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  • Zhu, Ruixin; Fogelholm, Mikael; Larsen, Thomas M.; Poppitt, Sally D.; Silvestre, Marta P.; Vestentoft, Pia S.; Jalo, Elli; Navas-Carretero, Santiago; Huttunen-Lenz, Maija; Taylor, Moira A.; Stratton, Gareth; Swindell, Nils; Kaartinen, Niina E.; Lam, Tony; Handjieva-Darlenska, Teodora; Handjiev, Svetoslav; Schlicht, Wolfgang; Martinez, J. Alfredo; Seimon, Radhika V.; Sainsbury, Amanda; Macdonald, Ian A.; Westerterp-Plantenga, Margriet S.; Brand-Miller, Jennie; Raben, Anne (2021)
    Background: Previous studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. Aim: To compare the long-term effects of two diets [high protein (HP)-low GI vs. moderate protein (MP)-moderate GI] and two PA programs [high intensity (HI) vs. moderate intensity (MI)] on subjective appetite sensations during WLM after >= 8% weight loss (WL). Methods: Data derived from the 3-years PREVIEW randomized intervention study. An 8-weeks WL phase using a low-energy diet was followed by a 148-weeks randomized WLM phase. For the WLM phase, participants were assigned to one of the four groups: HP-MI, HP-HI, MP-MI, and MP-HI. Available data from 2,223 participants with overweight or obesity (68% women; BMI >= 25 kg/m(2)). Appetite sensations including satiety, hunger, desire to eat, and desire to eat something sweet during the two phases (at 0, 8 weeks and 26, 52, 104, and 156 weeks) were assessed based on the recall of feelings during the previous week using visual analogue scales. Differences in changes in appetite sensations from baseline between the groups were determined using linear mixed models with repeated measures. Results: There was no significant diet x PA interaction. From 52 weeks onwards, decreases in hunger were significantly greater in HP-low GI than MP-moderate GI (P-time x diet = 0.018, P-dietgroup = 0.021). Although there was no difference in weight regain between the diet groups (P-time x diet = 0.630), hunger and satiety ratings correlated with changes in body weight at most timepoints. There were no significant differences in appetite sensations between the two PA groups. Decreases in hunger ratings were greater at 52 and 104 weeks in HP-HI vs. MP-HI, and greater at 104 and 156 weeks in HP-HI vs. MP-MI. Conclusions: This is the first long-term, large-scale randomized intervention to report that a HP-low GI diet was superior in preventing an increase in hunger, but not weight regain, during 3-years WLM compared with a MP-moderate GI diet. Similarly, HP-HI outperformed MP-HI in suppressing hunger. The role of exercise intensity requires further investigation.
  • Huvinen, Emilia; Tuomaala, Anna-Kaisa; Bergman, Paula H.; Meinilä, Jelena; Tammelin, Tuija; Kulmala, Janne; Engberg, Elina; Koivusalo, Saila B. (2021)
    Context: Early growth is associated with childhood adiposity, but the influence of lifestyle remains unknown. Objective: This work aimed to investigate the association of growth profiles from high-risk pregnancies with adiposity at age 5 years, taking into account lifestyle and several antenatal/postnatal exposures. Methods: This prospective cohort study included 609 children born during the Finnish Gestational Diabetes Prevention Study (RADIEL), recruiting women with body mass index (BMI) greater than or equal to 30 and/or prior gestational diabetes mellitus (GDM) (2008-2013). Altogether 332 children attended the 5-year follow-up (2014-2017). Main outcome measures included growth profiles based on ponderal index (PI = weight/height(3)), investigated using latent class mixed models. Adiposity was assessed with anthropometrics and body composition (InBody720). Results: We identified 3 growth profiles: ascending (n = 82), intermediate (n = 351), and descending (n = 149). Children with ascending growth had a higher body fat percentage, ISO-BMI, and waist circumference (P Conclusion: Accelerated early growth was associated with higher adiposity in 5-year-old children from high-risk pregnancies, even when adjusted for lifestyle. Reducing cesarean deliveries and promoting breastfeeding may be beneficial for postnatal growth.
