Technical Summary

The Fenland Study is a cohort of 12,435 participants born between 1950 and 1975 who have undergone detailed metabolic phenotyping with quantitative assessment of total and regional adiposity including ectopic fat deposition in the form of hepatic steatosis, using ultrasound and DEXA scanning. The recruitment of relatively young individuals before chronic disease onset was designed to investigate early processes and pathways to metabolic disease unaffected by therapy or co-existing disease. Fenland is one of the few cohorts with participants in young middle age, a gap noted in the recent MRC Strategic Review of UK Population Cohort Studies.

Key lifestyle determinants of metabolic disease have been characterised objectively. Resting metabolic rate and cardio-respiratory fitness have been measured, free-living physical activity energy expenditure estimated by combined heart rate and movement sensing and nutritional biomarker measurement undertaken. Metabolic phenotypes include a oral glucose tolerance test with measurement of insulin, c-peptide, insulin precursors, leptin and adiponectin. A GWAS (Genome-wide association study) of all individuals in the Fenland has been completed, and is contributing to investigations of the genetic basis of quantitative metabolic traits.

Follow-up phases are being undertaken with the objective of studying the relationship between change in objectively quantified behaviours and body composition and metabolic risk. The Fenland Study Phase 2 (Fenland 2) collected longitudinal data on key risk factors and continuous metabolic traits, in order to define the temporal and dynamic relationships between these exposures and changes in metabolism, which were limited by the cross-sectional nature of Fenland 1.

Measurements carried out in Fenland 1 were undertaken on the same cohort of participants in Fenland 2 in order to (a) investigate the determinants of change in metabolic and anthropometric variables and (b) to investigate the determinants of change in key lifestyle behaviours such as physical activity and dietary behaviour. In Fenland 2 we collected and stored mononuclear cells for the generation of induced pluripotent stem cells in order to enable us to study cellular processes in different tissues which could provide essential information used to infer mechanisms of, or predict risk for, metabolic diseases.

For Fenland Study Phase 3 (Fenland 3) we have introduced a bespoke Fenland Study app that participants with compatible devices can use to complete questionnaires and some measurements digitally at their own convenience in their own homes before the clinic visit. The app will also allow participants to get detailed feedback on their own results direct to their phone, as well as keep up with the latest news from the study.

Fenland has enabled a number of sub-studies to be efficiently conducted. These have investigated: the effects of measurement of physical activity and feedback on awareness, behavioural intentions and physical activity levels (the Feedback, Awareness and Behaviour Study); the level of validity of conclusions of studies of physical activity by estimating the size of any reactivity effect (the Fenland Measurement Reactivity Trial); the effect of providing genetic or phenotypic risk estimates on objectively measured physical activity (the Diabetes Risk Communication Trial); and the effect of vitamin D supplementation in people at risk of diabetes (the Vitamin D Supplementation trial).

The Fenland Covid-19 Study aimed to quantify the proportion of people who have had COVID-19 in the Fenland cohort, and to to investigate whether it was possible to identify the COVID-19 pre-symptomatic phase using measurements of signs and symptoms collected via a smartphone App to help scientists develop better measures of early detection.

Chief Investigator

Professor Nick Wareham

Principal Investigators

Dr Søren Brage
Dr Nita Forouhi
Professor Simon Griffin
Dr Kirsten Rennie

Status

Phase 3 follow up in progress.

Recruitment and data collection for Phases 1 and 2 is complete, with analysis and publication also on-going. Genome-wide genotyping on the entire cohort and metabolomics measurement (using the Biocrates kit) was completed in 2015.

Unit Role

The Fenland Study is led by the MRC Epidemiology Unit with responsibility for data and samples. Metabolomics measurement was undertaken in collaboration with MRC Human Nutrition Research.

Funding

The Fenland Study is core funded by the MRC. Metabolomics and extension of the GWAS analysis to cover the entire cohort was funded by the MRC Omics call (MC_PC_13046).

DOI

DOI: 10.22025/2017.10.101.00001

Data Sharing

• Fenland Study Data Dictionary

To access Fenland Study data email datasharing@mrc-epid.cam.ac.uk explaining the basics of the analysis you want to carry out. A member of our team will then contact you to discuss the details of your request.