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

• Published in: Diabetologia 2011-09, Vol.54 (9), p.2272-2282
• Main Authors: Langenberg, C, Sharp, S, Forouhi, N G, Franks, P W, Schulze, M B, Kerrison, N, Ekelund, U, Barroso, I, Panico, S, Tormo, M J, Spranger, J, Griffin, S, van der Schouw, Y T, Amiano, P, Ardanaz, E, Arriola, L, Balkau, B, Barricarte, A, Beulens, J W J, Boeing, H, Bueno-de-Mesquita, H B, Buijsse, B, Chirlaque Lopez, M D, Clavel-Chapelon, F, Crowe, F L, de Lauzon-Guillan, B, Deloukas, P, Dorronsoro, M, Drogan, D, Froguel, P, Gonzalez, C, Grioni, S, Groop, L, Groves, C, Hainaut, P, Halkjaer, J, Hallmans, G, Hansen, T, Huerta Castaño, J M, Kaaks, R, Key, T J, Khaw, K T, Koulman, A, Mattiello, A, Navarro, C, Nilsson, P, Norat, T, Overvad, K, Palla, L, Palli, D, Pedersen, O, Peeters, P H, Quirós, J R, Ramachandran, A, Rodriguez-Suarez, L, Rolandsson, O, Romaguera, D, Romieu, I, Sacerdote, C, Sánchez, M J, Sandbaek, A, Slimani, N, Sluijs, I, Spijkerman, A M W, Teucher, B, Tjonneland, A, Tumino, R, van der A, D L, Verschuren, W M M, Tuomilehto, J, Feskens, E, McCarthy, M, Riboli, E, Wareham, N J
• Format: Article
• Language: English
• Subjects: Age; Biological and medical sciences; Cancer; Clinical Medicine; Cohort analysis; Cohort Studies; Consortia; coronary-heart-disease; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - genetics; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diet; Endocrine pancreas. Apud cells (diseases); Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; Epidemiologic research design; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Europe - epidemiology; Exercise; Female; Follow-Up Studies; Gene loci; Gene-lifestyle interaction; Genetic epidemiology; Genetic Predisposition to Disease - genetics; genome-wide association; Genomes; Human Physiology; Humans; Incidence; Internal Medicine; International Cooperation; Klinisk medicin; Life Style; Lifestyles; loci; Male; Medical and Health Sciences; Medical research; Medical sciences; Medical screening; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Motor Activity - physiology; nutrition; Nutrition research; physical-activity; population-based incidence; prevalence; Prospective Studies; Questionnaires; Retrospective Studies; Risk Factors; spain; Type 2 diabetes
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-011-2182-9

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.