Searching for disease indicators in healthy people

LUMC researchers are looking for factors that point to illness at an early stage.

Prevention is better than cure. In order to be able to predict who will become ill, LUMC researchers are looking for factors that point in this direction at an early stage. The Netherlands Epidemiology of Obesity (NEO) study is following nearly 7,000 overweight patients in order to identify predicting factors for the development of diabetes, cardiovascular disease, kidney failure, osteoarthritis and lung disease. The first research results were published recently.

Nearly half of the Dutch adult population falls within the overweight range. This is associated with health risks, including an increased risk of contracting diabetes and cardiovascular disease. It is unclear why some overweight people develop a chronic disease while others do not. This also makes timely intervention difficult in people who are at high risk, especially since they form such a substantial population.

‘We did what could not be done’

To investigate this further, the LUMC launched the Netherlands Epidemiology of Obesity (NEO) study in 2008 under the leadership of Professor Frits Rosendaal. In the first four years, Rosendaal and his colleagues examined nearly 7,000 patients from the Leiden region, most of whom fell within the overweight range (BMI of 27 or higher).

Rosendaal explains: ‘What was remarkable was that we examined these people in great detail. Usually, with such large groups, researchers only take blood samples and ask the subjects to complete some questionnaires. We carried out an extensive examination of each patient that took about four hours and included an MRI scan, a lung function test, a cardiogram and a nutritional test. Nothing like this had ever been done before. We did what could not be done.’ What is also remarkable is that these are healthy people whose entire health profile is being monitored, together with the potential development of any condition. ‘This is an investment that allows us to create a treasure trove of data,’ he says enthusiastically.

Life-long study

‘Ideally we would like to follow these people throughout their life. Last year we did a follow-up via the participants’ GPs to find out which ones had become ill. We may ask people to return for a more extensive examination at some point, but that depends on funding. We hope that we will also be able to observe the effects of changes over time.’

Fat around organs is worse

The study has been going for a number of years, so the first results are coming in. One of the discoveries is that our health depends on where exactly fat is stored: just under the skin or around the organs. The two look the same from the outside. ‘We can use the MRI scans to determine the distribution of fat. It turns out that people with fat around their organs suffer more frequently from reduced insulin sensitivity, which is an early form of diabetes.’

New therapy

Ultimately, Rosendaal hopes to be able to establish many more such links. ‘Nearly all diseases occur more frequently in people who are overweight. This is not something that we really understand at this point. It looks as though all illnesses start out in the same way, and in this study we hope to discover whether this is indeed the case. This knowledge can then be used to develop new therapies and drugs.’