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Articles by M. Heier
Total Records ( 3 ) for M. Heier
  W. Rathmann , K. Strassburger , M. Heier , R. Holle , B. Thorand , G. Giani and C. Meisinger
  Aims:To determine the incidence of Type 2 diabetes in an elderly population in Germany and its association with clinical and lifestyle factors.
Methods:Oral glucose tolerance tests (OGTT, World Health Organization criteria) were carried out in a random sample of 1353 subjects (age group 55–74 years; 62% response) in Augsburg (Southern Germany) (1999–2001). The cohort was re-investigated in 2006–2008. Of those individuals without diabetes (baseline), 887 (74%) participated in the follow-up.
Results:Ninety-three (10.5%) developed diabetes during the 7-year follow-up period {standardized incidence rates [95% confidence interval (CI)] per 1000 person-years: total 15.5; 12.6, 19.1; men 20.2; 15.6, 26.1; women 11.3; 7.9, 16.1}. In both sexes, those who developed diabetes were slightly older, were more obese, had a more adverse metabolic profile (higher glucose values, HbA1c, fasting insulin, uric acid, and triglycerides) and were more likely to have hypertension at baseline than were participants remaining free of diabetes (P < 0.05). On stepwise logistic regression, age, parental diabetes, body mass index, uric acid, current smoking, HbA1c and fasting and 2-h glucose (OGTT) were strong predictors of diabetes incidence. The risk of diabetes was higher in subjects with isolated impaired glucose tolerance (odds ratio 8.8; 95% CI 5.0, 15.6) than in isolated impaired fasting glucose (4.7; 2.2, 10.0), although the difference did not reach statistical significance.
Conclusions:For the first time, we have estimated the incidence of Type 2 diabetes in an elderly German cohort and demonstrated that it is among the highest in Europe. The OGTT appears to be useful in identifying individuals with high Type 2 diabetes risk. Our results support a role of smoking in the progression to diabetes.
  C. Meisinger , K. Strassburger , M. Heier , B. Thorand , S. E. Baumeister , G. Giani and W. Rathmann
  Aims  Limited data are available for European populations regarding the prevalence of diabetes and disturbed glucose metabolism in younger individuals. Our aim was to estimate the prevalence of diagnosed and undiagnosed diabetes, isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT) and combined IFG/IGT in a population-based sample (n = 1653) from Southern Germany aged 35-59 years.

Methods  Oral glucose tolerance tests were carried out in all non-diabetic participants of the KORA F4 Study (2006-2008). Diabetes, IGT and IFG were defined according to the 1999 World Health Organization diagnostic criteria. The original IFG criteria (6.1-6.9 mmol/l) were used as recommended by the European Diabetes Epidemiology Group.

Results  The age-standardized prevalence was 2.2% for known diabetes, 2.0% for newly detected diabetes, 2.9% for i-IFG, 6.3% for i-IGT and 1.1% for combined IFG/IGT. About half of the cases with overt diabetes were undiagnosed in all age groups. The prevalence of i-IGT was approximately twice as high as that of i-IFG. The proportion of i-IGT varied between 3.2% (age group 35-44 years) and 11.8% (age group 55-59 years); the corresponding numbers for i-IFG were 1.1% and 5.9%. IFG/IGT was present in 1.2% of the total sample, and was most frequently found in the age group 55-59 years (2.4%). Overall, 16% of the study population had either diabetes or abnormalities of glucose metabolism.

Conclusions  The study reveals for the first time a high prevalence of impaired glucose regulation in the younger and middle-aged German population. The detection of disturbed glucose metabolism or diabetes needs to be improved.

  W. Rathmann , B. Kowall , M. Heier , C. Herder , R. Holle , B. Thorand , K. Strassburger , A. Peters , H.-E. Wichmann , G. Giani and C. Meisinger
  Background  The aim was to derive Type 2 diabetes prediction models for the older population and to check to what degree addition of 2-h glucose measurements (oral glucose tolerance test) and biomarkers improves the predictive power of risk scores which are based on non-biochemical as well as conventional clinical parameters.

Methods  Oral glucose tolerance tests were carried out in a population-based sample of 1353 subjects, aged 55-74 years (62% response) in Augsburg (Southern Germany) from 1999 to 2001. The cohort was reinvestigated in 2006-2008. Of those individuals without diabetes at baseline, 887 (74%) participated in the follow-up. Ninety-three (10.5%) validated diabetes cases occurred during the follow-up. In logistic regression analyses for model 1, variables were selected from personal characteristics and additional variables were selected from routinely measurable blood parameters (model 2) and from 2-h glucose, adiponectin, insulin and homeostasis model assessment of insulin resistance (HOMA-IR) (model 3).

Results  Age, sex, BMI, parental diabetes, smoking and hypertension were selected for model 1. Model 2 additionally included fasting glucose, HbA1c and uric acid. The same variables plus 2-h glucose were selected for model 3. The area under the receiver operating characteristic curve significantly increased from 0.763 (model 1) to 0.844 (model 2) and 0.886 (model 3) (P < 0.01). Biomarkers such as adiponectin and insulin did not improve the predictive abilities of models 2 and 3. Cross-validation and bootstrap-corrected model performance indicated high internal validity.

Conclusions  This longitudinal study in an older population provides models to predict the future risk of Type 2 diabetes. The OGTT, but not biomarkers, improved discrimination of incident diabetes.

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