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Obura M, Beulens JWJ, Slieker R, Koopman ADM, Hoekstra T, Nijpels G, Elders P, Dekker JM, Koivula RW, Kurbasic A, Laakso M, Hansen TH, Ridderstråle M, Hansen T, Pavo I, Forgie I, Jablonka B, Ruetten H, Mari A, McCarthy MI, Walker M, McDonald TJ, Perry MH, Pearson ER, Franks PW, 't Hart LM, Rutters F. Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time: An IMI-DIRECT study. Diabet Med 2021; 38:e14428. [PMID: 33067862 DOI: 10.1111/dme.14428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/10/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022]
Abstract
AIM To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. METHODS We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. RESULTS At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1-4. Participants in Subgroups 2-4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13-0.58), Subgroup 3 (β = 0.30; 95% CI 0.10-0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04-0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months. CONCLUSIONS Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.
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Affiliation(s)
- M Obura
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - J W J Beulens
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - R Slieker
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, The Netherlands
| | - A D M Koopman
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T Hoekstra
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
| | - G Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - P Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J M Dekker
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - R W Koivula
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
| | - A Kurbasic
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
| | - M Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Finland
| | - T H Hansen
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - M Ridderstråle
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - I Pavo
- Eli Lilly Regional Operations GmbH, Vienna, Austria
| | - I Forgie
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK
| | - B Jablonka
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - H Ruetten
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - A Mari
- Institute of Biomedical Engineering, National Research Council, Padova, Italy
| | - M I McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - M Walker
- Institute of Cellular Medicine (Diabetes), Newcastle University, Newcastle upon Tyne, UK
| | - T J McDonald
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School and Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - M H Perry
- Department of Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - E R Pearson
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - P W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - L M 't Hart
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Molecular Epidemiology Section, Leiden University Medical Centre, Leiden, The Netherlands
| | - F Rutters
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
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Rutters F, Nijpels G, Elders P, Stehouwer CDA, van der Heijden AA, Groeneveld L, 't Hart LM, Dekker JM, Beulens JWJ. Corrigendum to: Cohort Profile: The Hoorn Studies. Int J Epidemiol 2020; 49:357. [PMID: 31876905 DOI: 10.1093/ije/dyz260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Koopman ADM, Beulens JW, van der Heijden A, Elders P, Dekker JM, Alssema M, Rutters F. A prospective study on glucagon responses to oral glucose and mixed meal and 7-year change in fasting glucose. Clin Endocrinol (Oxf) 2019; 91:82-86. [PMID: 30919467 DOI: 10.1111/cen.13977] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The role of insufficient glucagon suppression after an oral load in the development of type 2 diabetes mellitus is unclear. The aim of this study was to examine the association between glucagon responses at baseline and fasting glucose levels 7 years later. METHODS Data of the Hoorn Meal Study were used, an observational cohort study among 121 persons without diabetes with a mean age of 61.1 ± 6.7 years and 50% being female. The glucagon response to an oral glucose tolerance test and mixed meal test was expressed as early and late incremental area under the curve. The association with change in fasting glucose levels at follow-up was assessed by linear regression analysis. RESULTS The early glucagon response following the mixed meal test was associated with an increase in fasting glucose levels of 0.18 mmol/L (95%-CI: 0.04-0.31, P = 0.01), per unit increase in the incremental area under the curve of glucagon, adjusted for confounders. No significant associations were observed for the late response after the mixed meal test or oral glucose tolerance test. CONCLUSIONS Within a population without diabetes, relative lack of glucagon suppression early after a meal was associated with increased glucose levels over time, suggesting a role of insufficient glucagon suppression in the deterioration of glycaemic control.
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Affiliation(s)
- Anitra D M Koopman
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Amber van der Heijden
- Department of General Practice and Elderly Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Petra Elders
- Department of General Practice and Elderly Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marjan Alssema
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Unilever Research and Development, Vlaardingen, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Agca R, Hopman LHGA, Laan KJC, van Halm VP, Peters MJL, Smulders YM, Dekker JM, Nijpels G, Stehouwer CDA, Voskuyl AE, Boers M, Lems WF, Nurmohamed MT. Cardiovascular Event Risk in Rheumatoid Arthritis Compared with Type 2 Diabetes: A 15-year Longitudinal Study. J Rheumatol 2019; 47:316-324. [PMID: 31092721 DOI: 10.3899/jrheum.180726] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Cardiovascular (CV) disease (CVD) risk is increased in rheumatoid arthritis (RA). However, longterm followup studies investigating this risk are scarce. METHODS The CARRÉ (CARdiovascular research and RhEumatoid arthritis) study is a prospective cohort study investigating CVD and its risk factors in 353 patients with longstanding RA. CV endpoints were assessed at baseline and 3, 10, and 15 years after the start of the study and are compared to a reference cohort (n = 2540), including a large number of patients with type 2 diabetes (DM). RESULTS Ninety-five patients with RA developed a CV event over 2973 person-years, resulting in an incidence rate of 3.20 per 100 person-years. Two hundred fifty-seven CV events were reported in the reference cohort during 18,874 person-years, resulting in an incidence rate of 1.36 per 100 person-years. Age- and sex-adjusted HR for CV events were increased for RA (HR 2.07, 95% CI 1.57-2.72, p < 0.01) and DM (HR 1.51, 95% CI 1.02-2.22, p = 0.04) compared to the nondiabetic participants. HR was still increased in RA (HR 1.82, 95% CI 1.32-2.50, p < 0.01) after additional adjustment for CV risk factors. Patients with both RA and DM or insulin resistance had the highest HR for developing CVD (2.21, 95% CI 1.01-4.80, p = 0.046 and 2.67, 95% CI 1.30-5.46, p < 0.01, respectively). CONCLUSION The incidence rate of CV events in established RA was more than double that of the general population. Patients with RA have an even higher risk of CVD than patients with DM. This risk remained after adjustment for traditional CV risk factors, suggesting that systemic inflammation is an independent contributor to CV risk.
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Affiliation(s)
- Rabia Agca
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands. .,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam.
| | - Luuk H G A Hopman
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Koen J C Laan
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Vokko P van Halm
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Mike J L Peters
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Yvo M Smulders
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Jacqueline M Dekker
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Giel Nijpels
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Coen D A Stehouwer
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Alexandre E Voskuyl
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Maarten Boers
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Willem F Lems
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
| | - Michael T Nurmohamed
- From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade; Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Department of Cardiology, and Department of Internal Medicine, and Department of Epidemiology and Biostatistics, and Department of General Practice, and EMGO Institute for Health and Care Research, Amsterdam UMC, VU University Medical Center; Amsterdam UMC, Academic Medical Center, Department of Cardiology; Department of Internal Medicine, and the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.,R. Agca, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; L.H. Hopman, PhD student, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology; K.J. Laan, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam; V.P. van Halm, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Cardiology, and Amsterdam UMC, Academic Medical Center, Department of Cardiology; M.J. Peters, MD, PhD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; Y.M. Smulders, MD, Amsterdam UMC, VU University Medical Center, Department of Internal Medicine; J.M. Dekker, Prof. Dr., Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; G. Nijpels, MD, Amsterdam UMC, VU University Medical Center, Department of General Practice, and Amsterdam UMC, VU University Medical Center, EMGO Institute for Health and Care Research; C.D. Stehouwer, MD, Maastricht University Medical Center, Department of Internal Medicine, and Maastricht University Medical Center, CARIM; A.E. Voskuyl, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M. Boers, MD, Amsterdam UMC, VU University Medical Center, Department of Epidemiology and Biostatistics; W.F. Lems, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center; M.T. Nurmohamed, MD, Amsterdam Rheumatology and Immunology Center, Department of Rheumatology in Reade, and Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, VU University Medical Center in Amsterdam
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5
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Rutters F, Nijpels G, Elders P, Stehouwer CDA, van der Heijden AA, Groeneveld L, 't Hart LM, Dekker JM, Beulens JWJ. Cohort Profile: The Hoorn Studies. Int J Epidemiol 2019; 47:396-396j. [PMID: 29244153 DOI: 10.1093/ije/dyx227] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 01/06/2023] Open
Affiliation(s)
- Femke Rutters
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Giel Nijpels
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - Petra Elders
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Amber A van der Heijden
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leen M 't Hart
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Department of Molecular Cell Biology.,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
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6
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Pennells L, Kaptoge S, Wood A, Sweeting M, Zhao X, White I, Burgess S, Willeit P, Bolton T, Moons KGM, van der Schouw YT, Selmer R, Khaw KT, Gudnason V, Assmann G, Amouyel P, Salomaa V, Kivimaki M, Nordestgaard BG, Blaha MJ, Kuller LH, Brenner H, Gillum RF, Meisinger C, Ford I, Knuiman MW, Rosengren A, Lawlor DA, Völzke H, Cooper C, Marín Ibañez A, Casiglia E, Kauhanen J, Cooper JA, Rodriguez B, Sundström J, Barrett-Connor E, Dankner R, Nietert PJ, Davidson KW, Wallace RB, Blazer DG, Björkelund C, Donfrancesco C, Krumholz HM, Nissinen A, Davis BR, Coady S, Whincup PH, Jørgensen T, Ducimetiere P, Trevisan M, Engström G, Crespo CJ, Meade TW, Visser M, Kromhout D, Kiechl S, Daimon M, Price JF, Gómez de la Cámara A, Wouter Jukema J, Lamarche B, Onat A, Simons LA, Kavousi M, Ben-Shlomo Y, Gallacher J, Dekker JM, Arima H, Shara N, Tipping RW, Roussel R, Brunner EJ, Koenig W, Sakurai M, Pavlovic J, Gansevoort RT, Nagel D, Goldbourt U, Barr ELM, Palmieri L, Njølstad I, Sato S, Monique Verschuren WM, Varghese CV, Graham I, Onuma O, Greenland P, Woodward M, Ezzati M, Psaty BM, Sattar N, Jackson R, Ridker PM, Cook NR, D'Agostino RB, Thompson SG, Danesh J, Di Angelantonio E. Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies. Eur Heart J 2019; 40:621-631. [PMID: 30476079 PMCID: PMC6374687 DOI: 10.1093/eurheartj/ehy653] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [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: 01/24/2018] [Revised: 05/03/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022] Open
Abstract
AIMS There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after 'recalibration', a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied. METHODS AND RESULTS Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at 'high' 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29-39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22-24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44-51 such individuals using original algorithms, in contrast to 37-39 individuals with recalibrated algorithms. CONCLUSION Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need.
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Affiliation(s)
- Lisa Pennells
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Angela Wood
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Mike Sweeting
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Xiaohui Zhao
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, UK
| | - Ian White
- MRC Clinical Trials Unit, University College London, 90 High Holborn, London, UK
| | - Stephen Burgess
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
- MRC Biostatistics Unit, Cambridge Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
- Department of Neurology and Neurosurgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Thomas Bolton
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Karel G M Moons
- Epidemiology: Methodology, Julius Center Research Program Methodology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Department of Epidemiology, Julius Center Research Program Cardiovascular Epidemiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, the Netherlands
| | - Randi Selmer
- Division of Epidemiology, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, Norway
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, Hjartavernd Holtasmá¡ri 1, Kópavogur, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmýrarvegur 16, Reykjavik, Iceland
| | - Gerd Assmann
- Assmann-Foundation for Prevention, Gronowskistraße 33, Münster, Germany
| | - Philippe Amouyel
- Institut Pasteur de Lille, 1 rue du Professeur Calmette, Lille, France
| | - Veikko Salomaa
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| | - Børge G Nordestgaard
- Department of Clinical Medicine, Copenhagen University Hospital, Blegdamsvej 3, Copenhagen, Denmark
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Neuenheimer Feld 581, Heidelberg, Germany
- University of Heidelberg, Grabengasse 1, Heidelberg, Germany
| | - Richard F Gillum
- Department of Medicine, Howard University College of Medicine, 2041 Georgia Avenue, Washington, DC, USA
| | - Christa Meisinger
- German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Ian Ford
- Institute of Health & Wellbeing, University of Glasgow, Boyd Orr Building, University Avenue, Glasgow, UK
| | - Matthew W Knuiman
- Faculty of Health and Medical Sciences, School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Perth, Western Australia, Australia
| | - Annika Rosengren
- Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 3, Gothenburg, Sweden
- Wallenberg Laboratory, Sahlgrenska University Hospital, Blå stråket 5, Gothenburg, Sweden
| | - Debbie A Lawlor
- Department of Social Medicine, University of Bristol, Bristol, UK
| | - Henry Völzke
- Institute of Community Medicine, University of Greifswald, Ellernholzstraße 1/2, Greifswald, Germany
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Rd, Southampton, UK
| | | | - Edoardo Casiglia
- Department of Medicine, University of Padova, 2 Via Giustiniani, Padova, Italy
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 1 Yliopistonranta, Kuopio, Finland
| | - Jackie A Cooper
- Centre for Cardiovascular Genetics, University College London, 5 University Street, London, UK
| | - Beatriz Rodriguez
- Department of Geriatric Medicine, University of Hawaii, 1960 East-West Road, Honolulu, HI, USA
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Ing 40, 5 tr, Uppsala, Sweden
| | | | - Rachel Dankner
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, USA
| | - Karina W Davidson
- Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, USA
| | - Robert B Wallace
- College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA, USA
| | - Dan G Blazer
- Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, USA
| | - Cecilia Björkelund
- Department of Public Health and Community Medicine, University of Gothenburg, Medicinaregatan 16, Gothenburg, Sweden
| | - Chiara Donfrancesco
- Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Istituto Superiore di Sanità (ISS), 299 Viale Regina Elena, Rome, Italy
| | | | - Aulikki Nissinen
- National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland
| | - Barry R Davis
- Department of Biostatistics, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, USA
| | - Sean Coady
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 31 Center Drive, Bethesda, MD, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK
| | - Torben Jørgensen
- Research Centre for Prevention and Health, 5 Øster Farimagsgade, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, 5 Øster Farimagsgade, Copenhagen, Denmark
- Aalborg University, Fredrik Bajers Vej 5, Aalborg, Denmark
| | - Pierre Ducimetiere
- Faculté de Médecine, Université Paris Descartes, 12 Rue de l'Ecole de Médecine, Paris, France
| | - Maurizio Trevisan
- CUNY School of Medicine, City College of New York, 160 Convent Ave, New York, NY, USA
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
| | - Carlos J Crespo
- School of Community Health, Portland State University, 506 SW Mill St, Portland, OR, USA
| | - Tom W Meade
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Marjolein Visser
- Department of Health Sciences, Vrije Universiteit Amsterdam, VU University Medical Center, De Boelelaan 1085, Amsterdam, the Netherlands
| | - Daan Kromhout
- Department of Epidemiology, University Medical Centre Groningen, University of Grogingen, Hanzeplein 1, Groningen, the Netherlands
| | - Stefan Kiechl
- Department of Neurology and Neurosurgery, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria
| | - Makoto Daimon
- Faculty of Medicine, Yamagata University, 1-4-12 Kojirakawa-machi, Yamagata, Japan
| | - Jackie F Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, UK
| | | | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, the Netherlands
| | - Benoît Lamarche
- Pavillon Ferdinand-Vandry, Université Laval, 2440 Hochelaga, Quebec, Canada
| | - Altan Onat
- Department of Cardiology, Cerrahpaşa Faculty of Medicine, Istanbul University, Beyazıt, Fatih, Istanbul, Turkey
| | | | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, the Netherlands
| | - Yoav Ben-Shlomo
- Bristol Neuroscience, Bristol University, Queens Road, Bristol, UK
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, UK
| | - Jacqueline M Dekker
- The Institute for Health and Care Research, VU University Medical Center, De Boelelaan 1085, Amsterdam, the Netherlands
| | | | - Nawar Shara
- Department of Biostatistics and Bioinformatics, MedStar Health Research Institute, 6525 Belcrest Road, Hyattsville, MD, USA
| | - Robert W Tipping
- Clinical Biostatistics, Merck, 2000 Galloping Hill Road, Kenilworth, NJ, USA
| | - Ronan Roussel
- Centre de Recherche des Cordeliers, INSERM, 15 rue de l'Ecole de Médecine, Paris, France
| | - Eric J Brunner
- Institute of Epidemiology & Health, University College London, 1-19 Torrington Place, London, UK
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, 21 Arcisstraße, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Str. 29, Munich, Germany
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, Japan
| | - Jelena Pavlovic
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, the Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Centre Groningen, University of Grogingen, Hanzeplein 1, Groningen, the Netherlands
| | - Dorothea Nagel
- Klinikum der Universität München, Ludwig-Maximilians-Universität, 15 Marchioninistraße, Munich, Germany
| | - Uri Goldbourt
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Elizabeth L M Barr
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, Australia
| | - Luigi Palmieri
- Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Istituto Superiore di Sanità (ISS), 299 Viale Regina Elena, Rome, Italy
| | - Inger Njølstad
- Department of Public Health, University of Tromsø, Hansine Hansens veg 18, Tromsø, Norway
| | - Shinichi Sato
- Chiba Prefectural Institute of Public Health, 666-2 Nito-no-machi Chuo-ku, Chiba, Japan
| | - W M Monique Verschuren
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, The Netherlands
| | - Cherian V Varghese
- Noncommunicable Diseases, Disability, Violence and Injury Prevention Department, World Health Organization, 20 Avenue Appia, Geneva 27, Switzerland
| | - Ian Graham
- School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
| | - Oyere Onuma
- Noncommunicable Diseases, Disability, Violence and Injury Prevention Department, World Health Organization, 20 Avenue Appia, Geneva 27, Switzerland
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 420 East Superior Street, Chicago, IL, USA
| | - Mark Woodward
- The George Institute for Global Health, University of Oxford, 75 George Street, Oxford, UK
- The George Institute for Global Health, University of New South Wales, 1 King Street Newtown, Sydney, Australia
| | - Majid Ezzati
- Faculty of Medicine, School of Public Health, Norfolk Place, St Mary's Campus, Imperial College London, London, UK
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Seattle, WA, USA
| | - Naveed Sattar
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
| | - Rod Jackson
- Faculty of Medical and Health Sciences, University of Auckland, 261 Morrin Road, Auckland, New Zealand
| | - Paul M Ridker
- Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, USA
| | - Nancy R Cook
- Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, USA
| | - Ralph B D'Agostino
- Mathematics and Statistics Department, Boston University, 111 Cummington Mall, Boston, MA, USA
| | - Simon G Thompson
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
| | - Emanuele Di Angelantonio
- Department of Public Health and Primary Care, University of Cambridge, 2 Worts' Causeway, Cambridge, UK
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7
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't Hart LM, Vogelzangs N, Mook-Kanamori DO, Brahimaj A, Nano J, van der Heijden AAWA, Willems van Dijk K, Slieker RC, Steyerberg EW, Ikram MA, Beekman M, Boomsma DI, van Duijn CM, Slagboom PE, Stehouwer CDA, Schalkwijk CG, Arts ICW, Dekker JM, Dehghan A, Muka T, van der Kallen CJH, Nijpels G, van Greevenbroek MMJ. Blood Metabolomic Measures Associate With Present and Future Glycemic Control in Type 2 Diabetes. J Clin Endocrinol Metab 2018; 103:4569-4579. [PMID: 30113659 DOI: 10.1210/jc.2018-01165] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Received: 05/29/2018] [Accepted: 07/30/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We studied whether blood metabolomic measures in people with type 2 diabetes (T2D) are associated with insufficient glycemic control and whether this association is influenced differentially by various diabetes drugs. We then tested whether the same metabolomic profiles were associated with the initiation of insulin therapy. METHODS A total of 162 metabolomic measures were analyzed using a nuclear magnetic resonance-based method in people with T2D from four cohort studies (n = 2641) and one replication cohort (n = 395). Linear and logistic regression analyses with adjustment for potential confounders, followed by meta-analyses, were performed to analyze associations with hemoglobin A1c levels, six glucose-lowering drug categories, and insulin initiation during a 7-year follow-up period (n = 698). RESULTS After Bonferroni correction, 26 measures were associated with insufficient glycemic control (HbA1c >53 mmol/mol). The strongest association was with glutamine (OR, 0.66; 95% CI, 0.61 to 0.73; P = 7.6 × 10-19). In addition, compared with treatment-naive patients, 31 metabolomic measures were associated with glucose-lowering drug use (representing various metabolite categories; P ≤ 3.1 × 10-4 for all). In drug-stratified analyses, associations with insufficient glycemic control were only mildly affected by different glucose-lowering drugs. Five of the 26 metabolomic measures (apolipoprotein A1 and medium high-density lipoprotein subclasses) were also associated with insulin initiation during follow-up in both discovery and replication. The strongest association was observed for medium high-density lipoprotein cholesteryl ester (OR, 0.54; 95% CI, 0.42 to 0.71; P = 4.5 × 10-6). CONCLUSION Blood metabolomic measures were associated with present and future glycemic control and might thus provide relevant cues to identify those at increased risk of treatment failure.
