9 results on '"De Masi, Federico"'
Search Results
2. The role of physical activity in metabolic homeostasis before and after the onset of type 2 diabetes: an IMI DIRECT study
- Author
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Koivula, Robert W, Atabaki-Pasdar, Naeimeh, Giordano, Giuseppe N, White, Tom, Adamski, Jerzy, Bell, Jimmy D, Beulens, Joline, Brage, Søren, Brunak, Søren, De Masi, Federico, Dermitzakis, Emmanouil T, Forgie, Ian M, Frost, Gary, Hansen, Torben, Hansen, Tue H, Hattersley, Andrew, Kokkola, Tarja, Kurbasic, Azra, Laakso, Markku, Mari, Andrea, McDonald, Timothy J, Pedersen, Oluf, Rutters, Femke, Schwenk, Jochen M, Teare, Harriet JA, Thomas, E Louise, Vinuela, Ana, Mahajan, Anubha, McCarthy, Mark I, Ruetten, Hartmut, Walker, Mark, Pearson, Ewan, Pavo, Imre, Franks, Paul W, IMI DIRECT Consortium, Koivula, Robert W [0000-0002-1646-4163], and Apollo - University of Cambridge Repository
- Subjects
Blood Glucose ,Male ,Denmark ,Glycemic Control ,Ectopic fat ,Cohort Studies ,Glycaemic control ,Homeostasis ,Humans ,Exercise ,Finland ,Aged ,Netherlands ,Sweden ,Physical activity ,Beta cell function ,Type 2 diabetes ,Glucose Tolerance Test ,Middle Aged ,Insulin sensitivity ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Structural equation modelling ,Female ,Insulin Resistance ,Energy Metabolism ,Prediabetes - Abstract
AIMS/HYPOTHESIS: It is well established that physical activity, abdominal ectopic fat and glycaemic regulation are related but the underlying structure of these relationships is unclear. The previously proposed twin-cycle hypothesis (TC) provides a mechanistic basis for impairment in glycaemic control through the interactions of substrate availability, substrate metabolism and abdominal ectopic fat accumulation. Here, we hypothesise that the effect of physical activity in glucose regulation is mediated by the twin-cycle. We aimed to examine this notion in the Innovative Medicines Initiative Diabetes Research on Patient Stratification (IMI DIRECT) Consortium cohorts comprised of participants with normal or impaired glucose regulation (cohort 1: N ≤ 920) or with recently diagnosed type 2 diabetes (cohort 2: N ≤ 435). METHODS: We defined a structural equation model that describes the TC and fitted this within the IMI DIRECT dataset. A second model, twin-cycle plus physical activity (TC-PA), to assess the extent to which the effects of physical activity in glycaemic regulation are mediated by components in the twin-cycle, was also fitted. Beta cell function, insulin sensitivity and glycaemic control were modelled from frequently sampled 75 g OGTTs (fsOGTTs) and mixed-meal tolerance tests (MMTTs) in participants without and with diabetes, respectively. Abdominal fat distribution was assessed using MRI, and physical activity through wrist-worn triaxial accelerometry. Results are presented as standardised beta coefficients, SE and p values, respectively. RESULTS: The TC and TC-PA models showed better fit than null models (TC: χ2 = 242, p = 0.004 and χ2 = 63, p = 0.001 in cohort 1 and 2, respectively; TC-PA: χ2 = 180, p = 0.041 and χ2 = 60, p = 0.008 in cohort 1 and 2, respectively). The association of physical activity with glycaemic control was primarily mediated by variables in the liver fat cycle. CONCLUSIONS/INTERPRETATION: These analyses partially support the mechanisms proposed in the twin-cycle model and highlight mechanistic pathways through which insulin sensitivity and liver fat mediate the association between physical activity and glycaemic control.
- Published
- 2020
3. Profiles of Glucose Metabolism in Different Prediabetes Phenotypes, Classified by Fasting Glycemia, 2-Hour OGTT, Glycated Hemoglobin, and 1-Hour OGTT: An IMI DIRECT Study.
