The Mexico City Prospective Study
Lead Research Organisation:
University of Oxford
Department Name: UNLISTED
Abstract
Experience in Western countries has shown that large population-based prospective studies are a valuable way of investigating many slow-acting causes of common chronic diseases. Over 15 years ago, we enrolled 150,000 Mexicans (100,000 women and 50,000 men) into the Mexico City Prospective Study (MCPS), asking them about their lifestyle, taking their physical measurements and storing their blood samples (allowing genetic variation to be measured). We have established reliable follow-up of cause-specific mortality and have recently reassessed a sample of 10k participants (predominantly to find out how risk factors change vary over time). We are also about to start a new programme of fieldwork to collect information on major non-fatal diseases that have occurred over the past 15 years. The MCPS is the largest prospective study that has been established among Mexicans (or Mexican Americans) and with >15 years of follow-up is now very well placed to examine the major genetic and non-genetic causes of disease in this population. In particular, a major problem in Mexico is obesity and diabetes (and, as a consequence, kidney disease and cardiovascular disease). Much of our future research will therefore be to investigate how obesity, diabetes and related risk factors (including genetic factors) inter-relate to cause premature morbidity and mortality in Mexican adults.
Technical Summary
Between 1998 and 2004, the Mexican Ministry of Health, in collaboration with epidemiologists at the University of Oxford’s Clinical Trial Service Unit & Epidemiological Studies Unit (in which the PHRU is embedded), established in Mexico City a prospective study in which over 150k middle-aged adults were enrolled (the ‘Mexico City Prospective Study’ [MCPS]). Participants completed a questionnaire, had a physical assessment (weight, height, waist and hip circumference, blood pressure) and gave a blood sample. Stored plasma and buffy coat samples (for DNA) of good quality are available for 98% of participants and are in long-term storage in Oxford in liquid nitrogen storage facilities. Participants are tracked for cause-specific mortality using the national mortality register, with nearly 20k dead by 2016. A resurvey of 10k survivors, including additional questions, measurements, and samples (urine) was completed in February 2019. Cohort-wide fieldwork to collect information on major non-fatal diseases will start in mid-2019. Funding to genotype and exome sequence the whole cohort has recently been obtained.
The MCPS is by far the largest study of its type in a Latin-American population. What sets it apart from other large blood-based cohorts is the extremely high prevalence of obesity and diabetes. By age 60, around half of women and one third of men had a body-mass index of at least 30 kg/m2 at recruitment, while more than one in five had received a diagnosis of diabetes. Those with diabetes had poor glycaemic control (mean HbA1c was 9%) and had an all-cause mortality rate at ages 35-74 that was four times greater than those without diabetes (much more extreme than has been documented in other populations studied to date).
We plan to continue to follow-up as well as enhance the cohort (eg, with the collection of information on non-fatal diseases) with the primary aim of continuing to study the major known environmental causal risk factors. However, the availability of genetic data in addition to a wide range of other phenotypic data that already exists – from a single study with >15 years follow-up covering a wide range of diseases, and in an admixed population in which adiposity and diabetes are much more common than in most previously-studied populations – creates substantial new research opportunities. These include: discovery of novel genetic variants for diabetes, adiposity and related traits; replication and fine-mapping studies, and trans-ethnic meta-analyses; causal evaluation of environmental risk factors and blood biomarkers (through Mendelian randomisation studies); phenome-wide association studies; creation of risk prediction tools; and genome wide association studies of other traits. The potential subsequent translational opportunities (eg, with respect to the development of novel therapeutic approaches) are substantial.
The MCPS is by far the largest study of its type in a Latin-American population. What sets it apart from other large blood-based cohorts is the extremely high prevalence of obesity and diabetes. By age 60, around half of women and one third of men had a body-mass index of at least 30 kg/m2 at recruitment, while more than one in five had received a diagnosis of diabetes. Those with diabetes had poor glycaemic control (mean HbA1c was 9%) and had an all-cause mortality rate at ages 35-74 that was four times greater than those without diabetes (much more extreme than has been documented in other populations studied to date).
