TY  - JOUR
AB  - BACKGROUND: Participants' study satisfaction is important for both compliance with study protocols and retention, but research on parent study satisfaction is rare. This study sought to identify factors associated with parent study satisfaction in The Environmental Determinants of Diabetes in the Young (TEDDY) study, a longitudinal, multinational (US, Finland, Germany, Sweden) study of children at risk for type 1 diabetes. The role of staff consistency to parent study satisfaction was a particular focus. METHODS: Parent study satisfaction was measured by questionnaire at child-age 15 months (5579 mothers, 4942 fathers) and child-age four years (4010 mothers, 3411 fathers). Multiple linear regression analyses were used to identify sociodemographic factors, parental characteristics, and study variables associated with parent study satisfaction at both time points. RESULTS: Parent study satisfaction was highest in Sweden and the US, compared to Finland. Parents who had an accurate perception of their child's type 1 diabetes risk and those who believed they can do something to prevent type 1 diabetes were more satisfied. More educated parents and those with higher depression scores had lower study satisfaction scores. After adjusting for these factors, greater study staff change frequency was associated with lower study satisfaction in European parents (mothers at child-age 15 months: - 0.30,95% Cl - 0.36, - 0.24, p < 0.001; mothers at child-age four years: -0.41, 95% Cl - 0.53, - 0.29, p < 0.001; fathers at child-age 15 months: -0.28, 95% Cl - 0.34, - 0.21, p < 0.001; fathers at child-age four years: -0.35, 95% Cl - 0.48, - 0.21, p < 0.001). Staff consistency was not associated with parent study satisfaction in the US. However, the number of staff changes was markedly higher in the US compared to Europe. CONCLUSIONS: Sociodemographic factors, parental characteristics, and study-related variables were all related to parent study satisfaction. Those that are potentially modifiable are of particular interest as possible targets of future efforts to improve parent study satisfaction. Three such factors were identified: parent accuracy about the child's type 1 diabetes risk, parent beliefs that something can be done to reduce the child's risk, and study staff consistency. However, staff consistency was important only for European parents. TRIAL REGISTRATION: NCT00279318 .
AU  - Melin, J.*
AU  - Lynch, K.F.*
AU  - Lundgren, M.*
AU  - Aronsson, C.A.*
AU  - Larsson, H.E.*
AU  - Johnson, S.B.*
AU  - TEDDY Study Group (Winkler, C.)
C1  - 67033
C2  - 53361
TI  - Is staff consistency important to parents' satisfaction in a longitudinal study of children at risk for type 1 diabetes: The TEDDY study.
JO  - BMC Endocr. Disord.
VL  - 22
IS  - 1
PY  - 2022
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - Background Highly walkable neighbourhoods may increase transport-related and leisure-time physical activity and thus decrease the risk for obesity and obesity-related diseases, such as type 2 diabetes (T2D). Methods We investigated the association between walkability and prevalent/incident T2D in a pooled sample from five German cohorts. Three walkability measures were assigned to participant's addresses: number of transit stations, points of interest, and impedance (restrictions to walking due to absence of intersections and physical barriers) within 640 m. We estimated associations between walkability and prevalent/incident T2D with modified Poisson regressions and adjusted for education, sex, age at baseline, and cohort. Results Of the baseline 16,008 participants, 1256 participants had prevalent T2D. Participants free from T2D at baseline were followed over a mean of 9.2 years (SD: 3.5, minimum: 1.6, maximum: 14.8 years). Of these, 1032 participants developed T2D. The three walkability measures were not associated with T2D. The estimates pointed toward a zero effect or were within 7% relative risk increase per 1 standard deviation with 95% confidence intervals including 1. Conclusion In the studied German settings, walkability differences might not explain differences in T2D.
AU  - Kartschmit, N.*
AU  - Sutcliffe, R.*
AU  - Sheldon, M.P.*
AU  - Moebus, S.*
AU  - Greiser, K.H.*
AU  - Hartwig, S.*
AU  - Thürkow, D.*
AU  - Stentzel, U.*
AU  - van den Berg, N.*
AU  - Wolf, K.
AU  - Maier, W.
AU  - Peters, A.
