| [Objectives:] The main hypothesis is that the increased risk of type 2 diabetes mellitus (DM) or cardiovascular disease (CVD) in obese subjects is due to an increased release of free fatty acids by adipose tissue. Recent work, however, suggests that there may be an alternative explanation. Adipose tissue may contribute to a pro-inflammatory state by the secretion of cytokines. The resulting elevation in circulating pro-inflammatory cytokines (secreted by inflammatory cells and by the adipose tissue) could cause insulin resistance and endothelial damage, leading to DM and CVD. The objective of this project is to study the relationship between measures of (abdominal) obesity and the risk of DM and CVD in participants in the Hoorn Study. Subsequently, it will be determined whether the expected association between measures of (abdominal) obesity and (sub-clinical) DM and CVD depends on levels of inflammation markers such as C-reactive protein and interleukin 6. [Methods:] The Hoorn Study, which is investigating glucose tolerance among 2,484 men and women, aged 50 to 74, was initiated in 1989. A sub-sample of subjects who participated in an extensive medical examination in 1990 and additional samples of the original participants in the Hoorn Study (a total of 400 subjects with a normal glucose tolerance, 100 with impaired glucose tolerance and 200 with diabetes) will be invited for a glucose tolerance test, anthropometry, DXA scan and extensive non-invasive measurements of vascular function and prevalent vascular disease (blood pressure, ankle-arm index, intima-media thickness, ECG). In addition, questions will be asked about life-style, and blood samples will be taken for the determination of lipids, genetic characteristics and inflammatory markers. [Results:] To date, a total of 270 subjects have undergone a complete examination (39%). Completion of the data collection is expected in September 2001. The results are not yet available. |
