Statistics Jobs in Australia:
2014 July - September
Sanjoy Paul, 25 July 2014
PhD Scholarship
QIMR Berghofer Medical Research Institute
PhD Projects with Clinical Trials and Biostatistics Unit - QIMR Berghofer Medical Research Institute
Topic: Evaluation of the obesity paradox in diabetes: A longitudinal case-control study
International collaborators:
Imperial College London, UK, and University of Leicester, UK
Project description:
Being overweight or obese is a risk factor for developing type 2 diabetes (T2DM). However, recent studies have reported increased mortality risk associated with normal body weight in people with incident diabetes compared to those who are overweight or obese. This “obesity paradox”, in which being overweight appears to be protective against mortality risk, is new in diabetes and the possible mechanisms behind this phenomenon are not yet explored. In general populations, however, a recent meta-analysis has reinforced the fact that compared to normal weight, obesity was associated with significantly higher all-cause mortality. This leads to the challenge of exploring the optimum adult body weight that best advances health, minimizes the risk of chronic disease like diabetes, and promotes longevity. This question has recently engaged the interest of the clinical investigators and public health professionals, since weight loss is so frequently a focus of management of T2DM. A comparative long-term longitudinal study of patients with newly diagnosed T2DM and non-diabetic controls is the best way to address this question of the obesity paradox. The consequences of answering this question have profound health and socio-economic implications for individuals and the population as a whole.
We propose to conduct a large comparative retrospective longitudinal case-control study to understand the possible reasons behind this observed "obesity paradox" in patients with T2DM. Specific aims are:
1. What is the relation between baseline body mass index (BMI) with cardiovascular risk, death due to cardiovascular diseases, death due to non-cardiovascular diseases and all-cause mortality (ACM) in those with and without incident T2DM after accounting for:
a. All co-morbidities, including the pre-existing cardiovascular and non-cardiovascular disease burden;
b. Weight trajectory prior to index date - allowing account to be made for those already losing weight because of serious co-morbidities.
2. Are there specific causes of death that could explain the increased mortality in individuals with normal weight (BMI: 18.5-25 kg/m2)?
3. Does the BMI trajectory over time after diagnosis explain the association of baseline BMI with vascular risks and mortality?
4. Are there any long-term interactions of cardiovascular (blood pressure, lipids) and glycaemic risk factors (e.g. glucose levels measured by HbA1c and hypoglycaemia), with body weight, that modify the risks?
Selection criteria:
- BSc or MSc in Statistics or Clinical Epidemiology, with some research experience;
- Interest in clinical research, especially in diabetes and metabolic diseases;
- Strong motivation to conduct independent research in the field of clinical biostatistics;
- Excellent programming knowledge with software, e.g. R & SAS;
- Ability to work independently and take responsibility of a program of work;
- Excellent written communication skills.
Contact:
Interested applicants may contact Professor Sanjoy Paul, Head of the Clinical Trials and Biostatistics Unit, QIMR Berghofer Medical Research Institute, and the Principal Investigator in this project. Email: sanjoy.paul@qimrberghofer.edu.au
