity in chronic temporal lobe epilepsy is widespread in nature despite a focal epileptic process. Cross-sectional analyses demonstrate that increasing duration of epilepsy is associated with worsening mental status. Individuals with less educational attainment (low cerebral reserve) exhibit especially poor cognitive function in association with chronicity of epilepsy.
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Affiliation(s)
- T O Oyegbile
- Department of Neurology, Chicago Medical School, North Chicago, IL, USA
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Abstract
AIMS Maintenance of the cellular integrity of the biliary epithelium may involve the production of mucins and mucin-associated peptides. In the luminal gastrointestinal tract, mucins and the mucin-associated trefoil peptides (TFF) are integral to cytoprotection and cellular repair of the mucosa. METHODS AND RESULTS Samples of normal and diseased human liver tissue were examined using histological and immunohistochemical techniques, for the expression of TFF and mucins. Bile ducts were classified as small, medium or large depending upon the number of biliary epithelial cells. TFF expression was demonstrated in biliary epithelial cells of both normal and diseased liver tissue. TFF expression was greatest in the large bile ducts. In normal liver tissue, expression of at least one TFF was demonstrated in 2-7% of small bile ducts, 5-31% of medium bile ducts and 31-85% of large bile ducts. Seventy-seven percent of large bile ducts secreted mucins and all three TFF concurrently, compared with 3% of medium bile ducts and no small bile ducts. Biliary disease resulted in an increased expression of TFF1 and TFF3 in the medium bile ducts. CONCLUSIONS The biliary epithelial cells in normal and diseased human liver tissue express TFF, particularly in the larger bile ducts. TFF expression may be up-regulated or induced in biliary diseases as a response to injury, as is seen in epithelial damage elsewhere in the gastrointestinal tract.
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Affiliation(s)
- G Srivatsa
- Department of Medicine, University of Melbourne at Western Hospital, Footscray, Victoria, Australia
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Rockman SP, Currie SA, Ciavarella M, Vincan E, Dow C, Thomas RJ, Phillips WA. Id2 is a target of the beta-catenin/T cell factor pathway in colon carcinoma. J Biol Chem 2001; 276:45113-9. [PMID: 11572874 DOI: 10.1074/jbc.m107742200] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Activation of beta-catenin/T cell factor (TCF) transcription as a result of mutations in the adenomatous polyposis coli (APC) and/or beta-catenin genes occurs in the majority of colon tumors. An increasing number of genes, including c-myc and cyclin D1, have been implicated as targets of this pathway. We now report that the dominant negative helix-loop-helix regulator Id2 is also a target of the beta-catenin/TCF transcription pathway in colon adenocarcinoma. Investigation of the mechanism for the overexpression of Id2 in colon carcinoma cells demonstrated that the Id2 promoter is activated, and the Id2 protein is up-regulated by beta-catenin. Conversely, reducing free beta-catenin blocked this induction of promoter activity. We have also used an electrophoretic mobility shift assay and supershift to identify a motif in the Id2 promoter that binds to TCF4 protein. Site-directed mutagenesis of this motif abolished promoter reporter activity. Both transfection of Id2 into SW480 cells and induction of Id2 in HT29 colon cells was found to increase anchorage-independent survival of these cells. Growing evidence associates disruption to Id2 expression with tumorigenesis, and our findings suggest that this dysregulation of Id2 expression is due to the activation of the beta-catenin/TCF pathway.
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Affiliation(s)
- S P Rockman
- Surgical Oncology Research Laboratory, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia
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Abstract
The aim of this study was to evaluate a new urine screening analyser in a Hospital Bacteriology Laboratory: the Cellfacts Urine Screening Analyser (Microbial Systems Limited (MSL), Coventry, England). A cohort of 1036 urine specimens were analysed by both the CellFacts and routine traditional methods. Using the CDC urinary tract infection decision levels, and compared to reference methods, the sensitivity and specificity were respectively 88.9% and 76.2%, and the predictive negative value and predictive positive value respectively 93.3% and 64.8%. Compared to the microscopy, the correlations of white blood cell count and red blood cell count were good, respectively (r = 0.8, p < 0.0001) and (r = 0.6, p < 0.0001). These results indicate that, although several positive samples were not reported, CellFacts facilitates efficient, rapid screening of infected urine specimens. This leads to perform a cytobacteriological analysis only on those results screened as positive by the automatic analysis system.