- Author
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Tura, Andrea, Grespan, Eleonora, Göbl, Christian S., Koivula, Robert W., Franks, Paul W., Pearson, Ewan R., Walker, Mark, Forgie, Ian M., Giordano, Giuseppe N., Pavo, Imre, Ruetten, Hartmut, Dermitzakis, Emmanouil T., McCarthy, Mark I., Pedersen, Oluf, Schwenk, Jochen M., Adamski, Jerzy, De Masi, Federico, Tsirigos, Konstantinos D., Brunak, Søren, and Viñuela, Ana
- Subjects
GLYCOSYLATED hemoglobin ,GLUCOSE metabolism ,INSULIN sensitivity ,PREDIABETIC state ,TYPE 2 diabetes - Abstract
Differences in glucose metabolism among categories of prediabetes have not been systematically investigated. In this longitudinal study, participants (N = 2,111) underwent a 2-h 75-g oral glucose tolerance test (OGTT) at baseline and 48 months. HbA1c was also measured. We classified participants as having isolated prediabetes defect (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], or HbA1c indicative of prediabetes [IA1c]), two defects (IFG+IGT, IFG+IA1c, or IGT+IA1c), or all defects (IFG+IGT+IA1c). β-Cell function (BCF) and insulin sensitivity were assessed from OGTT. At baseline, in pooling of participants with isolated defects, they showed impairment in both BCF and insulin sensitivity compared with healthy control subjects. Pooled groups with two or three defects showed progressive further deterioration. Among groups with isolated defect, those with IGT showed lower insulin sensitivity, insulin secretion at reference glucose (ISRr), and insulin secretion potentiation (P < 0.002). Conversely, those with IA1c showed higher insulin sensitivity and ISRr (P < 0.0001). Among groups with two defects, we similarly found differences in both BCF and insulin sensitivity. At 48 months, we found higher type 2 diabetes incidence for progressively increasing number of prediabetes defects (odds ratio >2, P < 0.008). In conclusion, the prediabetes groups showed differences in type/degree of glucometabolic impairment. Compared with the pooled group with isolated defects, those with double or triple defect showed progressive differences in diabetes incidence. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
4. The role of physical activity in metabolic homeostasis before and after the onset of type 2 diabetes: an IMI DIRECT study.
- Author
-
Koivula, Robert W., Atabaki-Pasdar, Naeimeh, Giordano, Giuseppe N., White, Tom, Adamski, Jerzy, Bell, Jimmy D., Beulens, Joline, Brage, Søren, Brunak, Søren, De Masi, Federico, Dermitzakis, Emmanouil T., Forgie, Ian M., Frost, Gary, Hansen, Torben, Hansen, Tue H., Hattersley, Andrew, Kokkola, Tarja, Kurbasic, Azra, Laakso, Markku, and Mari, Andrea
- Abstract
Aims/hypothesis: It is well established that physical activity, abdominal ectopic fat and glycaemic regulation are related but the underlying structure of these relationships is unclear. The previously proposed twin-cycle hypothesis (TC) provides a mechanistic basis for impairment in glycaemic control through the interactions of substrate availability, substrate metabolism and abdominal ectopic fat accumulation. Here, we hypothesise that the effect of physical activity in glucose regulation is mediated by the twin-cycle. We aimed to examine this notion in the Innovative Medicines Initiative Diabetes Research on Patient Stratification (IMI DIRECT) Consortium cohorts comprised of participants with normal or impaired glucose regulation (cohort 1: N ≤ 920) or with recently diagnosed type 2 diabetes (cohort 2: N ≤ 435). Methods: We defined a structural equation model that describes the TC and fitted this within the IMI DIRECT dataset. A second model, twin-cycle plus physical activity (TC-PA), to assess the extent to which the effects of physical activity in glycaemic regulation are mediated by components in the twin-cycle, was also fitted. Beta cell function, insulin sensitivity and glycaemic control were modelled from frequently sampled 75 g OGTTs (fsOGTTs) and mixed-meal tolerance tests (MMTTs) in participants without and with diabetes, respectively. Abdominal fat distribution was assessed using MRI, and physical activity through wrist-worn triaxial accelerometry. Results are presented as standardised beta coefficients, SE and p values, respectively. Results: The TC and TC-PA models showed better fit than null models (TC: χ
