Clinical trial NCT00482924: Observational Study of Early Metabolic and Vascular Changes in Obesity
Official title: Study for the Investigation of New Individual Risk Profiles and Therapeutic Strategies in Obesity Related Cardiovascular and Metabolic Disorders.
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Obesity
Atherosclerosis
Inflammation
Adiponectin Deficiency
Fatty Liver
Keywords: obesity
cardiovascular risk profiles
adipokines
preatherosclerosis
low grade inflammation
dyslipidemia
insulin resistance
brown adipose tissue
white adipose tissue
Lead sponsor: Medical University of Graz
Sponsor class: OTHER
Collaborators: name: Zukunftsfonds Steiermark
name: Bundesministerium für Gesundheit, Familie und Jugend
name: Steiermärkische Landesregierung
name: Graz University of Technology
name: University of Graz
name: Paracelsus Medical University
name: Technical University of Munich
First posted: 2007-06-06
Enrollment: 1500
Sex: ALL
Minimum age (years): 3
Maximum age (years): 55
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Probands are residents of Graz and from the federal state of styria.

Brief summary: To work against the increasing burden of obesity, the STYJOBS / EDECTA (STYrian Juvenile OBesity Study / Early DetECtion of Atherosclerosis) project was started at the Medical University of Graz in 2003. STYJOBS / EDECTA is a prospective, observational study to improve the understanding of atherosclerosis, cardiovascular risk, immune mediated low grade Inflammation, metabolic changes, and general disease propensity in obesity. The investigation of the "non-biased" early phase is strongly focused.

Based on this information, new and effective strategies for preclinical diagnostics and early intervention are of main interest. We seek a better understanding of critical lipid profiles, chronic immune-mediated inflammation, disturbed adipokine balance, critical adipose tissue topography, addiction like behaviour, genetics/epigenetics, early vascular pathology, and fatty liver disease. Interventional branches of study tested a holistic strategy comprehending sports, and lifestyle modification for efficiency. The investigative spectrum of STYJOBS / EDECTA comprehends also non-obese body weight extremes i.e. underweight/anorectic people.

Detailed description: Obesity is dramatically increasing in countries with so called western Lifestyle, whereby juveniles are affected in particular. Atherosclerosis, a major consequence of obesity, starts early in life and results in cardiovascular disease and stroke, the main causes of mortality in industrialized countries. STYJOBS / EDECTA is a prospective, observational study to improve the understanding of obesity associated pathologic conditions by investigation of the "non-biased" early phase.

We aim

To identify "individual metabolic high risk patterns" in obesity by linking lab parameters (adipokines, immune-inflammatory mediators, oxidative "stress" biomarkers, lipoproteins, molecular genetics, epigenetics), individual adipose tissue topography, early vascular damage, life style habits, and clinical data.

The STYJOBS/EDECTA-Database comprehends currently data from 1325 subjects.For each proband 282 variables are available (Clinical, anthropometric, carotis IMT, 82; Laboratory/Biomarkers, 100; Glucose metabolism, liver, kidney function, lipids, oxidative/nitrosative stress, adipokines, gut-brain axis, clotting, Genetic/mitochondrial function/miscellaneous,100), and the results of an early interventional trial by a holistic strategy.

To establish a comprehensive biobank. The STYJOBS/EDECTA-biomaterial resource comprises serum/plasma/DNA left over probes from currently 1256 probands.

EDECTA (Early DEteCTion of Atherosclerosis) extends the STYJOBS Database and Bioresource with normal weight and obese probands aged up to 80 years.

To improve the understanding of craving and addiction like behaviour in obesity (e.g.link insulin resistance - control of hedonic inputs).

Thus, the STYJOBS / EDECTA resource comprises in extendo data and biomaterial specimen from subjects afflicted with the preclinical phase of major sequels of obesity such as insulin resistance, cardiovascular disease, and probably also certain sorts of cancer.

To further improve the understanding of dysbalanced energy expenditure in obesity mitochondrial haplotypes are investigated in cooperation with Dr.Weghuber, Dr.Eder and Prof.Sperl from the Salzburg Paracelsus Private Medical School. All genetic and epigenetic measurements are performed by an anonymous approach (data privacy protection) after careful accreditation by the local ethical committee.

The investigative spectrum of STYJOBS / EDECTA is also extended to underweight/anorectic people. This condition is an attractive biologic "counterpart" to the overweight/obese group. Extremely underweight and anorectic patients are afflicted with profound metabolic abnormalities. Thus, it is interesting to investigate anorexia associated risk profiles in comparison to those found in overweight/obese people. Especially the craving like behaviour and the cardiovascular/"ox"Stress risk will be focused in our investigations.

Further, we investigate the role of tryptophan (TRP) metabolism in context with obesity, immune-mediated inflammation, skewing of T helper cells and mechanisms underlying uncontrolled overeating.

Eligibility criteria: Inclusion Criteria:

* general healthy condition except overweightness/obesity, age below 55 years

Exclusion Criteria:

* thyroid dysfunction, infections, chronic diseases (e.g. autoimmune, inflammatory), neoplasia

Primary outcomes:
measure: Anthropometric changes(BMI, SAT-Topography, waist/hipCF, waist to height ratio) during intervention
timeFrame: 12 months
Secondary outcomes:
measure: Obesity related biomarkers (fasting glucose, insulin, HOMA-index, HbA1c, liver transaminases, inflammatory markers, adipokines, clotting parameters, lipids, oxidative stress markers, Biomarkers related to tryptophan metabolism), performance diagnostics.
timeFrame: 12 months
Other outcomes:
Locations:
city: Graz
country: Austria
facility: Clinical Institute for Medical and Chemical Laboratory Diagnosis
state: Styria
Study officials:
affiliation: Medical University of Graz, Austria
name: Harald Mangge, Prof., MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Pilz S, Mangge H, Wellnitz B, Seelhorst U, Winkelmann BR, Tiran B, Boehm BO, Marz W. Adiponectin and mortality in patients undergoing coronary angiography. J Clin Endocrinol Metab. 2006 Nov;91(11):4277-86. doi: 10.1210/jc.2006-0836. Epub 2006 Aug 15.
citation: Murr C, Winklhofer-Roob BM, Schroecksnadel K, Maritschnegg M, Mangge H, Bohm BO, Winkelmann BR, Marz W, Fuchs D. Inverse association between serum concentrations of neopterin and antioxidants in patients with and without angiographic coronary artery disease. Atherosclerosis. 2009 Feb;202(2):543-9. doi: 10.1016/j.atherosclerosis.2008.04.047. Epub 2008 May 15.
citation: Pachler C, Ikeoka D, Plank J, Weinhandl H, Suppan M, Mader JK, Bodenlenz M, Regittnig W, Mangge H, Pieber TR, Ellmerer M. Subcutaneous adipose tissue exerts proinflammatory cytokines after minimal trauma in humans. Am J Physiol Endocrinol Metab. 2007 Sep;293(3):E690-6. doi: 10.1152/ajpendo.00034.2007. Epub 2007 Jun 19.