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Affiliation(s)
- H Gentelet
- Department of Bacteriology, CHU Bellevue Hospital, 42055 Saint-Etienne, France
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Whitty CJ, Carroll B, Armstrong M, Dow C, Snashall D, Marshall T, Chiodini PL. Utility of history, examination and laboratory tests in screening those returning to Europe from the tropics for parasitic infection. Trop Med Int Health 2000; 5:818-23. [PMID: 11123831 DOI: 10.1046/j.1365-3156.2000.00642.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To examine the utility of the different elements of screening expatriates and travellers returned from the tropics for parasitic disease (exposure history, symptoms, examination and laboratory tests). METHODS In phase 1 (conducted prospectively 1990-91), 1029 asymptomatic returnees had a detailed questionnaire and interview on risk-behaviour, physical examination and laboratory tests. In phase 2 (1997-98), 510 consecutive patients referred for routine screening (276 symptomatic and 234 asymptomatic) were screened with laboratory tests. RESULTS Exposure history did not correlate reliably with parasite burden. In phase 1 physical examination revealed 387 abnormalities, only three of which indicated parasitic disease. Schistosomal serology was positive in 11% (CI 9-13) of these asymptomatic cases including patients with light or no reported freshwater exposure. Stool microscopy was positive in 19% (CI 16-22) of cases not correlated with reported eating habits, and eosinophilia was present in 8% (CI 6-10). In phase 2 reported symptoms did not correlate with parasitic disease. Schistosomiasis was present in 15% (CI 13-24) of asymptomatic and 18% (CI 13-22) of symptomatic individuals (OR 1.2 P = 0.46); stool microscopy was positive in 14% of both symptomatic and asymptomatic patients, and eosinophilia in 9% of symptomatic and 6% of asymptomatic individuals. CONCLUSION Potentially serious asymptomatic infection is common in travellers. Detailed exposure history, symptom history and physical examination added little to detecting cases. Stool microscopy, schistosomal serology and eosinophil count all had good yield. Filarial serology had low yield in patients without eosinophilia.
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Affiliation(s)
- C J Whitty
- The Hospital for Tropical Diseases, London, UK
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Abstract
We describe the case of a heavy marijuana and tobacco smoker who presented with progressive exertional dyspnea of 2 months' duration, and bilateral nodular lung infiltrates. Examination of the lung fields was normal, and lung function tests showed mild airflow obstruction with moderately reduced gas transfer. BAL returned green-black fluid consisting predominantly of macrophages laden with carbon pigment. Thoracoscopic lung biopsy showed miliary necrotizing granulomata with an alveolar exudate of carbon-laden macrophages within macroscopically blackened lung. The differential diagnosis of pulmonary granulomata in this patient is discussed.
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Affiliation(s)
- D Cunnington
- Department of Respiratory Medicine, Western Hospital, Melbourne, Australia.
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Abstract
Methylation of the p16 gene was studied in 16 oesophageal tumours. Five (31%) of the tumours were found to be methylated in exon 1 and eight (50%) were methylated in exon 2. The loss of p16 protein correlated with methylation of exon 1 (P = 0.005). However, methylation of exon 2, but not exon 1, was found to be associated with late stage tumours (P = 0.01). We conclude that the methylation of exon 2 of p16 may have effects on the progression of oesophageal tumours that are independent of the expression of the p16 protein.