2 = 242, p = 0.004 and χ2 = 63, p = 0.001 in cohort 1 and 2, respectively; TC-PA: χ2 = 180, p = 0.041 and χ2 = 60, p = 0.008 in cohort 1 and 2, respectively). The association of physical activity with glycaemic control was primarily mediated by variables in the liver fat cycle. Conclusions/interpretation: These analyses partially support the mechanisms proposed in the twin-cycle model and highlight mechanistic pathways through which insulin sensitivity and liver fat mediate the association between physical activity and glycaemic control. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
5. Discovery of biomarkers for glycaemic deterioration before and after the onset of type 2 diabetes: descriptive characteristics of the epidemiological studies within the IMI DIRECT Consortium
- Author
-
Koivula, Robert W, Forgie, Ian M, Kurbasic, Azra, Viñuela, Ana, Heggie, Alison, Giordano, Giuseppe N, Hansen, Tue H, Hudson, Michelle, Koopman, Anitra DM, Rutters, Femke, Siloaho, Maritta, Allin, Kristine H, Brage, Søren, Brorsson, Caroline A, Dawed, Adem Y, De Masi, Federico, Groves, Christopher J, Kokkola, Tarja, Mahajan, Anubha, Perry, Mandy H, Rauh, Simone P, Ridderstråle, Martin, Teare, Harriet JA, Thomas, E Louise, Tura, Andrea, Vestergaard, Henrik, White, Tom, Adamski, Jerzy, Bell, Jimmy D, Beulens, Joline W, Brunak, Søren, Dermitzakis, Emmanouil T, Froguel, Philippe, Frost, Gary, Gupta, Ramneek, Hansen, Torben, Hattersley, Andrew, Jablonka, Bernd, Kaye, Jane, Laakso, Markku, McDonald, Timothy J, Pedersen, Oluf, Schwenk, Jochen M, Pavo, Imre, Mari, Andrea, McCarthy, Mark I, Ruetten, Hartmut, Walker, Mark, Pearson, Ewan, Franks, Paul W, and IMI DIRECT Consortium
- Subjects
Blood Glucose ,Male ,Genome ,Physical activity ,Insulin secretion ,Type 2 diabetes ,Glucose Tolerance Test ,Middle Aged ,Insulin sensitivity ,Ectopic fat ,Metformin ,3. Good health ,Diet ,Cohort Studies ,Prediabetic State ,Glucose ,Diabetes Mellitus, Type 2 ,Glycaemic control ,Humans ,Personalised medicine ,Female ,Prospective Studies ,Prediabetes ,Biomarkers ,Aged - Abstract
AIMS/HYPOTHESIS: Here, we describe the characteristics of the Innovative Medicines Initiative (IMI) Diabetes Research on Patient Stratification (DIRECT) epidemiological cohorts at baseline and follow-up examinations (18, 36 and 48 months of follow-up). METHODS: From a sampling frame of 24,682 adults of European ancestry enrolled in population-based cohorts across Europe, participants at varying risk of glycaemic deterioration were identified using a risk prediction algorithm (based on age, BMI, waist circumference, use of antihypertensive medication, smoking status and parental history of type 2 diabetes) and enrolled into a prospective cohort study (n = 2127) (cohort 1, prediabetes risk). We also recruited people from clinical registries with type 2 diabetes diagnosed 6-24 months previously (n = 789) into a second cohort study (cohort 2, diabetes). Follow-up examinations took place at ~18 months (both cohorts) and at ~48 months (cohort 1) or ~36 months (cohort 2) after baseline examinations. The cohorts were studied in parallel using matched protocols across seven clinical centres in northern Europe. RESULTS: Using ADA 2011 glycaemic categories, 33% (n = 693) of cohort 1 (prediabetes risk) had normal glucose regulation and 67% (n = 1419) had impaired glucose regulation. Seventy-six per cent of participants in cohort 1 was male. Cohort 1 participants had the following characteristics (mean ± SD) at baseline: age 62 (6.2) years; BMI 27.9 (4.0) kg/m2; fasting glucose 5.7 (0.6) mmol/l; 2 h glucose 5.9 (1.6) mmol/l. At the final follow-up examination the participants' clinical characteristics were as follows: fasting glucose 6.0 (0.6) mmol/l; 2 h OGTT glucose 6.5 (2.0) mmol/l. In cohort 2 (diabetes), 66% (n = 517) were treated by lifestyle modification and 34% (n = 272) were treated with metformin plus lifestyle modification at enrolment. Fifty-eight per cent of participants in cohort 2 was