We plan to continue to follow-up as well as enhance the cohort (eg, with the collection of information on non-fatal diseases) with the primary aim of continuing to study the major known environmental causal risk factors. However, the availability of genetic data in addition to a wide range of other phenotypic data that already exists – from a single study with >15 years follow-up covering a wide range of diseases, and in an admixed population in which adiposity and diabetes are much more common than in most previously-studied populations – creates substantial new research opportunities. These include: discovery of novel genetic variants for diabetes, adiposity and related traits; replication and fine-mapping studies, and trans-ethnic meta-analyses; causal evaluation of environmental risk factors and blood biomarkers (through Mendelian randomisation studies); phenome-wide association studies; creation of risk prediction tools; and genome wide association studies of other traits. The potential subsequent translational opportunities (eg, with respect to the development of novel therapeutic approaches) are substantial.
Organisations
- University of Oxford (Lead Research Organisation)
- HARVARD UNIVERSITY (Collaboration)
- Mexican Biobank (Collaboration)
- Universidad de Los Andes, Chile (Collaboration)
- Hospital General de México (Collaboration)
- UNIVERSITY OF CAMBRIDGE (Collaboration)
- AstraZeneca (Collaboration)
- UNIVERSITY OF OXFORD (Collaboration)
- AbbVie Inc (Collaboration)
- Nightingale Health Ltd. (Collaboration)
- International Common Disease Alliance (Collaboration)
- Regeneron Pharmaceuticals, Inc. (Collaboration)
- Yale University (Collaboration)
- Government of Mexico (Collaboration)
- University of Bristol (Collaboration)
Publications
Gnatiuc L
(2022)
Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults.
in European journal of preventive cardiology
Gnatiuc Louisa
(2020)
Adiposity and cause-specific mortality in the Mexico City Prospective Study
Aguilar-Ramirez D
(2022)
Adiposity and NMR-measured lipid and metabolic biomarkers among 30,000 Mexican adults.
in Communications medicine
Trichia E
(2023)
Alcohol and cause-specific mortality among 150,000 participants in the Mexico City Prospective Study
in European Heart Journal
Armas Rojas NB
(2021)
Alcohol consumption and cause-specific mortality in Cuba: prospective study of 120 623 adults.
in EClinicalMedicine
Thomson B
(2022)
Association Between Smoking, Smoking Cessation, and Mortality by Race, Ethnicity, and Sex Among US Adults.
in JAMA network open
Tapia-Conyer R
(2020)
Association of Blood Pressure With Cause-Specific Mortality in Mexican Adults.
in JAMA network open
Aguilar-Ramirez D
(2021)
Association of Kidney Function With NMR-Quantified Lipids, Lipoproteins, and Metabolic Measures in Mexican Adults.