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Affiliation(s)
- Leen M 't Hart
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden ZA, Netherlands
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden ZA, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam HV, Netherlands
| | - Nicole Vogelzangs
- Cardiovascular Research Institute Maastricht and Maastricht Centre for Systems Biology, Maastricht University, Maastricht LK, Netherlands
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden ZA, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden ZA, Netherlands
| | - Adela Brahimaj
- Department of Epidemiology, Erasmus Medical Center, Rotterdam GD, Netherlands
| | - Jana Nano
- Department of Epidemiology, Erasmus Medical Center, Rotterdam GD, Netherlands
- Institute of Epidemiology, German Research Center for Environment Health, Helmholtz Zentrum Munich, Munich, Germany
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung), Munich, Germany
| | - Amber A W A van der Heijden
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Ko Willems van Dijk
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden ZA, Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden ZA, Netherlands
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden ZA, Netherlands
| | - Roderick C Slieker
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden ZA, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam HV, Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden ZA, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam GD, Netherlands
| | - Marian Beekman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden ZA, Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam HV, Netherlands
| | | | - P Eline Slagboom
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden ZA, Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, Maastricht LK, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht LK, Netherlands
| | - Casper G Schalkwijk
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, Maastricht LK, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht LK, Netherlands
| | - Ilja C W Arts
- Cardiovascular Research Institute Maastricht and Maastricht Centre for Systems Biology, Maastricht University, Maastricht LK, Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam HV, Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam GD, Netherlands
- Department of Biostatistics and Epidemiology, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Taulant Muka
- Department of Epidemiology, Erasmus Medical Center, Rotterdam GD, Netherlands
| | - Carla J H van der Kallen
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, Maastricht LK, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht LK, Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Marleen M J van Greevenbroek
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, Maastricht LK, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht LK, Netherlands
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8
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van Dijk D, Balkau B, Segrestin B, Gottsäter M, Gabriel R, Hatunic M, Mari A, Dekker JM, Rutters F. Associations between sleep duration and sleep debt with insulin sensitivity and insulin secretion in the EGIR-RISC Study. Diabetes Metab 2018; 45:375-381. [PMID: 30439506 DOI: 10.1016/j.diabet.2018.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022]
Abstract
AIM Extremes in sleep duration play an important role in the development of type 2 diabetes. We examined the associations between sleep duration and sleep debt with estimates of insulin sensitivity and insulin secretion. METHODS Data were derived from the European multi-centre EGIR-RISC study. Sleep duration and sleep debt were derived from a sleep questionnaire asking about sleeping time during the week and during the weekend. Insulin sensitivity and insulin secretion were estimated from a 2-hour Oral Glucose Tolerance Test, with samples every 30 minutes. Associations between sleep duration and sleep debt with insulin sensitivity and insulin secretion, were analysed by multiple linear regression models corrected for possible confounders. RESULTS Sleep data were available in 1002 participants, 46% men, mean age 48 ± 8 years, who had an average sleep duration of 7 ± 1 hours [range 3-14] and an average sleep debt (absolute difference hours sleep weekend days minus weekdays) of 1 ± 1 hour [range 0-8]. With regard to insulin sensitivity, we observed an inverted U-shaped association between sleep duration and the Stumvoll MCR in (mL/kg/min), with a corrected β (95% CI) of 2.05 (0.8; 3.3) and for the quadratic term -0.2 (-0.3; -0.1). Similarly, a U-shaped association between sleep duration and log HOMA-IR in (µU/mL), with a corrected βs of -0.83 (-1.4; -0.24) and 0.06 (0.02; 0.10) for the quadratic term. Confounders showed an attenuating effect on the associations, while BMI mediated 60 to 91% of the association between sleep duration and insulin sensitivity. No significant associations were observed between sleep duration with insulin secretion or between sleep debt with either insulin sensitivity or insulin secretion. CONCLUSIONS Short and long sleep duration are associated with a lower insulin sensitivity, suggesting that sleep plays an important role in insulin resistance and may provide the link with development of type 2 diabetes.
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Affiliation(s)
- D van Dijk
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | - B Balkau
- Centre for Research in Epidemiology and Population Health (CESP), University Paris-Saclay, Université Paris Sud, UVSQ, UMRS 1018, 92300 Villejuif, France
| | - B Segrestin
- Department of Nutrition, CRNH-RA, Lyon 1 University, Hospices civils de Lyon, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - M Gottsäter
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - R Gabriel
- Instituto de Investigación Princesa IP, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Hatunic
- Endocrinology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - J M Dekker
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | - F Rutters
- Department Epidemiology and Biostatistics, Amsterdam University Medical Centres, Amsterdam, Netherlands; Amsterdam Public Health Institute, Amsterdam, the Netherlands.
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9
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Lorenz MW, Gao L, Ziegelbauer K, Norata GD, Empana JP, Schmidtmann I, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Amato M, Schminke U, Srinivasan SR, Lind L, Okazaki S, Stehouwer CDA, Willeit P, Polak JF, Steinmetz H, Sander D, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Staub D, Sirtori CR, Iglseder B, Beloqui O, Engström G, Friera A, Rozza F, Xie W, Parraga G, Grigore L, Plichart M, Blankenberg S, Su TC, Schmidt C, Tuomainen TP, Veglia F, Völzke H, Nijpels G, Willeit J, Sacco RL, Franco OH, Uthoff H, Hedblad B, Suarez C, Izzo R, Zhao D, Wannarong T, Catapano A, Ducimetiere P, Espinola-Klein C, Chien KL, Price JF, Bergström G, Kauhanen J, Tremoli E, Dörr M, Berenson G, Kitagawa K, Dekker JM, Kiechl S, Sitzer M, Bickel H, Rundek T, Hofman A, Mathiesen EB, Castelnuovo S, Landecho MF, Rosvall M, Gabriel R, de Luca N, Liu J, Baldassarre D, Kavousi M, de Groot E, Bots ML, Yanez DN, Thompson SG. Correction: Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. PLoS One 2018; 13:e0204633. [PMID: 30235339 PMCID: PMC6147579 DOI: 10.1371/journal.pone.0204633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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10
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Özcan B, Rutters F, Snoek FJ, Roosendaal M, Sijbrands EJ, Elders PJM, Holleman F, Pijl H, Tack CJ, Abbink EJ, de Valk HW, Wolffenbuttel BHR, Stehouwer CDA, Schaper NC, Dekker JM, Schram MT. High Diabetes Distress Among Ethnic Minorities Is Not Explained by Metabolic, Cardiovascular, or Lifestyle Factors: Findings From the Dutch Diabetes Pearl Cohort. Diabetes Care 2018; 41:1854-1861. [PMID: 29945936 DOI: 10.2337/dc17-2181] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/20/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes distress among patients from ethnic minorities is still poorly understood. We investigated the association between ethnicity and diabetes distress among ethnic minority groups of people with type 2 diabetes in the Netherlands, focusing on the possible effects of glycemic control, lifestyle factors, cardiovascular risk factors, and diabetes complications. RESEARCH DESIGN AND METHODS Cross-sectional data from the Dutch Diabetes Pearl cohort included people with type 2 diabetes from primary, secondary, and tertiary diabetes care programs. We used the 20-item Problem Areas in Diabetes Survey (PAID) scale to assess diabetes distress; a score ≥40 is considered to represent high distress. Ethnicity was estimated on the basis of country of birth. Sociodemographic and lifestyle data were self-reported; cardiovascular and metabolic data were retrieved from medical charts. Logistic regression analysis determined the association between ethnicity and diabetes distress, with Caucasians as the reference group. RESULTS Diabetes distress scores and ethnicity were available for 4,191 people with type 2 diabetes: 3,684 were Caucasian, 83 were Asian, 51 were Moroccan, 92 were African, 134 were Latin American, 46 were Turkish, and 101 were Hindustani-Surinamese. Overall, participants in minority groups had worse health outcomes than those of Caucasian descent, and diabetes distress was more prevalent (ranging from 9.6 to 31.7%, compared with 5.8% among Caucasians), even after adjusting for age, sex, education level, alcohol use, smoking, BMI, lipid profile, HbA1c, medication use, and the presence of diabetes complications. CONCLUSIONS Among people with type 2 diabetes in the Netherlands, ethnicity is independently associated with high diabetes distress. Further research is warranted to explain the higher prevalence of diabetes distress in minority groups and to develop effective interventions.
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Affiliation(s)
- Behiye Özcan
- Erasmus Medical Center, Rotterdam, the Netherlands
| | - Femke Rutters
- VU University Medical Center, Amsterdam, the Netherlands
| | - Frank J Snoek
- VU University Medical Center, Amsterdam, the Netherlands.,Academic Medical Center, Amsterdam, the Netherlands
| | - Mandy Roosendaal
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | | | | | | | - Hanno Pijl
- Leiden University Medical Center, Leiden, the Netherlands
| | - Cees J Tack
- Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | | | - Coen D A Stehouwer
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Nicholas C Schaper
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | | | - Miranda T Schram
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
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11
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Hulman A, Witte DR, Vistisen D, Balkau B, Dekker JM, Herder C, Hatunic M, Konrad T, Færch K, Manco M. Pathophysiological Characteristics Underlying Different Glucose Response Curves: A Latent Class Trajectory Analysis From the Prospective EGIR-RISC Study. Diabetes Care 2018; 41:1740-1748. [PMID: 29853473 DOI: 10.2337/dc18-0279] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/02/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Glucose measurements during an oral glucose tolerance test (OGTT) are useful in predicting diabetes and its complications. However, knowledge of the pathophysiology underlying differences in glucose curve shapes is sparse. We examined the pathophysiological characteristics that create different glucose curve patterns and studied their stability and reproducibility over 3 years of follow-up. RESEARCH DESIGN AND METHODS We analyzed data from participants without diabetes from the observational cohort from the European Group for the Study of Insulin Resistance: Relationship between Insulin Sensitivity and Cardiovascular Disease study; participants had a five-time point OGTT at baseline (n = 1,443) and after 3 years (n = 1,045). Measures of insulin sensitivity and secretion were assessed at baseline with a euglycemic-hyperinsulinemic clamp and intravenous glucose tolerance test. Heterogeneous glucose response patterns during the OGTT were identified using latent class trajectory analysis at baseline and at follow-up. Transitions between classes were analyzed with multinomial logistic regression models. RESULTS We identified four different glucose response patterns, which differed with regard to insulin sensitivity and acute insulin response, obesity, and plasma levels of lipids and inflammatory markers. Some of these associations were confirmed prospectively. Time to glucose peak was driven mainly by insulin sensitivity, whereas glucose peak size was related to both insulin sensitivity and secretion. The glucose patterns identified at follow-up were similar to those at baseline, suggesting that the latent class method is robust. We integrated our classification model into an easy-to-use online application that facilitates the assessment of glucose curve patterns for other studies. CONCLUSIONS The latent class analysis approach is a pathophysiologically insightful way to classify individuals without diabetes based on their response to glucose during an OGTT.