AU  - Ahmed, S.*
AU  - Köhnke, C.*
AU  - Mikolajczyk, R.*
AU  - Wienke, A.*
AU  - Kluttig, A.*
AU  - Rudge, G.*
C1  - 57832
C2  - 48083
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Walkability and its association with prevalent and incident diabetes among adults in different regions of Germany: Results of pooled data from five German cohorts.
JO  - BMC Endocr. Disord.
VL  - 20
IS  - 1
PB  - Bmc
PY  - 2020
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - Objectives To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models.Setting Five different regions and cities of Germany using data from five cohort studies.Participants For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male.Outcomes (1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height.Results Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (beta: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (beta: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (beta: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance.Conclusion We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.
AU  - Kartschmit, N.*
AU  - Sutcliffe, R.*
AU  - Sheldon, M.P.*
AU  - Moebus, S.*
AU  - Greiser, K.H.*
AU  - Hartwig, S.*
AU  - Thürkow, D.*
AU  - Stentzel, U.*
AU  - van den Berg, N.*
AU  - Wolf, K.
AU  - Maier, W.
AU  - Peters, A.
AU  - Ahmed, S.*
AU  - Köhnke, C.*
AU  - Mikolajczyk, R.*
AU  - Wienke, A.*
AU  - Kluttig, A.*
AU  - Rudge, G.*
C1  - 59000
C2  - 48517
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
TI  - Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: A cross-sectional analysis of pooled data from five German cohorts.
JO  - BMC Endocr. Disord.
VL  - 20
PB  - Bmj Publishing Group
PY  - 2020
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - Background Type 2 diabetes mellitus (T2DM) comprises the vast majority of all diabetes cases in adults, with alarmingly increasing prevalence over the past few decades worldwide. A particularly heavy healthcare burden of diabetes is noted in Europe, where 8.8% of the population aged 20-79 years is estimated to have diabetes according to the International Diabetes Federation. Multiple risk factors are implicated in the pathogenesis of T2DM with complex underlying interplay and intricate gene-environment interactions. Thus, intense research has been focused on studying the role of T2DM risk factors and on identifying vulnerable groups for T2DM in the general population which can then be targeted for prevention interventions. Methods For this narrative review, we conducted a comprehensive search of the existing literature on T2DM risk factors, focusing on studies in adult cohorts from European countries which were published in English after January 2000. Results Multiple lifestyle-related and sociodemographic factors were identified as related to high T2DM risk, including age, ethnicity, family history, low socioeconomic status, obesity, metabolic syndrome and each of its components, as well as certain unhealthy lifestyle behaviors. As Europe has an increasingly aging population, multiple migrant and ethnic minority groups and significant socioeconomic diversity both within and across different countries, this review focuses not only on modifiable T2DM risk factors, but also on the impact of pertinent demographic and socioeconomic factors. Conclusion In addition to other T2DM risk factors, low socioeconomic status can significantly increase the risk for prediabetes and T2DM, but is often overlooked. In multinational and multicultural regions such as Europe, a holistic approach, which will take into account both traditional and socioeconomic/socioecological factors, is becoming increasingly crucial in order to implement multidimensional public health programs and integrated community-based interventions for effective T2DM prevention.
AU  - Kyrou, I.*
AU  - Tsigos, C.*
AU  - Mavrogianni, C.*
AU  - Cardon, G.*
AU  - Van Stappen, V.*
AU  - Latomme, J.*
AU  - Kivelä, J.*
AU  - Wikström, K.*
AU  - Tsochev, K.*
AU  - Nanasi, A.*
AU  - Semanova, C.*
AU  - Mateo-Gallego, R.*
AU  - Lamiquiz-Moneo, I.*
AU  - Dafoulas, G.*
AU  - Timpel, P.*
AU  - Schwarz, P.E.
AU  - Iotova, V.*
AU  - Tankova, T.*
AU  - Makrilakis, K.*
AU  - Manios, Y.*
C1  - 58581
C2  - 48366
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: A narrative review with emphasis on data from Europe.
JO  - BMC Endocr. Disord.
VL  - 20
IS  - Suppl 1
PB  - Bmc
PY  - 2020
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - Background The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. Methods The aim of this paper is to describe the detailed methodology of the intervention's cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention's value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. Conclusions The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.