in The Journal of clinical endocrinology and metabolism
Related Projects
Project Reference | Relationship | Related To | Start | End | Award Value |
---|---|---|---|---|---|
MC_UU_00017/1 | 31/03/2019 | 31/03/2024 | £5,782,000 | ||
MC_UU_00017/2 | Transfer | MC_UU_00017/1 | 31/03/2019 | 31/03/2024 | £2,644,000 |
MC_UU_00017/3 | Transfer | MC_UU_00017/2 | 31/03/2019 | 31/03/2024 | £3,269,000 |
MC_UU_00017/4 | Transfer | MC_UU_00017/3 | 31/03/2019 | 31/03/2024 | £1,831,000 |
MC_UU_00017/5 | Transfer | MC_UU_00017/4 | 31/03/2019 | 31/03/2024 | £2,183,000 |
Description | European Association of Preventive Cardiology (EAPC) |
Geographic Reach | Europe |
Policy Influence Type | Participation in a guidance/advisory committee |
URL | https://www.escardio.org/Sub-specialty-communities/European-Association-of-Preventive-Cardiology-(EA... |
Description | Reviewer Scientific Abstracts |
Geographic Reach | Europe |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | Promotion of sound science |
Description | The World Heart Federation Reviewer for the Salim Yusuf Leadership Program applications |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Contribution to new or improved professional practice |
Impact | Contribution to the development of new scientific leaders |
Description | Amazon Web Services Health Equity Initiative |
Amount | $208,750 (USD) |
Organisation | Amazon.com |
Department | Amazon Web Services |
Sector | Private |
Country | United States |
Start | 03/2023 |
End | 02/2024 |
Description | Internal Funding: UK Biobank studies on cardio-metabolic risks and premature mortality |
Amount | £5,400 (GBP) |
Organisation | University of Oxford |
Sector | Academic/University |
Country | United Kingdom |
Start | 01/2021 |
End | 01/2024 |
Description | Nuffield Department of Population Health Intermediate Fellowship |
Amount | £200,000 (GBP) |
Organisation | University of Oxford |
Sector | Academic/University |
Country | United Kingdom |
Start | 01/2024 |
End | 01/2027 |
Description | Seed Funding |
Amount | $25,000 (USD) |
Organisation | World Heart Federation |
Sector | Charity/Non Profit |
Country | Switzerland |
Start |
Title | Mexico City Prospective Study Database |
Description | Data collected as part of Mexico City Prospective Study (MCPS) are available. These include baseline, resurvey, mortality and genetic data. Data can be transferred to the requestor or access provided via the online platform DNAnexus. |
Type Of Material | Database/Collection of data |
Year Produced | 2019 |
Provided To Others? | Yes |
Impact | We have shared data with over 60 research projects. Substantial genetic data are available from a previously unreported population. |
URL | https://www.ctsu.ox.ac.uk/research/mcps |
Title | Mexico City Prospective Study Variant Browser |
Description | MCPS genetic data can be viewed using the MCPS Variant Browser. |
Type Of Material | Database/Collection of data |
Year Produced | 2022 |
Provided To Others? | Yes |
Impact | Researchers can assess the genetic data available from MCPS. |
URL | https://rgc-mcps.regeneron.com/license-and-terms-of-use |
Description | Abbvie |
Organisation | AbbVie Inc |
Department | AbbVie (UK) |
Country | United Kingdom |
Sector | Private |
PI Contribution | Collaborative research projects using genetic data from the MCPS |
Collaborator Contribution | Abbvie contributed to the whole genome sequencing of 10,000 selected individuals from MCPS. |
Impact | None yet |
Start Year | 2021 |
Description | Astra Zeneca |
Organisation | AstraZeneca |
Department | Astra Zeneca |
Country | United States |
Sector | Private |
PI Contribution | Collaborative research projects using genetic data from the MCPS. |
Collaborator Contribution | In addition to the funding provided by joining the already-existing partnership between Oxford, Mexico and Regeneron, Astra Zeneca also contribute through regular scientific meetings with the teams in Mexico, Oxford and Regeneron. |
Impact | Collaborative publications |
Start Year | 2021 |
Description | Cognitive Impairment Collaboration |
Organisation | Universidad de Los Andes, Chile |
Country | Chile |
Sector | Academic/University |
PI Contribution | Collaborative meetings, provision of data and some analyses |
Collaborator Contribution | Collaborative meetings and some analyses |
Impact | n/a |
Start Year | 2024 |
Description | GWAS of Heart Failure |
Organisation | Harvard University |
Department | Harvard Medical School |
Country | United States |
Sector | Academic/University |
PI Contribution | Provision of meta-data |
Collaborator Contribution | Collaborative analyses |
Impact | n/a |
Start Year | 2023 |
Description | General Hospital of Mexico |
Organisation | General Hospital of Mexico |