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Affiliation(s)
- Adam Hulman
- Department of Public Health, Aarhus University, Aarhus, Denmark .,Danish Diabetes Academy, Odense, Denmark
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark
| | | | - Beverley Balkau
- Centre for Research in Epidemiology and Population Health, Faculty of Medicine, University Paris-South, Paris, France.,Faculty of Medicine, University of Versailles-St. Quentin, Versailles, France.,INSERM U1018, University Paris-Saclay, Villejuif, France
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Mensud Hatunic
- Department of Endocrinology, Mater Misericordiae University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - Thomas Konrad
- Institute for Metabolic Research, Goethe University, Frankfurt am Main, Germany
| | | | - Melania Manco
- Research Unit for Multi-factorial Diseases, Obesity and Diabetes, Istituti di Ricovero e Cura a Carattere Scientifico, Bambino Gesù Children's Hospital, Rome, Italy
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12
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Lorenz MW, Gao L, Ziegelbauer K, Norata GD, Empana JP, Schmidtmann I, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Amato M, Schminke U, Srinivasan SR, Lind L, Okazaki S, Stehouwer CDA, Willeit P, Polak JF, Steinmetz H, Sander D, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Staub D, Sirtori CR, Iglseder B, Beloqui O, Engström G, Friera A, Rozza F, Xie W, Parraga G, Grigore L, Plichart M, Blankenberg S, Su TC, Schmidt C, Tuomainen TP, Veglia F, Völzke H, Nijpels G, Willeit J, Sacco RL, Franco OH, Uthoff H, Hedblad B, Suarez C, Izzo R, Zhao D, Wannarong T, Catapano A, Ducimetiere P, Espinola-Klein C, Chien KL, Price JF, Bergström G, Kauhanen J, Tremoli E, Dörr M, Berenson G, Kitagawa K, Dekker JM, Kiechl S, Sitzer M, Bickel H, Rundek T, Hofman A, Mathiesen EB, Castelnuovo S, Landecho MF, Rosvall M, Gabriel R, de Luca N, Liu J, Baldassarre D, Kavousi M, de Groot E, Bots ML, Yanez DN, Thompson SG. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. PLoS One 2018; 13:e0191172. [PMID: 29649236 PMCID: PMC5896895 DOI: 10.1371/journal.pone.0191172] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 09/29/2017] [Accepted: 11/29/2017] [Indexed: 12/28/2022] Open
Abstract
AIMS Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
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Affiliation(s)
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Cambridge, United Kingdom
| | | | - Giuseppe Danilo Norata
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Jean Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, UMR, Paris, France
| | - Irene Schmidtmann
- Institut fuer Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitaetsmedizin Mainz, Mainz, Germany
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Stela McLachlan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Greifswald, Germany
| | - Sathanur R. Srinivasan
- Center for Cardiovascular Health, Department of Epidemiology, Biochemistry, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Shuhei Okazaki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Coen D. A. Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Joseph F. Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing & Feldafing, Feldafing, Germany
| | - Holger Poppert
- Department of Neurology, Technische Universität München, Munich, Germany
| | - Moise Desvarieux
- Department of Epidemiology,Mailman School of Public Health,Columbia University, New York, United States of America
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Daniel Staub
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Cesare R. Sirtori
- Center of Dyslipidemias, Niguarda Ca’ Granda Hospital, Milano, Italy
| | - Bernhard Iglseder
- Parcelsus Medical University, Salzburg, Austria
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
| | - Oscar Beloqui
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Alfonso Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Wuxiang Xie
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Liliana Grigore
- Centro Sisa per lo Studio della Aterosclerosi, Bassini Hospital, Cinisello Balsamo, Italy
| | - Matthieu Plichart
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | - Stefan Blankenberg
- 2nd Department of Medicine, Johannes Gutenberg-Universität, Mainz, Germany
- Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | | | - Henry Völzke
- German Center for Cardiovascular Research (DZHK),partner site Greifswald, Greifswald, Germany
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, Greifswald, Germany
| | - Giel Nijpels
- Department of General Practice, VU University Medical Center, Amsterdam, the Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralph L. Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Raffaele Izzo
- School of Medicine, Federico II University, Naples, Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Thapat Wannarong
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Internal Medicine, Faculty of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Alberico Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | | | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health,National Taiwan University, Taipei, Taiwan
| | - Jackie F. Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, Gothenburg University, Götheborg, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Elena Tremoli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Marcus Dörr
- Department B for Internal Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Jacqueline M. Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
| | | | - Manuel F. Landecho
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Maria Rosvall
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Rafael Gabriel
- Escuela National de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - Nicola de Luca
- School of Medicine, Federico II University, Naples, Italy
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Maryam Kavousi
- Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Eric de Groot
- Imagelabonline & Cardiovascular, Eindhoven and Lunteren, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, the Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - David N. Yanez
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Simon G. Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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13
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Wanders AJ, Alssema M, De Hoon SEM, Feskens EJM, van Woudenbergh GJ, van der Kallen CJ, Zock PL, Refsum H, Drevon CA, Elshorbagy A, Schalkwijk CG, Stehouwer CDA, Dekker JM, van Greevenbroek MMJ. Circulating Polyunsaturated Fatty Acids as Biomarkers for Dietary Intake across Subgroups: The CODAM and Hoorn Studies. Ann Nutr Metab 2018; 72:117-125. [PMID: 29393106 DOI: 10.1159/000486244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/10/2017] [Indexed: 11/19/2022]
Abstract
AIMS To evaluate whether participant characteristics and way of expressing circulating fatty acids (FA) influence the strengths of associations between self-reported intake and circulating levels of linoleic acid (LA), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). METHODS Cross-sectional analyses were performed in pooled data from the CODAM (n = 469) and Hoorn (n = 702) studies. Circulating FA were measured by gas liquid chromatography and expressed as proportions (% of total FA) and concentrations (µg/mL). Dietary intakes were calculated from a validated food frequency questionnaire. Effects of participant characteristics on associations between dietary and circulating FA were calculated using interaction analyses. RESULTS Standardized regression coefficients between dietary FA and proportions of circulating FA (% of total FA) were LA β = 0.28, ALA β = 0.13, EPA β = 0.34, and DHA β = 0.45. Body mass index (BMI), waist circumference, and presence of CVD influenced associations for LA; gender influenced LA, EPA, and DHA; alcohol intake influenced LA and DHA; and glucose tolerance status influenced ALA (p values interaction <0.05). Coefficients for circulating FA as concentrations were LA β = 0.19, ALA β = 0.10, EPA β = 0.31, and DHA β = 0.41. CONCLUSIONS This study suggests that characteristics such as BMI, alcohol intake, and expressing circulating FA as proportions or concentrations, influence associations between dietary and circulating FA.
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Affiliation(s)
- Anne J Wanders
- Unilever Research and Development, Vlaardingen, the Netherlands
| | - Marjan Alssema
- Unilever Research and Development, Vlaardingen, the Netherlands.,Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU Medical Center, Amsterdam, the Netherlands
| | - Sabine E M De Hoon
- Unilever Research and Development, Vlaardingen, the Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | | | | | - Peter L Zock
- Unilever Research and Development, Vlaardingen, the Netherlands
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Amany Elshorbagy
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom.,Department of Physiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU Medical Center, Amsterdam, the Netherlands
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14
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Rauh SP, Rutters F, van der Heijden AAWA, Luimes T, Alssema M, Heymans MW, Magliano DJ, Shaw JE, Beulens JW, Dekker JM. External Validation of a Tool Predicting 7-Year Risk of Developing Cardiovascular Disease, Type 2 Diabetes or Chronic Kidney Disease. J Gen Intern Med 2018; 33:182-188. [PMID: 29204973 PMCID: PMC5789113 DOI: 10.1007/s11606-017-4231-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 02/23/2017] [Revised: 06/09/2017] [Accepted: 11/03/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic cardiometabolic diseases, including cardiovascular disease (CVD), type 2 diabetes (T2D) and chronic kidney disease (CKD), share many modifiable risk factors and can be prevented using combined prevention programs. Valid risk prediction tools are needed to accurately identify individuals at risk. OBJECTIVE We aimed to validate a previously developed non-invasive risk prediction tool for predicting the combined 7-year-risk for chronic cardiometabolic diseases. DESIGN The previously developed tool is stratified for sex and contains the predictors age, BMI, waist circumference, use of antihypertensives, smoking, family history of myocardial infarction/stroke, and family history of diabetes. This tool was externally validated, evaluating model performance using area under the receiver operating characteristic curve (AUC)-assessing discrimination-and Hosmer-Lemeshow goodness-of-fit (HL) statistics-assessing calibration. The intercept was recalibrated to improve calibration performance. PARTICIPANTS The risk prediction tool was validated in 3544 participants from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). KEY RESULTS Discrimination was acceptable, with an AUC of 0.78 (95% CI 0.75-0.81) in men and 0.78 (95% CI 0.74-0.81) in women. Calibration was poor (HL statistic: p < 0.001), but improved considerably after intercept recalibration. Examination of individual outcomes showed that in men, AUC was highest for CKD (0.85 [95% CI 0.78-0.91]) and lowest for T2D (0.69 [95% CI 0.65-0.74]). In women, AUC was highest for CVD (0.88 [95% CI 0.83-0.94)]) and lowest for T2D (0.71 [95% CI 0.66-0.75]). CONCLUSIONS Validation of our previously developed tool showed robust discriminative performance across populations. Model recalibration is recommended to account for different disease rates. Our risk prediction tool can be useful in large-scale prevention programs for identifying those in need of further risk profiling because of their increased risk for chronic cardiometabolic diseases.
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Affiliation(s)
- Simone P Rauh
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Amber A W A van der Heijden
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, The Netherlands
| | - Thomas Luimes
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Marjan Alssema
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Unilever Research and Development, Vlaardingen, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - 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
| | - Jonathan E 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
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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15
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Ruijgrok C, Dekker JM, Beulens JW, Brouwer IA, Coupé VMH, Heymans MW, Sijtsma FPC, Mela DJ, Zock PL, Olthof MR, Alssema M. Size and shape of the associations of glucose, HbA 1c, insulin and HOMA-IR with incident type 2 diabetes: the Hoorn Study. Diabetologia 2018; 61:93-100. [PMID: 29018885 PMCID: PMC6448924 DOI: 10.1007/s00125-017-4452-7] [Citation(s) in RCA: 25] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/08/2017] [Indexed: 11/03/2022]
Abstract
AIMS/HYPOTHESIS Glycaemic markers and fasting insulin are frequently measured outcomes of intervention studies. To extrapolate accurately the impact of interventions on the risk of diabetes incidence, we investigated the size and shape of the associations of fasting plasma glucose (FPG), 2 h post-load glucose (2hPG), HbA1c, fasting insulin and HOMA-IR with incident type 2 diabetes mellitus. METHODS The study population included 1349 participants aged 50-75 years without diabetes at baseline (1989) from a population-based cohort in Hoorn, the Netherlands. Incident type 2 diabetes was defined by the WHO 2011 criteria or known diabetes at follow-up. Logistic regression models were used to determine the associations of the glycaemic markers, fasting insulin and HOMA-IR with incident type 2 diabetes. Restricted cubic spline logistic regressions were conducted to investigate the shape of the associations. RESULTS After a mean follow-up duration of 6.4 (SD 0.5) years, 152 participants developed diabetes (11.3%); the majority were screen detected by high FPG. In multivariate adjusted models, ORs (95% CI) for incident type 2 diabetes for the highest quintile in comparison with the lowest quintile were 9.0 (4.4, 18.5) for FPG, 6.1 (2.9, 12.7) for 2hPG, 3.8 (2.0, 7.2) for HbA1c, 1.9 (0.9, 3.6) for fasting insulin and 2.8 (1.4, 5.6) for HOMA-IR. The associations of FPG and HbA1c with incident diabetes were non-linear, rising more steeply at higher values. CONCLUSIONS/INTERPRETATION FPG was most strongly associated with incident diabetes, followed by 2hPG, HbA1c, HOMA-IR and fasting insulin. The strong association with FPG is probably because FPG is the most frequent marker for diabetes diagnosis. Non-linearity of associations between glycaemic markers and incident type 2 diabetes should be taken into account when estimating future risk of type 2 diabetes based on glycaemic markers.
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Affiliation(s)
- Carolien Ruijgrok
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands.
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ingeborg A Brouwer
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Femke P C Sijtsma
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
| | - David J Mela
- Unilever Research and Development, Vlaardingen, the Netherlands
| | - Peter L Zock
- Unilever Research and Development, Vlaardingen, the Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Marjan Alssema
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
- Unilever Research and Development, Vlaardingen, the Netherlands
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16
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Empana JP, Blom MT, Bӧttiger BW, Dagres N, Dekker JM, Gislason G, Jouven X, Meitinger T, Ristagno G, Schwartz PJ, Jonsson M, Tfelt-Hansen J, Truhlar A, Tan HL. Determinants of occurrence and survival after sudden cardiac arrest-A European perspective: The ESCAPE-NET project. Resuscitation 2017; 124:7-13. [PMID: 29246744 DOI: 10.1016/j.resuscitation.2017.12.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 08/10/2017] [Revised: 10/23/2017] [Accepted: 12/10/2017] [Indexed: 11/16/2022]
Abstract
AIMS The ESCAPE-NET project ("European Sudden Cardiac Arrest network- towards Prevention, Education and New Effective Treatments") aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies for survival after SCA on a European scale. METHODS This is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. RESULTS The 11 clinical studies with SCA cases comprise 85,790 SCA cases; the 5 observational prospective population cohorts include 53,060 subjects. A total of 15,000 SCA samples will be genotyped for common and rare variants at the Helmholtz Zentrum München (Germany) using the Illumina Global Screening Array which contains > 770,000 SNPs, and after imputation, a database of an estimated > 9 million variants will be available for genome wide association studies. Standardization of risk factors definition and outcomes is ongoing. An Executive Committee has been created along with a Collaboration Policy document. CONCLUSION ESCAPE-NET will complement ongoing efforts on SCA outside Europe and within Europe including the EuReCa project.
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Affiliation(s)
- Jean-Philippe Empana
- Université Paris Descartes, INSERM UMRS-970, Paris Cardiovascular Research Centre, Paris, France
| | - Marieke T Blom
- Department of Cardiology, Heart Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Bernd W Bӧttiger
- European Resuscitation Council, Brussels, Belgium; Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Nikolaos Dagres
- European Heart Rhythm Association, representing the European Society of Cardiology, Sophia Antipolis, France
| | | | - Gunnar Gislason
- Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark and Danish Heart Foundation
| | - Xavier Jouven
- Université Paris Descartes, INSERM UMRS-970, Paris Cardiovascular Research Centre, Paris, France
| | | | - Giuseppe Ristagno
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy; Italian Resuscitation Council, Bologna, Italy
| | - Peter J Schwartz
- IRCCS Istituto Auxologico Italiano, Reference Network for Rare and Low Prevalence Complexe Diseases of the Heart (ERN GUARD-HEART), Italy
| | - Martin Jonsson
- Center for Resuscitation Science, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Jacob Tfelt-Hansen
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark and Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark and Reference Network for Rare and Low Prevalence Complexe Diseases of the Heart (ERN GUARD-HEART)
| | - Anatolij Truhlar
- Emergency Medical Services of the Hradec Kralove Region, Czech Republic
| | - Hanno L Tan
- Department of Cardiology, Heart Center, Academic Medical Center, Amsterdam, The Netherlands.
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17
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Rutte A, Rauh SP, Schram MT, Nijpels G, DeVries JH, Holleman F, Pijl H, Dekkers OM, Özcan B, Sijbrands EJG, Tack CJ, Abbink EJ, de Valk HW, Silvius B, Wolffenbuttel BHR, Stehouwer CDA, Schaper NC, Dekker JM, Beulens JW, Elders PJM, Rutters F. Individual and partner's level of occupation and the association with HbA 1c levels in people with Type 2 diabetes mellitus: the Dutch Diabetes Pearl cohort. Diabet Med 2017; 34:1623-1628. [PMID: 28703888 DOI: 10.1111/dme.13422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 07/10/2017] [Indexed: 11/28/2022]
Abstract
AIMS Individual indicators of socio-economic status have been associated with glycaemic control in people with Type 2 diabetes, but little is known about the association between partner's socio-economic status and HbA1c levels. We therefore examined the cross-sectional association between individual and partner's level of occupation on HbA1c levels in people with Type 2 diabetes in the Netherlands. METHODS We included people with Type 2 diabetes with a partner who were treated in primary, secondary and tertiary care in the Diabetes Pearl cohort. Occupational level was classified according to International Standard Classification of Occupations (ISCO)-08 skill levels. Linear regression analyses were performed stratified for sex, and corrected for age, recruitment centre and diabetes medication. RESULTS In total, 3257 participants (59.8% men, mean 62.2±9.4 years) were included. For men, having a partner with an intermediate level of occupation was associated with lower HbA1c levels [e.g. ISCO level 3: -2 mmol/mol (95% CI -4;-1) or -0.2% (95% CI -0.4;-0.1)], compared with having a partner of the highest occupational level (ISCO level 4). In women, having an unemployed partner was associated with higher HbA1c levels [14 mmol/mol (95% CI 6; 22) or 1.3% (95% CI 0.6; 2.0)], compared with having a partner of the highest occupational level. CONCLUSIONS Partner's occupational status provided additional information on the association between socio-economic status and HbA1c levels in people with Type 2 diabetes. Women seemed to benefit from a partner with a higher occupational status, while men seemed to benefit from a partner with a lower status. Because of the cross-sectional nature of the present study, more research is necessary to explore this association.
