The KORA S4/F4/FF4 longitudinal study on (Pre)diabetes

Study objectives:

  • to describe the prevalence and trajectories of prediabetes and diabetes over 14 years in Southern Germany
  • to identify the impact of lifestyle, metabolic, hematologic, inflammatory, dietary and endocrine factors as well as cardiac function on trajectories of diabetes.
  • to study the consequences of diabetes including micro- and macrovascular complications.

More information on the KORA studies can be found on the KORA website / Studies.

Study design:
Population-based cohort study.

Study population:
4,261 participants took part in the baseline survey S4 (1999-2001), 3,080 participants in the first follow-up F4 (2006-2008) and 2,279 participants in the second follow-up FF4 (2013/14).

Study area:
City of Augsburg and the surrounding rural district Augsburg and Aichach-Friedberg.

Study period:
S4 (1999-2001), F4 (2006-2008) and FF4 (2013/14).

Study status:
Data analyses are ongoing.

Investigators at the Helmholtz Zentrum München:
B. Thorand, C. Huth, B. Linkohr, O. Lang, M. Marowsky-Köppl, A. Schneider, A. Peters (PI) (Institute of Epidemiology II), M. Laxy, R. Holle (Institute of Health Economics and Health Care Management, IGM).

C. Meisinger (Lehrstuhl für Epidemiologie der LMU München am UNIKA-T Augsburg, formerly HMGU); W. Rathmann, C. Herder, M. Roden (German Diabetes Center, Leibnitz Center for Diabetes Research at Heinrich Heine University, Düsseldorf), W. Koenig (University of Ulm), F. Kronenberg (Medical University Innsbruck).

The KORA research platform was initiated and financed by the Helmholtz Zentrum München - German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria. Additional funding for the KORA FF4 project came from the project partners e.g. for diabetes from the German Diabetes Center, Leibnitz Center for Diabetes Research at Heinrich Heine University Düsseldorf (DDZ).

Related publications:

  • Herder, C., Kannenberg, J. M., Huth, C., Carstensen-Kirberg, M., Rathmann, W., Koenig, W., Heier, M., Puttgen, S., Thorand, B., Peters, A., Roden, M., Meisinger, C., Ziegler, D. Proinflammatory cytokines predict the incidence and progression of distal sensorimotor polyneuropathy: KORA F4/FF4 study. Diabetes Care 2017; 40: 569-76.

  • Herder C, Kannenberg JM, Niersmann C, Huth C, Carstensen-Kirberg M, Wittenbecher C, Schulze M, Blüher M, Rathmann W, Peters A, Roden M, Meisinger C, Thorand B. Independent and opposite associations of serum levels of omentin-1 and adiponectin with increases of glycaemia and incident type 2 diabetes in an older population: KORA F4/FF4 study. European Journal of Endocrinology 177: 277–86, 2017.

  • Herder C, Kannenberg JM, Carstensen-Kirberg M, Huth C, Meisinger C, Koenig W, Peters A, Rathmann W, Roden M, Thorand B. Serum levels of interleukin-22, cardiometabolic risk factors and incident type 2 diabetes: KORA F4/FF4 study. Cardiovascular Diabetology 16: 17, 2017.

  • Kollerits B, Lamina C, Huth C, Marques-Vidal P, Kiechl S, Seppälä I, Cooper J, Hunt SC, Meisinger C, Herder C, Kedenko L, Willeit J, Thorand B, Dähnhardt D, Stöckl D, Willeit K, Roden M, Rathmann W, Paulweber B, Peters A, Kähönen M, Lehtimäki T, Raitakari OT, Humphries SE, Vollenweider P, Dieplinger H, Kronenberg F. Plasma Concentrations of Afamin Are Associated With Prevalent and Incident Type 2 Diabetes: A Pooled Analysis in More Than 20,000 Individuals. Diabetes Care 40:1386–1393, 2017.

  • Laxy M, Knoll G, Schunk M, Meisinger C, Huth C, Holle R. Quality of Diabetes Care in Germany Improved from 2000 to 2007 to 2014, but Improvements diminished since 2007. Evidence from the Population-Based KORA Studies. PLoS One, 11: e0164704, 2016 Oct 17, doi: 10.1371/journal.pone.0164704.

  • Herder, C., Bongaerts, B. W., Rathmann, W., Heier, M., Kowall, B., Koenig, W., Thorand, B., Roden, M., Meisinger, C., Ziegler, D. Differential association between biomarkers of subclinical inflammation and painful polyneuropathy: results from the KORA F4 study. Diabetes Care 2015; 38: 91-6.

  • Herder, C, Bongaerts, BW, Ouwens, DM, Rathmann, W, Heier, M, Carstensen-Kirberg, M, Koenig, W, Thorand, B, Roden, M, Meisinger, C, Ziegler, D, KORA Study Group. Low serum omentin levels in the elderly population with type 2 diabetes and polyneuropathy. Diabet Med 2015; 32: 1479-83.

  • Huth C / Beuerle S (contributed equally), Zierer A, Heier M, Herder C, Kaiser T, Koenig W, Kronenberg F, Oexle K, Rathmann W, Roden M, Schwab S, Seissler J, Stöckl D, Meisinger C, Peters A, Thorand B. Biomarkers of Iron Metabolism are Independently Associated with Impaired Glucose Metabolism and Type 2 Diabetes: the KORA F4 Study. European Journal of Endocrinology 173: 643–53, 2015.

  • Klüppelholz B, Thorand B, Koenig W, de las Heras Gala T, Meisinger C, Huth C, Giani G, Franks PW, Roden M, Rathmann W, Peters A, Herder C. Association of subclinical inflammation with deterioration of glycaemia before the diagnosis of type 2 diabetes: the KORA S4/F4 study. Diabetologia 58: 2269–77, 2015.

  • Herder C, Ouwens D.M., Carstensen M, Kowall B, Huth C, Meisinger C, Rathmann W, Roden M, Thorand B. Adiponectin May Mediate the Association Between Omentin, Circulating Lipids and Insulin Sensitivity: Results From the KORA F4 Study. European Journal of Endocrinology, 172: 423–32, 2015-

  • Rathmann W, Strassburger K, Heier M, Holle R, Thorand B, Giani G, Meisinger C. Incidence of Type 2 diabetes in the elderly German population and the effect of clinical and lifestyle risk factors: KORA S4/F4 cohort study. Diabet Med. 2009; 26: 1212-9.

  • Meisinger C, Strassburger K, Heier M, Thorand B, Baumeister SE, Giani G, Rathmann W. Prevalence of undiagnosed diabetes and impaired glucose regulation in 35-59-year-old individuals in Southern Germany: the KORA F4 Study. Diabet Med. 2010; 27: 360-2.

  • Kowall B, Rathmann W, Heier M, Holle R, Peters A, Thorand B, Herder C, Strassburger K, Giani G, Meisinger C. Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study. Int J Obes (Lond). 2012; 36: 826-33.

  • Herder C, Bongaerts BW, Rathmann W, Heier M, Kowall B, Koenig W, Thorand B, Roden M, Meisinger C, Ziegler D. Association of subclinical inflammation with polyneuropathy in the older population: KORA F4 study. Diabetes Care. 2013; 36: 3663-70.

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