Early Retinal Vessel Changes In Diabetes And The Metabolic Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$212,500.00
Summary
Diabetes mellitus affects a large proportion of adult Australians. Furthermore, many non-diabetic Australians are at high risk of developing diabetes (e.g., people with lesser glucose abnormalities, and those who are obese, have high blood pressure, or have high lipid levels). It has been suggested that diseases affecting small blood vessels (microvascular disease) in the body is closely related to the development of both diabetes and the pre-diabetes state. The current study will examine the re ....Diabetes mellitus affects a large proportion of adult Australians. Furthermore, many non-diabetic Australians are at high risk of developing diabetes (e.g., people with lesser glucose abnormalities, and those who are obese, have high blood pressure, or have high lipid levels). It has been suggested that diseases affecting small blood vessels (microvascular disease) in the body is closely related to the development of both diabetes and the pre-diabetes state. The current study will examine the relationship of microvascular disease in the retina (at the back of the eye) to diabetes, pre-diabetes status and diabetes complications. We will use a computer-imaging technique to measure the diameters of retinal blood vessel from digital photographs taken in 2,177 participants of the 1999-2000 Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, a community-based survey of people aged 25 years and older examining risk factors and complications of diabetes. In the proposed study, we aim to answer the following questions: 1) Are changes in the retinal blood vessel diameter (e.g., narrowed or dilated vessels) associated with diabetes and pre-diabetes? 2) Are these retinal vessel changes related to obesity, high blood pressure and high lipid levels? 3) Are retinal vessel changes related to diabetes complications, such as heart disease, kidney disease, nerve problems and foot ulcers? 4) Do retinal vessel diameter changes predict people who will subsequently develop diabetes, irrespective of their risk factor profile? Using this well-characterized population, and existing digital retinal photographs, the proposed study will offer a unique and cost-effective opportunity to address important gaps in our understanding of how diabetes and pre-diabetes develop, and whether they are related to microvascular diseases. This may ultimately lead to new treatment and preventive approaches targeted at the small blood vessels in the body.Read moreRead less
Retinal Vascular Signs As Predictors Of Systemic Disease Outcomes: 10-year Evolution In A Population-based Cohort
Funder
National Health and Medical Research Council
Funding Amount
$389,575.00
Summary
Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important sys ....Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important systemic health outcomes in the population-based cohort of residents attending the Blue Mountains Eye Study (BMES. Two types of retinal signs will be evaluated: firstly, the presence of specific clinical signs, such as focal narrowing of small retinal vessels (arterioles), nicking of retinal veins as arterioles cross them or presence of retinopathy (haemorrhages and other signs) secondly, measures of generalized retinal vessel calibre (narrowing) using a computer-assisted method developed for the U.S. studies. We will also develop new grading methods for two other signs. Late and will compare computer-assisted grading from 35mm slides to automated grading of vessels using a scanning device (being developed) to screen the eyes of older persons. This project builds upon our current 3-year NHMRC grant (ID153948; 2001-2003) Retinal vascular signs as risk markers for incident stroke or cerebrovascular death: A population-based assessment . In the last 2 years, this has explored different aspects of measurement and grading of these signs, has documented their relation to blood pressure and has begun to assess whether these features predict vascular events and other systemic outcomes in older Australians. The new project will assess the evolution of retinal microvascular signs over a 10-year period, using data and retinal photographs from the 10-year examinations of the BMES cohort, currently being collected, in a further current NHMRC grant (ID211069; 2002-2004).Read moreRead less
Retinal Vascular Signs As Risk Markers For Incident Stroke Or Cerebrovascular Death: A Population-based Assessment
Funder
National Health and Medical Research Council
Funding Amount
$410,199.00
Summary
Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of ....Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of retinal photographs taken on people who attended the Eye Study during 1992-4 and 5-year follow-up exams during 1997-9. We will grade these photographs manually (using a stereo-viewer), and with computer assistance to measure changes in the diameter of small arteries in the retina and other signs. By closely matching our grading technique to that used in a large American Study, we hope to develop reliable grading for these signs and will be able to compare our findings internationally. Our aim is to assess the frequency of abnormal retinal vessel changes in people of different age groups as well as the development and progression of these signs over time. Their relationship to well known vascular risk factors like smoking, blood pressure, obesity, diabetes and cholesterol will also be investigated. We hope to be able to discriminate those changes associated with an increased stroke risk from those due to normal ageing. We expect that the increased stroke risk associated with abnormal retinal vessel changes may be greater than shown in our early data. If confirmed, then these findings may provide a more sensitive and objective measure of stroke risk than relying on traditional risk factors, which are difficult to quantify and change with time. We may be able to develop simple rules so that doctors using an ophthalmoscope or examining a retinal photograph could identify high risk patients. These people could benefit from interventions to reduce their risk.Read moreRead less
