@misc{OseiBlockWippert2022,
  author    = {Osei, Francis and Block, Andrea and Wippert, Pia-Maria},
  title     = {Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Gesundheitswissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Gesundheitswissenschaftliche Reihe},
  number    = {6},
  doi       = {10.25932/publishup-58176},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-581769},
  pages     = {16},
  year      = {2022},
  abstract  = {Allostatic load (AL) exposure may cause detrimental effects on the neuroendocrine system, leading to metabolic syndrome (MetS). The primary mediators of AL involve serum dehydroepiandrosterone sulfate (DHEAS; a functional HPA axis antagonist); further, cortisol, urinary norepinephrine (NE), and epinephrine (EPI) excretion levels (assessed within 12-h urine as a golden standard for the evaluation of the HPA axis activity and sympathetic nervous system activity). However, the evidence of an association between the primary mediators of AL and MetS is limited. This systematic review aimed to critically examine the association between the primary mediators of AL and MetS. PubMed and Web of Science were searched for articles from January 2010 to December 2021, published in English. The search strategy focused on cross-sectional and case-control studies comprising adult participants with MetS, obesity, overweight, and without chronic diseases. The STROBE checklist was used to assess study quality control. Of 770 studies, twenty-one studies with a total sample size (n = 10,666) met the eligibility criteria. Eighteen studies were cross-sectional, and three were case-control studies. The included studies had a completeness of reporting score of COR \% = 87.0 ± 6.4\%. It is to be noted, that cortisol as a primary mediator of AL showed an association with MetS in 50\% (urinary cortisol), 40\% (serum cortisol), 60\% (salivary cortisol), and 100\% (hair cortisol) of the studies. For DHEAS, it is to conclude that 60\% of the studies showed an association with MetS. In contrast, urinary EPI and urinary NE had 100\% no association with MetS. In summary, there is a tendency for the association between higher serum cortisol, salivary cortisol, urinary cortisol, hair cortisol, and lower levels of DHEAS with MetS. Future studies focusing on longitudinal data are warranted for clarification and understanding of the association between the primary mediators of AL and MetS.},
  language  = {en}
}
@article{OseiBlockWippert2022,
  author    = {Osei, Francis and Block, Andrea and Wippert, Pia-Maria},
  title     = {Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review},
  series = {Frontiers in Endocrinology},
  volume    = {13},
  journal   = {Frontiers in Endocrinology},
  publisher = {Frontiers},
  address   = {Lausanne, Schweiz},
  issn      = {1664-2392},
  doi       = {10.3389/fendo.2022.946740},
  pages     = {16},
  year      = {2022},
  abstract  = {Allostatic load (AL) exposure may cause detrimental effects on the neuroendocrine system, leading to metabolic syndrome (MetS). The primary mediators of AL involve serum dehydroepiandrosterone sulfate (DHEAS; a functional HPA axis antagonist); further, cortisol, urinary norepinephrine (NE), and epinephrine (EPI) excretion levels (assessed within 12-h urine as a golden standard for the evaluation of the HPA axis activity and sympathetic nervous system activity). However, the evidence of an association between the primary mediators of AL and MetS is limited. This systematic review aimed to critically examine the association between the primary mediators of AL and MetS. PubMed and Web of Science were searched for articles from January 2010 to December 2021, published in English. The search strategy focused on cross-sectional and case-control studies comprising adult participants with MetS, obesity, overweight, and without chronic diseases. The STROBE checklist was used to assess study quality control. Of 770 studies, twenty-one studies with a total sample size (n = 10,666) met the eligibility criteria. Eighteen studies were cross-sectional, and three were case-control studies. The included studies had a completeness of reporting score of COR \% = 87.0 ± 6.4\%. It is to be noted, that cortisol as a primary mediator of AL showed an association with MetS in 50\% (urinary cortisol), 40\% (serum cortisol), 60\% (salivary cortisol), and 100\% (hair cortisol) of the studies. For DHEAS, it is to conclude that 60\% of the studies showed an association with MetS. In contrast, urinary EPI and urinary NE had 100\% no association with MetS. In summary, there is a tendency for the association between higher serum cortisol, salivary cortisol, urinary cortisol, hair cortisol, and lower levels of DHEAS with MetS. Future studies focusing on longitudinal data are warranted for clarification and understanding of the association between the primary mediators of AL and MetS.},