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Affiliation(s)
- A Rutte
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - S P Rauh
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - M T Schram
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - G Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J H DeVries
- Department of Internal Medicine, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - F Holleman
- Department of Internal Medicine, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - H Pijl
- Department of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, The Netherlands
| | - O M Dekkers
- Department of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, The Netherlands
| | - B Özcan
- Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E J G Sijbrands
- Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - C J Tack
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - E J Abbink
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - H W de Valk
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - B Silvius
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - B H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - C D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - N C Schaper
- Department of Endocrinology, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - J M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P J M Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Rutters
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
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18
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Cabout M, Alssema M, Nijpels G, Stehouwer CDA, Zock PL, Brouwer IA, Elshorbagy AK, Refsum H, Dekker JM. Circulating linoleic acid and alpha-linolenic acid and glucose metabolism: the Hoorn Study. Eur J Nutr 2017; 56:2171-2180. [PMID: 27418185 PMCID: PMC5579177 DOI: 10.1007/s00394-016-1261-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/28/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE Data on the relation between linoleic acid (LA) and alpha-linolenic acid (ALA) and type 2 diabetes mellitus (T2DM) risk are scarce and inconsistent. The aim of this study was to investigate the association of serum LA and ALA with fasting and 2 h post-load plasma glucose and glycated hemoglobin (HbA1c). METHOD This study included 667 participants from third examination (2000) of the population-based Hoorn study in which individuals with glucose intolerance were overrepresented. Fatty acid profiles in serum total lipids were measured at baseline, in 2000. Diabetes risk markers were measured at baseline and follow-up in 2008. Linear regression models were used in cross-sectional and prospective analyses. RESULTS In cross-sectional analyses (n = 667), serum LA was inversely associated with plasma glucose, both in fasting conditions (B = -0.024 [-0.045, -0.002]) and 2 h after glucose tolerance test (B = -0.099 [-0.158, -0.039]), but not with HbA1c (B = 0.000 [-0.014, 0.013]), after adjustment for relevant factors. In prospective analyses (n = 257), serum LA was not associated with fasting (B = 0.003 [-0.019, 0.025]) or post-load glucose (B = -0.026 [-0.100, 0.049]). Furthermore, no significant associations were found between serum ALA and glucose metabolism in cross-sectional or prospective analyses. CONCLUSIONS In this study, serum LA was inversely associated with fasting and post-load glucose in cross-sectional, but not in prospective analyses. Further studies are needed to elucidate the exact role of serum LA and ALA levels and dietary polyunsaturated fatty acids in glucose metabolism.
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Affiliation(s)
- Mieke Cabout
- Department of Health Sciences and EMGO Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Unilever Research and Development, Vlaardingen, The Netherlands.
| | - Marjan Alssema
- Unilever Research and Development, Vlaardingen, The Netherlands
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Giel Nijpels
- Department of General Practice and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter L Zock
- Unilever Research and Development, Vlaardingen, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences and EMGO Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amany K Elshorbagy
- Institute of Basic Medical Sciences, Department of Nutrition, University of Oslo, Oslo, Norway
| | - Helga Refsum
- Institute of Basic Medical Sciences, Department of Nutrition, University of Oslo, Oslo, Norway
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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19
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Koopman ADM, Rauh SP, van 't Riet E, Groeneveld L, van der Heijden AA, Elders PJ, Dekker JM, Nijpels G, Beulens JW, Rutters F. The Association between Social Jetlag, the Metabolic Syndrome, and Type 2 Diabetes Mellitus in the General Population: The New Hoorn Study. J Biol Rhythms 2017. [PMID: 28631524 PMCID: PMC5564947 DOI: 10.1177/0748730417713572] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Only a few studies have investigated the metabolic consequences of social jetlag. Therefore, we examined the association of social jetlag with the metabolic syndrome and type 2 diabetes mellitus in a population-based cohort. We used cross-sectional data from the New Hoorn Study cohort (n = 1585, 47% men, age 60.8 ± 6 years). Social jetlag was calculated as the difference in midpoint sleep (in hours) between weekdays and weekend days. Poisson and linear regression models were used to study the associations, and age was regarded as a possible effect modifier. We adjusted for sex, employment status, education, smoking, physical activity, sleep duration, and body mass index. In the total population, we only observed an association between social jetlag and the metabolic syndrome, with prevalence ratios adjusted for sex, employment status, and educational levels of 1.64 (95% CI 1.1-2.4), for participants with >2 h social jetlag, compared with participants with <1 h social jetlag. However, we observed an interaction effect of median age (<61 years). In older participants (≥61 years), no significant associations were observed between social jetlag status, the metabolic syndrome, and diabetes or prediabetes. In the younger group (<61 years), the adjusted prevalence ratios were 1.29 (95% CI 0.9-1.9) and 2.13 (95% CI 1.3-3.4) for the metabolic syndrome and 1.39 (95% CI 1.1-1.9) and 1.75 (95% CI 1.2-2.5) for diabetes/prediabetes, for participants with 1-2 h and >2 h social jetlag, compared with participants with <1 h social jetlag. In conclusion, in our population-based cohort, social jetlag was associated with a 2-fold increased risk of the metabolic syndrome and diabetes/prediabetes, especially in younger (<61 years) participants.
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Affiliation(s)
- Anitra D M Koopman
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam
| | - Simone P Rauh
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam
| | - Esther van 't Riet
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam
| | - Lenka Groeneveld
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam
| | - Amber A van der Heijden
- EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam.,Department of General Practice and Elderly Care, VU Medical Centre, Amsterdam
| | - Petra J Elders
- EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam.,Department of General Practice and Elderly Care, VU Medical Centre, Amsterdam
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam
| | - Giel Nijpels
- EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam.,Department of General Practice and Elderly Care, VU Medical Centre, Amsterdam
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam
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20
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van der Heijden AAWA, Rauh SP, Dekker JM, Beulens JW, Elders P, ‘t Hart LM, Rutters F, van Leeuwen N, Nijpels G. The Hoorn Diabetes Care System (DCS) cohort. A prospective cohort of persons with type 2 diabetes treated in primary care in the Netherlands. BMJ Open 2017; 7:e015599. [PMID: 28588112 PMCID: PMC5729999 DOI: 10.1136/bmjopen-2016-015599] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE People with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort. PARTICIPANTS The DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands. Enrolment in the cohort started in 1998 and this prospective dynamic cohort currently holds 12 673 persons with T2D. FINDINGS TO DATE Clinical measures are collected annually, with a high internal validity due to the centrally organised standardised examinations. Microvascular complications are assessed by measuring kidney function, and screening feet and eyes. Information on cardiovascular disease is obtained by 1) self-report, 2) electrocardiography and 3) electronic patient records. In subgroups of the cohort, biobanking and additional measurements were performed to obtain information on, for example, lifestyle, depression and genomics. Finally, the DCS cohort is linked to national cancer and all-cause mortality registers. A selection of published findings from the DCS includes identification of subgroups with distinct development of haemoglobin A1c, blood pressure and retinopathy, and their predictors; validation of a prediction model for personalised retinopathy screening; the assessment of the role of genetics in development and treatment of T2D, providing options for personalised medicine. FUTURE PLANS We will continue with the inclusion of persons with newly diagnosed T2D, follow-up of persons in the cohort and linkage to morbidity and mortality registries. Currently, we are involved in (inter)national projects on, among others, biomarkers and prediction models for T2D and complications and we are interested in collaborations with external researchers. TRIAL REGISTRATION ISRCTN26257579.
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Affiliation(s)
- Amber AWA van der Heijden
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Simone P Rauh
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Petra Elders
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Leen M ‘t Hart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Molecular Cell Biology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Molecular Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Nienke van Leeuwen
- Department of Molecular Cell Biology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Giel Nijpels
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
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21
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Westra S, Simsek S, Rutters F, Krul-Poel YMH, Stehouwer CDA, Dekker JM, Pouwer F. Low vitamin D levels are not a contributing factor to higher prevalence of depressive symptoms in people with Type 2 diabetes mellitus: the Hoorn study. Diabet Med 2017; 34:577-581. [PMID: 27647017 DOI: 10.1111/dme.13265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2016] [Indexed: 11/28/2022]
Abstract
AIM To test whether a low serum 25-hydroxyvitamin D level explains the greater prevalence of depression among people with Type 2 diabetes. METHODS We performed a cross-sectional analysis of 527 people, aged 60-87 years, who participated in a population-based cohort study. Type 2 diabetes, impaired glucose tolerance, impaired fasting glucose and normal glucose tolerance were defined according to the 2006 WHO criteria. The Centre for Epidemiologic Studies Depression questionnaire was administered, using a cut-off score of ≥ 16 to determine clinically relevant depressive symptoms. RESULTS Logistic regression analysis confirmed that women with impaired glucose tolerance/impaired fasting glucose and people with Type 2 diabetes did have a higher risk of depressive symptoms [unadjusted odds ratios 3.66 (95% CI 1.59 to 8.43) and 3.04 (95% CI 1.57 to 5.88), respectively], compared with people with normal glucose tolerance. Serum 25-hydroxyvitamin D level was not a mediating factor in the association between impaired glucose tolerance/impaired fasting glucose or Type 2 diabetes and depressive symptoms [unstandardized indirect effect 0.001 (95% CI -0.063 to 0.079) and 0.004 (95% CI -0.025 to 0.094), respectively]. CONCLUSIONS The study found no evidence that low vitamin D levels are a contributing factor to higher depression scores in people with Type 2 diabetes.
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Affiliation(s)
- S Westra
- Department of Internal Medicine, Medical Centre Alkmaar, Alkmaar, The Netherlands
| | - S Simsek
- Department of Internal Medicine, Medical Centre Alkmaar, Alkmaar, The Netherlands
- Department of Internal Medicine/Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Rutters
- EMGO+ Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Y M H Krul-Poel
- Department of Internal Medicine, Medical Centre Alkmaar, Alkmaar, The Netherlands
| | - C D A Stehouwer
- Maastricht University Medical Centre, Department of Internal Medicine and School of Cardiovascular Research Maastricht, Maastricht, The Netherlands
| | - J M Dekker
- EMGO+ Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Pouwer
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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22
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van Bussel BCT, Henry RMA, Schalkwijk CG, Dekker JM, Nijpels G, Feskens EJM, Stehouwer CDA. Alcohol and red wine consumption, but not fruit, vegetables, fish or dairy products, are associated with less endothelial dysfunction and less low-grade inflammation: the Hoorn Study. Eur J Nutr 2017; 57:1409-1419. [PMID: 28349255 PMCID: PMC5959974 DOI: 10.1007/s00394-017-1420-4] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 02/27/2017] [Indexed: 01/22/2023]
Abstract
Purpose
Endothelial dysfunction and low-grade inflammation are key phenomena in the pathobiology of cardiovascular disease (CVD). Their dietary modification might explain the observed reduction in CVD that has been associated with a healthy diet rich in fruit, vegetables and fish, low in dairy products and with moderate alcohol and red wine consumption. We investigated the associations between the above food groups and endothelial dysfunction and low-grade inflammation in a population-based cohort of Dutch elderly individuals. Methods Diet was measured by food frequency questionnaire (n = 801; women = 399; age 68.5 ± 7.2 years). Endothelial dysfunction was determined (1) by combining von Willebrand factor, and soluble intercellular adhesion molecule 1 (sICAM-1), vascular cell adhesion molecule 1, endothelial selectin and thrombomodulin, using Z-scores, into a biomarker score and (2) by flow-mediated vasodilation (FMD), and low-grade inflammation by combining C-reactive protein, serum amyloid A, interleukin 6, interleukin 8, tumour necrosis factor α and sICAM-1 into a biomarker score, with smaller FMD and higher scores representing more dysfunction and inflammation, respectively. We used linear regression analyses to adjust associations for sex, age, energy, glucose metabolism, body mass index, smoking, prior CVD, educational level, physical activity and each of the other food groups. Results Moderate [β (95% CI) −0.13 (−0.33; 0.07)] and high [−0.22 (−0.45; −0.003)] alcohol consumption, and red wine [−0.16 (−0.30; −0.01)] consumption, but none of the other food groups, were associated with a lower endothelial dysfunction biomarker score and a greater FMD. The associations for FMD were, however, not statistically significant. Only red wine consumption was associated with a lower low-grade inflammation biomarker score [−0.18 (−0.33; −0.04)]. Conclusions Alcohol and red wine consumption may favourably influence processes involved in atherothrombosis. Electronic supplementary material The online version of this article (doi:10.1007/s00394-017-1420-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- B C T van Bussel
- Department of Medicine, Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands.,School of Nutrition, and Translational Research in Metabolism (NUTRIM), MUMC+, Maastricht, The Netherlands.,Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands
| | - R M A Henry
- Department of Medicine, Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands.,Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands
| | - C G Schalkwijk
- Department of Medicine, Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands.,Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands
| | - J M Dekker
- The EMGO Institute for Health and Care Research (EMGO), Vrije Universiteit Medical Centre (VUMC), Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, VUMC, Amsterdam, The Netherlands
| | - G Nijpels
- Department of Epidemiology and Biostatistics, VUMC, Amsterdam, The Netherlands.,Department of General Practice, VUMC, Amsterdam, The Netherlands
| | - E J M Feskens
- Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - C D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands. .,School of Nutrition, and Translational Research in Metabolism (NUTRIM), MUMC+, Maastricht, The Netherlands. .,Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands. .,Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands. .,Department of Medicine, Maastricht University Medical Centre, Prof. Debyelaan 25, Maastricht, HX, 6229, The Netherlands.
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23
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van Moorsel D, Henry RM, Schaper NC, van Greevenbroek MM, van Rossum EF, 't Hart LM, Schalkwijk CG, van der Kallen CJ, Dekker JM, Stehouwer CD, Havekes B. BclI Glucocorticoid Receptor Polymorphism in Relation to Arterial Stiffening and Cardiac Structure and Function: The Hoorn and CODAM Studies. Am J Hypertens 2017; 30:286-294. [PMID: 28096152 DOI: 10.1093/ajh/hpw196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/15/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chronic glucocorticoid excess is associated with arterial stiffening and cardiac dysfunction. The BclI glucocorticoid receptor (GR) polymorphism increases GR sensitivity and is associated with a higher body mass index (BMI) and some proxies for cardiovascular disease (CVD). Whether BclI influences arterial stiffening and cardiac dysfunction is currently unknown. Therefore, the aim of the present study was to investigate the association of the BclI polymorphism with arterial stiffening and cardiac structure and function. METHODS We conducted an observational cohort study, combining 2 cohort studies designed to investigate genetic and metabolic determinants of CVD. We genotyped 1,124 individuals (age: 64.7 ± 8.5 years) from the Hoorn study and Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study for BclI. Several arterial stiffening indices of the carotid (Hoorn and CODAM study), brachial and femoral artery and the carotid-femoral pulse wave velocity (Hoorn study only) were determined. In addition, in the Hoorn study, we determined several variables of cardiac structure and function. RESULTS We identified 155 homozygous carriers (GG), 498 heterozygous carriers (CG), and 471 noncarriers (CC) of the BclI polymorphism. BclI genotypes did not display significant differences in variables of arterial stiffening (e.g., carotid distensibility coefficient (DC): 12.41 ± 5.37 vs. 12.87 ± 5.55 10-3/kPa [mean ± SD]; P = 0.38; homozygous vs. noncarriers). In addition, no clear differences in estimates of cardiac structure and function were found. CONCLUSIONS Even though BclI is associated with a higher BMI and some proxies of CVD, our results do not support the concept that BclI carrier status is associated with greater arterial stiffening or cardiac dysfunction.
