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Research interest

The research focus of the working group 'Diabetes Epidemiology' is the identification of novel determinants for type 2 diabetes (T2DM) and its major macrovascular and microvascular complications such as coronary heart disease, stroke or chronic kidney disease.

Our research is mainly based on data from the Cooperative Health Research in the Region of Augsburg (KORA) Study. For more than 20 years, the internationally known KORA study is examining the health of thousands of citizens in and around the city of Augsburg, Southern Germany, to investigate the effects of environmental behavioral, metabolic and genetic risk factors on the development of major chronic diseases including T2DM.

Project

Role of sex hormones in the prediction of type 2 diabetes and chronic kidney disease

Our current understanding of the impact of sex hormones on type 2 diabetes (T2DM) development is not satisfactory and more research is required to impact care and prevention. Emerging evidence from observational studies shows for instance that higher levels of sex-hormone binding globulin are associated with lower risk of T2D, whereas high testosterone levels have been shown to increase diabetes risk in women but not in men. Controversies exist in the association of estradiol levels and diabetes risk. Moreover, recent genetic studies have reported an involvement of sex hormones in the etiology of diabetes. On the other side, sex hormones might contribute to the progression of diabetic microvascular diseases. Sex differences reflecting abnormal hormonal levels have been reported in the incidence of chronic kidney disease (CKD), one of the major diabetes complications.

Therefore, the aim of the current project is to elucidate the etiological role of sex hormones in glucose metabolism, diabetes development and ultimately, their role in CKD. Secondary aim is to investigate whether these hormones improve prediction models of T2DM and CKD above classical diabetes risk factors. The knowledge gathered through the project is crucial to understand novel aspects of diabetes etiology which might lead to new avenues for disease prevention and help optimize current prediction tools for both T2DM and CKD.

The PhD thesis will include 2 to 3 peer-reviewed papers with the PhD student as first author based on data from the KORA F4/FF4 cohort study. This study includes 3,080 middle-aged men and women who were examined in 2006-08 (F4). A follow-up examination was conducted 7 years later (FF4). An oral glucose tolerance test (OGTT) was performed at baseline and at follow-up to assess the incidence of T2DM. Furthermore, estimated glomerular filtration rate was assessed at both time points to determine kidney function. Sex steroids were measured at baseline using Ultra-HPLC-MS/MS technology. Extensive lifestyle and metabolic risk factors for T2DM have been measured at baseline and follow-up.

The PhD project will include a 6 month stay at the Alberta Diabetes Institute (ADI). The ADI brings together leading scientists from diverse backgrounds to examine the influence that various factors have on the onset or management of diabetes. They are also translating this knowledge into practical application through clinical and community intervention. The cooperation partner at the ADI will be selected depending on the interests/career development goals of the PhD student.

Prerequisites for the project: good knowledge of biostatistical and epidemiological methods preferentially with a Master’s degree in one of the two disciplines.

The project will be conducted in cooperation with the Genome Analysis Center (Head: Prof. Dr. Jerzy Adamski).