Country | Mexico |
Sector | Hospitals |
PI Contribution | Collaboration with Prof Jaime Berumen, Head of the Genomic Medicine Unit at the General Hospital of Mexico (Faculty of Medicine, National Autonomous University of Mexico). Aim: To study the genetic causes of disease in the Mexican population (PI: Emberson; Co-investigators: Torres) Formal agreement in development |
Collaborator Contribution | Academic collaboration |
Impact | Collaborative publications |
Start Year | 2020 |
Description | International Common Disease Alliance |
Organisation | International Common Disease Alliance |
Sector | Charity/Non Profit |
PI Contribution | MCPS is a partner |
Collaborator Contribution | Academic collaboration |
Impact | none yet |
Start Year | 2022 |
Description | MCPS-INMEGEN Collaboration |
Organisation | Government of Mexico |
Department | National Institute of Genomic Medicine, Mexico |
Country | Mexico |
Sector | Public |
PI Contribution | Collaborative meetings, provision of data and some analyses. |
Collaborator Contribution | Collaborative meetings and some analyses. |
Impact | n/a |
Start Year | 2022 |
Description | MCPS-Kennedy Institute of Rheumatology Collaboration |
Organisation | University of Oxford |
Department | Kennedy Institute of Rheumatology |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaborative meetings, provision of data and some analyses. |
Collaborator Contribution | Collaborative meetings, provision of data and some analyses. |
Impact | n/a |
Start Year | 2023 |
Description | MCPS-Latin American Genomics Consortium Collaboration on Alcohol Consumption |
Organisation | Yale University |
Country | United States |
Sector | Academic/University |
PI Contribution | Provision of meta-data |
Collaborator Contribution | Collaborative analyses |
Impact | n/a |
Start Year | 2023 |
Description | MCPS-Quantitative Genetics Collaboration |
Organisation | University of Oxford |
Department | Nuffield Department of Population Health |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaborative meetings, provision of data and some analyses |
Collaborator Contribution | Collaborative meetings and some analyses |
Impact | n/a |
Start Year | 2023 |
Description | MRC Cross-Population Mendelian Randomization Network |
Organisation | University of Bristol |
Department | MRC Integrative Epidemiology Unit |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | To address the challenges in generalisability of target drugs for multiple populations and evaluate how Mendelian randomization can be used to address them. |
Collaborator Contribution | Cross-collaboration with researchers at the MRC Integrative Epidemiology Unit |
Impact | none yet |
Start Year | 2022 |
Description | Mexico Biobank |
Organisation | Mexican Biobank |
Country | Mexico |
Sector | Charity/Non Profit |
PI Contribution | MCPS is a partner |
Collaborator Contribution | Academic collaboration |
Impact | none yet |
Start Year | 2022 |
Description | Nightingale Health |
Organisation | Nightingale Health Ltd. |
Country | Finland |
Sector | Private |
PI Contribution | To study the relevance of NMR biomarkers for the prediction of diabetes in UK and Mexican adults using data from the UK Biobank and the Mexico City Prospective Study (PI: Emberson; Co-investigators: Aguilar-Ramirez, Trichia, Bragg). |
Collaborator Contribution | Academic collaboration |
Impact | Various scientific publications |
Start Year | 2020 |
Description | OMICS-PRED HDR-UK Collaboration |
Organisation | University of Cambridge |
Department | Department of Public Health and Primary Care |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Academic Collaboration |
Collaborator Contribution | Academic Collaboration |
Impact | n/a |
Start Year | 2023 |
Description | Regeneron Genetics Center |
Organisation | Regeneron Pharmaceuticals, Inc. |
Country | United States |
Sector | Private |
PI Contribution | Collaborative research projects using genetic data from the MCPS. |
Collaborator Contribution | The Regeneron Genetics Center genotyped and exome sequenced the entire MCPS cohort (an 'in-kind' contribution valued at the time as being >$100M) and continues to contribute through regular joint scientific meetings. |
Impact | Scientific publications, such as the discovery of GPR75 as a novel target for obesity (Akbari et al. Science 2021). |
Start Year | 2019 |
Description | The Metabolic Analysis in an Indigenous Sample (MAIS) cohort |
Organisation | Government of Mexico |
Department | National Institute of Genomic Medicine, Mexico |
Country | Mexico |
Sector | Public |
PI Contribution | Collaborative research to better understand the local ancestry of the individuals in the MCPS cohort. |