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Affiliation(s)
- Dirk van Moorsel
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ronald M Henry
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Heart and Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marleen M van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elisabeth F van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Leen M 't Hart
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
- Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carla J van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Coen D Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bas Havekes
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
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24
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Gaksch M, Jorde R, Grimnes G, Joakimsen R, Schirmer H, Wilsgaard T, Mathiesen EB, Njølstad I, Løchen ML, März W, Kleber ME, Tomaschitz A, Grübler M, Eiriksdottir G, Gudmundsson EF, Harris TB, Cotch MF, Aspelund T, Gudnason V, Rutters F, Beulens JWJ, van ‘t Riet E, Nijpels G, Dekker JM, Grove-Laugesen D, Rejnmark L, Busch MA, Mensink GBM, Scheidt-Nave C, Thamm M, Swart KMA, Brouwer IA, Lips P, van Schoor NM, Sempos CT, Durazo-Arvizu RA, Škrabáková Z, Dowling KG, Cashman KD, Kiely M, Pilz S. Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium. PLoS One 2017; 12:e0170791. [PMID: 28207791 PMCID: PMC5312926 DOI: 10.1371/journal.pone.0170791] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [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] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 12/16/2016] [Indexed: 01/15/2023] Open
Abstract
Background Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality. Methods In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488. Findings We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00–1.29), 1.33 (1.16–1.51), and 1.67 (1.44–1.89), respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OH)D and cancer mortality. There was also no significantly increased mortality risk at high 25(OH)D levels up to 125 nmol/L. Interpretation In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.
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Affiliation(s)
- Martin Gaksch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Guri Grimnes
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Ragnar Joakimsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Henrik Schirmer
- Tromsø Cardiovascular Research Group UNN, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B. Mathiesen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Winfried März
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Synlab Academy, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Marcus E. Kleber
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Department of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany
| | - Andreas Tomaschitz
- Department of Cardiology, Medical University of Graz, Graz, Austria
- Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria
- Department of Internal Medicine - Cardiology, Charité University Hospital Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Martin Grübler
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
- Department of Cardiology, Medical University of Graz, Graz, Austria
- Swiss Cardiovascular Center Bern, Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | | | | | - Tamara B. Harris
- National Institute on Aging, Laboratory of Epidemiology, and Population Sciences, Bethesda, Maryland, United States of America
| | - Mary F. Cotch
- Division of Epidemiology and Clinical Applications, National Eye Institute, Bethesda, Maryland, United States of America
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Femke Rutters
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Joline W. J. Beulens
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Esther van ‘t Riet
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Giel Nijpels
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Jacqueline M. Dekker
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Diana Grove-Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Markus A. Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Gert B. M. Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Karin M. A. Swart
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section, VU University medical center, Amsterdam, the Netherlands
| | - Natasja M. van Schoor
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Christopher T. Sempos
- National Institute of Health Office of Dietary Supplements, Bethesda, Maryland, United States of America
| | - Ramón A. Durazo-Arvizu
- Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, Maywood, Illinois, United States of America
| | - Zuzana Škrabáková
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Kirsten G. Dowling
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- Irish Centre for Fetal and Neonatal Translational Research [INFANT], University College Cork, Cork, Ireland
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
- * E-mail:
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25
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Rauh SP, Heymans MW, Koopman ADM, Nijpels G, Stehouwer CD, Thorand B, Rathmann W, Meisinger C, Peters A, de Las Heras Gala T, Glümer C, Pedersen O, Cederberg H, Kuusisto J, Laakso M, Pearson ER, Franks PW, Rutters F, Dekker JM. Predicting glycated hemoglobin levels in the non-diabetic general population: Development and validation of the DIRECT-DETECT prediction model - a DIRECT study. PLoS One 2017; 12:e0171816. [PMID: 28187151 PMCID: PMC5302787 DOI: 10.1371/journal.pone.0171816] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 06/09/2016] [Accepted: 01/26/2017] [Indexed: 11/27/2022] Open
Abstract
Aims/hypothesis To develop a prediction model that can predict HbA1c levels after six years in the non-diabetic general population, including previously used readily available predictors. Methods Data from 5,762 initially non-diabetic subjects from three population-based cohorts (Hoorn Study, Inter99, KORA S4/F4) were combined to predict HbA1c levels at six year follow-up. Using backward selection, age, BMI, waist circumference, use of anti-hypertensive medication, current smoking and parental history of diabetes remained in sex-specific linear regression models. To minimize overfitting of coefficients, we performed internal validation using bootstrapping techniques. Explained variance, discrimination and calibration were assessed using R2, classification tables (comparing highest/lowest 50% HbA1c levels) and calibration graphs. The model was externally validated in 2,765 non-diabetic subjects of the population-based cohort METSIM. Results At baseline, mean HbA1c level was 5.6% (38 mmol/mol). After a mean follow-up of six years, mean HbA1c level was 5.7% (39 mmol/mol). Calibration graphs showed that predicted HbA1c levels were somewhat underestimated in the Inter99 cohort and overestimated in the Hoorn and KORA cohorts, indicating that the model’s intercept should be adjusted for each cohort to improve predictions. Sensitivity and specificity (95% CI) were 55.7% (53.9, 57.5) and 56.9% (55.1, 58.7) respectively, for women, and 54.6% (52.7, 56.5) and 54.3% (52.4, 56.2) for men. External validation showed similar performance in the METSIM cohort. Conclusions/interpretation In the non-diabetic population, our DIRECT-DETECT prediction model, including readily available predictors, has a relatively low explained variance and moderate discriminative performance, but can help to distinguish between future highest and lowest HbA1c levels. Absolute HbA1c values are cohort-dependent.
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Affiliation(s)
- Simone P Rauh
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Anitra D M Koopman
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Giel Nijpels
- Department of General Practice and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Coen D Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Tonia de Las Heras Gala
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Glostrup Hospital, Capital Region of Denmark, Denmark
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henna Cederberg
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Johanna Kuusisto
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Markku Laakso
- Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
| | - Ewan R Pearson
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, United Kingdom
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skane University Hospital Malmö, Malmö, Sweden.,Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.,Harvard Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Femke Rutters
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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26
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Hulman A, Simmons RK, Vistisen D, Tabák AG, Dekker JM, Alssema M, Rutters F, Koopman ADM, Solomon TPJ, Kirwan JP, Hansen T, Jonsson A, Gjesing AP, Eiberg H, Astrup A, Pedersen O, Sørensen TIA, Witte DR, Færch K. Heterogeneity in glucose response curves during an oral glucose tolerance test and associated cardiometabolic risk. Endocrine 2017; 55:427-434. [PMID: 27699707 DOI: 10.1007/s12020-016-1126-z] [Citation(s) in RCA: 21] [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: 08/24/2016] [Accepted: 09/14/2016] [Indexed: 02/06/2023]
Abstract
We aimed to examine heterogeneity in glucose response curves during an oral glucose tolerance test with multiple measurements and to compare cardiometabolic risk profiles between identified glucose response curve groups. We analyzed data from 1,267 individuals without diabetes from five studies in Denmark, the Netherlands and the USA. Each study included between 5 and 11 measurements at different time points during a 2-h oral glucose tolerance test, resulting in 9,602 plasma glucose measurements. Latent class trajectories with a cubic specification for time were fitted to identify different patterns of plasma glucose change during the oral glucose tolerance test. Cardiometabolic risk factor profiles were compared between the identified groups. Using latent class trajectory analysis, five glucose response curves were identified. Despite similar fasting and 2-h values, glucose peaks and peak times varied greatly between groups, ranging from 7-12 mmol/L, and 35-70 min. The group with the lowest and earliest plasma glucose peak had the lowest estimated cardiovascular risk, while the group with the most delayed plasma glucose peak and the highest 2-h value had the highest estimated risk. One group, with normal fasting and 2-h values, exhibited an unusual profile, with the highest glucose peak and the highest proportion of smokers and men. The heterogeneity in glucose response curves and the distinct cardiometabolic risk profiles may reflect different underlying physiologies. Our results warrant more detailed studies to identify the source of the heterogeneity across the different phenotypes and whether these differences play a role in the development of type 2 diabetes and cardiovascular disease.
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Affiliation(s)
- Adam Hulman
- Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus, Denmark.
- Danish Diabetes Academy, Odense, Denmark.
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
| | - Rebecca K Simmons
- Danish Diabetes Academy, Odense, Denmark
- Department of Public Health, Section of General Practice, Aarhus University, Aarhus, Denmark
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Adam G Tabák
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jacqueline M Dekker
- Department of Biostatistics and Epidemiology, VU Medical Center, Amsterdam, Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, Netherlands
| | - Marjan Alssema
- Department of Biostatistics and Epidemiology, VU Medical Center, Amsterdam, Netherlands
- Unilever Research and Development, Vlaardingen, Netherlands
| | - Femke Rutters
- Department of Biostatistics and Epidemiology, VU Medical Center, Amsterdam, Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, Netherlands
| | - Anitra D M Koopman
- Department of Biostatistics and Epidemiology, VU Medical Center, Amsterdam, Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, Netherlands
| | - Thomas P J Solomon
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, UK
- Institute for Metabolism and Systems Research, University of Birmingham, Edgbaston, UK
| | - John P Kirwan
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Jonsson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Prior Gjesing
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Eiberg
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospital, The Capital Region, Copenhagen, Denmark
| | - Daniel R Witte
- Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
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27
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Simons N, Dekker JM, van Greevenbroek MMJ, Nijpels G, 't Hart LM, van der Kallen CJH, Schalkwijk CG, Schaper NC, Stehouwer CDA, Brouwers MCGJ. A Common Gene Variant in Glucokinase Regulatory Protein Interacts With Glucose Metabolism on Diabetic Dyslipidemia: the Combined CODAM and Hoorn Studies. Diabetes Care 2016; 39:1811-7. [PMID: 27660121 DOI: 10.2337/dc16-0153] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/28/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Small molecules that disrupt the binding between glucokinase and glucokinase regulatory protein (GKRP) are potential new glucose-lowering targets. They stimulate hepatic glucose disposal by increasing glucokinase activity in the liver. It can, however, be anticipated that increased hepatic glucokinase activity might be accompanied by the development of hypertriglyceridemia, particularly in type 2 diabetes. We examined whether the strength of association between rs1260326, a common, functional gene variant in GKRP, and plasma lipids is affected by glucose metabolism. RESEARCH DESIGN AND METHODS rs1260326 was genotyped in subjects with normal glucose metabolism (n = 497), subjects with impaired glucose metabolism (n = 256), and patients with type 2 diabetes (n = 351) in the combined Hoorn and Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) studies. RESULTS The strength of association between the rs1260326 minor T allele and plasma triglycerides increased from normal glucose metabolism to impaired glucose metabolism to type 2 diabetes (P for interaction = 0.002). The inverse relation between rs1260326 and plasma HDL cholesterol was again most prominent in type 2 diabetes (P for interaction = 0.004). Similar trends were observed when the Hoorn and CODAM cohorts were analyzed separately. Comparable results were obtained when glucose metabolism strata were replaced by continuous indices of glucose metabolism, i.e., HbA1c and fasting plasma glucose. CONCLUSIONS These findings illustrate that common gene variants, such as rs1260326, can have substantial effect sizes when they are studied in specific populations, such as type 2 diabetes. Moreover, our results shed light on potential side effects of small molecule disruptors of the GKRP-glucokinase complex, especially when glucose control is suboptimal.
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Affiliation(s)
- Nynke Simons
- Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Marleen M J van Greevenbroek
- Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Giel Nijpels
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Leen M 't Hart
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands Section of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Carla J H van der Kallen
- Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martijn C G J Brouwers
- Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
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28
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Rauh SP, Rutters F, Thorsted BL, Wolden ML, Nijpels G, van der Heijden AAWA, Walraven I, Elders PJ, Heymans MW, Dekker JM. Self-reported hypoglycaemia in patients with type 2 diabetes treated with insulin in the Hoorn Diabetes Care System Cohort, the Netherlands: a prospective cohort study. BMJ Open 2016; 6:e012793. [PMID: 27645557 PMCID: PMC5030618 DOI: 10.1136/bmjopen-2016-012793] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Our aim was to study the prevalence of self-reported hypoglycaemic sensations and its association with mortality in patients with type 2 diabetes (T2D) treated with insulin in usual care. METHODS Demographics, clinical characteristics and mortality data were obtained from 1667 patients with T2D treated with insulin in the Hoorn Diabetes Care System Cohort (DCS), a prospective cohort study using clinical care data. Self-reported hypoglycaemic sensations were defined as either mild: events not requiring help; or severe: events requiring help from others (either medical assistance or assistance of others). The association between hypoglycaemic sensations and mortality was analysed using logistic regression analysis. RESULTS At baseline, 981 patients (59%) reported no hypoglycaemic sensations in the past year, 612 (37%) reported only mild sensations and 74 (4%) reported severe hypoglycaemic sensations. During a median follow-up of 1.9 years, 98 patients (5.9%) died. Reporting only mild hypoglycaemic sensations was associated with a lower mortality risk (OR 0.48, 95% CI 0.28 to 0.80), while reporting severe sensations was not significantly associated with mortality (OR 0.76, 95% CI 0.33 to 1.80), compared with reporting no hypoglycaemic sensations, and adjusting for demographic and clinical characteristics. Sensitivity analyses showed an OR of 1.38 (95% CI 0.31 to 6.11) for patients reporting severe hypoglycaemic sensations requiring medical assistance. CONCLUSIONS Self-reported hypoglycaemic sensations are highly prevalent in our insulin-treated T2D population. Patients reporting hypoglycaemic sensations not requiring medical assistance did not have an increased risk of mortality, suggesting that these sensations are not an indicator of increased short-term mortality risk in patients with T2D.
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Affiliation(s)
- Simone P Rauh
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | | | | | - Giel Nijpels
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Amber A W A van der Heijden
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Iris Walraven
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Petra J Elders
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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29
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Rutters F, Besson H, Walker M, Mari A, Konrad T, Nilsson PM, Balkau B, Dekker JM. The Association Between Sleep Duration, Insulin Sensitivity, and β-Cell Function: The EGIR-RISC Study. J Clin Endocrinol Metab 2016; 101:3272-80. [PMID: 27355399 DOI: 10.1210/jc.2016-1045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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] [Indexed: 11/19/2022]
Abstract
CONTEXT In the past decade, over 3 dozen studies reported a relationship between self-reported short sleep and disturbed glucose metabolism. A study with insulin sensitivity assessed according to the gold standard hyperinsulinemic-euglycemic clamp is, however, still missing. OBJECTIVE To evaluate the cross-sectional association of sleep duration with insulin sensitivity and β-cell function in the European group for the study of insulin resistance (EGIR-RISC) study cohort. DESIGN, SETTING, PARTICIPANTS, AND MEASURES We used data from the baseline measurements of the European, multicentre EGIR-RISC study that included 1319 clinically healthy participants. Sleep and physical activity were measured using a single-axis accelerometer. Insulin sensitivity and β-cell function were estimated by hyperinsulinemic-euglycemic clamp and from the oral glucose insulin sensitivity index model, using an oral glucose tolerance test. Associations of sleep duration with insulin sensitivity and β-cell function were analyzed by multiple linear regression, stratified by sex. RESULTS In our current analysis, we included 788 participants (57% women, age 44 ± 8 y), who had an average sleep duration of 7.3 ± 1.5 hours. In men, we observed an inverted U-shaped association between sleep duration categorized per hour and M/I (in μmol/min per kgFFM/nM per hour) (β-estimate [95% confidence intervals] 41 [2, 80]; P = .04 and β(2)-estimate -3 [-6, -0.2], P = .04) as well as a trend for the oral glucose insulin sensitivity index (in mL/min per kgFFM) (β-estimate [95% confidence intervals] 0.8 [-0.4, 2]; P = .17). In women, we observed a U-shaped association between sleep duration and β-cell function (in pmol/min per m(2)/mM per hour) (β-estimate -45 [-86, -3]; P = .04 and β(2)-estimate 3 [0.2, 6]; P = .04). CONCLUSIONS Sleep duration is associated with insulin sensitivity and β-cell function in a sex-specific manner in clinically healthy people.