citation: Pilz S, Mangge H, Obermayer-Pietsch B, Marz W. Visfatin/pre-B-cell colony-enhancing factor: a protein with various suggested functions. J Endocrinol Invest. 2007 Feb;30(2):138-44. doi: 10.1007/BF03347412.
citation: Arnold T, Brandlhofer S, Vrtikapa K, Stangl H, Hermann M, Zwiauer K, Mangge H, Karwautz A, Huemer J, Koller D, Schneider WJ, Strobl W. Effect of obesity on plasma clusterin, [corrected] a proposed modulator of leptin action. Pediatr Res. 2011 Mar;69(3):237-42. doi: 10.1203/PDR.0b013e31820930cb.
citation: Fritsch P, Kleber M, Schlagenhauf A, Laschnik B, Fritsch M, Muntean W, Mangge H, Reinehr T. Normalization of haemostatic alterations in overweight children with weight loss due to lifestyle intervention. Atherosclerosis. 2011 May;216(1):170-3. doi: 10.1016/j.atherosclerosis.2011.01.042. Epub 2011 Feb 2.
citation: Hasija R, Pistorio A, Ravelli A, Demirkaya E, Khubchandani R, Guseinova D, Malattia C, Canhao H, Harel L, Foell D, Wouters C, De Cunto C, Huemer C, Kimura Y, Mangge H, Minetti C, Nordal EB, Philippet P, Garozzo R, Martini A, Ruperto N; Pediatric Rheumatology International Trials Organization. Therapeutic approaches in the treatment of juvenile dermatomyositis in patients with recent-onset disease and in those experiencing disease flare: an international multicenter PRINTO study. Arthritis Rheum. 2011 Oct;63(10):3142-52. doi: 10.1002/art.30475.
citation: Almer G, Wernig K, Saba-Lepek M, Haj-Yahya S, Rattenberger J, Wagner J, Gradauer K, Frascione D, Pabst G, Leitinger G, Mangge H, Zimmer A, Prassl R. Adiponectin-coated nanoparticles for enhanced imaging of atherosclerotic plaques. Int J Nanomedicine. 2011;6:1279-90. doi: 10.2147/IJN.S18739. Epub 2011 Jun 21.
citation: Almer G, Saba-Lepek M, Haj-Yahya S, Rohde E, Strunk D, Frohlich E, Prassl R, Mangge H. Globular domain of adiponectin: promising target molecule for detection of atherosclerotic lesions. Biologics. 2011;5:95-105. doi: 10.2147/BTT.S22863. Epub 2011 Sep 7.
citation: Landauer F, Huber G, Paulmichl K, O'Malley G, Mangge H, Weghuber D. Timely diagnosis of malalignment of the distal extremities is crucial in morbidly obese juveniles. Obes Facts. 2013;6(6):542-51. doi: 10.1159/000357280. Epub 2013 Dec 6.
citation: Reininghaus EZ, McIntyre RS, Reininghaus B, Geisler S, Bengesser SA, Lackner N, Hecht K, Birner A, Kattnig F, Unterweger R, Kapfhammer HP, Zelzer S, Fuchs D, Mangge H. Tryptophan breakdown is increased in euthymic overweight individuals with bipolar disorder: a preliminary report. Bipolar Disord. 2014 Jun;16(4):432-40. doi: 10.1111/bdi.12166. Epub 2013 Dec 12.
citation: Gradauer K, Barthelmes J, Vonach C, Almer G, Mangge H, Teubl B, Roblegg E, Dunnhaupt S, Frohlich E, Bernkop-Schnurch A, Prassl R. Liposomes coated with thiolated chitosan enhance oral peptide delivery to rats. J Control Release. 2013 Dec 28;172(3):872-8. doi: 10.1016/j.jconrel.2013.10.011. Epub 2013 Oct 16.
citation: Bengesser SA, Lackner N, Birner A, Fellendorf FT, Platzer M, Mitteregger A, Unterweger R, Reininghaus B, Mangge H, Wallner-Liebmann SJ, Zelzer S, Fuchs D, McIntyre RS, Kapfhammer HP, Reininghaus EZ. Peripheral markers of oxidative stress and antioxidative defense in euthymia of bipolar disorder--Gender and obesity effects. J Affect Disord. 2015 Feb 1;172:367-74. doi: 10.1016/j.jad.2014.10.014. Epub 2014 Oct 22.