  language  = {en}
}
@article{BlockSchulzeDeekenetal.2021,
  author    = {Block, Andrea and Schulze, Susanne and Deeken, Friederike and H{\"a}usler, Andreas and Rezo, Anna and Rapp, Michael A. and Wippert, Pia-Maria},
  title     = {Effects of inflammatory markers and biographical stress on treatment response in depression},
  series = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology},
  volume    = {131},
  journal   = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology},
  number    = {Supplement},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0306-4530},
  doi       = {10.1016/j.psyneuen.2021.105535},
  pages     = {S24 -- S24},
  year      = {2021},
  abstract  = {Background Recent research emphasized the role of inflammatory processes in the pathophysiology of depression. Theories hypothesizes that life events (LE) can affect the immune system and trigger depressive symptoms. LE are also considered as one of the best predictors for the onset and course of depressive disorders. Methods Observational study across three treatment settings: n=208 depressive patients (75.5\%f, M 46.6 y) were examined on depression (BDI-II), life events (ILE) and inflammatory markers (IL-6, CRP, fibrinogen, ICAM-1, TNF-alpha, E-selectin) at baseline (t0), 5-week(t1) and 5-month(t2) follow-up. Effects and interactions were analyzed with regression models. Results LE were associated with depressive symptoms at t0 (beta=.209; p=.002) and both follow-ups. Except for CRP, which was linked to depression symptoms at t2 (betai=-.190; p=.032), there were no effects of inflammatory markers on depressive symptoms. At t1, an interaction between CRP and LE in total (beta=-.249; p=.041) was found as well as for LE in the past five years (beta=-.122; p=.027). Similar interactions were found between cumulative LE and ICAM-1 (beta=-.197; p=.003) and IL-6 (beta=-.425; p=.001). Conclusion The cumulative burden of LE effects symptoms and treatment outcome in depressive patients. There is some evidence that inflammatory marker may have long-term effects on treatment outcome as they seem to weaken the determining relation between LE and depression.},
  language  = {en}
}
@misc{BlockBonaventuraGrahnetal.2022,
  author    = {Block, Andrea and Bonaventura, Klaus and Grahn, Patricia and Bestgen, Felix and Wippert, Pia-Maria},
  title     = {Stress management in pre-and postoperative care amongst practitioners and patients in cardiac catheterization laboratory: a study protocol},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {801},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-56698},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-566980},
  pages     = {10},
  year      = {2022},
  abstract  = {Background: As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization. Methods: The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis. Discussion: This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines},
  language  = {en}
}
@article{BlockBonaventuraGrahnetal.2022,
  author    = {Block, Andrea and Bonaventura, Klaus and Grahn, Patricia and Bestgen, Felix and Wippert, Pia-Maria},
  title     = {Stress management in pre-and postoperative care amongst practitioners and patients in cardiac catheterization laboratory: a study protocol},
  series = {Frontiers in Cardiovascular Medicine},
  volume    = {9},
  journal   = {Frontiers in Cardiovascular Medicine},
  publisher = {Frontiers},
  address   = {Lausanne, Schweiz},
  issn      = {2297-055X},
  doi       = {10.3389/fcvm.2022.830256},
  pages     = {1 -- 10},
  year      = {2022},
  abstract  = {Background: As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization. Methods: The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis. Discussion: This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines},
  language  = {en}
}
@misc{StuchteyBlockOseietal.2022,
  author    = {Stuchtey, Fidelis Christin and Block, Andrea and Osei, Francis and Wippert, Pia-Maria},
  title     = {Lipid Biomarkers in Depression: Does Antidepressant Therapy Have an Impact?},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-56024},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-560240},
  pages     = {1 -- 11},
  year      = {2022},
  abstract  = {Studies have revealed mixed results on how antidepressant drugs affect lipid profiles of patients with major depression disorder (MDD). Even less is known about how patients respond to a switch of antidepressant medication with respect to their metabolic profile. For this, effects of a switch in antidepressants medication on lipid markers were studied in MDD patients. 15 participants (females = 86.67\%; males = 13.33\%; age: 49.45 ± 7.45 years) with MDD and a prescribed switch in their antidepressant medication were recruited at a psychosomatic rehabilitation clinic. Participants were characterized (with questionnaires and blood samples) at admission to the rehabilitation clinic (baseline, T0) and followed up with a blood sample two weeks (T1) later. HDL, LDL, total cholesterol, and triglycerides were determined (T0), and their change analyzed (Wilcoxon test) at follow up (T1). Decrements in HDL (p = 0.041), LDL (p < 0.001), and total cholesterol (p < 0.001) were observed two weeks after a switch in antidepressant medication. Triglycerides showed no difference (p = 0.699). Overall, LDL, HDL, and total cholesterol are affected by a change in antidepressant drugs in patients with MDD. These observations are of clinical relevance for medical practitioners in the planning and management of treatment strategies for MDD patients.},
  language  = {en}
}
@article{StuchteyBlockOseietal.2022,
  author    = {Stuchtey, Fidelis Christin and Block, Andrea and Osei, Francis and Wippert, Pia-Maria},
  title     = {Lipid Biomarkers in Depression: Does Antidepressant Therapy Have an Impact?},
  series = {Healthcare : open access journal},
  volume    = {10},
  journal   = {Healthcare : open access journal},
  edition   = {2},
  publisher = {MDPI},
  address   = {Basel, Schweiz},
  issn      = {2227-9032},
  doi       = {10.3390/healthcare10020333},
  pages     = {1 -- 11},
  year      = {2022},
  abstract  = {Studies have revealed mixed results on how antidepressant drugs affect lipid profiles of patients with major depression disorder (MDD). Even less is known about how patients respond to a switch of antidepressant medication with respect to their metabolic profile. For this, effects of a switch in antidepressants medication on lipid markers were studied in MDD patients. 15 participants (females = 86.67\%; males = 13.33\%; age: 49.45 ± 7.45 years) with MDD and a prescribed switch in their antidepressant medication were recruited at a psychosomatic rehabilitation clinic. Participants were characterized (with questionnaires and blood samples) at admission to the rehabilitation clinic (baseline, T0) and followed up with a blood sample two weeks (T1) later. HDL, LDL, total cholesterol, and triglycerides were determined (T0), and their change analyzed (Wilcoxon test) at follow up (T1). Decrements in HDL (p = 0.041), LDL (p < 0.001), and total cholesterol (p < 0.001) were observed two weeks after a switch in antidepressant medication. Triglycerides showed no difference (p = 0.699). Overall, LDL, HDL, and total cholesterol are affected by a change in antidepressant drugs in patients with MDD. These observations are of clinical relevance for medical practitioners in the planning and management of treatment strategies for MDD patients.},
  language  = {en}
}
@article{FrodlJanowitzSchmaaletal.2017,
  author    = {Frodl, Thomas and Janowitz, Deborah and Schmaal, Lianne and Tozzi, Leonardo and Dobrowolny, Henrik and Stein, Dan J. and Veltman, Dick J. and Wittfeld, Katharina and van Erp, Theo G. M. and Jahanshad, Neda and Block, Andrea and Hegenscheid, Katrin and Voelzke, Henry and Lagopoulos, Jim and Hatton, Sean N. and Hickie, Ian B. and Frey, Eva Maria and Carballedo, Angela and Brooks, Samantha J. and Vuletic, Daniella and Uhlmann, Anne and Veer, Ilya M. and Walter, Henrik and Schnell, Knut and Grotegerd, Dominik and Arolt, Volker and Kugel, Harald and Schramm, Elisabeth and Konrad, Carsten and Zurowski, Bartosz and Baune, Bernhard T. and van der Wee, Nic J. A. and van Tol, Marie-Jose and Penninx, Brenda W. J. H. and Thompson, Paul M. and Hibar, Derrek P. and Dannlowski, Udo and Grabe, Hans J.},
