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. 2011 Sep;54(9):2272-82.
doi: 10.1007/s00125-011-2182-9. Epub 2011 Jun 30.

Design and cohort description of the InterAct Project: an examination of the interaction of genetic and lifestyle factors on the incidence of type 2 diabetes in the EPIC Study

InterAct Consortium  1 ; C Langenberg, S Sharp, N G Forouhi, P W Franks, M B Schulze, N Kerrison, U Ekelund, I Barroso, S Panico, M J Tormo, J Spranger, S Griffin, Y T van der Schouw, P Amiano, E Ardanaz, L Arriola, B Balkau, A Barricarte, J W J Beulens, H Boeing, H B Bueno-de-Mesquita, B Buijsse, M D Chirlaque Lopez, F Clavel-Chapelon, F L Crowe, B de Lauzon-Guillan, P Deloukas, M Dorronsoro, D Drogan, P Froguel, C Gonzalez, S Grioni, L Groop, C Groves, P Hainaut, J Halkjaer, G Hallmans, T Hansen, J M Huerta Castaño, R Kaaks, T J Key, K T Khaw, A Koulman, A Mattiello, C Navarro, P Nilsson, T Norat, K Overvad, L Palla, D Palli, O Pedersen, P H Peeters, J R Quirós, A Ramachandran, L Rodriguez-Suarez, O Rolandsson, D Romaguera, I Romieu, C Sacerdote, M J Sánchez, A Sandbaek, N Slimani, I Sluijs, A M W Spijkerman, B Teucher, A Tjonneland, R Tumino, D L van der A, W M M Verschuren, J Tuomilehto, E Feskens, M McCarthy, E Riboli, N J Wareham
Affiliations

Design and cohort description of the InterAct Project: an examination of the interaction of genetic and lifestyle factors on the incidence of type 2 diabetes in the EPIC Study

InterAct Consortium et al. Diabetologia. 2011 Sep.

Abstract

Aims/hypothesis: Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes.

Methods: Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex.

Results: A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age.

Conclusions/interpretation: InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development.

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Figures

Figure 1
Figure 1
Overview of the InterAct type 2 diabetes (T2D) case-cohort study nested within 8 of the 10 EPIC Europe countries.
Figure 2
Figure 2
Hazard ratios for incident type 2 diabetes in men compared to women across InterAct centres and countries (I2 57%). France, Naples and Utrecht included women only and are excluded.
Figure 3
Figure 3
a-b. Hazard ratios for incident type 2 diabetes per 10 years of age across InterAct centres and countries (I2 71% in men, 61% in women; analysis with calendar time as the underlying timescale).
Figure 3
Figure 3
a-b. Hazard ratios for incident type 2 diabetes per 10 years of age across InterAct centres and countries (I2 71% in men, 61% in women; analysis with calendar time as the underlying timescale).
See this image and copyright information in PMC

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