BackgroundThe composition of gut flora has been proposed as a cause of obesity, a major risk factor for type 2 diabetes. The objective of this study was to assess whether serum short chain fatty acids, a major by-product of fermentation in gut flora, are associated with obesity and/or diabetes-related traits (insulin sensitivity and secretion).MethodsThe association of serum short chain fatty acids levels with measures of obesity was assessed using body mass index, computerized tomography scan, and dual photon X-ray absorptiometry scan. Insulin sensitivity and insulin secretion were both determined from an oral glucose tolerance test and insulin sensitivity was also determined from a hyperinsulinemic euglycemic clamp.ResultsIn this population of young, obese women, acetate was negatively associated with visceral adipose tissue determined by computerized tomography scan and dual photon X-ray absorptiometry scan, but not body mass index. The level of the short chain fatty acids acetate, but not propionate or butyrate, was also negatively associated with fasting serum insulin and 2 hour insulin levels in the oral glucose tolerance test.ConclusionsIn this population, serum acetate was negatively associated with visceral adipose tissue and insulin levels. Future studies need to verify these findings and expand on these observations in larger cohorts of subjects.

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25×10−8), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genome-wide significant associations with hyperopia. These regions overlapped with loci on 15q14 (minimum p value = 9.11×10−11) and 8q12 (minimum p value 1.82×10−11) previously reported for MSE and myopia age at onset. We also used an intermarker linkage- disequilibrium-based method for calculating the effective number of tests in targeted regional replication analyses. We analyzed myopia (which represents the closest phenotype in our data to the one used by Kiefer et al.) and showed replication of 10 additional loci associated with myopia previously reported by Kiefer et al. This is the first replication of these loci using myopia as the trait under analysis. “Replication-level” association was also seen between hyperopia and 12 of Kiefer et al.'s published loci. For the loci that show evidence of association to both myopia and hyperopia, the estimated effect of the risk alleles were in opposite directions for the two traits. This suggests that these loci are important contributors to variation of refractive error across the distribution.

Polycystic ovary syndrome (PCOS) is a complex genetic disease characterized by heritable reproductive and metabolic abnormalities. Genetic variants associated with the reproductive phenotype have been mapped to the fibrillin-3 (FBN3) gene and to a novel transcription factor-7-like 2 (TCF7L2) locus (rs11196236 G). The association of these genetic variants with metabolic phenotypes was investigated in 31 PCOS and 18 control women of European ancestry. The insulinogenic index during an oral glucose tolerance test (I30/G30) and insulin secretion rates at the maximal dose during a graded-glucose infusion (ISRmax) were used as indices of insulin secretion. Endogenous glucose production (EGP) and insulin sensitivity (M/I) were determined during a euglycemic clamp. The disposition index (DI) was calculated using M/I and I30/G30 or ISRmax. Compared with noncarriers (n=10) and control (n=10), M/I was decreased (P=1.1 × 10−5) in heterozygous and homozygous PCOS carriers (n=14) of rs11196236 G and this variant predicted M/I (partial r2=0.34, P=0.005) in a regression analysis. Post-absorptive EGP tended to be higher (P=0.040) in heterozygous and homozygous PCOS carriers of the FBN3-associated allele (n=12), allele 8 of D19S884 (FBN3+), compared to PCOS noncarriers (n=19). PCOS carriers of the rs12255372 T (TCF7L2 Caucasian type 2 diabetes mellitus locus) had no significant associated metabolic phenotypes. We conclude that rs11196236 G TCF7L2 variant is associated with peripheral insulin resistance in PCOS but this effect is not seen in control women. The FBN3 risk allele may be associated with changes in basal glucose homeostasis in PCOS. These findings require replication in additional PCOS cohorts.

This project was supported by the following National Institutes of Health grants: K23 DK080988-01A1 to S.S. and UL1RR029879 to CTSA at University of Illinois. None of the authors report any conflict of interests.

Implementation of multicenter and/or longitudinal studies requires an effective quality assurance program to identify trends, data inconsistencies and process variability of results over time. The Diabetes Control and Complications Trial (DCCT) and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study represent over 30 years of data collection among a cohort of participants across 27 clinical centers. The quality assurance plan is overseen by the Data Coordinating Center and is implemented across the clinical centers and central reading units. Each central unit incorporates specific DCCT/EDIC quality monitoring activities into their routine quality assurance plan. The results are reviewed by a data quality assurance committee whose function is to identify variances in quality that may impact study results from the central units as well as within and across clinical centers, and to recommend implementation of corrective procedures when necessary. Over the 30-year period, changes to the methods, equipment, or clinical procedures have been required to keep procedures current and ensure continued collection of scientifically valid and clinically relevant results. Pilot testing to compare historic processes with contemporary alternatives is performed and comparability is validated prior to incorporation of new procedures into the study. Details of the quality assurance plan across and within the clinical and central reading units are described, and quality outcomes for core measures analyzed by the central reading units (e.g. biochemical samples, fundus photographs, ECGs) are presented.