citation: Lackner N, Mangge H, Reininghaus EZ, McIntyre RS, Bengesser SA, Birner A, Reininghaus B, Kapfhammer HP, Wallner-Liebmann SJ. Body fat distribution and associations with metabolic and clinical characteristics in bipolar individuals. Eur Arch Psychiatry Clin Neurosci. 2015 Jun;265(4):313-9. doi: 10.1007/s00406-014-0559-8. Epub 2014 Nov 8.
citation: Mangge H, Becker K, Fuchs D, Gostner JM. Antioxidants, inflammation and cardiovascular disease. World J Cardiol. 2014 Jun 26;6(6):462-77. doi: 10.4330/wjc.v6.i6.462.
citation: Wallner-Liebmann SJ, Moeller R, Horejsi R, Jurimae T, Jurimae J, Maestu J, Purge P, Saar M, Tafeit E, Kaimbacher P, Kruschitz R, Weghuber D, Schnedl WJ, Mangge H. Normal weight estonian prepubertal boys show a more cardiovascular-risk-associated adipose tissue distribution than austrian counterparts. ISRN Obes. 2013 Jan 14;2013:506751. doi: 10.1155/2013/506751. eCollection 2013.
citation: Mangge H, Weghuber D, Prassl R, Haara A, Schnedl W, Postolache TT, Fuchs D. The Role of Vitamin D in Atherosclerosis Inflammation Revisited: More a Bystander than a Player? Curr Vasc Pharmacol. 2015;13(3):392-8. doi: 10.2174/1570161111666131209125454.
citation: Raheja UK, Fuchs D, Giegling I, Brenner LA, Rovner SF, Mohyuddin I, Weghuber D, Mangge H, Rujescu D, Postolache TT. In psychiatrically healthy individuals, overweight women but not men have lower tryptophan levels. Pteridines. 2015 Jun;26(2):79-84. doi: 10.1515/pterid-2015-0002.
citation: Mangge H, Pruller F, Zelzer S, Ainodhofer H, Pailer S, Kieslinger P, Haybaeck J, Obermayer-Pietsch B, Cvirn G, Gruber HJ. Hypothyroidism Exacerbates Thrombophilia in Female Rats Fed with a High Fat Diet. Int J Mol Sci. 2015 Jul 10;16(7):15776-84. doi: 10.3390/ijms160715776.
citation: Lackner N, Bengesser SA, Birner A, Painold A, Fellendorf FT, Platzer M, Reininghaus B, Weiss EM, Mangge H, McIntyre RS, Fuchs D, Kapfhammer HP, Wallner-Liebmann SJ, Reininghaus EZ. Abdominal obesity is associated with impaired cognitive function in euthymic bipolar individuals. World J Biol Psychiatry. 2016 Oct;17(7):535-46. doi: 10.3109/15622975.2015.1046917. Epub 2015 Jun 12.
citation: Zelzer S, Mangge H, Pailer S, Ainoedhofer H, Kieslinger P, Stojakovic T, Scharnagl H, Pruller F, Weghuber D, Datz C, Haybaeck J, Obermayer-Pietsch B, Trummer C, Gostner J, Gruber HJ. Oxidized LDL Is Strictly Limited to Hyperthyroidism Irrespective of Fat Feeding in Female Sprague Dawley Rats. Int J Mol Sci. 2015 May 21;16(5):11689-98. doi: 10.3390/ijms160511689.
citation: Mangge H, Almer G, Stelzer I, Reininghaus E, Prassl R. Laboratory medicine for molecular imaging of atherosclerosis. Clin Chim Acta. 2014 Nov 1;437:19-24. doi: 10.1016/j.cca.2014.06.029. Epub 2014 Jul 5.
citation: Mangge H, Ciardi C, Becker K, Strasser B, Fuchs D, Gostner JM. Influence of Antioxidants on Leptin Metabolism and its Role in the Pathogenesis of Obesity. Adv Exp Med Biol. 2017;960:399-413. doi: 10.1007/978-3-319-48382-5_17.
