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Design and cohort description of the InterAct Project: an examination of the interaction of genetic and lifestyle factors on the incidence of type 2 diabetes in the EPIC Study
Open accessAbstract
Aims/hypothesis Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes.Methods Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex.Results A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age.Conclusions/interpretation InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development.
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Metadata
- Authors
- The InterAct Consortium
- Venue
- Diabetologia
- Published
- 2011-06-30
- Volume
- 54
- Issue
- 9
- Pages
- 2272-2282
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC4222062
- OpenAlex
- W1522058342
- Cited by
- 208
- References
- 33
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 8 · 2023: 9 · 2022: 13 · 2021: 11 · 2020: 15 · 2019: 14 · 2018: 15 · 2017: 15 · 2016: 17 · 2015: 18 · 2014: 20 · 2013: 19 · 2012: 13
- FWCI
- 10.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Wellcome Trust (083270/Z/07/Z, 090532, 083270/083270/z)
- Cancer Research UK
- European Commission (LSHM_CT_2006_037197)
- Bundesministerium für Bildung und Forschung (KFO218/1)
- Universitair Medisch Centrum Utrecht
- Canadian Institutes of Health Research (G0601261)
- Medical Research Council (MC_EX_G0800783)
- World Cancer Research Fund
- Agentschap NL (grant IGE05012, IGE05012)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gene-lifestyle interaction, genetic susceptibility, diet, physical activity, EPIC cohort, INTERACT project, case-cohort design, diabetes incidence, sex differences in diabetes risk, behavioral risk factors, genetic loci, subgroup effects, waist circumference, body mass index, random-effects meta-analysis, Cox proportional hazards model
- MeSH terms
- Diabetes Mellitus, Type 2, Diet, Europe, Female, Follow-Up Studies, Humans, International Cooperation, Life Style, Male, Middle Aged, Motor Activity, Prospective Studies, Retrospective Studies, Risk Factors, Cohort Studies, Incidence, Genetic Predisposition to Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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