@article{EichelmannSellemWittenbecheretal.2022,
  author    = {Eichelmann, Fabian and Sellem, Laury and Wittenbecher, Clemens and J{\"a}ger, Susanne and Kuxhaus, Olga and Prada, Marcela and Cuadrat, Rafael and Jackson, Kim G. and Lovegrove, Julie A. and Schulze, Matthias Bernd},
  title     = {Deep lipidomics in human plasma: cardiometabolic disease risk and effect of dietary fat modulation},
  series = {Circulation},
  volume    = {146},
  journal   = {Circulation},
  number    = {1},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0009-7322},
  doi       = {10.1161/CIRCULATIONAHA.121.056805},
  pages     = {21 -- 35},
  year      = {2022},
  abstract  = {Background: In blood and tissues, dietary and endogenously generated fatty acids (FAs) occur in free form or as part of complex lipid molecules that collectively represent the lipidome of the respective tissue. We assessed associations of plasma lipids derived from high-resolution lipidomics with incident cardiometabolic diseases and subsequently tested if the identified risk-associated lipids were sensitive to dietary fat modification. Methods: The EPIC Potsdam cohort study (European Prospective Investigation into Cancer and Nutrition) comprises 27 548 participants recruited within an age range of 35 to 65 years from the general population around Potsdam, Germany. We generated 2 disease-specific case cohorts on the basis of a fixed random subsample (n=1262) and all respective cohort-wide identified incident primary cardiovascular disease (composite of fatal and nonfatal myocardial infarction and stroke; n=551) and type 2 diabetes (n=775) cases. We estimated the associations of baseline plasma concentrations of 282 class-specific FA abundances (calculated from 940 distinct molecular species across 15 lipid classes) with the outcomes in multivariable-adjusted Cox models. We tested the effect of an isoenergetic dietary fat modification on risk-associated lipids in the DIVAS randomized controlled trial (Dietary Intervention and Vascular Function; n=113). Participants consumed either a diet rich in saturated FAs (control), monounsaturated FAs, or a mixture of monounsaturated and n-6 polyunsaturated FAs for 16 weeks. Results: Sixty-nine lipids associated (false discovery rate<0.05) with at least 1 outcome (both, 8; only cardiovascular disease, 49; only type 2 diabetes, 12). In brief, several monoacylglycerols and FA16:0 and FA18:0 in diacylglycerols were associated with both outcomes; cholesteryl esters, free fatty acids, and sphingolipids were largely cardiovascular disease specific; and several (glycero)phospholipids were type 2 diabetes specific. In addition, 19 risk-associated lipids were affected (false discovery rate<0.05) by the diets rich in unsaturated dietary FAs compared with the saturated fat diet (17 in a direction consistent with a potential beneficial effect on long-term cardiometabolic risk). For example, the monounsaturated FA-rich diet decreased diacylglycerol(FA16:0) by 0.4 (95\% CI, 0.5-0.3) SD units and increased triacylglycerol(FA22:1) by 0.5 (95\% CI, 0.4-0.7) SD units. Conclusions: We identified several lipids associated with cardiometabolic disease risk. A subset was beneficially altered by a dietary fat intervention that supports the substitution of dietary saturated FAs with unsaturated FAs as a potential tool for primary disease prevention.},
  language  = {en}
}
@article{MuehlenbruchZhuoBardenheieretal.2019,
  author    = {M{\"u}hlenbruch, Kristin and Zhuo, Xiaohui and Bardenheier, Barbara and Shao, Hui and Laxy, Michael and Icks, Andrea and Zhang, Ping and Gregg, Edward W. and Schulze, Matthias Bernd},
  title     = {Selecting the optimal risk threshold of diabetes risk scores to identify high-risk individuals for diabetes prevention},
  series = {Acta Diabetologica},
  volume    = {57},
  journal   = {Acta Diabetologica},
  number    = {4},
  publisher = {Springer},
  address   = {Mailand},
  issn      = {0001-5563},
  doi       = {10.1007/s00592-019-01451-1},
  pages     = {447 -- 454},
  year      = {2019},
  abstract  = {Aims: Although risk scores to predict type 2 diabetes exist, cost-effectiveness of risk thresholds to target prevention interventions are unknown. We applied cost-effectiveness analysis to identify optimal thresholds of predicted risk to target a low-cost community-based intervention in the USA. Methods: We used a validated Markov-based type 2 diabetes simulation model to evaluate the lifetime cost-effectiveness of alternative thresholds of diabetes risk. Population characteristics for the model were obtained from NHANES 2001-2004 and incidence rates and performance of two noninvasive diabetes risk scores (German diabetes risk score, GDRS, and ARIC 2009 score) were determined in the ARIC and Cardiovascular Health Study (CHS). Incremental cost-effectiveness ratios (ICERs) were calculated for increasing risk score thresholds. Two scenarios were assumed: 1-stage (risk score only) and 2-stage (risk score plus fasting plasma glucose (FPG) test (threshold 100 mg/dl) in the high-risk group). Results: In ARIC and CHS combined, the area under the receiver operating characteristic curve for the GDRS and the ARIC 2009 score were 0.691 (0.677-0.704) and 0.720 (0.707-0.732), respectively. The optimal threshold of predicted diabetes risk (ICER < \$50,000/QALY gained in case of intervention in those above the threshold) was 7\% for the GDRS and 9\% for the ARIC 2009 score. In the 2-stage scenario, ICERs for all cutoffs >= 5\% were below \$50,000/QALY gained. Conclusions: Intervening in those with >= 7\% diabetes risk based on the GDRS or >= 9\% on the ARIC 2009 score would be cost-effective. A risk score threshold >= 5\% together with elevated FPG would also allow targeting interventions cost-effectively.},
  language  = {en}
}
@article{JannaschNickelBergmannetal.2022,
  author    = {Jannasch, Franziska and Nickel, Daniela V. and Bergmann, Manuela M. and Schulze, Matthias Bernd},
  title     = {A new evidence-based diet score to capture associations of food consumption and chronic disease risk},
  series = {Nutrients / Molecular Diversity Preservation International (MDPI)},
  volume    = {14},
  journal   = {Nutrients / Molecular Diversity Preservation International (MDPI)},
  number    = {11},
  publisher = {MDPI},
  address   = {Basel},
  issn      = {2072-6643},
  doi       = {10.3390/nu14112359},
  pages     = {16},
  year      = {2022},
  abstract  = {Previously, the attempt to compile German dietary guidelines into a diet score was predominantly not successful with regards to preventing chronic diseases in the EPIC-Potsdam study. Current guidelines were supplemented by the latest evidence from systematic reviews and expert papers published between 2010 and 2020 on the prevention potential of food groups on chronic diseases such as type 2 diabetes, cardiovascular diseases and cancer. A diet score was developed by scoring the food groups according to a recommended low, moderate or high intake. The relative validity and reliability of the diet score, assessed by a food frequency questionnaire, was investigated. The consideration of current evidence resulted in 10 key food groups being preventive of the chronic diseases of interest. They served as components in the diet score and were scored from 0 to 1 point, depending on their recommended intake, resulting in a maximum of 10 points. Both the reliability (r = 0.53) and relative validity (r = 0.43) were deemed sufficient to consider the diet score as a stable construct in future investigations. This new diet score can be a promising tool to investigate dietary intake in etiological research by concentrating on 10 key dietary determinants with evidence-based prevention potential for chronic diseases.},
  language  = {en}
}