male. Cohort 2 participants had the following characteristics at baseline: age 62 (8.1) years; BMI 30.5 (5.0) kg/m2; fasting glucose 7.2 (1.4) mmol/l; 2 h glucose 8.6 (2.8) mmol/l. At the final follow-up examination, the participants' clinical characteristics were as follows: fasting glucose 7.9 (2.0) mmol/l; 2 h mixed-meal tolerance test glucose 9.9 (3.4) mmol/l. CONCLUSIONS/INTERPRETATION: The IMI DIRECT cohorts are intensely characterised, with a wide-variety of metabolically relevant measures assessed prospectively. We anticipate that the cohorts, made available through managed access, will provide a powerful resource for biomarker discovery, multivariate aetiological analyses and reclassification of patients for the prevention and treatment of type 2 diabetes.
6. The role of physical activity in metabolic homeostasis before and after the onset of type 2 diabetes: an IMI DIRECT study
- Author
-
Koivula, Robert W, Atabaki-Pasdar, Naeimeh, Giordano, Giuseppe N, White, Tom, Adamski, Jerzy, Bell, Jimmy D, Beulens, Joline, Brage, Søren, Brunak, Søren, De Masi, Federico, Dermitzakis, Emmanouil T, Forgie, Ian M, Frost, Gary, Hansen, Torben, Hansen, Tue H, Hattersley, Andrew, Kokkola, Tarja, Kurbasic, Azra, Laakso, Markku, Mari, Andrea, McDonald, Timothy J, Pedersen, Oluf, Rutters, Femke, Schwenk, Jochen M, Teare, Harriet JA, Thomas, E Louise, Vinuela, Ana, Mahajan, Anubha, McCarthy, Mark I, Ruetten, Hartmut, Walker, Mark, Pearson, Ewan, Pavo, Imre, Franks, Paul W, and IMI DIRECT Consortium
- Subjects
Blood Glucose ,Male ,Denmark ,Glycemic Control ,Ectopic fat ,Cohort Studies ,Glycaemic control ,Homeostasis ,Humans ,Exercise ,Finland ,Aged ,Netherlands ,Sweden ,Physical activity ,Beta cell function ,Type 2 diabetes ,Glucose Tolerance Test ,Middle Aged ,Insulin sensitivity ,3. Good health ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Structural equation modelling ,Female ,Insulin Resistance ,Energy Metabolism ,Prediabetes - Abstract
AIMS/HYPOTHESIS: It is well established that physical activity, abdominal ectopic fat and glycaemic regulation are related but the underlying structure of these relationships is unclear. The previously proposed twin-cycle hypothesis (TC) provides a mechanistic basis for impairment in glycaemic control through the interactions of substrate availability, substrate metabolism and abdominal ectopic fat accumulation. Here, we hypothesise that the effect of physical activity in glucose regulation is mediated by the twin-cycle. We aimed to examine this notion in the Innovative Medicines Initiative Diabetes Research on Patient Stratification (IMI DIRECT) Consortium cohorts comprised of participants with normal or impaired glucose regulation (cohort 1: N ≤ 920) or with recently diagnosed type 2 diabetes (cohort 2: N ≤ 435). METHODS: We defined a structural equation model that describes the TC and fitted this within the IMI DIRECT dataset. A second model, twin-cycle plus physical activity (TC-PA), to assess the extent to which the effects of physical activity in glycaemic regulation are mediated by components in the twin-cycle, was also fitted. Beta cell function, insulin sensitivity and glycaemic control were modelled from frequently sampled 75 g OGTTs (fsOGTTs) and mixed-meal tolerance tests (MMTTs) in participants without and with diabetes, respectively. Abdominal fat distribution was assessed using MRI, and physical activity through wrist-worn triaxial accelerometry. Results are presented as standardised beta coefficients, SE and p values, respectively. RESULTS: The TC and TC-PA models showed better fit than null models (TC: χ2 = 242, p = 0.004 and χ2 = 63, p = 0.001 in cohort 1 and 2, respectively; TC-PA: χ2 = 180, p = 0.041 and χ2 = 60, p = 0.008 in cohort 1 and 2, respectively). The association of physical activity with glycaemic control was primarily mediated by variables in the liver fat cycle. CONCLUSIONS/INTERPRETATION: These analyses partially support the mechanisms proposed in the twin-cycle model and highlight mechanistic pathways through which insulin sensitivity and liver fat mediate the association between physical activity and glycaemic control.