citation: Mangge H. Beyond Cholesterol - New Cardiovascular Biomarkers. Nestle Nutr Inst Workshop Ser. 2016;84:81-8. doi: 10.1159/000436990. Epub 2016 Jan 14.
citation: Moeller R, Horejsi R, Pilz S, Lang N, Sargsyan K, Dimitrova R, Tafeit E, Giuliani A, Almer G, Mangge H. Evaluation of risk profiles by subcutaneous adipose tissue topography in obese juveniles. Obesity (Silver Spring). 2007 May;15(5):1319-24. doi: 10.1038/oby.2007.154.
citation: Cimenti C, Mangge H, Haidl H, Zach D, Muntean W. Thrombin generation in severely obese children. J Thromb Haemost. 2006 Aug;4(8):1834-6. doi: 10.1111/j.1538-7836.2006.02038.x. No abstract available.
citation: Pilz S, Horejsi R, Moller R, Almer G, Scharnagl H, Stojakovic T, Dimitrova R, Weihrauch G, Borkenstein M, Maerz W, Schauenstein K, Mangge H. Early atherosclerosis in obese juveniles is associated with low serum levels of adiponectin. J Clin Endocrinol Metab. 2005 Aug;90(8):4792-6. doi: 10.1210/jc.2005-0167. Epub 2005 May 31.
citation: Mangge H, Schauenstein K, Stroedter L, Griesl A, Maerz W, Borkenstein M. Low grade inflammation in juvenile obesity and type 1 diabetes associated with early signs of atherosclerosis. Exp Clin Endocrinol Diabetes. 2004 Jul;112(7):378-82. doi: 10.1055/s-2004-821023.
citation: Gruber HJ, Mayer C, Meinitzer A, Almer G, Horejsi R, Moller R, Pilz S, Marz W, Gasser R, Truschnig-Wilders M, Mangge H. Asymmetric dimethylarginine (ADMA) is tightly correlated with growth in juveniles without correlations to obesity related disorders. Exp Clin Endocrinol Diabetes. 2008 Oct;116(9):520-4. doi: 10.1055/s-2008-1062712. Epub 2008 Apr 1.
citation: Mangge H, Pilz S, Haj-Yahya S, Almer G. Uric acid indicates a high cardiovascular risk profile but is not closely associated with insulin resistance in obese adolescents. Diabetes Care. 2008 Apr;31(4):e21. doi: 10.2337/dc07-2411. No abstract available.
citation: Gruber HJ, Mayer C, Mangge H, Fauler G, Grandits N, Wilders-Truschnig M. Obesity reduces the bioavailability of nitric oxide in juveniles. Int J Obes (Lond). 2008 May;32(5):826-31. doi: 10.1038/sj.ijo.0803795. Epub 2008 Jan 15.
citation: Mangge H, Almer G, Haj-Yahya S, Grandits N, Gasser R, Pilz S, Moller R, Horejsi R. Nuchal thickness of subcutaneous adipose tissue is tightly associated with an increased LMW/total adiponectin ratio in obese juveniles. Atherosclerosis. 2009 Mar;203(1):277-83. doi: 10.1016/j.atherosclerosis.2008.06.013. Epub 2008 Jun 26.
citation: Wilders-Truschnig M, Mangge H, Lieners C, Gruber H, Mayer C, Marz W. IgG antibodies against food antigens are correlated with inflammation and intima media thickness in obese juveniles. Exp Clin Endocrinol Diabetes. 2008 Apr;116(4):241-5. doi: 10.1055/s-2007-993165. Epub 2007 Dec 10.
citation: Mangge H, Almer G, Haj-Yahya S, Pilz S, Gasser R, Moller R, Horejsi R. Preatherosclerosis and adiponectin subfractions in obese adolescents. Obesity (Silver Spring). 2008 Dec;16(12):2578-84. doi: 10.1038/oby.2008.439. Epub 2008 Oct 9.
