Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

Ari V. Ahola-Olli; Linda Mustelin; Maria Kalimeri; Johannes Kettunen; Jari Jokelainen; Juha Auvinen; Katri Puukka; Aki S. Havulinna; Terho Lehtimäki; Mika Kähönen; Markus Juonala; Sirkka Keinänen-Kiukaanniemi; Veikko Salomaa; Markus Perola; Marjo-Riitta Järvelin; Mika Ala-Korpela; Olli Raitakari; Peter Würtz

doi:10.1007/s00125-019-05001-w

Mentally tiring work and type 2 diabetes in women: a 22-year follow-up study

Acta Endocrinologica ◽

10.1530/eje-18-0804 ◽

2019 ◽

Vol 180 (4) ◽

pp. 257-263

Author(s):

Guy Fagherazzi ◽

Gaelle Gusto ◽

Douae El Fatouhi ◽

Francesca Romana Mancini ◽

Beverley Balkau ◽

...

Keyword(s):

Type 2 Diabetes ◽

Job Demands ◽

Diabetes Risk ◽

Work Related Stress ◽

Overweight Women ◽

Work Related ◽

Increased Risk ◽

Related Stress ◽

Incident Cases

Hypothesis Previous work suggested no or inconsistent associations between components of work-related stress and type 2 diabetes risk, but suggested sex-specific differences should be further investigated, as women potentially had higher risks. Methods We analyzed data from 73 517 women, mostly teachers, from the E3N cohort study followed for 22 years (1992–2014), to study the association between mentally tiring work, used as a proxy of job demands, and type 2 diabetes risk. Univariate and multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals. Results A total of 4187 incident cases of type 2 diabetes cases were observed. There was a higher type 2 diabetes risk for women with a ‘Very mentally tiring work’ when compared to women with ‘Little or not mentally tiring work’ (HR = 1.21 (1.09–1.35)). This association was independent of unhealthy lifestyle and traditional metabolic factors. An interaction between mentally tiring work and BMI was detected (P < 0.0001), with a stronger association being observed in non-overweight women, HR = 1.26 (1.08–1.47) vs HR = 1.14 (0.98, 1.32), in overweight women. Conclusions We observed an increased risk of type 2 diabetes associated with mentally tiring work, used as a proxy of job demands. These observational results suggest the importance of taking into consideration the potential long-term metabolic impact of work-related stress for women working in a demanding environment. Increased support for such women should be investigated in intervention studies.

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Multiple sleep dimensions and type 2 diabetes risk among women in the Sister Study: differences by race/ethnicity

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000652 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000652 ◽

Cited By ~ 1

Author(s):

Ketrell L McWhorter ◽

Yong-Moon Park ◽

Symielle A Gaston ◽

Kacey B Fang ◽

Dale P Sandler ◽

...

Keyword(s):

Type 2 Diabetes ◽

Ethnic Minorities ◽

Sleep Latency ◽

Diabetes Risk ◽

Poor Sleep ◽

Increased Risk ◽

Race Ethnicity ◽

Racial Ethnic

ObjectivePoor sleep has been associated with type 2 diabetes. Since racial/ethnic minorities experience a disproportionately high prevalence of poor sleep and type 2 diabetes, we sought to determine the relationships between multiple sleep dimensions and incident type 2 diabetes and to investigate if these relationships vary by race/ethnicity.Research design and methodsProspective data were analyzed from the Sister Study, which enrolled 50 884 women from 2003 to 2009. Participants self-reported sleep duration, sleep latency, night awakenings, and napping at baseline, and a physician’s diagnosis of type 2 diabetes at follow-up. Multivariable-adjusted HRs and 95% CIs were estimated using Cox proportional hazards models.ResultsAmong the 39 071 eligible participants, 87% self-identified as white, 8% black and 5% Hispanic/Latina. The mean follow-up period was 8.5±2.1 years and 1785 type 2 diabetes cases were reported. The incidence rate per 1000 person-years was 5.4 for whites, 13.3 for blacks and 11.6 for Hispanics/Latinas. There was a positive but non-significant increased risk of type 2 diabetes among women who reported short sleep, latency >30 min and frequent night awakenings. In fully-adjusted models, frequent napping was associated with a 19% (HR 1.19, 95% CI 1.04 to 1.37) higher type 2 diabetes risk in the overall sample. Poor sleep among racial/ethnic minorities ranged from a 1.4-fold to a 3.2-fold higher type 2 diabetes risk than whites with recommended sleep.ConclusionsFrequent napping was associated with higher type 2 diabetes risk. Racial/ethnic minorities with poor sleep had a higher type 2 diabetes risk than whites with recommended sleep.