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Affiliation(s)
- Femke Rutters
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Herve Besson
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Mark Walker
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Andrea Mari
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Thomas Konrad
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Peter M Nilsson
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Beverley Balkau
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics (F.R., J.M.D.), Vrije Universiteit Medical Centre, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Care Research (F.R., J.M.D.), Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; PHARMO Institute for Drug Outcome Research (H.B.), Utrecht, The Netherlands; Institute of Cellular Medicine (M.W.), Medical School Newcastle University, Newcastle, United Kingdom; Institute of Neuroscience (A.M.), National Research Council, Padova, Italy; Institute for Metabolic Research (T.K.), Frankfurt, Germany; Department of Clinical Sciences (P.M.N.), Lund University and University Hospital Malmo, Lund, Sweden; and Inserm U1081CESP (B.B.), Centre for Research in Epidemiology and Population Health, Renal and Cardiovascular Epidemiology, Villejuif, France
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Linssen PB, Henry RM, Schalkwijk CG, Dekker JM, Nijpels G, Brunner-La Rocca HP, Stehouwer CDA. Serum advanced glycation endproducts are associated with left ventricular dysfunction in normal glucose metabolism but not in type 2 diabetes: The Hoorn Study. Diab Vasc Dis Res 2016; 13:278-85. [PMID: 27190078 DOI: 10.1177/1479164116640680] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate whether serum advanced glycation endproducts are associated with left ventricular systolic and diastolic function in participants with normal glucose metabolism, impaired glucose metabolism and type 2 diabetes mellitus. METHODS Participants from a cross-sectional, population-based study (n = 280 with normal glucose metabolism, n = 171 with impaired glucose metabolism, n = 242 with type 2 diabetes mellitus) underwent echocardiography. Serum protein-bound advanced glycation endproducts [i.e. Nε-(carboxymethyl)lysine, pentosidine and Nε-(carboxyethyl)lysine] were measured. Linear regression analyses were used and stratified according to glucose metabolism status. RESULTS In normal glucose metabolism, higher Nε-(carboxymethyl)lysine and pentosidine levels were associated with worse diastolic function (left atrial volume index and left atrial volume × left ventricular mass index product term) and higher Nε-(carboxymethyl)lysine and Nε-(carboxyethyl)lysine levels with worse systolic function (ejection fraction). In impaired glucose metabolism, a similar pattern emerged, though less consistent. In type 2 diabetes mellitus, these associations were non-existent for diastolic function or even reversed for systolic function. CONCLUSION This suggests that serum advanced glycation endproducts are associated with impaired left ventricular function in normal glucose metabolism, but that with deteriorating glucose metabolism status, serum advanced glycation endproducts may not mirror heart failure risk.
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Affiliation(s)
- Pauline Bc Linssen
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ronald Ma Henry
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jacqueline M Dekker
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Giel Nijpels
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Hans-Peter Brunner-La Rocca
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Coen DA Stehouwer
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
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Mast MR, Walraven I, Hoekstra T, Jansen APD, van der Heijden AAWA, Elders PJM, Heine RJ, Dekker JM, Nijpels G, Hugtenburg JG. Effectiveness of insulin therapy in people with Type 2 diabetes in the Hoorn Diabetes Care System. Diabet Med 2016; 33:794-802. [PMID: 26946450 DOI: 10.1111/dme.13110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 03/01/2016] [Indexed: 12/28/2022]
Abstract
AIMS To identify HbA1c trajectories after the start of insulin treatment and to identify clinically applicable predictors of the response to insulin therapy. METHODS The study population comprised 1203 people with Type 2 diabetes included in the Hoorn Diabetes Care System (n = 9849). Inclusion criteria were: age ≥ 40 years; initiation of insulin during follow-up after failure to reach HbA1c levels ≤ 53 mmol/mol (7%) with oral glucose-lowering agents; and a follow up ≥ 2 years after initiating insulin. Latent class growth modelling was used to identify trajectories of HbA1c . Subjects considered to be 'off target' had HbA1c levels ≥ 53 mmol/mol (7.0%) during one-third or more of the follow-up time, and those considered to be 'on target' had HbA1c levels ≥ 53 mmol/mol (7.0%) during less than one-third of the follow-up time. RESULTS Four HbA1c trajectories were identified. Most people (88.7%) were classified as having a stable HbA1c trajectory of ~57 mmol/mol (7.4%). Only 24.4% of the people were on target in response to insulin; this was associated with lower HbA1c levels and a higher age at the start of insulin treatment. CONCLUSIONS Using latent class growth modelling, four HbA1c trajectories were identified. A quarter of the people starting insulin were on target. Low HbA1c levels and advanced age at the start of insulin therapy were associated with better response to insulin therapy. Initiating insulin earlier improves the likelihood of achieving and sustaining glycaemic control.
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Affiliation(s)
- M R Mast
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Clinical Pharmacology and Pharmacy, VU University, Amsterdam, The Netherlands
| | - I Walraven
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University, Amsterdam, The Netherlands
- Department of Ophthalmology, VU University Medical Centre, Amsterdam, The Netherlands
| | - T Hoekstra
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
| | - A P D Jansen
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University, Amsterdam, The Netherlands
| | - A A W A van der Heijden
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University, Amsterdam, The Netherlands
| | - P J M Elders
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University, Amsterdam, The Netherlands
| | - R J Heine
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J M Dekker
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University, Amsterdam, The Netherlands
| | - G Nijpels
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, VU University, Amsterdam, The Netherlands
| | - J G Hugtenburg
- EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Clinical Pharmacology and Pharmacy, VU University, Amsterdam, The Netherlands
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Mast R, Danielle Jansen AP, Walraven I, Rauh SP, van der Heijden AAWA, Heine RJ, Elders PJM, Dekker JM, Nijpels G, Hugtenburg JG. Time to insulin initiation and long-term effects of initiating insulin in people with type 2 diabetes mellitus: the Hoorn Diabetes Care System Cohort Study. Eur J Endocrinol 2016; 174:563-71. [PMID: 26837781 DOI: 10.1530/eje-15-1149] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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] [Received: 11/25/2015] [Accepted: 02/02/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to assess the time to insulin initiation in type 2 diabetes mellitus (T2DM) patients treated with oral glucose-lowering agents and to determine the baseline characteristics associated with time to insulin initiation. This was evaluated in T2DM patients with HbA1c levels consistently ≥7.0% during total follow up and in those with fluctuating HbA1c levels around 7.0%. DESIGN AND METHODS Prospective, observational study was performed, comprising 2418 persons with T2DM aged ≥40 years who entered the Diabetes Care System between 1998 and 2012 with a minimum follow up of at least 3 years, following the first HbA1c level ≥7.0%. Cox regression analyses were performed to assess the determinants of time to insulin initiation. Data related to long-term effects of insulin initiation were studied at baseline and at the end of follow up using descriptive summary statistics. RESULTS Two-thirds of the patients initiated insulin during follow up. The time to insulin varied from 1.2 years (range 0.3-3.1) in patients with HbA1c levels consistently ≥7.0% to 5.4 years (range 3.0-7.5) in patients with fluctuating HbA1c levels around 7.0%. Longer diabetes duration (hazard ratio (HR) 1.04 95% CI 1.03-1.05) and lower age (HR 1.00 95% CI 0.99-1.00) at baseline were associated with a shorter time to initiation. More insulin initiators had retinopathy compared with patients that remained on oral glucose-lowering agents during follow up. CONCLUSION The time to insulin initiation was short, and most of the patients with HbA1c levels consistently ≥7.0% were initiating insulin. Longer diabetes duration and younger age shortened the time to insulin.
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Affiliation(s)
- Ruth Mast
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - A P Danielle Jansen
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Iris Walraven
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Simone P Rauh
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Amber A W A van der Heijden
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Robert J Heine
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Petra J M Elders
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Jacqueline M Dekker
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Giel Nijpels
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
| | - Jacqueline G Hugtenburg
- EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA EMGO Institute for Health and Care ResearchDepartments of Clinical Pharmacology and PharmacyGeneral Practice and Elderly Care MedicineEpidemiology and BiostatisticsOphthalmologyVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsEli Lilly and Company893 S Delaware St, Indianapolis, Indiana, USA
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Malanda UL, Bot SDM, Kostense PJ, Snoek FJ, Dekker JM, Nijpels G. Effects of self-monitoring of glucose on distress and self-efficacy in people with non-insulin-treated Type 2 diabetes: a randomized controlled trial. Diabet Med 2016; 33:537-46. [PMID: 26171942 DOI: 10.1111/dme.12849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 07/03/2015] [Indexed: 11/27/2022]
Abstract
AIMS To investigate the effects of self-monitoring of glucose in blood or urine, on diabetes-specific distress and self-efficacy, compared with usual care in people with non-insulin-treated Type 2 diabetes mellitus. METHODS One hundred and eighty-one participants with non-insulin-treated Type 2 diabetes mellitus [diabetes duration ≥ 1 year, age 45-75 years, HbA1c ≥ 53.0 mmol/mol (7.0%), self-monitoring frequency < 3 times in the previous year] were randomly assigned to blood self-monitoring (n = 60), urine self-monitoring (n = 59) or usual care (n = 62). Primary outcomes were between-group differences in diabetes-specific distress [Problem Areas in Diabetes scale (PAID)] and self-efficacy [Confidence in Diabetes Self-Care questionnaire (CIDS-2)] after 12 months. Secondary outcomes included changes in HbA1c , treatment satisfaction and depressive symptoms. RESULTS There were no statistically significant between-group differences in changes in PAID and CIDS-2 after 12 months. Mean difference in PAID between blood monitoring and control was -2.2 [95% confidence interval (CI) -7.1 to 2.7], between urine monitoring and control was -0.9 (95% CI -4.4 to 2.5) and between blood monitoring and urine monitoring was -2.0 (95% CI -4.1 to 0.1). Mean difference in CIDS-2 between blood monitoring and control was 0.6 [95% CI (-2.0 to 2.1), between urine monitoring and control was 2.8 (95% CI -2.3 to 7.9)] and between blood monitoring and urine monitoring was -3.3 (95% CI -7.9 to 1.3). No statistically significant between-group differences in change in any of the secondary outcome measures were found. CONCLUSIONS This study did not find statistical or clinical evidence for a long-term effect of self-monitoring of glucose in blood or urine on diabetes-specific distress and self-efficacy in people with moderately controlled non-insulin-treated Type 2 diabetes mellitus. (Current Controlled Trials ISRCTN84568563).
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Affiliation(s)
- U L Malanda
- Department of General Practice & Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - S D M Bot
- Department of General Practice & Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - P J Kostense
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - F J Snoek
- Department of Medical Psychology, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - J M Dekker
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - G Nijpels
- Department of General Practice & Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands
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Cashman KD, Dowling KG, Škrabáková Z, Gonzalez-Gross M, Valtueña J, De Henauw S, Moreno L, Damsgaard CT, Michaelsen KF, Mølgaard C, Jorde R, Grimnes G, Moschonis G, Mavrogianni C, Manios Y, Thamm M, Mensink GB, Rabenberg M, Busch MA, Cox L, Meadows S, Goldberg G, Prentice A, Dekker JM, Nijpels G, Pilz S, Swart KM, van Schoor NM, Lips P, Eiriksdottir G, Gudnason V, Cotch MF, Koskinen S, Lamberg-Allardt C, Durazo-Arvizu RA, Sempos CT, Kiely M. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr 2016; 103:1033-44. [PMID: 26864360 PMCID: PMC5527850 DOI: 10.3945/ajcn.115.120873] [Citation(s) in RCA: 785] [Impact Index Per Article: 98.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/28/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. OBJECTIVE This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe. DESIGN The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n= 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. RESULTS An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. CONCLUSIONS Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.
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Affiliation(s)
- Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, and
| | - Kirsten G Dowling
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Zuzana Škrabáková
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Marcela Gonzalez-Gross
- ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain; CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
| | - Jara Valtueña
- ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain
| | | | - Luis Moreno
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guri Grimnes
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Gert Bm Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Martina Rabenberg
- Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Markus A Busch
- Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Lorna Cox
- Medical Research Council Human Nutrition Research Unit, Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Sarah Meadows
- Medical Research Council Human Nutrition Research Unit, Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Gail Goldberg
- Medical Research Council Human Nutrition Research Unit, Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Ann Prentice
- Medical Research Council Human Nutrition Research Unit, Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research
| | - Giel Nijpels
- Department of General Practice & Elderly Care Medicine, and
| | - Stefan Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Karin M Swart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research
| | - Paul Lips
- Department of Internal Medicine, Section of Endocrinology, Vrije Universiteit University Medical Center, Amsterdam, Netherlands
| | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | - Mary Frances Cotch
- Division of Epidemiology and Clinical Applications, National Eye Institute and
| | - Seppo Koskinen
- Department of Health, Functional Capacity and Welfare and Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Ramon A Durazo-Arvizu
- Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL
| | | | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
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35
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van der Heijden AAWA, Feenstra TL, Hoogenveen RT, Niessen LW, de Bruijne MC, Dekker JM, Baan CA, Nijpels G. Policy evaluation in diabetes prevention and treatment using a population-based macro simulation model: the MICADO model. Diabet Med 2015; 32:1580-7. [PMID: 26010494 DOI: 10.1111/dme.12811] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 05/19/2015] [Indexed: 12/21/2022]
Abstract
AIMS To test a simulation model, the MICADO model, for estimating the long-term effects of interventions in people with and without diabetes. METHODS The MICADO model includes micro- and macrovascular diseases in relation to their risk factors. The strengths of this model are its population scope and the possibility to assess parameter uncertainty using probabilistic sensitivity analyses. Outcomes include incidence and prevalence of complications, quality of life, costs and cost-effectiveness. We externally validated MICADO's estimates of micro- and macrovascular complications in a Dutch cohort with diabetes (n = 498,400) by comparing these estimates with national and international empirical data. RESULTS For the annual number of people undergoing amputations, MICADO's estimate was 592 (95% interquantile range 291-842), which compared well with the registered number of people with diabetes-related amputations in the Netherlands (728). The incidence of end-stage renal disease estimated using the MICADO model was 247 people (95% interquartile range 120-363), which was also similar to the registered incidence in the Netherlands (277 people). MICADO performed well in the validation of macrovascular outcomes of population-based cohorts, while it had more difficulty in reflecting a highly selected trial population. CONCLUSIONS Validation by comparison with independent empirical data showed that the MICADO model simulates the natural course of diabetes and its micro- and macrovascular complications well. As a population-based model, MICADO can be applied for projections as well as scenario analyses to evaluate the long-term (cost-)effectiveness of population-level interventions targeting diabetes and its complications in the Netherlands or similar countries.
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MESH Headings
- Amputation, Surgical/adverse effects
- Amputation, Surgical/economics
- Blindness/complications
- Blindness/economics
- Blindness/epidemiology
- Blindness/therapy
- Clinical Trials as Topic
- Cohort Studies
- Combined Modality Therapy/economics
- Computer Simulation
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/economics
- Diabetes Mellitus, Type 2/prevention & control
- Diabetes Mellitus, Type 2/therapy
- Diabetic Angiopathies/economics
- Diabetic Angiopathies/epidemiology
- Diabetic Angiopathies/prevention & control
- Diabetic Angiopathies/therapy
- Diabetic Nephropathies/economics
- Diabetic Nephropathies/epidemiology
- Diabetic Nephropathies/prevention & control
- Diabetic Nephropathies/therapy
- Health Care Costs
- Health Policy
- Humans
- Incidence
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/economics
- Kidney Failure, Chronic/epidemiology
- Kidney Failure, Chronic/therapy
- Models, Cardiovascular
- Models, Economic
- Mortality
- Netherlands/epidemiology
- Peripheral Vascular Diseases/complications
- Peripheral Vascular Diseases/economics
- Peripheral Vascular Diseases/epidemiology
- Peripheral Vascular Diseases/therapy
- Prevalence
- Quality of Life
- Risk Factors
- Vascular Diseases/economics
- Vascular Diseases/epidemiology
- Vascular Diseases/prevention & control
- Vascular Diseases/therapy
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Affiliation(s)
- A A W A van der Heijden
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - T L Feenstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - R T Hoogenveen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - L W Niessen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- School of Medicine, Policy and Practice, University of East Anglia, Norwich, UK
| | - M C de Bruijne
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - J M Dekker
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - C A Baan
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - G Nijpels
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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36
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Gaens KH, Ferreira I, van de Waarenburg MP, van Greevenbroek MM, van der Kallen CJ, Dekker JM, Nijpels G, Rensen SS, Stehouwer CD, Schalkwijk CG. Protein-Bound Plasma N
ε
-(Carboxymethyl)lysine Is Inversely Associated With Central Obesity and Inflammation and Significantly Explain a Part of the Central Obesity–Related Increase in Inflammation. Arterioscler Thromb Vasc Biol 2015; 35:2707-13. [DOI: 10.1161/atvbaha.115.306106] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/21/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Katrien H.J. Gaens
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Isabel Ferreira
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Marjo P.H. van de Waarenburg
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Marleen M. van Greevenbroek
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Carla J.H. van der Kallen
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Jacqueline M. Dekker
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Giel Nijpels
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Sander S. Rensen
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Coen D.A. Stehouwer
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
| | - Casper G. Schalkwijk
- From the Department of Internal Medicine (K.H.J.G., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), CARIM School for Cardiovascular Diseases (K.H.J.G., I.F., M.P.H.v.d.W., M.M.v.G., C.J.H.v.d.K., C.D.A.S., C.G.S.), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) (I.F.), Department of General Surgery (S.S.R.), and NUTRIM School for Nutrition, Toxicology and Metabolism (S.S.R.), Maastricht University Medical Centre, The Netherlands; Division of Epidemiology and
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37
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Teunissen CE, van der Flier WM, Scheltens P, Duits A, Wijnstok N, Nijpels G, Dekker JM, Blankenstein RMA, Heijboer AC. Serum leptin is not altered nor related to cognitive decline in Alzheimer's disease. J Alzheimers Dis 2015; 44:809-13. [PMID: 25352450 DOI: 10.3233/jad-141503] [Citation(s) in RCA: 37] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Low plasma leptin levels can be a risk factor for Alzheimer's disease (AD) but the relation of leptin with disease progression in clinical AD is unknown. OBJECTIVE The aim of this study was to investigate the relation between serum leptin concentrations and cognitive decline in clinical AD. METHODS Serum leptin levels were analyzed in 295 non-obese subjects including healthy controls (n = 65), patients with subjective memory complaints (n = 99), patients with AD (n = 100), and patients with vascular dementia (n = 31). Leptin levels were related to hippocampal atrophy, baseline Mini-Mental State Examination (MMSE) scores and annual decline in MMSE measured over 2 years (range 0.4-4.5 years). RESULTS Serum leptin levels were similar in AD patients compared to healthy controls and patients with subjective memory complaints. No correlation was observed between leptin concentrations and MMSE, annual change in MMSE during follow-up or atrophy. CONCLUSION Serum leptin levels are not altered in this population of relatively young AD or vascular dementia patients (mean 60) compared to healthy and clinical control groups and were not related to cognitive decline. These results suggest that peripheral leptin levels do not play a role in evolution of AD pathology.
