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In the two present prospective cohort studies we conducted on population-based sample from the North-eastern adult Germans, the following main results were obtained. First, CP had a moderate effect on CVD and all-cause mortality [93]. In further analyses, we investigated the association of CP and mortality considering DM as a mediator in the CP-Mortality association. We did not, however, come up with enough evidence supporting this hypothesis. Furthermore, no substantial evidence was found on our hypothesis suggesting a joint effect of CP and DM on mortality [93]. Second, we studied the causal effect of CP on diabetes incidence or long-term change of Hba1c level using 11-years of follow-up data from SHIP. However, our data did not indicate any independent effect of CP on the incidence of diabetes mellitus after comprehensive confounder adjustment using DAGs. Models that consider baseline periodontal status effect on long term change of Hba1c revealed similar non-significant results [94].
The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented.