Research Unit 'Epidemiology of Chronic Diseases'
Head: Annette Peters
Projects:
Cardiovascular diseases, type 2 diabetes and other chronic diseases:
The aim of this research area is to identify determinants of major chronic diseases such as coronary heart disease, stroke and type 2 diabetes and to characterise the interactions between various risk factors in the prediction of these diseases. Furthermore, the aim is to evaluate whether trends in the morbidity and mortality of these chronic diseases are associated with changes in clinical risk factors, lifestyle factors or the health care system. In this respect gender differences are of particular interest.
The four population based Augsburg-Surveys (S1 1984/85, S2 1989/90, S3 1994/95, S4 1999/2001) together with written follow-up questionnaires and a mortality follow-up for all survey participants of S1-S3 (up to 31.12.2002) form the basis for a prospective cohort study. Furthermore, data from two family studies, i.e. the Family Heart Study 1996/97 and the Diabetes Family Study 2001/02 are available for analyses concerning the above mentioned topics.
The main topic of the population based cross-sectional and longitudinal studies as well as of the Family Heart Study and the Family Diabetes Study is the evaluation of the impact of the classical risk factors (smoking, hypertension, hyperlipidemia, diabetes, obesity, body composition, dietary habits and psychological and psychosocial factors) and of the more recently identified risk factors (haemostaseological factors, inflammatory markers, endothelial dysfunction) on cardiovascular and metabolic outcomes.
One focus of the current research is the role of inflammation and of genetic polymorphisms related to the inflammatory process in the aetiology of type 2 diabetes and cardiovascular disease. Furthermore, the effects of the health care system on the development and prognosis of the above mentioned chronic diseases are evaluated. Research on the determinants of the metabolic syndrome in particular in young adults will be another focus of our research in the coming years.
- Registry of Acute Myocardial Infarction (Herzinfarktregister)
- MONICA/KORA Cohort Study S1-S4
- KORA-Study F4 (2006/2008): Follow-up examination of the KORA survey S4, identification of risk factors for early disease stages
- KORA-Study F3 (2004/2005): Substudy on trends of cardiovascular risk factors and the identification of new risk factors for chronic diseases
- KORA-Survey 2000 S4 (1999/2001): Substudy on cardiovascular risk factors and chronic diseases
- Family study on genetics of type 2 diabetes mellitus
- Genetics of Atrial fibrillation (AFNET Subproject A4)
- Cardiogenics
- MORGAM Project: A multinational collaborative study
Subclinical inflammation:
A principle aim of the research unit of 'Epidemiology of Chronic Diseases' of the Institute of Epidemiology is the identification of new risk factors for cardiovascular disease and type 2 diabetes. One focus of our current research is to examine the association of biomarkers of inflammation and genetic polymorphisms related to inflammatory processes, respecitvely with type 2 diabetes and coronary heart disease. In this context, we will particularly look at possible interactions between genetic, metabolic and lifestyle factors. The overall aim of this research is to identify novel predictors for both diseases and to further clarify the role of inflammation in the etiology of type 2 diabetes and coronary heart disease.
- Inflammation and endothelial dysfunction as determinants of incident diabetes mellitus and myocardial infarction
- Inflammation and endothelial dysfunction as a common cause underlying diabetes type 2 and myocardial infarction. Role of intermediate phenotypes and genetic variants
- Replication of results from 500K GWA studies of inflammatory markers and evaluation of a 50K vascular disease SNP array in the large MONICA/KORA case-cohort study
Aging:
Life expectancy has increased substantially in the last century in all western countries. The fourth report on the situation of the aged population presented by the German Federal Ministry of Family Affairs, Senior Citizens, Women and Youth in 2002 points at specific needs for intensified research activities. One of the major points is the lack of longitudinal studies based on large samples and performed in interdisciplinary cooperation between clinicians, epidemiologists, and social scientists. In addition, the need for methodically sound intervention studies in this age group is emphasized (1) Our study will be based on a large population-based KORA study (Cooperative Health Research in the Region of Augsburg) with long-term follow-up and extensive clinical data offers a unique opportunity to fill this gap.
Mental health:
The KORA study platform offers the unique opportunity to promote and advance the scientific understanding of the interrelationships among social, psychological, behavioural and biological factors in human health and disease from a population based epidemiological research perspective.
The interdisciplinary lay-out of the KORA research platform allows to link recent state-of-the-art-developments in somatic medicine and other fields of science (e.g. inflammation reseach) to psycho-behavioural concepts and thus contributes to the integration of psychological and somatic aspects of chronic disease processes.
Evaluating the impact of long acting chronic stress conditions on health and bridging the gap between psychological and various somatic health outcomes is a major challenge of the mental health topic. Risky behavioural patterns (e.g., smoking, eating habits, and physical exercise) and their immediate consequences (e.g., obesity) confer risks for most of the major health problems in industrialized nations. Hence, determinants of these behaviours and their modifications remain central topics in mental health science.
Challenges and opportunities in the future include changes in demographics and patterns of health, the need for a more comprehensive model of the domain of health behaviour and prevention and the need to integrate behavioural and psychosocial risk and resilience especially for the older people to promote positive mental health and successful aging in the fast growing older population.