citation: Wallner-Liebmann S, Koschutnig K, Reishofer G, Sorantin E, Blaschitz B, Kruschitz R, Unterrainer HF, Gasser R, Freytag F, Bauer-Denk C, Schienle A, Schafer A, Mangge H. Insulin and hippocampus activation in response to images of high-calorie food in normal weight and obese adolescents. Obesity (Silver Spring). 2010 Aug;18(8):1552-7. doi: 10.1038/oby.2010.26. Epub 2010 Feb 18.
citation: Mangge H, Freytag F, Almer G, Weghuber D, Bauer-Denk C, Fuchs D. Serum neopterin is not increased in obese juveniles. J Obes. 2011;2011:946795. doi: 10.1155/2011/946795. Epub 2011 Jan 12.
citation: Mangge H, Almer G, Truschnig-Wilders M, Schmidt A, Gasser R, Fuchs D. Inflammation, adiponectin, obesity and cardiovascular risk. Curr Med Chem. 2010;17(36):4511-20. doi: 10.2174/092986710794183006.
citation: Mangge H, Renner W, Almer G, Weghuber D, Moller R, Horejsi R. Rs9939609 variant of the fat mass and obesity-associated gene and trunk obesity in adolescents. J Obes. 2011;2011:186368. doi: 10.1155/2011/186368. Epub 2011 Jan 13.
citation: Mangge H, Almer G, Zelzer S, Vasan R, Kraigher-Krainer E, Gasser R, Schnedl W, Ille R, Wallner S, Moller R, Horejsi R, Weghuber D. N-terminal pro-B-type natriuretic peptide in early and advanced phases of obesity. Clin Chem Lab Med. 2011 Sep;49(9):1539-45. doi: 10.1515/CCLM.2011.627. Epub 2011 Jun 10.
citation: Zelzer S, Fuchs N, Almer G, Raggam RB, Pruller F, Truschnig-Wilders M, Schnedl W, Horejsi R, Moller R, Weghuber D, Ille R, Mangge H. High density lipoprotein cholesterol level is a robust predictor of lipid peroxidation irrespective of gender, age, obesity, and inflammatory or metabolic biomarkers. Clin Chim Acta. 2011 Jul 15;412(15-16):1345-9. doi: 10.1016/j.cca.2011.03.031. Epub 2011 Apr 15.
citation: Stelzer I, Zelzer S, Raggam RB, Pruller F, Truschnig-Wilders M, Meinitzer A, Schnedl WJ, Horejsi R, Moller R, Weghuber D, Reeves G, Postolache TT, Mangge H. Link between leptin and interleukin-6 levels in the initial phase of obesity related inflammation. Transl Res. 2012 Feb;159(2):118-24. doi: 10.1016/j.trsl.2011.10.001. Epub 2011 Nov 4.
citation: Pruller F, Raggam RB, Posch V, Almer G, Truschnig-Wilders M, Horejsi R, Moller R, Weghuber D, Ille R, Schnedl W, Mangge H. Trunk weighted obesity, cholesterol levels and low grade inflammation are main determinants for enhanced thrombin generation. Atherosclerosis. 2012 Jan;220(1):215-8. doi: 10.1016/j.atherosclerosis.2011.09.035. Epub 2011 Oct 14.
citation: Mangge H, Summers KL, Meinitzer A, Zelzer S, Almer G, Prassl R, Schnedl WJ, Reininghaus E, Paulmichl K, Weghuber D, Fuchs D. Obesity-related dysregulation of the tryptophan-kynurenine metabolism: role of age and parameters of the metabolic syndrome. Obesity (Silver Spring). 2014 Jan;22(1):195-201. doi: 10.1002/oby.20491. Epub 2013 Jul 5.
citation: Mangge H, Summers K, Almer G, Prassl R, Weghuber D, Schnedl W, Fuchs D. Antioxidant food supplements and obesity-related inflammation. Curr Med Chem. 2013;20(18):2330-7. doi: 10.2174/0929867311320180004.
citation: Weghuber D, Zelzer S, Stelzer I, Paulmichl K, Kammerhofer D, Schnedl W, Molnar D, Mangge H. High risk vs. "metabolically healthy" phenotype in juvenile obesity - neck subcutaneous adipose tissue and serum uric acid are clinically relevant. Exp Clin Endocrinol Diabetes. 2013 Jul;121(7):384-90. doi: 10.1055/s-0033-1341440. Epub 2013 Mar 21.