  • Al-Ahmadi, Jawaher; Enani, Sumia; Bahijri, Suhad; Al-Raddadi, Rajaa; Jambi, Hanan; Eldakhakhny, Basmah; Borai, Anwar; Ajabnoor, Ghada; Tuomilehto, Jaakko (2022)
    Context: Waist circumference (WC) is used in screening for metabolic syndrome (MetS) based on its association with cardiometabolic risk.This might apply differently in ethnically different populations. Associations with other measures are also unclear. Objective: This work aimed to investigate the association between neck circumference (NC), WC, WC:hip circumference, WC:height (VVC:Ht), NC:Ht, fat percentage, body mass index (BMI), conicity index, abdominal volume index, and weight-adjusted waist index with nonanthropometric components of MetS in nondiabetic Saudi adults. Methods: This cross-sectional study took place in public health centers in Jeddah, comprising 1365 Saudi adults (772 men and 593 women) aged 18 years or older not previously diagnosed with diabetes. Main outcome measures included the presence of 2 or more nonanthropometric components of the MetS were used to define clinical metabolic abnormality (CMA). The predictive ability of studied anthropometric indices for CMA was determined using the area under receiver operating characteristics (AUC) curve and binary logistic regression. Results: A total of 157 men and 83 women had CMA. NC and NC:Ht had the highest predictive ability for CMA in men (odds ratio [OR](NC) = 1.79, P < .001 and ORNC:Ht = 1.68, P < .001; AUC(NC) = 0.69 [95% CI, 0.64-0.74] and ALS, = 0.69 [95% CI, 0.64-0.73]). In women, WC had the highest predictive ability ORWC = 1.81, P< .001; AUC(WC) = 0.75 [95% CI, 0.69-0.80]). Conclusion: Upper-body anthropometric indicators that were associated with subcutaneous fat had the highest predictive ability for CMA in men whereas abdominal obesity indictors had the best predictive ability in women, suggesting that fat distribution might contribute to CMA in a sex-specific manner.
  • Neuvonen, Elisa; Lehtisalo, Jenni; Ngandu, Tiia; Levälahti, Esko; Antikainen, Riitta; Hänninen, Tuomo; Laatikainen, Tiina; Lindström, Jaana; Paajanen, Teemu; Soininen, Hilkka; Strandberg, Timo; Tuomilehto, Jaakko; Kivipelto, Miia; Solomon, Alina (2022)
    Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60-77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group x time coefficient -0.006, 95% CI -0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (-0.140, p = 0.005) and memory (-0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung >= 40 points) had less intervention benefit to executive functioning (group x time x Zung -0.096, 95% CI -0.163 to -0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
  • Buso, Marion E. C.; Seimon, Radhika V.; McClintock, Sally; Muirhead, Roslyn; Atkinson, Fiona S.; Brodie, Shannon; Dodds, Jarron; Zibellini, Jessica; Das, Arpita; Wild-Taylor, Anthony L.; Burk, Jessica; Fogelholm, Mikael; Raben, Anne; Brand-Miller, Jennie C.; Sainsbury, Amanda (2021)
    Background: Previous research showed that weight-reducing diets increase appetite sensations and/or circulating ghrelin concentrations for up to 36 months, with transient or enduring perturbations in circulating concentrations of the satiety hormone peptide YY. Objective: This study assessed whether a diet that is higher in protein and low in glycemic index (GI) may attenuate these changes. Methods: 136 adults with pre-diabetes and a body mass index of >= 25 kg/m(2) underwent a 2-month weight-reducing total meal replacement diet. Participants who lost >= 8% body weight were randomized to one of two 34-month weight-maintenance diets: a higher-protein and moderate-carbohydrate (CHO) diet with low GI, or a moderate-protein and higher-CHO diet with moderate GI. Both arms involved recommendations to increase physical activity. Fasting plasma concentrations of total ghrelin and total peptide YY, and appetite sensations, were measured at 0 months (pre-weight loss), at 2 months (immediately post-weight loss), and at 6, 12, 24, and 36 months. Results: There was a decrease in plasma peptide YY concentrations and an increase in ghrelin after the 2-month weight-reducing diet, and these values approached pre-weight-loss values by 6 and 24 months, respectively (P = 0.32 and P = 0.08, respectively, vs. 0 months). However, there were no differences between the two weight-maintenance diets. Subjective appetite sensations were not affected by the weight-reducing diet nor the weight-maintenance diets. While participants regained an average of similar to 50% of the weight they had lost by 36 months, the changes in ghrelin and peptide YY during the weight-reducing phase did not correlate with weight regain. Conclusion: A higher-protein, low-GI diet for weight maintenance does not attenuate changes in ghrelin or peptide YY compared with a moderate-protein, moderate-GI diet.
