Finding patterns to different chronic diseases

It is well known that a number of large chronic disease groups tend to congregate within certain families, but the reason for this is unknown. However, one knows that the purely genetic component can only explain a minor part of this family pattern, which is why one wants to look for other explanations. Such may be found in how environmental factors affect genetics (so-called epigenetics) but also other mechanisms such as impact in fetal life or early childhood and different forms of bacterial patterns in the gastrointestinal tract (microbiota) where different family members tend to be similar. To date, 4300 individuals have been surveyed (November 2019) and the study aims to have examined 6,000 individuals in 2021.

Health survey , dietary data and tissue samples

The Malmö Offspring Study, MOS (Malmö Family Study) is a health survey with the purpose of research to map family patterns behind, for example, cardiovascular disease and diabetes. The target group consists of children and grandchildren for index persons (generation 1) who were previously examined within the framework of the Malmö Diet Cancer Study's Cardiovascular Arm (MKC-CVA) at a baseline 1992-1996 [1].

MOS includes a body examination, a questionnaire, blood sampling, technical examinations, dietary registration and sampling from urine and faeces. The technical examinations include neck ultrasound, arterial stiffness measurement, 24-hour peripheral and central blood pressure, peripheral circulation, ankle-arm index and spirometry. To this should be added cognitive tests as well as estimation of glucose metabolic control and transdermal determination of Advanced Glycation End (AGE) products, a measure of tissue glycation (skin autofluorescence AGE).

Participants will receive feed-back answers to deviating tests or technical examinations if there are cause for action and further referral for treatment and follow-up.

The Biobank

Samples are stored in Region Skåne's biobank (BD47), including DNA. The study is approved through the Regional Ethics Review Board in Lund (Dnr. 2012/594) and the personal data act PUL (Sw. “Personuppgiftslagen”) reported via Lund University. The physician in charge of the study is Professor/Senior consultant Peter M Nilsson, who together with Professor/Senior consultant Olle Melander jointly have a scientific management responsibility for MOS together with the steering group for MOS. The study is based on a broad collaboration with a number of other researchers [5-7].

Funding

MOS is supported by the Strategic Research Area EpiHealth at Lund University as well as the Swedish Research Council, the Heart and Lung Foundation (“Hjärtlungfonden2) and the Region Skåne County Council (ALF funds).

The study includes the following specific studies of the participants

• Body examination with measurement of height, weight, blood pressure (in the arm and centrally for 24 hours)
• Blood sampling including DNA samples for certain genetic analyzes of defined diseases, for analysis of gene-environment interaction
• Technical examinations (external): ultrasound of neck arteries, measurement of blood flow in fingers and feet, 24-hour blood pressure measurement, arterial stiffness measurement, measurement of respiratory capacity (spirometry)
• Memory and speed test (cognition tests: MOCA, AQT, Trail making test)
• Questionnaires with questions about lifestyle, education, stress
• Diet registration via computer for four days (you can log in at home and fill in) by model of the National Food Agency's dietary surveys
• Urine sample and stool sample (to estimate the composition of the bacterial flora in the intestine)

Contact persons for MOS are

Peter M Nilsson, Professor of Clinical Cardiovascular Research at the Department of Clinical Sciences in Malmö, Lund University, and Chief Medical Officer at Skåne University Hospital in Malmö, 040-33 24 15, 0704-50 34 56, Peter [dot] Nilsson [at] med [dot] lu [dot] se (Peter[dot]Nilsson[at]med[dot]lu[dot]se)

Olle Melander, professor of internal medicine at the Department of Clinical Sciences in Malmö, Lund University, and chief physician at Skåne University Hospital in Malmö, 040-39 12 09, Mobile work: 040-39 12 21, Olle [dot] Melander [at] med [dot] lu [dot] se (Olle[dot]Melander[at]med[dot]lu[dot]se)

Malmo Offspring Dental Study (MODS)

In conjunction with MOS (Malmö Family Study), participants are offered a free and painless examination of their dental health at the School of Dentistry, Malmö. The examination consists of a dental and oral examination with x-ray and saliva test to diagnose, among other things, holes in the teeth (caries) and tooth loss. A first study looked at the association between parodontitis and carotid plaque area [8].

The study is led by a Doctor of dentistry, Associate professor Daniel Jönsson at the School of Dentistry, Malmö University.

References

1. Ohlsson B, Orho-Melander M, Nilsson PM. Higher Levels of Serum Zonulin may rather be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations. Int J Mol Sci.2017; 18(3).
2. Ottosson F, Brunkwall L, Ericson U, Nilsson PM, Almgren P, Fernandez C, Melander O, Orho-Melander M. Connection Between BMI-Related Plasma Metabolite Profile and Gut Microbiota. J Clin Endocrinol Metab. 2018; 103(4):1491-1501.
3. Sperling J, Nilsson PM. Does early life programming influence arterial stiffness and central hemodynamics in adulthood? J Hypertens. 2020; 38(3):481-488
4. Jönsson D, Orho-Melander M, Demmer RT, Engström G, Melander O, Klinge B, Nilsson PM. Periodontal disease is associated with carotid plaque area: The Malmö Offspring Dental Study (MODS). J Intern Med. 2020; 287(3): 301-309