Observational Study of Early Metabolic and Vascular Changes in Obesity (STYJOBS)
To work against the increasing burden of obesity, the STYJOBS / EDECTA (STYrian Juvenile OBesity Study / Early DetECtion of Atherosclerosis) project was started at the Medical University of Graz in 2003. STYJOBS / EDECTA is a prospective, observational study to improve the understanding of atherosclerosis, cardiovascular risk, immune mediated low grade inflammation, and metabolic changes in obesity by investigation of the "non-biased" early phase.
The main focus is the early identification of obesity and "worse lifestyle" related individual high risk profiles for cardiovascular/metabolic/immune-inflammatory disease in juvenile, young, and adult persons up to the age of 65 years. Based on this information, new and effective strategies are developed for preclinical diagnostics and early intervention. Concerning mechanisms of obesity and "bad" lifestyle associated pathologic conditions, risk biomarker patterns, chronic immune-mediated inflammation, disturbed adipokine balance, individual adipose tissue topography, brown and white adipose tissue (BAT/WAT) function, addiction like behaviour, genetics/epigenetics, early vascular pathology, and fatty liver disease are in focus of research. Interventional branches of study tested a holistic strategy comprehending sports, and lifestyle modification for efficiency. A better understanding of the role of a disturbed energy expenditure in the etiology of obesity should give the basis for new paradigms in therapy of obesity.
The investigative spectrum of STYJOBS / EDECTA was recently extended also to non-obese body weight extremes i.e. underweight/anorectic people.
|Obesity Atherosclerosis Inflammation Adiponectin Deficiency Fatty Liver||Other: Lifestyle intervention|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Study for the Investigation of New Individual Risk Profiles and Therapeutic Strategies in Obesity Related Cardiovascular and Metabolic Disorders.|
- Anthropometric changes(BMI, SAT-Topography, waist/hipCF, waist to height ratio) during intervention [ Time Frame: 12 months ]
- Obesity related biomarkers (fasting glucose, insulin, HOMA-index, HbA1c, liver transaminases, inflammatory markers, adipokines, clotting parameters, lipids, oxidative stress markers, Biomarkers related to tryptophan metabolism), performance diagnostics. [ Time Frame: 12 months ]
Biospecimen Retention: Samples With DNA
|Study Start Date:||January 2003|
|Estimated Study Completion Date:||December 2019|
|Estimated Primary Completion Date:||December 2018 (Final data collection date for primary outcome measure)|
The cohort consists of age and sex matched normal weighted controls and overweight/obese persons.
Definition for "overweight": BMI >90th and <97th percentile, if under 18 years of age, and BMI >25 and <29.9 kg/m2 if over 18 years of age.
Definition for "obese": BMI >97th percentile, if under 18 years of age, and BMI >30kg/m2, if over 18 years of age.
Other: Lifestyle intervention
Regular sports and dietary advices. Controlled by analysis of laboratory parameters, BMI change and performance diagnostics. No drugs included so far.
Other Name: lifestyle counseling
A lifestyle intervention following a holistic schedule was done in a subgroup of obese juveniles.
Obesity is dramatically increasing in countries with so called western Lifestyle, whereby juveniles are affected in particular. Atherosclerosis, a major consequence of obesity, starts early in life and results in cardiovascular disease and stroke, the main causes of mortality in industrialized countries. STYJOBS / EDECTA is a prospective, observational study to improve the understanding of atherosclerosis and metabolic changes in obesity by investigation of the "non-biased" early phase.
• Identification of "individual metabolic high risk patterns" in obesity by linking lab parameters (adipokines, immune-inflammatory mediators, oxidative "stress" biomarkers, lipoproteins, molecular genetics, epigenetics), individual adipose tissue topography, early vascular changes (carotis intima media thickness by sonography), life style habits, and clinical data.
The STYJOBS/EDECTA-Database comprehends currently data from 1325 subjects.For each proband 282 variables are available (Clinical, anthropometric, carotis IMT, 82; Laboratory/Biomarkers, 100; Glucose metabolism, liver, kidney function, lipids, oxidative/nitrosative stress, adipokines, gut-brain axis, clotting, Genetic/mitochondrial function/miscellaneous,100), and the results of an early interventional trial by a holistic strategy (i.e. SAT- Risk profile guided Sport Program, Nutritional Device, Behavioral Therapy).
- To establish a comprehensive biobank. The STYJOBS/EDECTA-biomaterial resource comprises serum/plasma/DNA left over probes from currently 1256 probands.
- To improve the understanding of craving and addiction like behaviour in obesity (e.g.link insulin resistance - control of hedonic inputs).
- EDECTA (Early DEteCTion of Atherosclerosis) extends the STYJOBS Database and Bioresource with normal weight and obese probands aged up to 65 years.
Thus, the STYJOBS / EDECTA resource comprises in extendo data and biomaterial specimen from subjects afflicted with the preclinical phase of major sequels of obesity such as insulin resistance, cardiovascular disease, and probably also certain sorts of cancer.
An essential part of the identification of novel individual risk profiles is given by the combined analysis of clinical, anthropometric data, biomarkers (e.g. adipokines, oxidative/nitrosative "stress" markers, inflammatory cytokines), BAT/WAT balance, genetics, and epigenetics (e.g. microRNAs). To further improve the understanding of dysbalanced energy expenditure in obesity mitochondrial haplotypes are investigated in cooperation with Dr.Weghuber, Dr.Eder and Prof.Sperl from the Salzburg Paracelsus Private Medical School. All genetic and epigenetic measurements are performed by an anonymous approach (data privacy protection) after careful accreditation by the local ethical committee.
The investigative spectrum of STYJOBS / EDECTA is also extended to underweight/anorectic people. This condition is an attractive biologic "counterpart" to the overweight/obese group. Extremely underweight and anorectic patients are afflicted with profound metabolic abnormalities. Thus, it is interesting to investigate anorexia associated risk profiles in comparison to those found in overweight/obese people. Especially the craving like behaviour and the cardiovascular/"ox"Stress risk will be focused in our investigations.
Further, we investigate the role of tryptophan (TRP) metabolism in context with obesity, immune-mediated inflammation, skewing of T helper cells and mechanisms underlying uncontrolled overeating.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00482924
|Contact: Harald Mangge, Prof., MD||+43 316 385 ext firstname.lastname@example.org|
|Clinical Institute for Medical and Chemical Laboratory Diagnosis||Recruiting|
|Graz, Styria, Austria, 8036|
|Contact: Harald Mangge, Prof., MD +43316 385 ext 83340 email@example.com|
|Principal Investigator: Harald Mangge, Prof., MD|
|Principal Investigator:||Harald Mangge, Prof., MD||Medical University of Graz, Austria|