7. The role of physical activity in metabolic homeostasis before and after the onset of type 2 diabetes: an IMI DIRECT study
- Author
-
Koivula, Robert W., Atabaki-Pasdar, Naeimeh, Giordano, Giuseppe N., White, Tom, Adamski, Jerzy, Bell, Jimmy D., Beulens, Joline, Brage, Søren, Brunak, Søren, De Masi, Federico, Dermitzakis, Emmanouil T., Forgie, Ian M., Frost, Gary, Hansen, Torben, Hansen, Tue H., Hattersley, Andrew, Kokkola, Tarja, Kurbasic, Azra, Laakso, Markku, Mari, Andrea, McDonald, Timothy J., Pedersen, Oluf, Rutters, Femke, Schwenk, Jochen M., Teare, Harriet J. A., Thomas, E. Louise, Vinuela, Ana, Mahajan, Anubha, McCarthy, Mark I., Ruetten, Hartmut, Walker, Mark, Pearson, Ewan, Pavo, Imre, and Franks, Paul W.
- Subjects
Physical activity ,Structural equation modelling ,Glycaemic control ,Beta cell function ,Type 2 diabetes ,16. Peace & justice ,Insulin sensitivity ,Prediabetes ,Article ,Ectopic fat ,3. Good health - Abstract
Aims/hypothesis: It is well established that physical activity, abdominal ectopic fat and glycaemic regulation are related but the underlying structure of these relationships is unclear. The previously proposed twin-cycle hypothesis (TC) provides a mechanistic basis for impairment in glycaemic control through the interactions of substrate availability, substrate metabolism and abdominal ectopic fat accumulation. Here, we hypothesise that the effect of physical activity in glucose regulation is mediated by the twin-cycle. We aimed to examine this notion in the Innovative Medicines Initiative Diabetes Research on Patient Stratification (IMI DIRECT) Consortium cohorts comprised of participants with normal or impaired glucose regulation (cohort 1: N ≤ 920) or with recently diagnosed type 2 diabetes (cohort 2: N ≤ 435). Methods: We defined a structural equation model that describes the TC and fitted this within the IMI DIRECT dataset. A second model, twin-cycle plus physical activity (TC-PA), to assess the extent to which the effects of physical activity in glycaemic regulation are mediated by components in the twin-cycle, was also fitted. Beta cell function, insulin sensitivity and glycaemic control were modelled from frequently sampled 75 g OGTTs (fsOGTTs) and mixed-meal tolerance tests (MMTTs) in participants without and with diabetes, respectively. Abdominal fat distribution was assessed using MRI, and physical activity through wrist-worn triaxial accelerometry. Results are presented as standardised beta coefficients, SE and p values, respectively. Results: The TC and TC-PA models showed better fit than null models (TC: χ2 = 242, p = 0.004 and χ2 = 63, p = 0.001 in cohort 1 and 2, respectively; TC-PA: χ2 = 180, p = 0.041 and χ2 = 60, p = 0.008 in cohort 1 and 2, respectively). The association of physical activity with glycaemic control was primarily mediated by variables in the liver fat cycle. Conclusions/interpretation: These analyses partially support the mechanisms proposed in the twin-cycle model and highlight mechanistic pathways through which insulin sensitivity and liver fat mediate the association between physical activity and glycaemic control.