  • Hansen, Sylvia; Huttunen-Lenz, Maija; Sluik, Diewertje; Brand-Miller, Jennie; Drummen, Mathijs; Fogelholm, Mikael; Handjieva-Darlenska, Teodora; Macdonald, Ian; Martinez, Alfredo J.; Larsen, Thomas Meinert; Poppitt, Sally; Raben, Anne; Schlicht, Wolfgang (2018)
    PurposeWeight loss has been demonstrated to be a successful strategy in diabetes prevention. Although weight loss is greatly influenced by dietary behaviors, social-cognitive factors play an important role in behavioral determination. This study aimed to identify demographic and social-cognitive factors (intention, self-efficacy, outcome expectancies, social support, and motivation with regard to dietary behavior and goal adjustment) associated with weight loss in overweight and obese participants from the PREVIEW study who had pre-diabetes.MethodProspective correlational data from 1973 adult participants were analyzed. The participants completed psychological questionnaires that assessed social-cognitive variables with regard to dietary behavior. Stepwise multiple regression analyses were performed to identify baseline demographic and social-cognitive factors associated with weight loss.ResultsOverall, being male, having a higher baseline BMI, having a higher income, perceiving fewer disadvantages of a healthy diet (outcome expectancies), experiencing less discouragement for healthy eating by family and friends (social support), and lower education were independently linked to greater weight loss. When evaluating females and males separately, education was no longer associated with weight loss.ConclusionThe results indicate that a supportive environment in which family members and friends avoid discouraging healthy eating, with the application of a strategy that uses specific behavior change techniques to emphasize the benefits of outcomes, i.e., the benefits of a healthy diet, may support weight loss efforts. Weight loss programs should therefore always address the social environment of persons who try to lose body weight because family members and friends can be important supporters in reaching a weight loss goal.
  • Åberg, Fredrik; Luukkonen, Panu K.; But, Anna; Salomaa, Veikko; Britton, Annie; Petersen, Kasper Meidahl; Bojesen, Stig Egil; Balling, Mie; Nordestgaard, Borge G.; Puukka, Pauli; Männistö, Satu; Lundqvist, Annamari; Perola, Markus; Jula, Antti; Färkkilä, Martti (2022)
    Background & Aims: Current screening strategies for chronic liver disease focus on detection of subclinical advanced liver fibrosis but cannot identify those at high future risk of severe liver disease. Our aim was to develop and validate a risk pre-diction model for incident chronic liver disease in the general population based on widely available factors. Methods: Multivariable Cox regression analyses were used to develop prediction models for liver-related outcomes with and without laboratory measures (Modellab and Modelnon-lab) in 25,760 individuals aged 40-70 years. Their data were sourced from the Finnish population-based health examination surveys FINRISK 1992-2012 and Health 2000 (derivation cohort). The models were externally validated in the Whitehall II (n = 5,058) and Copenhagen City Heart Study (CCHS) (n = 3,049) cohorts. Results: The absolute rate of incident liver outcomes per 100,000 person-years ranged from 53 to 144. The final prediction model included age, sex, alcohol use (drinks/week), waist-hip ratio, diabetes, and smoking, and Modellab also included gamma-glutamyltransferase values. Internally validated Wolbers' C -sta-tistics were 0.77 for Modellab and 0.75 for Modelnon-lab, while apparent 15-year AUCs were 0.84 (95% CI 0.75-0.93) and 0.82 (95% CI 0.74-0.91). The models identified a small proportion (< 2%) of the population with > 10% absolute 15-year risk for liver events. Of all liver events, only 10% occurred in participants in the lowest risk category. In the validation cohorts, 15-year AUCs were 0.78 (Modellab) and 0.65 (Modelnon-lab) in the CCHS cohort, and 0.78 (Modelnon-lab) in the Whitehall II cohort. Conclusions: Based on widely available risk factors, the Chronic Liver Disease (CLivD) score can be used to predict risk of future advanced liver disease in the general population. Lay summary: Liver disease often progresses silently without symptoms and thus the diagnosis is often delayed until severe complications occur and prognosis becomes poor. In order to identify individuals in the general population who have a high risk of developing severe liver disease in the future, we developed and validated a Chronic Liver Disease (CLivD) risk prediction score, based on age, sex, alcohol use, waist-hip ratio, diabetes, and smoking, with or without measurement of the liver enzyme gamma-glutamyltransferase. The CLivD score can be used as part of health counseling, and for planning further liver investigations and follow-up. (C) 2022 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver.