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Affiliation(s)
- S Kempster
- Department of Surgery, University of Melbourne, Western Hospital, Footscray, Victoria, Australia
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Abstract
BACKGROUND The aim of this study was to analyse medical evacuations and short tours (collectively known as medevacs) in British Foreign and Commonwealth Office (FCO) staff and dependents residing overseas. Further aims were to look for groups with a disproportionate number of medical evacuations/short tours, and to identify events which may have been predictable in retrospect. For the purposes of this study, a medical evacuation was defined as a journey to the UK or an appropriate regional referral center for medical treatment or review, and a medical short tour was an early termination of posting for medical reasons. METHOD The medical records of all staff and dependents who had been medically evacuated/short toured in 1995 were retrospectively analysed. Information collected included demographic details, whether the medevac was an emergency or a predicted necessity, why the medevac was required, the diagnosis, and the time from medical clearance to medevac. RESULTS In 1995, 160 medevacs involving 137 individuals were authorized. This represented 3.08% of individuals overseas, with only 0.4% of individuals posted overseas being evacuated with new medical events within 1 year of medical clearance. The proportion of medevacs for staff was significantly higher than for dependents (spouses and children), and staff in their 20s and fast-stream diplomats (young "high-flyers" with a university education) were over-represented in the evacuee group. Non-physical problems were predominant in the latter groups. The main reason for evacuation (70%) was that medical facilities were considered unsuitable, and just over half of the medevacs (51%) were considered by the investigating team to have been unpredictable. CONCLUSIONS Only a small percent of individuals posted overseas required medevac. The likelihood of evacuation was significantly higher in staff when compared to dependents, and certain grades/age groups appeared to be over-represented in the evacuee group. These groups are possibly more vulnerable, particularly to non-physical problems, and this is a potential area for future research. A prospective study of medical events overseas is proposed to see if these results are reproduced. If these findings are confirmed, medical clearance and FCO posting procedures may need to be altered for groups which are identified as being vulnerable.
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Affiliation(s)
- D Patel
- Foreign and Commonwealth Office (FCO) Medical Adviser, PC-MW, FCO, London, UK
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Clarke AH, Thomas WR, Rolland JM, Dow C, O'Brien RM. Murine allergic respiratory responses to the major house dust mite allergen Der p 1. Int Arch Allergy Immunol 1999; 120:126-34. [PMID: 10545766 DOI: 10.1159/000024230] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although many studies have examined chronic asthma, limited data exist on acute immunopathogenic events induced by allergens. The aim of the study was to investigate the acute cellular, serologic and histopathologic events in airway inflammation produced by intranasal challenge of mice sensitised to the major house dust mite allergen Der p 1. METHODS C57BL/6 mice were immunised subcutaneously with Der p 1 in alum. Mice were bled and challenged intranasally with Der p 1 on day 14 and killed on day 17. Lungs were fixed in situ, processed and stained with haematoxylin and eosin. The degree of inflammation and eosinophil infiltration was quantified by image analysis. Specific IgE was determined by passive cutaneous anaphylaxis. Cells from spleen and draining lymph nodes were cultured for 24 h with Der p 1, and IL-3/GM-CSF released into supernatants was measured by bioassay. RESULTS Intranasal challenge of sensitised mice induced eosinophilic influx into the large and small airways and the alveolar regions of the lung, mucus plugging and in severe cases numerous Charcot-Leyden crystals. The quantitation of the inflammation induced by different sensitisation and challenge doses showed that optimal inflammation could be produced using only 1 microg of allergen for both sensitisation and challenge. The degree of inflammation was not related to the titre of IgE antibody and was indeed produced in its absence. T cell reactivity of spleen cells to the allergen was decreased suggesting cell migration or inactivation. CONCLUSIONS Mice sensitised and challenged intranasally with as little as 1 microg of Der p 1 produced an extensive pulmonary eosinophilic inflammation which shared many of the features of the inflammation found in asthma. The small amount of allergens required and the use of intranasal challenge should provide a useful model.
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Affiliation(s)
- A H Clarke
- Medicine and Pathology, Western Hospital Footscray, Perth, Australia
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Affiliation(s)
- W C Burns
- University of Melbourne, Department of Surgery, Western Hospital, Footscray VIC, Australia
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