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Abstract 20: Carbohydrate Quality, Measured Using Multiple Carbohydrate Quality Metrics, is Negatively Associated with Risk of Type 2 Diabetes in US Women

Circulation ◽

10.1161/circ.131.suppl_1.20 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Hala AlEssa ◽

Shilpa Bhupathiraju ◽

Vasanti Malik ◽

Nicole Wedick ◽

Hannia Campos ◽

...

Keyword(s):

Type 2 Diabetes ◽

Quality Metrics ◽

Dietary Factors ◽

Increased Risk ◽

Carbohydrate Quality ◽

Cereal Fiber ◽

High Starch ◽

Incident Cases

Background: Carbohydrate quality may be an important determinant of type 2 diabetes (T2D), however, the relationships between various carbohydrate quality metrics and T2D risk have not been systematically investigated. Objective: To prospectively examine the association between carbohydrate, starch, fiber, and different combinations of these nutrients in relation to the risk of T2D in US women. Methods: We prospectively collected information on diet and lifestyle behaviors among 70,041 women from the Nurses Health Study every 2-4 years, after baseline in 1984. These participants were free of diagnosed cardiovascular disease, cancer, or diabetes at baseline. We used Cox proportional hazards regression models to assess the association between dietary factors of interest and incidence of T2D. Results: With 24 years of follow-up we ascertained 6,934 incident cases of T2D during 1,484, 213 person years of follow-up. After adjusting for age, lifestyle and dietary variables, total carbohydrate intake was not associated with T2D (RR=0.98, 95% CI: 0.89 - 1.08, p for trend=0.84), while starch was positively associated with T2D (RR=1.23, 95%CI: 1.12 - 1.35), p for trend <0.0001), comparing the highest to lowest quintile. Total fiber (RR= 0.80, 95%CI: 0.72 - 0.89, p for trend < 0.0001), cereal fiber (RR= 0.71, 95%CI: 0.65 - 0.78, p for trend < 0.0001) and fruit fiber (RR= 0.80, 95%CI: 0.73 - 0.88, p for trend < 0.0001) were all inversely associated with T2D, comparing extreme quintiles. . There was a borderline significant positive association between the ratio of carbohydrate to total fiber intake and risk of T2D (RR= 1.09, 95%CI: 1.00 - 1.20, p for trend = 0.039), and stronger positive associations between the ratios of carbohydrate to cereal fiber (RR= 1.28, 95%CI: 1.17 - 1.39, p for trend < 0.0001), starch to total fiber (RR= 1.12, 95%CI: 1.02 - 1.23, p for trend = 0.030) and starch to cereal fiber (RR= 1.39, 95%CI: 1.27 - 1.53, p for trend < 0.0001) with T2D, comparing extreme quintiles.. Conclusion: Diets with high starch, low fiber and high starch to cereal fiber ratio were associated with increased risk of T2D. Using the starch to cereal fiber ratio of the overall diet is a potentially useful way of assessing carbohydrate quality in relation to T2D.

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Intentional weight loss as a predictor of type 2 diabetes occurrence in a general adult population

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001560 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001560

Author(s):

Laura Sares-Jäske ◽

Paul Knekt ◽

Antti Eranti ◽

Niina E Kaartinen ◽

Markku Heliövaara ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Adult Population ◽

Self Report ◽

Intentional Weight Loss ◽

Increased Risk ◽

General Adult Population ◽

Incident Cases

IntroductionObservational and intervention studies have verified that weight loss predicts a reduced type 2 diabetes (T2D) risk. At the population level, knowledge on the prediction of self-report intentional weight loss (IWL) on T2D incidence is, however, sparse. We studied the prediction of self-report IWL on T2D incidence during a 15-year follow-up in a general adult population.Research design and methodsThe study sample from the representative Finnish Health 2000 Survey comprised 4270 individuals, aged 30–69 years. IWL was determined with questions concerning dieting attempts and weight loss during the year prior to baseline. Incident T2D cases during a 15-year follow-up were drawn from national health registers. The strength of the association between IWL and T2D incidence was estimated with the Cox model.ResultsDuring the follow-up, 417 incident cases of T2D occurred. IWL predicted an increased risk of T2D incidence (HR 1.44; 95% CI 1.11 to 1.87, p=0.008) in a multivariable model. In interaction analyses comparing individuals with and without IWL, a suggestively elevated risk emerged in men, the younger age group, among less-educated people and in individuals with unfavorable values in several lifestyle factors.ConclusionsSelf-report IWL may predict an increased risk of T2D in long-term, probably due to self-implemented IWL tending to fail. The initial prevention of weight gain and support for weight maintenance after weight loss deserve greater emphasis in order to prevent T2D.