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Affiliation(s)
- Charlotte E Teunissen
- Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Anneli Duits
- Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Nienke Wijnstok
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, the Netherlands EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Giel Nijpels
- EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands Department of General Practice, VU University Medical Center, Amsterdam, the Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Rien M A Blankenstein
- Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
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38
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van Moorsel D, van Greevenbroek MMJ, Schaper NC, Henry RMA, Geelen CC, van Rossum EFC, Nijpels G, 't Hart LM, Schalkwijk CG, van der Kallen CJH, Sauerwein HP, Dekker JM, Stehouwer CDA, Havekes B. BclI glucocorticoid receptor polymorphism in relation to cardiovascular variables: the Hoorn and CODAM studies. Eur J Endocrinol 2015; 173:455-64. [PMID: 26139210 DOI: 10.1530/eje-15-0381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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] [Received: 04/10/2015] [Accepted: 07/02/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Excess glucocorticoids are known to cause hypertension and cardiovascular disease (CVD). The BclI glucocorticoid receptor (GR) polymorphism increases glucocorticoid sensitivity and is associated with adverse metabolic effects. Previous studies investigating cardiovascular implications have shown inconsistent results. Therefore, the aim of the present study was to investigate the association of the BclI polymorphism with blood pressure, atherosclerosis, low-grade inflammation, endothelial dysfunction, and prevalent CVD. DESIGN Observational cohort study, combining two cohort studies designed to investigate genetic and metabolic determinants of CVD. METHODS We genotyped 1228 individuals (aged 64.7 years±8.5) from the Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study and Hoorn study for the BclI polymorphism. We measured blood pressure, ankle-brachial index (ABI), and carotid intima-media thickness (cIMT). Low-grade inflammation and endothelial dysfunction scores were computed by averaging Z-scores of six low-grade inflammation markers and four endothelial dysfunction markers respectively. Prevalent CVD was assessed with questionnaires, hospital records, ECG, and ABI. RESULTS Homozygous carriers (GG) had higher mean arterial pressure (103.8±12.4 mmHg vs 101.6±12.2 mmHg (mean±S.D.); P<0.05) compared with non-carriers (CC). Homozygous carriers had lower ABI compared with heterozygous carriers (CG) (1.08±0.13 vs 1.11±0.14; P<0.05). After adjustment for all covariates in the full model, the association with ABI was no longer significant. BclI was not associated with systolic blood pressure, cIMT, low-grade inflammation, endothelial dysfunction, and prevalent CVD. CONCLUSIONS The BclI polymorphism of the GR gene may contribute to an unfavorable cardiovascular profile; however, the effects on cardiovascular variables appear to be limited and partly mediated by the metabolic phenotype exerted by BclI.
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Affiliation(s)
- Dirk van Moorsel
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Marleen M J van Greevenbroek
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Nicolaas C Schaper
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Ronald M A Henry
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Charlotte C Geelen
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Giel Nijpels
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Leen M 't Hart
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Casper G Schalkwijk
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Carla J H van der Kallen
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Hans P Sauerwein
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Jacqueline M Dekker
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
| | - Bas Havekes
- Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht University Medical Center, 6200 MD Maastricht, The NetherlandsSection Molecular EpidemiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht, The NetherlandsSchool for Cardiovascular Diseases Maastricht (CARIM)Maastricht, The Netherlands andSchool for Public Health and Primary Care (CAPHRI)Maastricht, The Netherlands Department of Internal MedicineDivision of Endocrinology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Internal MedicineMaastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsAdelante Center of Expertise in Rehabilitation and Audiology6432 CC Adelante, Hoensbroek, The NetherlandsDepartment of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical Center, 1007 MB Amsterdam, The NetherlandsDepartment of Molecular Cell BiologyLeiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Human BiologyMaastricht
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Dekker LH, van Dam RM, Snijder MB, Peters RJG, Dekker JM, de Vries JHM, de Boer EJ, Schulze MB, Stronks K, Nicolaou M. Comparable Dietary Patterns Describe Dietary Behavior across Ethnic Groups in the Netherlands, but Different Elements in the Diet Are Associated with Glycated Hemoglobin and Fasting Glucose Concentrations. J Nutr 2015; 145:1884-91. [PMID: 26136591 DOI: 10.3945/jn.114.207472] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 06/08/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ethnic minority populations in Western societies suffer from a disproportionate burden of type 2 diabetes (T2D). Insight into the role of dietary patterns in T2D may assist public health nutrition efforts in addressing these health disparities. OBJECTIVE We explored the association between dietary patterns and biomarkers of T2D in 5 ethnic groups living in Amsterdam, Netherlands. METHODS A total of 3776 men and women aged 18-70 y of Dutch, South Asian Surinamese, African-Surinamese, Turkish, and Moroccan origin from the HELIUS (HEalthy LIfe in an Urban Setting) study were included. Diet was assessed by using a food-frequency questionnaire, and dietary patterns were derived separately per ethnic group. First, food group-based dietary patterns were derived by using principal components analysis and the association with glycated hemoglobin (HbA1c) and plasma fasting glucose was assessed by using multivariable linear regression. Second, biomarker-driven dietary patterns based on HbA1c and fasting glucose concentrations were derived by applying reduced rank regression. RESULTS Two comparable food group-based dietary patterns were identified in each ethnic group: a "meat and snack" pattern and a "vegetable" pattern. The meat-and-snack pattern derived within the Dutch origin population was significantly associated with HbA1c (β = 0.09; 95% CI: 0.00, 0.19) and fasting glucose (β = 0.18; 95% CI: 0.09, 0.26) concentrations. A biomarker-derived pattern characterized by red and processed meat was observed among Dutch-origin participants; however, among ethnic minority groups, this pattern was characterized by other foods including ethnicity-specific foods (e.g., roti, couscous). CONCLUSIONS Although similar food group dietary patterns were derived within 5 ethnic groups, the association of the meat-and-snack pattern with fasting glucose concentrations differed by ethnicity. Taken together with the finding of ethnic differences in biomarker-driven dietary patterns, our results imply that addressing T2D risk in multiethnic populations requires ethnicity-specific approaches.
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Affiliation(s)
| | - Rob M van Dam
- Saw Swee Hock School of Public Health and Departments of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | | | - Ron J G Peters
- Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam, Netherlands
| | | | - Evelien J de Boer
- National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention, and Health Services, Bilthoven, Netherlands; and
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
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40
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Gijsberts CM, Groenewegen KA, Hoefer IE, Eijkemans MJC, Asselbergs FW, Anderson TJ, Britton AR, Dekker JM, Engström G, Evans GW, de Graaf J, Grobbee DE, Hedblad B, Holewijn S, Ikeda A, Kitagawa K, Kitamura A, de Kleijn DPV, Lonn EM, Lorenz MW, Mathiesen EB, Nijpels G, Okazaki S, O’Leary DH, Pasterkamp G, Peters SAE, Polak JF, Price JF, Robertson C, Rembold CM, Rosvall M, Rundek T, Salonen JT, Sitzer M, Stehouwer CDA, Bots ML, den Ruijter HM. Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events. PLoS One 2015; 10:e0132321. [PMID: 26134404 PMCID: PMC4489855 DOI: 10.1371/journal.pone.0132321] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [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: 04/08/2015] [Accepted: 06/12/2015] [Indexed: 11/18/2022] Open
Abstract
Background Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events. Methods We used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity. Results Ethnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites. Conclusion The magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention.
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Affiliation(s)
- Crystel M. Gijsberts
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Karlijn A. Groenewegen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Imo E. Hoefer
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Marinus J. C. Eijkemans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Folkert W. Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
- Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands
- Institute of Cardiovascular Science, faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Todd J. Anderson
- Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
| | - Annie R. Britton
- Department of Epidemiology and Public Health University College London, London, United Kingdom
| | - Jacqueline M. Dekker
- Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Gunnar Engström
- Dept of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Greg W. Evans
- Department of Biostatistical Sciences and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Jacqueline de Graaf
- Department of General Internal Medicine, Division of Vascular Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Diederick E. Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Bo Hedblad
- Dept of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Suzanne Holewijn
- Department of General Internal Medicine, Division of Vascular Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Ai Ikeda
- Osaka Medical Center for Health Science and Promotion, Osaka, Japan
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women Medical University, Tokyo, Japan
| | - Akihiko Kitamura
- Osaka Medical Center for Health Science and Promotion, Osaka, Japan
| | - Dominique P. V. de Kleijn
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
- Cardiovascular Research Institute & Surgery, Singapore, Singapore
| | - Eva M. Lonn
- Department of Medicine, Division of Cardiology and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Matthias W. Lorenz
- Department of Neurology, University Hospital, Goethe-University, Frankfurt am Main, Germany
| | - Ellisiv B. Mathiesen
- Brain and Circulation Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Giel Nijpels
- Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Shuhei Okazaki
- Stroke Center, Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Daniel H. O’Leary
- Department of Radiology, Tufts Medical Center, Boston, MA, United States of America
| | - Gerard Pasterkamp
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sanne A. E. Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joseph F. Polak
- Department of Radiology, Tufts Medical Center, Boston, MA, United States of America
| | - Jacqueline F. Price
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Christine Robertson
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Christopher M. Rembold
- Cardiology Division, Department of Internal Medicine, University of Virginia, Charlottesville, VA, United States of America
| | - Maria Rosvall
- Dept of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | | | - Matthias Sitzer
- Department of Neurology, University Hospital, Goethe-University, Frankfurt am Main, Germany and Department of Neurology Klinikum Herford, Germany
| | - Coen D. A. Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hester M. den Ruijter
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- * E-mail:
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41
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Eikendal AL, Groenewegen KA, Anderson TJ, Britton AR, Engström G, Evans GW, de Graaf J, Grobbee DE, Hedblad B, Holewijn S, Ikeda A, Kitagawa K, Kitamura A, Lonn EM, Lorenz MW, Mathiesen EB, Nijpels G, Dekker JM, Okazaki S, O’Leary DH, Polak JF, Price JF, Robertson C, Rembold CM, Rosvall M, Rundek T, Salonen JT, Sitzer M, Stehouwer CD, Hoefer IE, Peters SA, Bots ML, den Ruijter HM. Common Carotid Intima-Media Thickness Relates to Cardiovascular Events in Adults Aged <45 Years. Hypertension 2015; 65:707-13. [DOI: 10.1161/hypertensionaha.114.04658] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population–based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11–1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden.
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Affiliation(s)
- Anouk L.M. Eikendal
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Karlijn A. Groenewegen
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Todd J. Anderson
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Annie R. Britton
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Gunnar Engström
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Greg W. Evans
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Jacqueline de Graaf
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Diederick E. Grobbee
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Bo Hedblad
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Suzanne Holewijn
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Ai Ikeda
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Kazuo Kitagawa
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Akihiko Kitamura
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Eva M. Lonn
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Matthias W. Lorenz
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Ellisiv B. Mathiesen
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Giel Nijpels
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Jacqueline M. Dekker
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Shuhei Okazaki
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Daniel H. O’Leary
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Joseph F. Polak
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Jacqueline F. Price
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Christine Robertson
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Christopher M. Rembold
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Maria Rosvall
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Tatjana Rundek
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Jukka T. Salonen
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Matthias Sitzer
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Coen D.A. Stehouwer
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Imo E. Hoefer
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Sanne A.E. Peters
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Michiel L. Bots
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
| | - Hester M. den Ruijter
- From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College
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Walraven I, Mast MR, Hoekstra T, Jansen APD, van der Heijden AAWA, Rauh SP, Rutters F, van 't Riet E, Elders PJM, Moll AC, Polak BCP, Dekker JM, Nijpels G. Distinct HbA1c trajectories in a type 2 diabetes cohort. Acta Diabetol 2015; 52:267-75. [PMID: 25287012 DOI: 10.1007/s00592-014-0633-8] [Citation(s) in RCA: 45] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 07/15/2014] [Indexed: 12/14/2022]
Abstract
AIMS The aim of this study was to identify subgroups of type 2 diabetes mellitus patients with distinct hemoglobin A1c (HbA1c) trajectories. Subgroup characteristics were determined and the prevalence of microvascular complications over time was investigated. STUDY DESIGN AND SETTING Data from a cohort of 5,423 type 2 diabetes patients from a managed primary care system were used [mean follow-up 5.7 years (range 2-9 years)]. Latent class growth modeling was used to identify subgroups of patients with distinct HbA1c trajectories. Multinomial logistic regression analyses were conducted to determine which characteristics were associated with different classes. RESULTS Four subgroups were identified. The first and largest subgroup (83 %) maintained good glycemic control over time (HbA1c ≤53 mmol/mol), the second subgroup (8 %) initially showed severe hyperglycemia, but reached the recommended HbA1c target within 2 years. Patients within this subgroup had significantly higher baseline HbA1c levels but were otherwise similar to the good glycemic control group. The third subgroup (5 %) showed hyperglycemia and a delayed response without reaching the recommended HbA1c target. The fourth subgroup (3.0 %) showed deteriorating hyperglycemia over time. Patients within the last two subgroups were significantly younger, had higher HbA1c levels and a longer diabetes duration at baseline. These subgroups also showed a higher prevalence of retinopathy and microalbuminuria. CONCLUSION Four subgroups with distinct HbA1c trajectories were identified. More than 90 % reached and maintained good glycemic control (subgroup one and two). Patients within the two subgroups that showed a more unfavorable course of glycemic control were younger, had higher HbA1c levels and a longer diabetes duration at baseline.
