Understanding cardiovascular risk and disease progression among individuals with a high-risk of developing diabetes.

Aim and purpose
The ADDITION-PRO study builds upon the Danish ADDITION study, which was finalised in 2010. The ADDITION study[LINK] examined whether it was cost-effective to screen people for diabetes in primary care. During this study more than 10,000 individuals were screened for blood glucose levels, cholesterol and blood pressure, as well as early signs of diabetes complications on kidneys, eyes, feet and heart.

The haves and have-nots
The ADDITION Pro study builds on this solid data by following disease progression among nearly 2,100 individuals from the Addition study with a high-risk of developing diabetes and cardiovascular disease (CVD).

We wanted to know: Who develops diabetes and CVD, and who does not? Why? What are the differences in genes, biomarkers and lifestyles among the different groups?

These are key questions that, if answered, could lead to more evidence-based medical and/or lifestyle interventions to slow down the progression of diabetes and CVD among high-risk individuals.

Design, method and theory
The ADDITION-PRO study is designed to increase understanding of diabetes and CVD risk and its underlying mechanisms among individuals.

Different from many other population studies, The ADDITION-PRO study has recruited people from the screened population of the ADDITION study. This gives the study a solid scientific basis for quantifying diabetes progression rates according to glucose tolerance status and to examine the development of early markers of cardiovascular and micro-vascular diabetic complications.

Key features of this study include:

1. A carefully characterised cohort at different levels of diabetes risk;
2. Detailed measurement of their anthropometric, body composition, biochemical and cardiovascular risk factors;
3. Objective measurement of their physical activity;
4. Examination of the initial stages of micro- and macrovascular complications;
5. Long-term follow-up of hard clinical outcomes, including mortality and CVD. • 

Target groups
Our target group includes people at a high risk of developing diabetes and CVD.

Expected outcomes

Results from the study will inform policy makers about CVD risk reduction and treatment among individuals at a high risk of diabetes. The detailed phenotyping of this cohort will also lay the path to answer research questions concerning early changes in cardiometabolic physiology.

Finally, it is our long-term ambition to do an intervention study in this well-characterised group of individuals when we have thoroughly analysed the data. Our overall aim will be to prevent early diabetes complications (nerve-, kidney-, eye- and cardiovascular complications) before the onset of diabetes.


PhD projects
- Troels Mygind Jensen: Methylglyoxal and methylglyoxal-derived advanced glycation end products in diabetic complications,

- Annelotte Philipsen: Investigating the importance of abdominal fat distribution in the development of disturbances in glucose metabolism,

- Anne-Louise Smidt Hansen: The role of different dimensions of physical activity and sedentary behaviour in glucose regulation (defended 19 April 2013),

- Nanna Borup Johansen: Aortic stiffness, glycaemia and cardiometabolic risk management (defended 26 March 2013).

Recent publications

- Hansen AL, Carstensen B, Helge JW, Johansen NB, Gram B, Christiansen JS, Brage S, Lauritzen T, Jørgensen ME, Aadahl M, Witte DR; ADDITION-Denmark Steering Committee. Combined Heart Rate- and Accelerometer-Assessed Physical Activity Energy Expenditure and Associations With Glucose Homeostasis Markers in a Population at High Risk of Developing Diabetes: The ADDITION-PRO Study. Diabetes Care. 2013 Jun 18.

- Johansen NB, Hansen AL, Jensen TM, Philipsen A, Rasmussen SS, Jørgensen ME, Simmons RK, Lauritzen T, Sandbæk A, Witte DR. Protocol for ADDITION-PRO: a longitudinal cohort study of the cardiovascular experience of individuals at high risk for diabetes recruited from Danish primary care. BMC Public Health. 2012 Dec 14;12:1078

Sidst opdateret 14-02-2017


Nanna Borup Johansen
Clinical Epidemiology Research


Research manager Marit Eika Jørgensen explains the background of the study.