citation: Mangge H, Zelzer S, Puerstner P, Schnedl WJ, Reeves G, Postolache TT, Weghuber D. Uric acid best predicts metabolically unhealthy obesity with increased cardiovascular risk in youth and adults. Obesity (Silver Spring). 2013 Jan;21(1):E71-7. doi: 10.1002/oby.20061. Epub 2013 Jan 29.
citation: Almer G, Frascione D, Pali-Scholl I, Vonach C, Lukschal A, Stremnitzer C, Diesner SC, Jensen-Jarolim E, Prassl R, Mangge H. Interleukin-10: an anti-inflammatory marker to target atherosclerotic lesions via PEGylated liposomes. Mol Pharm. 2013 Jan 7;10(1):175-86. doi: 10.1021/mp300316n. Epub 2012 Dec 4.
citation: Mangge H, Zelzer S, Meinitzer A, Stelzer I, Schnedl WJ, Weghuber D, Fuchs D, Postolache TT, Aigner E, Datz C, Reininghaus EZ. 25OH-Vitamin D3 Levels in Obesity and Metabolic Syndrome-Unaltered in Young and not Correlated to Carotid IMT in All Ages. Curr Pharm Des. 2015;21(17):2243-9. doi: 10.2174/1381612821666150105160931.
citation: Mangge H, Stelzer I, Reininghaus EZ, Weghuber D, Postolache TT, Fuchs D. Disturbed tryptophan metabolism in cardiovascular disease. Curr Med Chem. 2014 Jun;21(17):1931-7. doi: 10.2174/0929867321666140304105526.
citation: Ebner S, Mangge H, Langhof H, Halle M, Siegrist M, Aigner E, Paulmichl K, Paulweber B, Datz C, Sperl W, Kofler B, Weghuber D. Mitochondrial Haplogroup T Is Associated with Obesity in Austrian Juveniles and Adults. PLoS One. 2015 Aug 31;10(8):e0135622. doi: 10.1371/journal.pone.0135622. eCollection 2015.
citation: Mangge H, Baumgartner B, Schnedl W. Letter: PNPLA3, metabolic syndrome and NAFLD status in obese subjects--authors' reply. Aliment Pharmacol Ther. 2015 Sep;42(5):630-1. doi: 10.1111/apt.13318. No abstract available.
citation: Mangge H, Baumgartner BG, Zelzer S, Pruller F, Schnedl WJ, Reininghaus EZ, Haybaeck J, Lackner C, Stauber R, Aigner E, Weghuber D. Patatin-like phospholipase 3 (rs738409) gene polymorphism is associated with increased liver enzymes in obese adolescents and metabolic syndrome in all ages. Aliment Pharmacol Ther. 2015 Jul;42(1):99-105. doi: 10.1111/apt.13232. Epub 2015 May 5.
citation: Mangge H, Zelzer S, Pruller F, Schnedl WJ, Weghuber D, Enko D, Bergsten P, Haybaeck J, Meinitzer A. Branched-chain amino acids are associated with cardiometabolic risk profiles found already in lean, overweight and obese young. J Nutr Biochem. 2016 Jun;32:123-7. doi: 10.1016/j.jnutbio.2016.02.007. Epub 2016 Mar 21.
citation: Marsche G, Zelzer S, Meinitzer A, Kern S, Meissl S, Pregartner G, Weghuber D, Almer G, Mangge H. Adiponectin Predicts High-Density Lipoprotein Cholesterol Efflux Capacity in Adults Irrespective of Body Mass Index and Fat Distribution. J Clin Endocrinol Metab. 2017 Nov 1;102(11):4117-4123. doi: 10.1210/jc.2017-00933.
citation: Mangge H, Renner W, Almer G, Gruber HJ, Zelzer S, Moeller R, Horejsi R, Herrmann M. Subcutaneous adipose tissue distribution and telomere length. Clin Chem Lab Med. 2019 Aug 27;57(9):1358-1363. doi: 10.1515/cclm-2018-0801.