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Affiliation(s)
- Iris Walraven
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands,
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43
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Pilz S, Gaksch M, Kienreich K, Grübler M, Verheyen N, Fahrleitner-Pammer A, Treiber G, Drechsler C, Ó Hartaigh B, Obermayer-Pietsch B, Schwetz V, Aberer F, Mader J, Scharnagl H, Meinitzer A, Lerchbaum E, Dekker JM, Zittermann A, März W, Tomaschitz A. Effects of vitamin D on blood pressure and cardiovascular risk factors: a randomized controlled trial. Hypertension 2015; 65:1195-201. [PMID: 25801871 DOI: 10.1161/hypertensionaha.115.05319] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/08/2015] [Indexed: 01/13/2023]
Abstract
UNLABELLED Vitamin D deficiency is a risk factor for arterial hypertension, but randomized controlled trials showed mixed effects of vitamin D supplementation on blood pressure (BP). We aimed to evaluate whether vitamin D supplementation affects 24-hour systolic ambulatory BP monitoring values and cardiovascular risk factors. The Styrian Vitamin D Hypertension Trial is a single-center, double-blind, placebo-controlled study conducted from June 2011 to August 2014 at the endocrine outpatient clinic of the Medical University of Graz, Austria. We enrolled 200 study participants with arterial hypertension and 25-hydroxyvitamin D levels below 30 ng/mL. Study participants were randomized to receive either 2800 IU of vitamin D3 per day as oily drops (n=100) or placebo (n=100) for 8 weeks. Primary outcome measure was 24-hour systolic BP. Secondary outcome measures were 24-hour diastolic BP, N-terminal-pro-B-type natriuretic peptide, QTc interval, renin, aldosterone, 24-hour urinary albumin excretion, homeostasis model assessment-insulin resistance, triglycerides, high-density lipoprotein cholesterol, and pulse wave velocity. A total of 188 participants (mean [SD] age, 60.1 [11.3] years; 47% women; 25-hydroxyvitamin D, 21.2 [5.6] ng/mL) completed the trial. The mean treatment effect (95% confidence interval) for 24-hour systolic BP was -0.4 (-2.8 to 1.9) mm Hg (P=0.712). Triglycerides increased significantly (mean change [95% confidence interval], 17 [1-33] mg/dL; P=0.013), but no further significant effects were observed for secondary outcomes. Vitamin D supplementation in hypertensive patients with low 25-hydroxyvitamin D has no significant effect on BP and several cardiovascular risk factors, but it was associated with a significant increase in triglycerides. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT02136771.
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Affiliation(s)
- Stefan Pilz
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.).
| | - Martin Gaksch
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Katharina Kienreich
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Martin Grübler
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Nicolas Verheyen
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Astrid Fahrleitner-Pammer
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Gerlies Treiber
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Christiane Drechsler
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Bríain Ó Hartaigh
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Barbara Obermayer-Pietsch
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Verena Schwetz
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Felix Aberer
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Julia Mader
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Hubert Scharnagl
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Andreas Meinitzer
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Elisabeth Lerchbaum
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Jacqueline M Dekker
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Armin Zittermann
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Winfried März
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
| | - Andreas Tomaschitz
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.)
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Pilz S, Rutters F, Nijpels G, Stehouwer CDA, Højlund K, Nolan JJ, Balkau B, Dekker JM. Response to Comment on Pilz et al. Insulin sensitivity and albuminuria: the RISC study. Diabetes Care 2014;37:1597-1603. Diabetes Care 2015; 38:e31. [PMID: 25614703 DOI: 10.2337/dc14-2671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Stefan Pilz
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Giel Nijpels
- Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Kurt Højlund
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | | | - Beverley Balkau
- INSERM, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease over the Lifecourse and Determinants of Early Nutrition, Villejuif, France University of Paris-Sud 11, Villejuif, France
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
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Dekker JM. [Sodium-glucose co-transporter 2 inhibitor for diabetes?]. Ned Tijdschr Geneeskd 2015; 159:A9861. [PMID: 26732223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Following initial expectations, raised by the results of the United Kingdom Prospective Diabetes Study, intervention studies aimed at tight glucose control did not reduce cardiovascular disease. The EMPA-REG OUTCOME, an empagliflozin intervention study in over 7,000 patients with type 2 diabetes mellitus and a history of cardiovascular disease, for the first time showed a rapid reduction in cardiovascular mortality. The diversity in global recruitment centres and level of glucose control during the intervention may limit the generalisability of these promising results in a high-risk population to generally well-controlled Dutch patients.
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Affiliation(s)
- Jacqueline M Dekker
- Vrije Universiteit medisch centrum, afd. Epidemiologie en Biostatistiek, Amsterdam
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Abstract
Stressful life events are associated with the metabolic syndrome in cross-sectional studies, but prospective studies addressing this issue are rare and limited. We therefore evaluated whether the number of stressful life events is associated with incident metabolic syndrome. We assessed the association between the number of stressful life events experienced in the 5 years up until baseline and incident metabolic syndrome after 6.5 years at follow-up in the Hoorn study, a middle-aged and elderly population-based cohort. Participants with prevalent metabolic syndrome at baseline were excluded. Metabolic syndrome was defined according to the Adult Treatment Panel III, including fasting plasma glucose levels, HDL-C levels, triglyceride levels, waist circumference and hypertension. We included 1099 participants (47% male; age 60 ± 7 years). During 6.5 years of follow-up, 238 participants (22%) developed the metabolic syndrome. Logistic regression adjusted for age, sex, education level and follow-up duration showed a positive association between the number of stressful life events at baseline and incident metabolic syndrome [OR 1.13 (1.01-1.27) per event, p = 0.049]. In addition, a Poisson model showed a significant positive association between the number of stressful life events at baseline and the number of metabolic syndrome factors at follow-up [OR 1.05 (1.01-1.11) per event, p = 0.018]. Finally, we observed a significant association between the number of stressful life events at baseline and waist circumference at follow-up [adjusted for confounders β 0.86 (0.39-1.34) cm per event, p < 0.001]. Overall, we concluded that persons who reported more stressful life events at baseline had a significantly increased risk for developing metabolic syndrome during 6.5 years of follow-up, in a middle-aged and elderly population-based cohort.
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Affiliation(s)
- Femke Rutters
- a Department of Epidemiology and Biostatistics
- b EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands
| | - Stefan Pilz
- c Department of Internal Medicine, Division of Endocrinology and Metabolism , Medical University of Graz , Graz , Austria
| | - Anitra D M Koopman
- a Department of Epidemiology and Biostatistics
- b EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands
| | - Simone P Rauh
- a Department of Epidemiology and Biostatistics
- b EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands
| | - Frans Pouwer
- d Centre of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University , Tilburg , the Netherlands
| | - Coen D A Stehouwer
- e Department of Internal Medicine and Cardiovascular Research Institute (CARIM) , Maastricht University Medical Centre , Maastricht , the Netherlands , and
| | - Petra J Elders
- b EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands
- f Department of General Practice , VU University Medical Centre , Amsterdam , the Netherlands
| | - Giel Nijpels
- b EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands
- f Department of General Practice , VU University Medical Centre , Amsterdam , the Netherlands
| | - Jacqueline M Dekker
- a Department of Epidemiology and Biostatistics
- b EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands
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van Sloten TT, Henry RMA, Dekker JM, Nijpels G, Unger T, Schram MT, Stehouwer CDA. Endothelial Dysfunction Plays a Key Role in Increasing Cardiovascular Risk in Type 2 Diabetes. Hypertension 2014; 64:1299-305. [DOI: 10.1161/hypertensionaha.114.04221] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thomas T. van Sloten
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Ronald M. A. Henry
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Jacqueline M. Dekker
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Giel Nijpels
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Thomas Unger
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Miranda T. Schram
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
| | - Coen D. A. Stehouwer
- From the Department of Medicine (T.T.v.S., R.M.A.H., M.T.S., C.D.A.S.), Cardiovascular Research Institute Maastricht (T.T.v.S., R.M.A.H., T.U., M.T.S., C.D.A.S.), and School for Nutrition, Toxicology and Metabolism (T.T.v.S.), Maastricht University Medical Centre, Maastricht, the Netherlands; and EMGO Institute for Health and Care Research (J.M.D., G.N.) and Department of Epidemiology and Biostatistics (J.M.D.), VU University Medical Centre, Amsterdam, the Netherlands
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Scott RA, Fall T, Pasko D, Barker A, Sharp SJ, Arriola L, Balkau B, Barricarte A, Barroso I, Boeing H, Clavel-Chapelon F, Crowe FL, Dekker JM, Fagherazzi G, Ferrannini E, Forouhi NG, Franks PW, Gavrila D, Giedraitis V, Grioni S, Groop LC, Kaaks R, Key TJ, Kühn T, Lotta LA, Nilsson PM, Overvad K, Palli D, Panico S, Quirós JR, Rolandsson O, Roswall N, Sacerdote C, Sala N, Sánchez MJ, Schulze MB, Siddiq A, Slimani N, Sluijs I, Spijkerman AM, Tjonneland A, Tumino R, van der A DL, Yaghootkar H, McCarthy MI, Semple RK, Riboli E, Walker M, Ingelsson E, Frayling TM, Savage DB, Langenberg C, Wareham NJ. Common genetic variants highlight the role of insulin resistance and body fat distribution in type 2 diabetes, independent of obesity. Diabetes 2014; 63:4378-4387. [PMID: 24947364 PMCID: PMC4241116 DOI: 10.2337/db14-0319] [Citation(s) in RCA: 141] [Impact Index Per Article: 14.1] [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] [Indexed: 02/02/2023]
Abstract
We aimed to validate genetic variants as instruments for insulin resistance and secretion, to characterize their association with intermediate phenotypes, and to investigate their role in type 2 diabetes (T2D) risk among normal-weight, overweight, and obese individuals. We investigated the association of genetic scores with euglycemic-hyperinsulinemic clamp- and oral glucose tolerance test-based measures of insulin resistance and secretion and a range of metabolic measures in up to 18,565 individuals. We also studied their association with T2D risk among normal-weight, overweight, and obese individuals in up to 8,124 incident T2D cases. The insulin resistance score was associated with lower insulin sensitivity measured by M/I value (β in SDs per allele [95% CI], -0.03 [-0.04, -0.01]; P = 0.004). This score was associated with lower BMI (-0.01 [-0.01, -0.0]; P = 0.02) and gluteofemoral fat mass (-0.03 [-0.05, -0.02; P = 1.4 × 10(-6)) and with higher alanine transaminase (0.02 [0.01, 0.03]; P = 0.002) and γ-glutamyl transferase (0.02 [0.01, 0.03]; P = 0.001). While the secretion score had a stronger association with T2D in leaner individuals (Pinteraction = 0.001), we saw no difference in the association of the insulin resistance score with T2D among BMI or waist strata (Pinteraction > 0.31). While insulin resistance is often considered secondary to obesity, the association of the insulin resistance score with lower BMI and adiposity and with incident T2D even among individuals of normal weight highlights the role of insulin resistance and ectopic fat distribution in T2D, independently of body size.
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Affiliation(s)
- Robert A Scott
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Dorota Pasko
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - Adam Barker
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Larraitz Arriola
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Instituto BIO-Donostia, Basque Government, San Sebastian, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Beverley Balkau
- Inserm, CESP, U1018, Villejuif, France
- Univ Paris-Sud, UMRS 1018, Villejuif, France
| | - Aurelio Barricarte
- Navarre Public Health Institute (ISPN), Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Inês Barroso
- The Wellcome Trust Sanger Institute, Cambridge, United Kingdom
- University of Cambridge Metabolic Research Laboratories, Cambridge, UK
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
| | | | | | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, VrijeUniversiteit Medical Center, Amsterdam, The Netherlands
| | - Guy Fagherazzi
- Inserm, CESP, U1018, Villejuif, France
- Univ Paris-Sud, UMRS 1018, Villejuif, France
| | - Ele Ferrannini
- Department of Internal Medicine, University of Pisa, Pisa, Italy
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Paul W Franks
- Lund University, Malmö, Sweden
- Umeå University, Umeå, Sweden
| | - Diana Gavrila
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University Sweden
| | - Sara Grioni
- Epidemiology and Prevention Unit, Milan, Italy
| | - Leif C Groop
- University Hospital Scania, Malmö, Sweden
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Rudolf Kaaks
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | | | - Tilman Kühn
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Luca A Lotta
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Kim Overvad
- Department of Public Health, Section for Epidemiology, 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, Naples, Italy
| | | | | | - Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - 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
| | - Núria Sala
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, and Translational Research Laboratory, Catalan Institute of Oncology (IDIBELL), Barcelona, Spain
| | - María-José Sánchez
- Andalusian School of Public Health, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada (Spain)
| | | | - Afshan Siddiq
- School of Public Health, Imperial College London, UK
| | - Nadia Slimani
- International Agency for Research on Cancer, Lyon, France
| | - Ivonne Sluijs
- University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | | | - Daphne L van der A
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Hanieh Yaghootkar
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - Mark I McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Robert K Semple
- University of Cambridge Metabolic Research Laboratories, Cambridge, UK
| | - Elio Riboli
- School of Public Health, Imperial College London, UK
| | - Mark Walker
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Tim M Frayling
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - David B Savage
- University of Cambridge Metabolic Research Laboratories, Cambridge, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Rutte A, van Splunter MMI, van der Heijden AAWA, Welschen LMC, Elders PJM, Dekker JM, Snoek FJ, Enzlin P, Nijpels G. Prevalence and Correlates of Sexual Dysfunction in Men and Women With Type 2 Diabetes. J Sex Marital Ther 2014; 41:680-690. [PMID: 25256659 DOI: 10.1080/0092623x.2014.966399] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study aimed to assess the prevalence and correlates of sexual dysfunction in a sample of Dutch men and women with type 2 diabetes. Patients with type 2 diabetes who were between the ages of 40 and 75 years from 4 Dutch diabetes centers were asked to complete self-report questionnaires covering sociodemographic characteristics, medical characteristics, clinical depression (Center for Epidemiological Studies), and sexual dysfunction (in men: International Index of Erectile Function; in women: Female Sexual Function Index). In total, 158 type 2 diabetes patients (68% men) completed the cross-sectional survey. On the basis of predefined criteria, 69% of men and 70% of women were classified with some degree of sexual dysfunction. Univariable logistic regression analyses revealed that sexual dysfunctions were associated with higher age, clinical depression (Center for Epidemiological Studies score ≥16), and one or more diabetes-related complications in both men and women. Multivariable logistic regression analyses revealed that clinical depression was most strongly associated with both male (OR = 6.87, 95% CI [1.77, 26.63]) and female (OR = 9.33, 95% CI [1.03, 84.87]) sexual dysfunction. In conclusion, sexual dysfunction is highly prevalent in men and women with type 2 diabetes and is associated with higher age, clinical depression, and diabetes-related complications. These results suggest that addressing sexual dysfunction in diabetes care is important.
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Affiliation(s)
- Anne Rutte
- a Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research VU University Medical Center , Amsterdam , The Netherlands
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Walraven I, van den Hurk K, van 't Riet E, Kamp O, Schalkwijk CG, Stehouwer CDA, Paulus WJ, Moll AC, Dekker JM, Polak BCP, Nijpels G. Low-grade inflammation and endothelial dysfunction explain the association between retinopathy and left ventricular ejection fraction in men: an 8-year follow-up of the Hoorn Study. J Diabetes Complications 2014; 28:819-23. [PMID: 25044234 DOI: 10.1016/j.jdiacomp.2014.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 05/08/2014] [Revised: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this study was to prospectively investigate the association of retinopathy with changes in left ventricular (LV) function. METHODS Within the Hoorn Study, a population-based cohort study of diabetes in The Netherlands, retinal photography and echocardiography were performed in the year 2000 (baseline) and 2008 (follow-up). Retinopathy was graded according to the Eurodiab classification and further defined as absent or present retinopathy. LV systolic and diastolic functions were assessed by LV ejection fraction (%), LV mass (g/m(2.7)) and left atrial (LA) volume indices and the ratio of LV inflow (E) and early diastolic lengthening (e') velocities. Linear regression analyses stratified for sex were completed to investigate associations of retinopathy with changes in LV function in participants with impaired glucose metabolism and type 2 diabetes. RESULTS One hundred forty-seven participants (58% men, mean age 66) were included in the study, of whom 13.6% were present with retinopathy at baseline. LV ejection fraction was similar among participants with and without retinopathy (60.2% versus 60.7%) at baseline. Eight years later, retinopathy was significantly associated with a lower LV ejection fraction (β -8.0 95% CI -15.37 to -0.68) in men, independent of risk factors. Microvascular endothelial dysfunction ([ED] β -4.87 95% CI -13.40 to 3.67) and low-grade inflammation ([LGI] β -5.30 95% CI -13.72 to 3.12) both diminished the association. No significant associations between retinopathy and other LV function parameters were observed. CONCLUSION Retinopathy was significantly associated with a lower LV ejection fraction in men but not in women. LGI and ED might explain the observed association.
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Affiliation(s)
- Iris Walraven
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Katja van den Hurk
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; Sanquin Research, Department of Donor Studies, Amsterdam, The Netherlands
| | - Esther van 't Riet
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Otto Kamp
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Walter J Paulus
- Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Annette C Moll
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands
| | - Bettine C P Polak
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands
| | - Giel Nijpels
- EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands; Department of General Practice, VU University Medical Center, Amsterdam, The Netherlands
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