8. The role of physical activity in metabolic homeostasis before and after the onset of type 2 diabetes: an IMI DIRECT study
- Author
-
Koivula, Robert W., Atabaki-Pasdar, Naeimeh, Giordano, Giuseppe N., White, Tom, Adamski, Jerzy, Bell, Jimmy D., Beulens, Joline, Brage, Søren, Brunak, Søren, De Masi, Federico, Dermitzakis, Emmanouil T., Forgie, Ian M., Frost, Gary, Hansen, Torben, Hansen, Tue H., Hattersley, Andrew, Kokkola, Tarja, Kurbasic, Azra, Laakso, Markku, Mari, Andrea, McDonald, Timothy J., Pedersen, Oluf, Rutters, Femke, Schwenk, Jochen M., Teare, Harriet J. A., Thomas, E. Louise, Vinuela, Ana, Mahajan, Anubha, McCarthy, Mark I., Ruetten, Hartmut, Walker, Mark, Pearson, Ewan, Pavo, Imre, and Franks, Paul W.
- Subjects
Physical activity ,Structural equation modelling ,Glycaemic control ,Beta cell function ,Type 2 diabetes ,Insulin sensitivity ,Prediabetes ,Article ,Ectopic fat ,3. Good health - Abstract
Aims/hypothesis: It is well established that physical activity, abdominal ectopic fat and glycaemic regulation are related but the underlying structure of these relationships is unclear. The previously proposed twin-cycle hypothesis (TC) provides a mechanistic basis for impairment in glycaemic control through the interactions of substrate availability, substrate metabolism and abdominal ectopic fat accumulation. Here, we hypothesise that the effect of physical activity in glucose regulation is mediated by the twin-cycle. We aimed to examine this notion in the Innovative Medicines Initiative Diabetes Research on Patient Stratification (IMI DIRECT) Consortium cohorts comprised of participants with normal or impaired glucose regulation (cohort 1: N ≤ 920) or with recently diagnosed type 2 diabetes (cohort 2: N ≤ 435). Methods: We defined a structural equation model that describes the TC and fitted this within the IMI DIRECT dataset. A second model, twin-cycle plus physical activity (TC-PA), to assess the extent to which the effects of physical activity in glycaemic regulation are mediated by components in the twin-cycle, was also fitted. Beta cell function, insulin sensitivity and glycaemic control were modelled from frequently sampled 75 g OGTTs (fsOGTTs) and mixed-meal tolerance tests (MMTTs) in participants without and with diabetes, respectively. Abdominal fat distribution was assessed using MRI, and physical activity through wrist-worn triaxial accelerometry. Results are presented as standardised beta coefficients, SE and p values, respectively. Results: The TC and TC-PA models showed better fit than null models (TC: χ2 = 242, p = 0.004 and χ2 = 63, p = 0.001 in cohort 1 and 2, respectively; TC-PA: χ2 = 180, p = 0.041 and χ2 = 60, p = 0.008 in cohort 1 and 2, respectively). The association of physical activity with glycaemic control was primarily mediated by variables in the liver fat cycle. Conclusions/interpretation: These analyses partially support the mechanisms proposed in the twin-cycle model and highlight mechanistic pathways through which insulin sensitivity and liver fat mediate the association between physical activity and glycaemic control.
