The University of Auckland
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HVN TOFI_FU Metadata Record - Characterising the Pre-diabetic Asian and Caucasian Phenotype: The 'TOFI' Profile - 3-year Follow-up

posted on 2024-05-16, 04:15 authored by Sally PoppittSally Poppitt, Jennifer Miles-ChanJennifer Miles-Chan

This metadata record and it's attached files make statements about the kinds of data collected as part of this research, and set out policies for governance of that data, now and in the future.

Description: Background: People of Asian descent are at much higher risk of poor metabolic health and diabetes at a younger age and a lower body weight than those of European Caucasian descent. The reason why some individuals are more susceptible than others and what controls their diabetes risk may lie in the storage of body fat and may be identified through early changes in serum metabolite profile. Gaining even small amounts of body weight can lead to the fat ‘spilling over’ from adipose tissue and into important organs such as the muscle, liver and pancreas, which in turn may significantly increase risk of disease. Often known as the TOFI profile – ‘Thin on the Outside, Fat on the Inside’ – people who appear ostensibly slim and/or mildly overweight can develop diabetes whilst those who are very overweight and/or obese may not. Few predictive biomarkers of early diabetes risk and propensity to susceptibility or resilience have yet been determined.

Objective: To investigate diabetic risk profile, susceptibility and resilience to weight gain and increasing adiposity in a population of Asian Chinese and Caucasian adults using body composition and metabolomic techniques; and, to conduct 3-year follow-up to determine whether these markers may predict who worsens towards and/or develops frank diabetes.

Design: This is a longitudinal follow-up study of 357 participants, aged 18-70 years, of Asian Chinese and Caucasian European ethnicity who enrolled in the TOFI_Asia study in 2016/17. At baseline and 3-year follow-up, fasting blood samples will be collected to assess diabetic profile based on fasting plasma glucose, and also for untargeted metabolomics profiling; whole body and segmental fat free mass and adipose tissue fat mass will be measured on a single occasion using DEXA scanning; and in a subset of 70 individuals ectopic lipid storage in key organs including liver, pancreas and muscle will be re-measured using MRI/S.



University of Auckland

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HVN Project / Programme Name


Data access requirements

No individual participant data for this trial will be made available. This is in accordance to National Health and Disability Ethics Committees application that all data generated will only be used for this study only.

Principal investigator organisation

University of Auckland

Collaborating researchers and affiliations

Principal Investigators: Professor Sally Poppitt, Director, Human Nutrition Unit, University of Auckland, Auckland A Prof Jennifer Miles-Chan, Human Nutrition Unit, University of Auckland, Auckland Dr Karl Fraser, Senior Research Scientist, AgResearch, Palmerston North Associate Investigators: Dr Rinki Murphy (University of Auckland) Dr Ivana Sequeira-Bisson (University of Auckland)

Data description

Outcomes of the study and associated data Primary outcome - Characteristics that predict susceptability and resilience to type 2 diabetes from blood markers and body composition at 3 years post-enrolment (all participants, n= 357) - Pancreas and liver fat deposition using untargeted LC-MS methodology (subgroup, n= 70) at 3 years post-enrolment - Novel plasma metabolomic markers predictive of pancreas and liver fat deposition and risk of developing type 2 diabetes at 3 years post-enrolment (subgroup, n= 70) Associated data: fasting plasma glucose, insulin, HbA1c, full lipid profile, liver function tests, novel metabolomic biomarkers, body composition (DeXA), ectopic visceral, pancreas and liver fat (MRI/S) Secondary outcomes - Impact of MRI determined pacreas and liver fat on pancreatic beta-cell function and insulin secretion using an intravenous glucose tolerance test (subgroup, n=25) [Subject to funding] - Cardiorespiratory fitness as assessed by the YMCA cycle ergometer submaximal test (subgroup, n=70) [Subject to funding] Associated data: steady-state heart rate (SSHR) during cycle ergometer test Other outcome measures and associated data - Gut microbiome - Height - Weight - Waist and hip circumference - Blood pressure - Demographics, medical history, concurrent medication and alcohol consumption - Food frequency questionnaire (FFQ) - Adverse events

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