  • Vornanen, Marleena; Konttinen, Hanna; Peltonen, Markku; Haukkala, Ari (2021)
    Background Perceived disease risk may reflect actual risk indicators and/or motivation to change lifestyle. Yet, few longitudinal studies have assessed how perceived risk relates to risk indicators among different disease risk groups. We examined in a 5-year follow-up, whether perceived risks of diabetes and cardiovascular disease predicted physical activity, body mass index (BMI kg/m(2)), and blood glucose level, or the reverse. We examined further whether perceived risk, self-efficacy, and outcome beliefs together predicted changes in these risk indicators. Method Participants were high diabetes risk participants (N = 432) and low/moderate-risk participants (N = 477) from the national FINRISK 2002 study who were followed up in 2007. Both study phases included questionnaires and health examinations with individual feedback letters. Data were analyzed using gender- and age-adjusted structural equation models. Results In cross-lagged autoregressive models, perceived risks were not found to predict 5-year changes in physical activity, BMI, or 2-h glucose. In contrast, higher BMI and 2-h glucose predicted 5-year increases in perceived risks (beta-values 0.07-0.15,P-values <0.001-0.138). These associations were similar among high- and low/moderate-risk samples. In further structural equation models, higher self-efficacy predicted increased physical activity among both samples (beta-values 0.10-0.16,P-values 0.005-0.034). Higher outcome beliefs predicted lower BMI among the low/moderate-risk sample (beta-values - 0.04 to - 0.05,P-values 0.008-0.011). Conclusion Perceived risk of chronic disease rather follows risk indicators than predicts long-term lifestyle changes. To promote sustained lifestyle changes, future intervention studies need to examine the best ways to combine risk feedback with efficient behavior change techniques.
  • Lehtisalo, Jenni; Levälahti, Esko; Lindström, Jaana; Hänninen, Tuomo; Paajanen, Teemu; Peltonen, Markku; Antikainen, Riitta; Laatikainen, Tiina; Strandberg, Timo; Soininen, Hilkka; Tuomilehto, Jaakko; Kivipelto, Miia; Ngandu, Tiia (2019)
    Introduction: Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. Methods: We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60-77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. Results: Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). Discussion: Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition. (C) 2018 The Authors. Published by Elsevier Inc.
  • Kivimäki, Mika; Tabák, Adam G. (2018)
  • Bahijri, Suhad; Al-Raddadi, Rajaa; Ajabnoor, Ghada; Jambi, Hanan; Al Ahmadi, Jawaher; Borai, Anwar; Barengo, Noël C; Tuomilehto, Jaakko (2020)
    Abstract Aims/Introduction To develop a non-invasive risk score to identify Saudis having prediabetes or undiagnosed type 2 diabetes. Methods Adult Saudis without diabetes were recruited randomly using a stratified two-stage cluster sampling method. Demographic, dietary, lifestyle variables, personal and family medical history were collected using a questionnaire. Blood pressure and anthropometric measurements were taken. Body mass index was calculated. The 1-h oral glucose tolerance test was carried out. Glycated hemoglobin, fasting and 1-h plasma glucose were measured, and obtained values were used to define prediabetes and type 2 diabetes (dysglycemia). Logistic regression models were used for assessing the association between various factors and dysglycemia, and Hosmer?Lemeshow summary statistics were used to assess the goodness-of-fit. Results A total of 791 men and 612 women were included, of whom 69 were found to have diabetes, and 259 had prediabetes. The prevalence of dysglycemia was 23%, increasing with age, reaching 71% in adults aged ≥65 years. In univariate analysis age, body mass index, waist circumference, use of antihypertensive medication, history of hyperglycemia, low physical activity, short sleep and family history of diabetes were statistically significant. The final model for the Saudi Diabetes Risk Score constituted sex, age, waist circumference, history of hyperglycemia and family history of diabetes, with the score ranging from 0 to 15. Its fit based on assessment using the receiver operating characteristic curve was good, with an area under the curve of 0.76 (95% confidence interval 0.73?0.79). The proposed cut-point for dysglycemia is 5 or 6, with sensitivity and specificity being approximately 0.7. Conclusion The Saudi Diabetes Risk Score is a simple tool that can effectively distinguish Saudis at high risk of dysglycemia.