The Australian Parkinson's Project - Uncovering Genetic Risk Factors For Sporadic PD
Funder
National Health and Medical Research Council
Funding Amount
$768,546.00
Summary
Parkinson s disease (PD) is a progressively disabling movement disorder afflicting many elderly Australians. It is caused by the degeneration of specific nerve cells in the brain that produce certain chemicals and patients suffer from an inability to move fluently (or ultimately at all). At present we do not know what triggers this neurodegeneration, but it is believed that complex interactions between inherited (genetic) and environmental factors contribute significantly to the phenomenon. This ....Parkinson s disease (PD) is a progressively disabling movement disorder afflicting many elderly Australians. It is caused by the degeneration of specific nerve cells in the brain that produce certain chemicals and patients suffer from an inability to move fluently (or ultimately at all). At present we do not know what triggers this neurodegeneration, but it is believed that complex interactions between inherited (genetic) and environmental factors contribute significantly to the phenomenon. This project aims to learn more about these complex interactions and their association with PD. People with PD and unaffected individuals will be recruited from throughout Australia and we will look for specific combinations of genetic, environmental and lifestyle factors that either increase or decrease an individual's risk for PD. This research will identify the most common dominant genetic and environmental influences for PD in Australia, enabling scientists to focus on the most relevant biological pathways to target therapeutically.Read moreRead less
Vitamin D And Risk Of Cancer And Mortality In The Melbourne Collaborative Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$519,829.00
Summary
Overseas studies indicate that vitamin D might protect against certain cancers and other diseases such as heart disease and diabetes. Vitamin D is made when skin is exposed to sunlight. Because sunlight is stronger in Australia than in most of the USA and Europe, where most studies were conducted, the results of those studies might not be relevant to Australia. In this study, we will see if vitamin D is important for cancer and mortality in Australia.
Kidskin: An Intervention To Reduce Sun Exposure In Children
Funder
National Health and Medical Research Council
Funding Amount
$307,775.00
Summary
Melanoma is an important public health problem in Australia. Almost all melanoma is caused by exposure to sunlight, and childhood exposure appears to be particularly important. Thus, if we can reduce childhood exposure, we should ultimately be able to reduce the incidence of melanoma. Despite nation-wide campaigns such as SunSmart, children in Australia still get too much sun exposure. The school offers an ideal opportunity for implementing sun-safety campaigns in children. In 1995, we began the ....Melanoma is an important public health problem in Australia. Almost all melanoma is caused by exposure to sunlight, and childhood exposure appears to be particularly important. Thus, if we can reduce childhood exposure, we should ultimately be able to reduce the incidence of melanoma. Despite nation-wide campaigns such as SunSmart, children in Australia still get too much sun exposure. The school offers an ideal opportunity for implementing sun-safety campaigns in children. In 1995, we began the Kidskin study, which aims to develop, implement and test a school-based program to reduce sun exposure. Preliminary data from the study show that we successfully reduced exposure. However, we are not certain that we have reduced their risk of melanoma. To see if we have reduced the risk of melanoma, we are counting the children's moles. Moles are strongly related to melanoma, and are our best way of measuring actual risk of melanoma. If we are successful, it will be the first time anyone has shown that reducing exposure to sunlight during childhood will lead to a reduction in the incidence of melanoma in later life.Read moreRead less
Helping Women Meet Their Activity Goals: Randomised Trial Of A Personalised Program Delivered By Mobile Telephone
Funder
National Health and Medical Research Council
Funding Amount
$493,346.00
Summary
Cardiovascular disease is the leading cause of death in Australian women, but is less likely among women who are active. Because women are less active than men, and women with young children are the least active of all, we developed a program to increase postnatal women's physical activity. Women in the pilot study reported high program satisfaction and more physical activity, because the program focused on them (not their kids) and helped them prioritise time for physical activity.
DNA methylation is a process that plays a critical role throughout life by altering the expression of genes. We aim to investigate the potential use of methylation as a target for prevention strategies and for men with no clinical evidence of disease, as a marker of their risk for prostate cancer, particularly its aggressive form.