9. Discovery of biomarkers for glycaemic deterioration before and after the onset of type 2 diabetes: descriptive characteristics of the epidemiological studies within the IMI DIRECT Consortium
- Author
-
Koivula, Robert W., Forgie, Ian M., Kurbasic, Azra, Viñuela, Ana, Heggie, Alison, Giordano, Giuseppe N., Hansen, Tue H., Hudson, Michelle, Koopman, Anitra D. M., Rutters, Femke, Siloaho, Maritta, Allin, Kristine H., Brage, Søren, Brorsson, Caroline A., Dawed, Adem Y., De Masi, Federico, Groves, Christopher J., Kokkola, Tarja, Mahajan, Anubha, Perry, Mandy H., Rauh, Simone P., Ridderstråle, Martin, Teare, Harriet J. A., Thomas, E. Louise, Tura, Andrea, Vestergaard, Henrik, White, Tom, Adamski, Jerzy, Bell, Jimmy D., Beulens, Joline W., Brunak, Søren, Dermitzakis, Emmanouil T., Froguel, Philippe, Frost, Gary, Gupta, Ramneek, Hansen, Torben, Hattersley, Andrew, Jablonka, Bernd, Kaye, Jane, Laakso, Markku, McDonald, Timothy J., Pedersen, Oluf, Schwenk, Jochen M., Pavo, Imre, Mari, Andrea, McCarthy, Mark I., Ruetten, Hartmut, Walker, Mark, Pearson, Ewan, and Franks, Paul W.
- Subjects
Genome ,Physical activity ,Insulin secretion ,Glycaemic control ,Personalised medicine ,Type 2 diabetes ,16. Peace & justice ,Insulin sensitivity ,Prediabetes ,Article ,Ectopic fat ,3. Good health ,Diet - Abstract
Aims/hypothesis: Here, we describe the characteristics of the Innovative Medicines Initiative (IMI) Diabetes Research on Patient Stratification (DIRECT) epidemiological cohorts at baseline and follow-up examinations (18, 36 and 48 months of follow-up). Methods: From a sampling frame of 24,682 adults of European ancestry enrolled in population-based cohorts across Europe, participants at varying risk of glycaemic deterioration were identified using a risk prediction algorithm (based on age, BMI, waist circumference, use of antihypertensive medication, smoking status and parental history of type 2 diabetes) and enrolled into a prospective cohort study (n = 2127) (cohort 1, prediabetes risk). We also recruited people from clinical registries with type 2 diabetes diagnosed 6–24 months previously (n = 789) into a second cohort study (cohort 2, diabetes). Follow-up examinations took place at ~18 months (both cohorts) and at ~48 months (cohort 1) or ~36 months (cohort 2) after baseline examinations. The cohorts were studied in parallel using matched protocols across seven clinical centres in northern Europe. Results: Using ADA 2011 glycaemic categories, 33% (n = 693) of cohort 1 (prediabetes risk) had normal glucose regulation and 67% (n = 1419) had impaired glucose regulation. Seventy-six per cent of participants in cohort 1 was male. Cohort 1 participants had the following characteristics (mean ± SD) at baseline: age 62 (6.2) years; BMI 27.9 (4.0) kg/m2; fasting glucose 5.7 (0.6) mmol/l; 2 h glucose 5.9 (1.6) mmol/l. At the final follow-up examination the participants’ clinical characteristics were as follows: fasting glucose 6.0 (0.6) mmol/l; 2 h OGTT glucose 6.5 (2.0) mmol/l. In cohort 2 (diabetes), 66% (n = 517) were treated by lifestyle modification and 34% (n = 272) were treated with metformin plus lifestyle modification at enrolment. Fifty-eight per cent of participants in cohort 2 was male. Cohort 2 participants had the following characteristics at baseline: age 62 (8.1) years; BMI 30.5 (5.0) kg/m2; fasting glucose 7.2 (1.4) mmol/l; 2 h glucose 8.6 (2.8) mmol/l. At the final follow-up examination, the participants’ clinical characteristics were as follows: fasting glucose 7.9 (2.0) mmol/l; 2 h mixed-meal tolerance test glucose 9.9 (3.4) mmol/l. Conclusions/interpretation: The IMI DIRECT cohorts are intensely characterised, with a wide-variety of metabolically relevant measures assessed prospectively. We anticipate that the cohorts, made available through managed access, will provide a powerful resource for biomarker discovery, multivariate aetiological analyses and reclassification of patients for the prevention and treatment of type 2 diabetes.
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