  • e-PREDICE Consortium; Gabriel, Rafael; Lindström, Jaana; Tuomilehto, Jaakko (2020)
    Objectives To assess the effects of early management of hyperglycaemia with antidiabetic drugs plus lifestyle intervention compared with lifestyle alone, on microvascular function in adults with pre-diabetes. Methods Trial design: International, multicenter, randomised, partially double-blind, placebo-controlled, clinical trial. Participants Males and females aged 45–74 years with IFG, IGT or IFG+IGT, recruited from primary care centres in Australia, Austria, Bulgaria, Greece, Kuwait, Poland, Serbia, Spain and Turkey. Intervention Participants were randomized to placebo; metformin 1.700 mg/day; linagliptin 5 mg/day or fixed-dose combination of linagliptin/metformin. All patients were enrolled in a lifestyle intervention program (diet and physical activity). Drug intervention will last 2 years. Primary Outcome: composite end-point of diabetic retinopathy estimated by the Early Treatment Diabetic Retinopathy Study Score, urinary albumin to creatinine ratio, and skin conductance in feet estimated by the sudomotor index. Secondary outcomes in a subsample include insulin sensitivity, beta-cell function, biomarkers of inflammation and fatty liver disease, quality of life, cognitive function, depressive symptoms and endothelial function. Results One thousand three hundred ninety one individuals with hyperglycaemia were assessed for eligibility, 424 excluded after screening, 967 allocated to placebo, metformin, linagliptin or to fixed-dose combination of metformin + linagliptin. A total of 809 people (91.1%) accepted and initiated the assigned treatment. Study sample after randomization was well balanced among the four groups. No statistical differences for the main risk factors analysed were observed between those accepting or rejecting treatment initiation. At baseline prevalence of diabetic retinopathy was 4.2%, severe neuropathy 5.3% and nephropathy 5.7%. Conclusions ePREDICE is the first -randomized clinical trial with the aim to assess effects of different interventions (lifestyle and pharmacological) on microvascular function in people with pre-diabetes. The trial will provide novel data on lifestyle modification combined with glucose lowering drugs for the prevention of early microvascular complications and diabetes. Registration - ClinicalTrials.Gov Identifier: NCT03222765 - EUDRACT Registry Number: 2013-000418-39
  • From, Svetlana; Liira, Helena; Leppävuori, Jenni Katariina; Remes-Lyly, Taina; Tikkanen, Heikki; Pitkala, Kaisu (2013)
  • Saunajoki, Anni; Auvinen, Juha; Bloigu, Aini; Saramies, Jouko; Tuomilehto, Jaakko; Uusitalo, Hannu; Hussi, Esko; Cederberg-Tamminen, Henna; Suija, Kadri; Keinänen-Kiukaanniemi, Sirkka; Timonen, Markku (2022)
    The purpose of this study was to examine and compare the associations between albuminuria and fasting (FPG), 1 h post-load (1 h PG) and 2 h post-load plasma glucose (2 h PG) in an oral glucose tolerance test (OGTT). A total of 496 people free of known diabetes (mean age 72 years) participated in the examinations including the OGTT with plasma glucose measurements at 0, 1, and 2 h and levels of HbA1c. Albuminuria was determined by the urinary albumin-to-creatinine ratio and was defined as >= 3.0 mg/mmol. Compared with those without albuminuria, participants with albuminuria had significantly higher 1 h PG and 2 h PG levels, but not FPG or HbA1c levels. An elevated 1 h PG increased the estimated odds ratio of albuminuria more than three times in people with prediabetic 1 h PG (8.6-11.5 mmol/L: OR 3.60; 95% CI 1.70-7.64) and diabetic 1 h PG (>= 11.6 mmol/L: OR 3.05; 95% CI 1.29-7.23). After adjusting for blood pressure and age, the association of elevated 1 h PG with albuminuria remained significant. Prediabetic or diabetic FPG, 2 h PG, or HbA1c did not have a statistically significant association with albuminuria. These findings suggest that 1 h PG seems to be the best glycemic parameter and is useful in recognizing persons with an elevated risk of early kidney disease due to hyperglycemia.
