The Maastricht Study

In the Western world, the prevalence of obesity is increasing at an alarming
rate. Consequently, the prevalence of the metabolic syndrome, type 2 diabetes
and cardiovascular disease is increasing. A particular alarming phenomenon is
that the occurrence of obesity shifts towards younger generations (<50 years)
in an ageing population (currently 51% of the Dutch adult population is
moderately to severely overweight (BMI >= 25 kg/m2). In addition, it has become
increasingly clear that the presence of obesity not only precedes the
development of the metabolic syndrome, type 2 diabetes and cardiovascular
disease but also of many other chronic illnesses (such as osteoporosis,
depression, dementia and chronic lung disease) and that particularly the
presence of type 2 diabetes seems to accelerate the development of other
chronic illnesses.
The above will most certainly have an important impact on society, future
health care and the individual patient. Yet, the underlying pathophysiology of
the above phenomena is only partially understood. It is therefore of paramount
importance to come to a better understanding of the pathophysiology of obesity,
the metabolic syndrome and type 2 diabetes in order to withstand the increasing
demands of the obesity epidemic upon society.

Aim of the Maastricht Study

The primary objectives of the Maastricht Study are:
1. to study the development of obesity, the metabolic syndrome and type 2
diabetes in the general population.
2. to study the development of cardiovascular disease in the general population
and how diabetes and the metabolic syndrome accelerate this.
3. to study the clustering of other chronic diseases in the general population
and
how diabetes and the metabolic syndrome accelerate this.
4. to identify novel biomarkers or risk factors in order to facilitate the
identification of the high-risk patient which would benefit most from early
intervention.

The Maastricht Study is closely intertwined with the Pearl String Initiative on
Diabetes (het Parelsnoer Initiatief (*Diabetes Parel*); METC 09/107) and The
Maastricht Study will act as covering structure. In short, the aim of the
Pearl String Initiative on Diabetes (Appendix III) is to set up a nation-wide
diabetes biobank of individuals with type 2 diabetes in order to identify risk
markers for cardiovascular and diabetes-related complications and to evaluate
the effectiveness of therapy and medication. The data set is oriented towards
the prediction of cardiovascular morbidity and mortality (METC 09/107). The
Maastricht Study will expand this initiative by additional phenotyping of all
Pearl Sting Initiative participants (n = 3000), by sampling an additional
cohort of 2000 Maastricht Study participants with type 2 diabetes and by
sampling a cohort of 5000 Maastricht Study participants without type 2 diabetes
(Figure 1). Of note: all Pearl String participants will be asked to give
informed consent to participate in the Maastricht Study separately from the
Pearl String Initiative.

Nature and extent of the burden and risks associated with participation,
benefit and group relatedness: Participation involves four site visits, in
which a detailed health check is conducted. The detailed assessment of health
status may reveal prevalent disease in a preclinical and/or asymptomatic stage.
On the one hand, awareness of normally unknown pathology may affect a person*s
perception of his own health condition negatively. On the other hand, early
detection is likely to have favourable effects on disease progression and
enable early intervention. Each participant will receive an individual
lifestyle advice on how to improve his or her health.