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Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies

Gut ◽

10.1136/gutjnl-2020-322557 ◽

2020 ◽

pp. gutjnl-2020-322557 ◽

Cited By ~ 2

Author(s):

Jinqiu Yuan ◽

Qiangsheng He ◽

Long H Nguyen ◽

Martin C S Wong ◽

Junjie Huang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Controlled Trial ◽

Health Study ◽

Increased Risk ◽

Randomised Controlled ◽

Incident Cases

ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use.

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Dietary Inflammatory and Insulinemic Potential and Risk of Type 2 Diabetes: Results from Three Prospective U.S. Cohort Studies

10.2337/figshare.12739601.v1 ◽

2020 ◽

Author(s):

Dong Hoon Lee ◽

Jun Li ◽

Yanping Li ◽

Gang Liu ◽

Kana Wu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Repeated Measures ◽

Hazard Ratio ◽

Diabetes Risk ◽

Health Study ◽

Diabetes Incidence ◽

Incident Type ◽

Increased Risk

Objective: To examine whether proinflammatory and hyperinsulinemic diets are associated with increased risk of type 2 diabetes. Research Design and Methods: We prospectively followed 74,767 women from the Nurses’ Health Study (1984-2016), 90,786 women from the Nurses’ Health Study 2 (1989-2017), and 39,442 men from the Health Professionals Follow-up Study (1986-2016). Using repeated measures of food frequency questionnaires, we calculated empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores which are food-based indices that characterize dietary inflammatory or insulinemic potential based on circulating biomarkers of inflammation or C-peptide. Diagnoses of type 2 diabetes were confirmed by validated supplementary questionnaires. Results: We documented 19,666 incident type 2 diabetes cases over 4.9 million person-years of follow-up. In the pooled multivariable-adjusted analyses, individuals in the highest EDIP or EDIH quintile had 3.11 times (95% CI, 2.96-3.27) and 3.40 times (95% CI, 3.23-3.58) higher type 2 diabetes risk, respectively, compared to those in the lowest quintile. Additional adjustment for body mass index (BMI) attenuated the associations (Hazard ratio, 1.95; 95% CI, 1.85-2.05 for EDIP; Hazard ratio, 1.87; 95% CI, 1.78-1.98 for EDIH), suggesting adiposity partly mediates the observed associations. Moreover, individuals in both highest EDIP and EDIH quintiles had 2.34 times higher type 2 diabetes risk (95% CI, 2.17-2.52), compared to those in both lowest quintiles, after adjustment for BMI. Conclusions: <a>H</a>igher dietary inflammatory and insulinemic potential were associated with an increased type 2 diabetes incidence. Findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking dietary patterns and type 2 diabetes development.

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Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

10.1101/513648 ◽

2019 ◽

Cited By ~ 1

Author(s):

Ari V. Ahola-Olli ◽

Linda Mustelin ◽

Maria Kalimeri ◽

Johannes Kettunen ◽

Jari Jokelainen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Odds Ratio ◽

Free Cholesterol ◽

Density Lipoprotein ◽

Odds Ratios ◽

Lipoprotein Particles ◽

Increased Risk ◽

Incident Cases

ABSTRACTObjectiveAdvances in metabolomics now allow high-throughput biomarker profiling of large population studies. We aimed to identify circulating metabolic biomarkers predictive of type 2 diabetes in young adults.MethodsNuclear magnetic resonance metabolomics was used to quantify 229 metabolic measures in 11,896 individuals from four Finnish cohorts (mean age 33 years, range 24–45). Associations between baseline metabolites and risk of type 2 diabetes onset during 8–15 years of follow-up (392 incident cases) were assessed by logistic regression adjusted for sex, age, body mass index, and fasting glucose.ResultsOut of 229 metabolic measures, 113 were associated with incident diabetes in meta-analysis of the four cohorts (P<0.0009; odds ratios per 1-SD: 0.59–1.50). Among the strongest predictors of diabetes risk were branched-chained and aromatic amino acids (odds ratios 1.31–1.33), triglyceride fractions within the largest very-low-density lipoprotein particles (VLDL; odds ratios 1.33–1.50)), as well as linoleic omega-6 fatty acids (odds ratio 0.75) and free cholesterol in large high-density lipoprotein particles (HDL; odds ratio 0.59). A biomarker score comprised of phenylalanine, free cholesterol in large HDL, and the ratio of cholesteryl esters to total lipids in large VLDL was predictive of the risk for future diabetes in an independent validation cohort (odds ratio 10.1 [95% confidence intervals 4.2-24.1] comparing individuals in upper vs lower fifth of biomarker score). Adjustment for routine lipids and insulin attenuated the odds ratio to 5.8 [2.2-15.1].ConclusionsMetabolic aberrations across multiple molecular pathways are predictive of the long-term risk of type 2 diabetes in young adults. Comprehensive metabolic profiling may potentially help targeting preventive interventions for young asymptomatic individuals at increased risk for type 2 diabetes.