AU  - Willems, R.*
AU  - Pil, L.*
AU  - Lambrinou, C.P.*
AU  - Kivelä, J.*
AU  - Wikström, K.*
AU  - Gonzalez-Gil, E.M.*
AU  - De Miguel-Etayo, P.*
AU  - Nánási, A.*
AU  - Semánová, C.*
AU  - Van Stappen, V.*
AU  - Cardon, G.*
AU  - Tsochev, K.*
AU  - Iotova, V.*
AU  - Chakarova, N.*
AU  - Makrilakis, K.*
AU  - Dafoulas, G.*
AU  - Timpel, P.*
AU  - Schwarz, P.E.
AU  - Manios, Y.*
AU  - Annemans, L.*
C1  - 58580
C2  - 48367
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Methodology of the health economic evaluation of the Feel4Diabetes-study.
JO  - BMC Endocr. Disord.
VL  - 20
PB  - Bmc
PY  - 2020
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - Background: The aim of this study was to investigate the effect of a lifestyle intervention in obesity on the soluble form of the activated leukocyte cell adhesion molecule (sALCAM) and its association with metabolic parameters. Methods: Twenty-nine obese subjects selected from the OPTIFAST (R) 52 program. This program consisted into 2 crucial phases: an initial 12-week active weight reduction phase, followed by a 40-week weight maintenance phase. At baseline, after 12 weeks and at the end of the program, fasting glucose and insulin, total cholesterol, LDL-C, HDL-C, triglycerides, adiponectin, leptin, high sensitivity CRP, sALCAM, homeostasis model assessment-estimated insulin resistance (HOMA-IR) and leptin-to-adiponectin-ratio were determined. Oral glucose tolerance test (OGTT) was performed when indicated. Results: At baseline, the serum concentration of sALCAM was increased and correlated positively with HOMA-IR and negatively with age. At the end of the program, sALCAM concentrations decreased significantly. Multivariate analysis showed that sALCAM significantly correlated with age, glucose concentration after 2 h OGTT and the HOMA-IR. A higher decrease of HOMA-IR during the study was observed in subjects with higher concentration of sALCAM at baseline. Conclusions: sALCAM might be a novel biomarker in obesity that correlates and predicts insulin sensitivity improvement and that can be affected by lifestyle intervention.
AU  - Sulaj, A.*
AU  - Zemva, J.*
AU  - Zech, U.*
AU  - Woehning, A.*
AU  - Brune, M.*
AU  - Rudofsky, G.*
AU  - Nawroth, P.P.
AU  - Fleming, T.*
AU  - von Bauer, R.*
C1  - 49884
C2  - 41896
CY  - London
TI  - The effect of lifestyle intervention in obesity on the soluble form of activated leukocyte cell adhesion molecule.
JO  - BMC Endocr. Disord.
VL  - 16
PB  - Biomed Central Ltd
PY  - 2016
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - BACKGROUND: Unspecific symptoms often proceed a serious chronic disease condition long before the onset of the disease. The role of an unspecific premonitory symptom (UPMS) pattern as premonitory signs of subsequent type 2 diabetes mellitus (T2DM) diagnosis independent of established cardio-metabolic risk factors is unclear and therefore was examined in the present study. METHODS: The study population consisted of 10,566 participants aged 25-74 years at baseline drawn from the population-based MONICA/KORA Cohort Study conducted in 1984-2009 in the Augsburg region (Germany). Unspecific premonitory symptoms were assessed following the Somatic Symptom Scale-8 (SSS-8). The impact of the score on T2DM risk within a mean follow-up time of 16 years was estimated by Cox regression. RESULTS: Within follow-up, 974 newly diagnosed T2DM cases were observed. The risk for T2DM increased by a hazard ratio (HR) of 1.03 (95% CI 1.01-1.04, p value < 0.001) for a one unit increase of the UPMS score in a Cox model adjusted for age, sex and survey. Additional adjustment for cardio-metabolic risk factors attenuated this effect (HR = 1.02) but significance remained (p value = 0.01). CONCLUSIONS: Suffering from an elevated burden of unspecific somatic symptoms is associated with T2DM long before the onset and independent of established cardio-metabolic risk factors. Further research is needed to obtain insight in potential underlying pathophysiological mechanisms.
AU  - Baumert, J.J.
AU  - Meisinger, C.
AU  - Lukaschek, K.
AU  - Emeny, R.T.
AU  - Rückert, I.-M.
AU  - Kruse, J.*
AU  - Ladwig, K.-H.
