Christina C. Dahm

A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Nada Assi, France
  • Aurelie Moskal, France
  • Nadia Slimani, France
  • Vivian Viallon, France
  • Veronique Chajes, France
  • Heinz Freisling, France
  • Stefano Monni, Germany
  • Sven Knueppel, Germany
  • Jana Förster, Germany
  • Elisabete Weiderpass, Norway
  • Leila Lujan-Barroso, Spain
  • Pilar Amiano, Spain
  • Eva Ardanaz, Spain
  • Esther Molina-Montes, Spain
  • Diego Salmerón, Spain
  • José Ramón Quirós, Spain
  • Anja Olsen
  • Anne Tjønneland, Denmark
  • Christina C Dahm
  • Kim Overvad
  • Laure Dossus, France
  • Agnès Fournier, France
  • Laura Baglietto, Australia
  • Renee Turzanski Fortner, Germany
  • Rudolf Kaaks, Germany
  • Antonia Trichopoulou, Greece
  • Christina Bamia, Greece
  • Philippos Orfanos, Greece
  • Maria Santucci De Magistris, Italy
  • Giovanna Masala, Italy
  • Claudia Agnoli, Italy
  • Fulvio Ricceri, Italy
  • Rosario Tumino, Italy
  • H Bas Bueno de Mesquita, Netherlands
  • Marije F Bakker, Netherlands
  • Petra Hm Peeters, Netherlands
  • Guri Skeie, Norway
  • Tonje Braaten, Norway
  • Anna Winkvist, Sweden
  • Ingegerd Johansson, Sweden
  • Kay-Tee Khaw, United Kingdom
  • Nicholas J Wareham, United Kingdom
  • Tim Key, United Kingdom
  • Ruth Travis, United Kingdom
  • Julie A Schmidt, United Kingdom
  • Melissa A Merritt, United Kingdom
  • Elio Riboli, United Kingdom
  • Isabelle Romieu, France
  • Pietro Ferrari, France
Aims: Increased glucose excursions and postprandial hyperglycaemia have been suggested as unique risk factors for cardiovascular disease (CVD) and mortality in patients with diabetes mellitus. Much of the evidence is based on a single 2 h glucose value after oral glucose tolerance testing in epidemiological studies. We examined the association between various indices of glycaemia measured during everyday activities and metabolic CVD risk factors in the A1C-Derived Average Glucose (ADAG) study. Methods: Participants (268 with type 1 diabetes, 159 with type 2 diabetes) completed 16 weeks of intensive continuous glucose monitoring (CGM) and self-monitoring of blood glucose (SMBG). From these data, common indices of postprandial glycaemia, overall hyperglycaemia, glucose variability and HbA1c were derived. The associations between glycaemic indices and known CVD risk factors (lipids, high-sensitivity C-reactive protein and blood pressure) were explored in linear regression models. Results: For both diabetes types, the overall strongest associations with CVD risk factors were seen for the measures of average glycaemia (mean blood glucose and HbA1c). Associations between self-monitored postprandial and fasting glucose and CVD risk factors were weaker, but significant. Measurements of blood glucose variability showed non-significant associations. Overall, calculations based on CGM were not more informative than those based on frequent SMBG. Conclusions/interpretation: Mean glycaemia and HbA1c show consistent and stronger associations with CVD risk factors than fasting glucose or postprandial glucose levels or measures of glucose variability in patients with diabetes.
Original languageEnglish
JournalPublic Health Nutrition
Pages (from-to)242-254
Number of pages13
Publication statusPublished - Feb 2016

    Research areas

  • breast cancer, European Prospective Investigation into Cancer and Nutrition, nutrient patterns, principal component analysis, treelet transform

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