Diet, Inflammation, Body Composition and Type 2 Diabetes: Insights from epidemiological studies

With this thesis, I aim to further clarify how the factors diet, inflammation and body composition interact with each other and affect risk of type 2 diabetes from an epidemiological perspective

The role of positron-emission tomography in the diagnosis of giant cell arteritis

Abstract Background: Giant cell arteritis (GCA) is an inflammatory disease of the larger vessels, typically affecting the temporal arteries, but involvement of the carotid and thoracic arteries is not uncommon. Serious complications such as blindness can occur if the disease is left untreated. Currently, the gold standard test for GCA is a temporal biopsy, but this invasive technique is not without risks and frequently inaccurate. We investigate the use of 18-fluoro-desoxyglucose (18F-FDG) positron emission tomography (PET) as a new diagnostic means in GCA. Methods: We performed a literature search in the MEDLINE database for original research articles written in the English language that discussed the use of PET in diagnosing GCA. After applying selection criteria, 9 articles were included for literature review and 4 of these were incorporated in a meta-analysis. Results: 18-FDG uptake in the extracranial arteries is correlated to the presence GCA within patients suspected for vasculitis. In our meta-analysis we found the following results: sensitivity 85% (95% CI; 74-92%, I2=0.0%), specificity 91% (95% CI; 82-96%, I2=31.2%), positive likelihood ratio 7.18 (95% CI; 3.43-15.06, I2 =10.1%) and negative likelihood ratio 0.19 (95% CI; 0.11-0.33, I2= 0.0%). Discussion: 18F-FDG-PET cannot replace temporal artery biopsy at the present time, because of its limited ability to visualise the cranial arteries. However, PET may be provide valuable information when extracranial involvement is suspected, specifically in biopsy-negative patients who are strongly suspected of having GCA

Plant versus animal based diets and insulin resistance, prediabetes and type 2 diabetes: the Rotterdam Study

Vegan or vegetarian diets have been suggested to reduce type 2 diabetes (T2D) risk. However, not much is known on whether variation in the degree of having a plant-based versus animal-based diet may be beneficial for prevention of T2D. We aimed to investigate whether level of adherence to a diet high in plant-based foods and low in animal-based foods is associated with insulin resistance, prediabetes, and T2D. Our analysis included 6798 participants (62.7 ± 7.8 years) from the Rotterdam Study (RS), a prospective population-based cohort in the Netherlands. Dietary intake data were collected with food-frequency questionnaires at baseline of three sub-cohorts of RS (RS-I-1: 1989–1993, RS-II-1: 2000–2001, RS-III-1: 2006–2008). We constructed a continuous plant-based dietary index (range 0–92) assessing adherence to a plant-based versus animal-based diet. Insulin resistance at baseline and follow-up was assessed using homeostasis model assessment of insulin resistance (HOMA-IR). Prediabetes and T2D were collected from general practitioners’ records, pharmacies’ databases, and follow-up examinations in our research center until 2012. We used multivariable linear mixed models to examine association of the index with longitudinal HOMA-IR, and multivariable Cox proportional-hazards regression models to examine associations of the index with risk of prediabetes and T2D. During median 5.7, and 7.3 years of follow-up, we documented 928 prediabetes cases and 642 T2D cases. After adjusting for sociodemographic and lifestyle factors, a higher score on the plant-based dietary index was associated with lower insulin resistance (per 10 units higher score: β = −0.09; 95% CI: − 0.10; − 0.08), lower prediabetes risk (HR = 0.89; 95% CI: 0.81; 0.98), and lower T2D risk [HR = 0.82 (0.73; 0.92)]. After additional adjustment for BMI, associations attenuated and remained statistically significant for longitudinal insulin resistance [β = −0.05 (− 0.06; − 0.04)] and T2D risk [HR = 0.87 (0.79; 0.99)], but no longer for prediabetes risk [HR = 0.93 (0.85; 1.03)]. In conclusion, a more plant-based and less animal-based diet may lower risk of insulin resistance, prediabetes and T2D. These findings strengthen recent dietary recommendations to adopt a more plant-based diet. Clinical Trial Registry number and website NTR6831, http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6831

Dietary protein intake and all-cause and cause-specific mortality: results from the Rotterdam Study and a meta-analysis of prospective cohort studies

Evidence for associations between long-term protein intake with mortality is not consistent. We aimed to examine associations of dietary protein from different s

The association between serum uric acid and incidence of prediabetes and type 2 diabetes mellitus.

<p>The association between serum uric acid and incidence of prediabetes and type 2 diabetes mellitus.</p

Quartile-specific hazard ratios for serum uric acid in association with incident prediabetes and incident type 2 diabetes mellitus.

<p>Quartile-specific hazard ratios for serum uric acid in association with incident prediabetes and incident type 2 diabetes mellitus.</p

Subgroup analyses for the association between serum uric acid and incident prediabetes and incident type 2 diabetes mellitus.

<p>Subgroup analyses for the association between serum uric acid and incident prediabetes and incident type 2 diabetes mellitus.</p