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Dietary Inflammatory and Insulinemic Potential and Risk of Type 2 Diabetes: Results from Three Prospective U.S. Cohort Studies

10.2337/figshare.12739601 ◽

2020 ◽

Author(s):

Dong Hoon Lee ◽

Jun Li ◽

Yanping Li ◽

Gang Liu ◽

Kana Wu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Repeated Measures ◽

Hazard Ratio ◽

Diabetes Risk ◽

Health Study ◽

Diabetes Incidence ◽

Incident Type ◽

Increased Risk

Objective: To examine whether proinflammatory and hyperinsulinemic diets are associated with increased risk of type 2 diabetes. Research Design and Methods: We prospectively followed 74,767 women from the Nurses’ Health Study (1984-2016), 90,786 women from the Nurses’ Health Study 2 (1989-2017), and 39,442 men from the Health Professionals Follow-up Study (1986-2016). Using repeated measures of food frequency questionnaires, we calculated empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores which are food-based indices that characterize dietary inflammatory or insulinemic potential based on circulating biomarkers of inflammation or C-peptide. Diagnoses of type 2 diabetes were confirmed by validated supplementary questionnaires. Results: We documented 19,666 incident type 2 diabetes cases over 4.9 million person-years of follow-up. In the pooled multivariable-adjusted analyses, individuals in the highest EDIP or EDIH quintile had 3.11 times (95% CI, 2.96-3.27) and 3.40 times (95% CI, 3.23-3.58) higher type 2 diabetes risk, respectively, compared to those in the lowest quintile. Additional adjustment for body mass index (BMI) attenuated the associations (Hazard ratio, 1.95; 95% CI, 1.85-2.05 for EDIP; Hazard ratio, 1.87; 95% CI, 1.78-1.98 for EDIH), suggesting adiposity partly mediates the observed associations. Moreover, individuals in both highest EDIP and EDIH quintiles had 2.34 times higher type 2 diabetes risk (95% CI, 2.17-2.52), compared to those in both lowest quintiles, after adjustment for BMI. Conclusions: <a>H</a>igher dietary inflammatory and insulinemic potential were associated with an increased type 2 diabetes incidence. Findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking dietary patterns and type 2 diabetes development.

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Do adolescent sedentary behavior levels predict type 2 diabetes risk in adulthood?

BMC Public Health ◽

10.1186/s12889-021-10948-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jillian A. Scandiffio ◽

Ian Janssen

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Sedentary Behavior ◽

Smoking Status ◽

Cox Proportional Hazards ◽

Diabetes Risk ◽

Sedentary Behaviors ◽

Increased Risk ◽

Incident Cases

Abstract Background The objective was to determine whether time spent in different types of sedentary behavior during adolescence are associated with the risk of developing type 2 diabetes in adulthood. Methods Participants were 3942 adolescents aged 16 years who were part of the 1970 British Cohort Study. Sedentary behavior was assessed using a questionnaire that asked participants to indicate how much time they spent watching TV and videos, using the computer, reading, and doing homework. Incident cases of type 2 diabetes were determined quadrennially until 46 years of age. The association between adolescent sedentary behaviors and type 2 diabetes was determined using Cox proportional hazards regression that controlled for sex, body mass index, sugary beverage consumption, smoking status, physical activity at baseline, and physical activity in adulthood . Results There were 91 incident cases of type 2 diabetes with an incidence rate of 9 cases/10,000 person-years. By comparison to those who watched TV and videos for 2 or less hours/day, type 2 diabetes risk was not different in those who watched for 2.1–4.0 h/day (HR = 0.89, 95% CI = 0.54, 1.47) but was increased by 2.06-fold (95% CI = 1.24, 3.43) in those who watched for more than 4 h/day. Time spent using a computer, reading, and doing homework were not significantly associated with type 2 diabetes. Conclusion Spending more than 4 h/day watching television and videos at age 16 was associated with an increased risk of type 2 diabetes. Conversely, using a computer and non-screen based sedentary behaviors were not associated with type 2 diabetes risk.

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