Advertisement

Use of Multiple Metabolic and Genetic Markers to Improve the Prediction of Type 2 Diabetes: the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study

  1. Matthias B. Schulze, DrPH (matthias.schulze{at}wzw.tum.de)1,2,
  2. Cornelia Weikert, MD2,3,
  3. Tobias Pischon, MD2,
  4. Manuela M. Bergmann, PhD2,
  5. Hadi Al-Hasani, PhD4,
  6. Erwin Schleicher, PhD5,
  7. Andreas Fritsche, MD5,
  8. Hans-Ulrich Häring, MD5,
  9. Heiner Boeing, PhD2 and
  10. Hans-Georg Joost, MD4
  1. 1 Public Health Nutrition Unit, Technische Universität München, Freising, Germany
  2. 2 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  3. 3 Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medicine Berlin, Germany
  4. 4 Department of Pharmacology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  5. 5 Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University of Tübingen, Tübingen, Germany

    Abstract

    Objective: We investigated whether metabolic biomarkers and single nucleotide polymorphisms (SNPs) improve diabetes prediction beyond age, anthropometry and lifestyle risk factors.

    Research Design and Methods: A case-cohort study within a prospective study was designed. We randomly selected a subcohort (n=2,500) from 26,444 participants of whom 1,962 were diabetes-free at baseline. Of the 801 incident type 2 diabetes cases identified in the cohort during 7 years of follow-up 579 remained for analyses after exclusions. Prediction models were compared by receiver operator characteristics (ROC) and integrated discrimination improvement.

    Results: Case-control discrimination by the lifestyle characteristics (ROC-AUC: 0.8465) improved with plasma glucose (ROC-AUC: 0.8672, p<0.001) and HbA1c (ROC-AUC: 0.8859, p<0.001). ROC-AUC further improved with HDL-cholesterol, triglycerides, γ-glutamyltransferase, and alanine-aminotransferase (0.9000, p=0.002). Twenty SNPs didn't improve discrimination beyond these characteristics (p=0.69).

    Conclusion: Metabolic markers, but not genotyping for 20 diabetogenic SNPs, improve discrimination of incident type 2 diabetes beyond lifestyle risk factors.

    Footnotes

      • Received February 3, 2009.
      • Accepted July 12, 2009.

    This Article

    1. Published online before print August 31, 2009, doi: 10.2337/dc09-0197 Diabetes Care August 31, 2009
    1. » Abstract
    2. Full Text (PDF)
    3. Online-Only Appendix
    4. All Versions of this Article:
      1. dc09-0197v1
      2. 32/11/2116 most recent

    Current Issue

    1. February 2012, 35 (2)
    1. Current Issue
    1. Alert me to new issues of Diabetes Care
    Advertisement