  • Baek, Jeanha; Robert-Nicoud, Ghislaine; Hidalgo, Carmen Herrera; Borg, Melissa L.; Iqbal, Muhammad N.; Berlin, Roger; Lindgren, Maria; Waara, Erik; Udden, Anna; Pietiläinen, Kirsi; Bengtsson, Tore (2022)
    Aim: To investigate the effect of oral consumption of engineered mesoporous silica particles, SiPore15 (R), on long-term blood glucose levels and other metabolic parameters in individuals with prediabetes and newly diagnosed Type 2 diabetes. Method: An open-label, single-arm, multicenter trial was conducted in which SiPore15 was consumed three times daily for 12 weeks. Hemoglobin A1c (HbA1c, primary end point) and an array of metabolic parameters were measured at baseline and throughout the trial. Result: SiPore15 treatment significantly reduced HbA1c by a clinically meaningful degree and improved several disease-associated parameters with minimal side effects. Conclusion: The results from this study demonstrate the potential use of SiPore15 as a treatment for prediabetes that may also delay or prevent the onset of Type 2 diabetes.
  • Liu, Ching-Ti; Merino, Jordi; Rybin, Denis; DiCorpo, Daniel; Benke, Kelly S.; Bragg-Gresham, Jennifer L.; Canouil, Mickaël; Corre, Tanguy; Grallert, Harald; Isaacs, Aaron; Kutalik, Zoltan; Lahti, Jari; Marullo, Letizia; Marzi, Carola; Rasmussen-Torvik, Laura J.; Rocheleau, Ghislain; Rueedi, Rico; Scapoli, Chiara; Verweij, Niek; Vogelzangs, Nicole; Willems, Sara M.; Yengo, Loïc; Bakker, Stephan J. L.; Beilby, John; Hui, Jennie; Kajantie, Eero; Müller-Nurasyid, Martina; Rathmann, Wolfgang; Balkau, Beverley; Bergmann, Sven; Eriksson, Johan G.; Florez, Jose C.; Froguel, Philippe; Harris, Tamara; Hung, Joseph; James, Alan L.; Kavousi, Maryam; Miljkovic, Iva; Musk, Arthur W.; Palmer, Lyle J.; Peters, Annette; Roussel, Ronan; van der harst, Pim; van Duijn, Cornelia M.; Vollenweider, Peter; Barroso, Inês; Prokopenko, Inga; Dupuis, Josée; Meigs, James B.; Bouatia-Naji, Nabila (2019)
    Type 2 diabetes (T2D) affects the health of millions of people worldwide. The identification of genetic determinants associated with changes in glycemia over time might illuminate biological features that precede the development of T2D. Here we conducted a genome-wide association study of longitudinal fasting glucose changes in up to 13,807 non-diabetic individuals of European descent from nine cohorts. Fasting glucose change over time was defined as the slope of the line defined by multiple fasting glucose measurements obtained over up to 14 years of observation. We tested for associations of genetic variants with inverse-normal transformed fasting glucose change over time adjusting for age at baseline, sex, and principal components of genetic variation. We found no genome-wide significant association (P < 5 x 10(-8)) with fasting glucose change over time. Seven loci previously associated with T2D, fasting glucose or HbA1c were nominally (P < 0.05) associated with fasting glucose change over time. Limited power influences unambiguous interpretation, but these data suggest that genetic effects on fasting glucose change over time are likely to be small. A public version of the data provides a genomic resource to combine with future studies to evaluate shared genetic links with T2D and other metabolic risk traits.
  • Huvinen, Emilia; Eriksson, Johan G.; Stach-Lempinen, Beata; Tiitinen, Aila; Koivusalo, Saila B. (2018)
    AimsGestational diabetes (GDM) affects a growing number of women and identification of individuals at risk, e.g., with risk prediction models, would be important. However, the performance of GDM risk scores has not been optimal. Here, we assess the impact of GDM heterogeneity on the performance of two top-rated GDM risk scores.MethodsThis is a substudy of the RADIEL triala lifestyle intervention study including women at high GDM risk. We assessed the GDM risk score by Teede and that developed by Van Leeuwen in our high-risk cohort of 510 women. To investigate the heterogeneity of GDM, we further divided the women according to GDM history, BMI, and parity. With the goal of identifying novel predictors of GDM, we further analyzed 319 women with normal glucose tolerance in the first trimester.ResultsBoth risk scores underestimated GDM incidence in our high-risk cohort. Among women with a BMI30kg/m(2) and/or previous GDM, 49.4% developed GDM and 37.4% received the diagnosis already in the first trimester. Van Leeuwen score estimated a 19% probability of GDM and Teede succeeded in risk identification in 61%. The lowest performance of the risk scores was seen among the non-obese women. Fasting plasma glucose, HbA(1c), and family history of diabetes were predictors of GDM in the total study population. Analysis of subgroups did not provide any further information.ConclusionsOur findings suggest that the marked heterogeneity of GDM challenges the development of risk scores for detection of GDM.
