SABRE Visit 3 (25 year follow-up visit) started in July 2014 and will end in 2018. We are grateful to the British Heart Foundation for funding this research programme.
We are inviting participants and their partners to come to our clinic at University College London. We will also ask them to complete 3 questionnaires about their health and lifestyle and to give permission for us to link to some of their health-related records, for example, regarding hospital admissions and GP visits.
The aims of the study are to build on what we have learned already from the first study and from visit 2(2008-2011). We will measure changes in the health of the heart and circulation, with a special focus on the health of the blood vessels of the brain, as well as early signs of diabetes. We also want to look at physical function and how well (or otherwise) people are keeping as they get older.
The more we understand about what causes these problems, the more likely we are to be able to work out how to prevent or to treat them in people of all ethnicities.
In our clinic we carry out detailed measurements of blood pressure and assess the health of the heart and large and small blood vessel using non-invasive measurements, such as echocardiography. We will carry out MRI scans of the brain, together with a test of memory and problem solving as at visit 2. We will measure levels of glucose and fats in the blood as well as some markers of inflammation and how well the liver, kidneys and lungs are working. There will be some simple tests of balance and eyesight. A short exercise test (walking) will measure how well the heart and circulation are working during exercise.
Participants and their partners who are unable to visit our clinic can still take part in the study by completing the health and lifestyle questionnaires and /or by giving permission for us to link to their health-related records so that we can follow-up their health.
Click here to access Participant information sheets for the study.
We are still working hard on analysing the data that we have collected since 1989 and a clutch of new manuscripts have been accepted for publication in scientific journals.
Recently (Diabetologia 2015, in press,http://dx.doi.org/10.1007/s00125-015-3517-8) we found that higher levels of some amino acids, in particular tyrosine, were already present in non-diabetic South Asian individuals back in 1989-91. Some of these amino acids, again especially tyrosine, more strongly predicted later development of type 2 diabetes in the South Asian people than in the Europeans in our study, even after adjustment for other risk factors such as obesity and insulin resistance. A given increase (one standard deviation) in tyrosine increased risk of developing diabetes by just 10% in Europeans, while in South Asians the increase in risk was 47%.
This study has fitted another piece of the jigsaw of complicated underlying reasons as to why South Asians are at such high risk of developing type 2 diabetes compared with European origin populations. This is the first study that has looked at the links between amino acid levels (the building blocks of proteins) and the future development of diabetes in people of both European and South Asian origins living in one geographical area. Disturbances of amino acid are likely to occur in the liver, kidneys, muscle and adipose tissues. We don’t pretend to have all the answers, but believe that our findings suggest that amino acid disturbances (in particular tyrosine) may be a focus for future research, paving the way for better prevention and potentially for targeted treatments in South Asian individuals.
In another recent manuscript (Psychological Medicine, 2015, http://www.ncbi.nlm.nih.gov/pubmed/25677948) we found that people of South Asian, African or African–Caribbean origins were significantly more likely to have depressive symptoms than people of European origin. These symptoms were most explained (but not entirely) by physical health in the South Asians and by socioeconomic disadvantage in the African and African-Caribbean groups. The study highlights the need to build on understanding for these ethnic differences and to identify opportunities for interventions to address inequalities.
We’ve changed institutions and in 2013 we moved from Imperial College to University College London.
We have had a paper published in the journal, PLoS One, showing that South Asian people were significantly more likely to experience objective and self-reported disability in older age than Europeans. This excess risk could not be explained by demographic, behavioural and chronic disease risk factors. In contrast, a reduced risk of the most severe measure of disability was observed in the African Caribbean group, compared with the European sample.
This is the first study in the UK to examine disability rates in different ethnic groups. We now need to develop our knowledge about the causes of disability across different groups and understand whether beliefs about healthy aging and functioning in older age contribute to these disability levels.
Here is a link to the published paper: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0045602
Our paper published in the journal Diabetes Care found that the risk of developing Type 2 diabetes before the age of 80 is roughly double for the South Asian and African Caribbean people in our study as compared with white Europeans.
Our results also showed an interesting difference between the women and the men. The higher risk for the women can be explained in terms of insulin resistance and greater waist fat measured 20 years earlier, but those factors only explained a small part of the excess risk for the men. More research is needed into risk factors which may act at different stages of life in order to fully explain why South Asian, African and African Caribbean men and women are at such high risk of developing diabetes.
There were a lot of news stories and online reports about these study results. Here are links to a few of them: