The Prospective investigation of Obesity, Energy and Metabolism (POEM)
The Prospective investigation of Obesity, Energy and Metabolism (POEM) is aiming to study pathophysiological links between obesity and vascular dysfunction and future cardiovascular disorders.This study aim originates from observations that some obese subjects show an absence of associated metabolic disturbances like diabetes, dyslipidemia and hypertension.This group has been denoted “metabolically healthy obese”. It is however a controversy whether or not this group will suffer from future cardiovascular disorders. Furthermore, although it has been known for decades that obesity in most cases are linked with vascular dysfunction, the mechanisms whereby obesity induce endothelial dysfunction, atherosclerosis and later myocardial infarction are not known.
In order to study those matters further, the POEM study aims to investigate a population-based sample of 50-year old inhabitants of the city of Uppsala invited in a random manner. To obtain a sufficient power, the study will also include a certain number of obese subjects of the same age identified in another health screening project.
The subjects will be investigated be several methods regarding obesity and fat distribution, such as bioimpedance, DXA (collaborator Karl Michaelsson) and MRI (collaborators Håkan Ahlström, Lars Johansson, Joel Kullberg).Regarding energy and metabolism, basal energy expenditure will be measured by indirect calorimetry, maximal VO2 will be evaluated by a maximal bicycle test, physical activity will be evaluated by an accelerometer (collaborator Johan Sundström), an oral glucose tolerance test with insulin determinations will be performed, lipids will be evaluated and food habits will be estimated by a FFQ (collaborator Alicja Volk). A number test evaluating endothelial function, arterial compliance, atherosclerosis, myocardial geometry and function and heart rate variability will be performed together with a 24h ambulatory blood pressure recording. Also a device evaluating sleep characteristics for the diagnosis of sleep apnea will be used (collaborator Eva Lindberg).
Blood and DNA will be collected and biobanked for future analysis of biomarkers and genetics.
A follow-up after 10 years is planned for evaluation of development of obesity, hypertension and other cardiovascular diseases. The first subject was included in the study in September 2010.