C1  - 42973
C2  - 35901
TI  - A pattern of unspecific somatic symptoms as long-term premonitory signs of type 2 diabetes: Findings from the population-based MONICA/KORA cohort study, 1984-2009.
JO  - BMC Endocr. Disord.
VL  - 14
PY  - 2014
SN  - 1472-6823
ER  - 

TY  - JOUR
AB  - BACKGROUND: Not all obese subjects have an adverse metabolic profile predisposing them to developing type 2 diabetes or cardiovascular disease. The BioSHaRE-EU Healthy Obese Project aims to gain insights into the consequences of (healthy) obesity using data on risk factors and phenotypes across several large-scale cohort studies. Aim of this study was to describe the prevalence of obesity, metabolic syndrome (MetS) and metabolically healthy obesity (MHO) in ten participating studies. METHODS: Ten different cohorts in seven countries were combined, using data transformed into a harmonized format. All participants were of European origin, with age 18-80 years. They had participated in a clinical examination for anthropometric and blood pressure measurements. Blood samples had been drawn for analysis of lipids and glucose. Presence of MetS was assessed in those with obesity (BMI ≥ 30 kg/m2) based on the 2001 NCEP ATP III criteria, as well as an adapted set of less strict criteria. MHO was defined as obesity, having none of the MetS components, and no previous diagnosis of cardiovascular disease. RESULTS: Data for 163,517 individuals were available; 17% were obese (11,465 men and 16,612 women). The prevalence of obesity varied from 11.6% in the Italian CHRIS cohort to 26.3% in the German KORA cohort. The age-standardized percentage of obese subjects with MetS ranged in women from 24% in CHRIS to 65% in the Finnish Health2000 cohort, and in men from 43% in CHRIS to 78% in the Finnish DILGOM cohort, with elevated blood pressure the most frequently occurring factor contributing to the prevalence of the metabolic syndrome. The age-standardized prevalence of MHO varied in women from 7% in Health2000 to 28% in NCDS, and in men from 2% in DILGOM to 19% in CHRIS. MHO was more prevalent in women than in men, and decreased with age in both sexes. CONCLUSIONS: Through a rigorous harmonization process, the BioSHaRE-EU consortium was able to compare key characteristics defining the metabolically healthy obese phenotype across ten cohort studies. There is considerable variability in the prevalence of healthy obesity across the different European populations studied, even when unified criteria were used to classify this phenotype.
AU  - van Vliet-Ostaptchouk, J.V.*
AU  - Nuotio, M.L.*
AU  - Slagter, S.N.*
AU  - Doiron, D.*
AU  - Fischer, K.*
AU  - Foco, L.*
AU  - Gaye, A.*
AU  - Gögele, M.*
AU  - Heier, M.
AU  - Hiekkalinna, T.*
AU  - Joensuu, A.*
AU  - Newby, C.*
AU  - Pang, C.P.*
AU  - Partinen, E.*
AU  - Reischl, E.
AU  - Schwienbacher, C.*
AU  - Tammesoo, M.L.*
AU  - Swertz, M.A.*
AU  - Burton, P.R*
AU  - Ferretti, V.*
AU  - Fortier, I.*
AU  - Giepmans, L.*
AU  - Harris, J.R.*
AU  - Hillege, H.L.*
AU  - Holmen, J.*
AU  - Jula, A.*
AU  - Kootstra-Ros, J.E.*
AU  - Kvaløy, K.*
AU  - Holmen, T.L.*
AU  - Männistö, S.*
AU  - Metspalu, A.*
AU  - Midthjell, K.*
AU  - Murtagh, M.J.*
AU  - Peters, A.
AU  - Pramstaller, P.P.*
AU  - Saaristo, T.*
AU  - Salomaa, V.*
AU  - Stolk, R.P.*
AU  - Uusitupa, M.*
AU  - van der Harst, P.*
AU  - van der Klauw, M.M.*
AU  - Waldenberger, M.
AU  - Perola, M.*
AU  - Wolffenbuttel, B.H.*
C1  - 30759
C2  - 33837
CY  - London
TI  - The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: A collaborative analysis of ten large cohort studies.
JO  - BMC Endocr. Disord.
VL  - 14
IS  - 1
PB  - Biomed Central Ltd
PY  - 2014
SN  - 1472-6823
ER  -