Principal investigator

Dr. Rachel Dankner

Subinvestigators

Gertner Institute:

Ms Flora Lubin; Ms Angela Chetrit, Cardiovascular Epidemiology Unit; Ms. Liraz Olmer, Biostatistics Unit; Ms Tamara Rodkin, Information and Computerization Unit.

Sheba Medical Center:

Prof. Dror Harats, Head of the Institute of Lipid and Atherosclerosis Research; Dr. Ben-Ami Sela, Head of the Chemical Pathology Institute; Prof. Abraham Karasik, Head of the Endocrinology Institute.

Description of the Project

A 30-year, longitudinal study that monitors a research cohort to detect risk factors for diabetes and cardiovascular disease. In 1967, 8400 people were selected from the national population registry, stratified by gender (50% each men and women), age (33% in each decade of birth: 1912-1921, 1922-1931 and 1932-1941) and ethnic origin (25% from each region of origin: Yemen, the rest of Asia, North Africa, Europe/Americas).

First stage:

5,710 people were recruited from the original sample and information was gathered about their smoking habits, socio-demographic characteristics, height, weight and blood pressure (6-10 measurements on consecutive days).

Second stage:

In 1979-1982, approximately 3,600 of the people who participated in the first stage were interviewed individually and anthropometric data (weight, height and blood pressure) was collected. In addition, a sub-sample was given additional tests: EKG, blood, glucose tolerance, insulin and lipid profile. The sub-sample was also interviewed for quantitative information about dietary habits and physical exercise.

Third stage:

The third stage began in 2000 and includes follow-up on the surviving members of the sub-sample from the second stage who were tested for glucose tolerance, blood insulin and lipid profile. Participants are being interviewed individually, anthropometric data (weight, height and blood pressure) is collected and the following tests done: resting EKG, three blood pressure measurements and comprehensive blood tests including glucose tolerance, lipids and apolipoproteins, homocysteine, folic acid, vitamin B12 and DNA extraction. As of 2004, blood counts and CRP results are also being collected. Plasma is being frozen for testing at a later date. Approximately 1,200 surviving participants have been examined and information is also being collected about the morbidity and cause of death of those who have died.

Objectives

• Stage 1: To determine the occurrence of hypertension in the various ethnic groups within the Jewish population of the State of Israel.
• Stage 2: To determine the occurrence of diabetes and the incidence of hypertension after ten years of monitoring. The presence of hyperinsulinemia was tested as a factor linking glucose intolerance, obesity, hypertension and poor lipid profile (syndrome X).
• To examine the differences in lifestyle (smoking, diet and physical activity), body mass index and blood pressure in the different ethnic groups, and the connection between these factors and general mortality/cardiovascular mortality.
• Stage 3: To test the connection between an abnormal glucose tolerance test in stage 2 and the occurrence of diabetes twenty years later.
• To examine cardiovascular morbidity and mortality, diabetes and cancer in the stage 2 cohort.
• To identify the risk profile for the diabetes and cardiovascular morbidity during the 25-year monitoring after stage 2, with emphasis on the metabolic syndrome and hyperinsulinemia as primary causes of morbidity.

Type of study

Longitudinal study (prospective, cohort) 

Financing organization

Stage 1 and 2:

US National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases; The Israeli German Fund; The Israel-US Binational Fund; The Sackler School of Medicine Shreiber Fund

Stage 3:

Research grant from the Chief Scientist of the Ministry of Health, Hendrik Gutwirth Foundation, Tel Aviv University; Public Trustee via the Chief Scientist of the Ministry of Health; Pinhas Sapir Foundation of the National Lottery; Pfizer Israel, Israel Diabetes Association, The Russell Berrie Foundation and D Cure, Diabetes Care in Israel.

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