  • Laitinen, Tomi T.; Ruohonen, Saku; Juonala, Markus; Magnussen, Costan G.; Mikkila, Vera; Mikola, Hanna; Hutri-Kahonen, Nina; Laitinen, Tomi; Tossavainen, Paivi; Jokinen, Eero; Niinikoski, Harri; Jula, Antti; Viikari, Jorma S. A.; Ronnemaa, Tapani; Raitakari, Olli T.; Pahkala, Katja (2017)
    Background: Ideal cardiovascular health (CVH), defined by the American Heart Association, is associated with incident cardiovascular disease in adults. However, association of the ideal CVH in childhood with current and future cardiac structure and function has not been studied. Methods and results: The sample comprised 827 children participating in the longitudinal Special Turku Coronary Risk Factor Intervention Project (STRIP) and The Cardiovascular Risk in Young Finns Study (YFS). In STRIP, complete data on the seven ideal CVH metrics and left ventricular (LV) mass measured with echocardiography were available at the age of 15 (n= 321), 17 (n= 309) and 19 (n= 283) years. In YFS, the cohort comprised children aged 12-18 years (n = 506) with complete ideal CVH metrics data from childhood and 25 years later in adulthood, and echocardiography performed in adulthood. In STRIP, ideal CVH score was inversely associated with LV mass during childhood (P = 0.036). In YFS, childhood ideal CVH score was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume in adulthood (all P <0.01). In addition, improvement of the ideal CVH score between childhood and adulthood was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume (all P Conclusions: Childhood ideal CVH score has a long-lasting effect on cardiac structure and function, and the association is evident already in childhood. Our findings support targeting the ideal CVHmetrics as part of primordial prevention of cardiovascular diseases. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Penn, Linda; White, Martin; Lindstrom, Jaana; den Boer, Annemieke Th.; Blaak, Ellen; Eriksson, Johan G.; Feskens, Edith; Ilanne-Parikka, Pirjo; Keinanen-Kiukaanniemi, Sirkka M.; Walker, Mark; Mathers, John C.; Uusitupa, Matti; Tuomilehto, Jaakko (2013)
  • Meinilä, Jelena; Valkama, Anita; Koivusalo, Saila B.; Stach-Lempinen, Beata; Rono, Kristiina; Lindstrom, Jaana; Kautiainen, Hannu; Eriksson, Johan G.; Erkkola, Maijaliisa (2017)
    The aim was to analyse whether changes in the Healthy Food Intake Index (HFII) during pregnancy are related to gestational diabetes (GDM) risk. The 251 pregnant women participating had a pre-pregnancy BMI >= 30 kg/m(2) and/or a history of GDM. A 75 g oral glucose tolerance test (OGTT) was performed during the first and second trimesters of pregnancy for assessment of GDM. A normal OGTT result at first trimester was an inclusion criterion for the study. FFQ collected at first and second trimesters served for calculating the HFII. A higher HFII score reflects higher adherence to the Nordic Nutrition Recommendations (NNR) (score range 0-17). Statistical methods included Student's t test, Mann-Whitney U test, Fisher's exact test and linear and logistic regression analyses. The mean HFII at first trimester was 10.1 (95 % CI 9.7, 10.4) points, and the mean change from the first to the second trimester was 0.35 (95 % CI 0.09, 0.62) points. The range of the HFII changes varied from -7 to 7. The odds for GDM decreased with higher HFII change (adjusted OR 0.83 per one unit increase in HFII; 95 % CI 0.69, 0.99; P=0.043). In the analysis of the association between HFII-sub-indices and GDM, odds for GDM decreased with higher HFII-Fat change (fat percentage of milk and cheese, type of spread and cooking fats) but it was not significant in a fully adjusted model (P=0.058). Dietary changes towards the NNR during pregnancy seem to be related to a lower risk for GDM.