  title     = {Childhood adversity impacts on brain subcortical structures relevant to depression},
  series = {Journal of psychiatric research},
  volume    = {86},
  journal   = {Journal of psychiatric research},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0022-3956},
  doi       = {10.1016/j.jpsychires.2016.11.010},
  pages     = {58 -- 65},
  year      = {2017},
  abstract  = {Childhood adversity plays an important role for development of major depressive disorder (MDD). There are differences in subcortical brain structures between patients with MDD and healthy controls, but the specific impact of childhood adversity on such structures in MDD remains unclear. Thus, aim of the present study was to investigate whether childhood adversity is associated with subcortical volumes and how it interacts with a diagnosis of MDD and sex. Within the ENIGMA-MDD network, nine university partner sites, which assessed childhood adversity and magnetic resonance imaging in patients with MDD and controls, took part in the current joint mega-analysis. In this largest effort world-wide to identify subcortical brain structure differences related to childhood adversity, 3036 participants were analyzed for subcortical brain volumes using FreeSurfer. A significant interaction was evident between childhood adversity, MDD diagnosis, sex, and region. Increased exposure to childhood adversity was associated with smaller caudate volumes in females independent of MDD. All subcategories of childhood adversity were negatively associated with caudate volumes in females - in particular emotional neglect and physical neglect (independently from age, ICV, imaging site and MDD diagnosis). There was no interaction effect between childhood adversity and MDD diagnosis on subcortical brain volumes. Childhood adversity is one of the contributors to brain structural abnormalities. It is associated with subcortical brain abnormalities that are relevant to psychiatric disorders such as depression. (C) 2016 Published by Elsevier Ltd.},
  language  = {en}
}
@article{SchraplauBlockHaeusleretal.2021,
  author    = {Schraplau, Anne and Block, Andrea and H{\"a}usler, Andreas and Wippert, Pia-Maria and Rapp, Michael A. and V{\"o}ller, Heinz and Bonaventura, Klaus and Mayer, Frank},
  title     = {Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study},
  series = {Pilot and Feasibility Studies},
  volume    = {7},
  journal   = {Pilot and Feasibility Studies},
  publisher = {BioMed Central (Springer Nature)},
  address   = {London},
  issn      = {2055-5784},
  doi       = {10.1186/s40814-021-00898-w},
  pages     = {1 -- 11},
  year      = {2021},
  abstract  = {Background The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a "Mobile Brandenburg Cohort" to reveal new causes and risk factors for MetS. Methods In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis. Discussion The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the "Mobile Brandenburg Cohort" create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions. Trial registration German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.},
  language  = {en}
}
@misc{SchraplauBlockHaeusleretal.2021,
  author    = {Schraplau, Anne and Block, Andrea and H{\"a}usler, Andreas and Wippert, Pia-Maria and Rapp, Michael A. and V{\"o}ller, Heinz and Bonaventura, Klaus and Mayer, Frank},
  title     = {Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study: the Mobile Brandenburg Cohort},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-54950},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-549506},
  pages     = {1 -- 11},
  year      = {2021},
  abstract  = {Background The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a "Mobile Brandenburg Cohort" to reveal new causes and risk factors for MetS. Methods In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis. Discussion The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the "Mobile Brandenburg Cohort" create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions. Trial registration German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.},
  language  = {en}
}