Collaborator Contribution | The MAIS Investigators provided individual level genetic data to Oxford for 716 individuals from 60 of the 68 recognized ethnic groups in Mexico. Oxford. The Oxford and MAIS investigators are currently working together (with Mexico, Regeneron and Astra Zeneca) on joint analyses. |
Impact | none yet |
Start Year | 2021 |
Description | Trans-ancestry meta-analysis improves performance of genetic scores for multiple adiposity-related traits in East Asian populations |
Organisation | University of Oxford |
Department | China Kadoorie Biobank |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | MCPS contributed summary statistics. |
Collaborator Contribution | academic partnership |
Impact | publication: https://doi.org/10.1101/2022.07.05.22277254 |
Start Year | 2022 |
Title | MCPS Data Showcase |
Description | The MCPS Data Showcase is a web-based facility that enables researchers to explore the data that is collected by MCPS in order to plan data requests and analyses. |
Type Of Technology | Webtool/Application |
Year Produced | 2019 |
Impact | Researchers are able to plan analyses more efficiently. |
URL | https://datashare.ndph.ox.ac.uk/mexico/index.cgi |
Description | Appearance on UNAM-TV discussing the MCPS |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Appearance on UNAM-TV discussing the MCPS |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.youtube.com/watch?v=9ylITDT60xE |
Description | Assessor for UNIQPlus Research Placement applications |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | Equal Opportunities for career development of talented students from disadvantaged backgrounds |
Year(s) Of Engagement Activity | 2020,2021,2022,2023 |
Description | Commented publication on Preventable CVD risk factors |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The European Society of Preventive Cardiology Bulletin |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.escardio.org/Sub-specialty-communities/European-Association-of-Preventive-Cardiology-(EA... |
Description | Discussion as part of OxPop Festival of Global Health |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | Discussion following screening of 'El Susto' (documentary on sugary drinks in Mexico) as part of the OxPop Festival of Global Health |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.ndph.ox.ac.uk/events/oxpop-festival-of-global-health-el-susto |
Description | Epidemiology and R Training |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Undergraduate students |
Results and Impact | We funded and arranged training courses for 4 students from Mexico. |
Year(s) Of Engagement Activity | 2023 |
Description | Interview for Science magazine |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Interview for Science magazine in relation to a high profile publication and release of data. |
Year(s) Of Engagement Activity | 2023 |
Description | MCPS Oxford-Mexico City Research Day |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | A research day consisting of talks about current research for an invited audience of researchers from Mexico City. |
Year(s) Of Engagement Activity | 2023 |
Description | My First Grant: Introduction for Early-Career Researchers |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Other audiences |
Results and Impact | Event with presentations by experts with a panel discussion |
Year(s) Of Engagement Activity | 2022 |
Description | Online research symposia for the Centre for Personalised Medicine |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Jason Torres. Co-organiser of two online research symposia for the Centre for Personalised Medicine, both of which are available to the general public. |
Year(s) Of Engagement Activity | 2021 |
URL | https://cpm.well.ox.ac.uk/term/pm-practice-genes-behaviour-and-metabolic-health |
Description | School visit Causeway School, Eastbourne |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | • Speaker at post-16 provision fair, Causeway School, Eastbourne |
Year(s) Of Engagement Activity | 2019 |
Description | Science Festival: Festival of Tomorrow |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Schools |
Results and Impact | Communication with the public about maths and science for human health |
Year(s) Of Engagement Activity | 2024 |
URL | https://www.festivaloftomorrow.com/ |
Description | Talk: Metabolómica por Espectroscopía de Resonancia Magnética Nuclear en el Estudio Prospectivo de la Ciudad de México |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | A talk given at Instituto Nacional de Medicina Genómica, Mexico: Metabolómica por Espectroscopía de Resonancia Magnética Nuclear en el Estudio Prospectivo de la Ciudad de México |
Year(s) Of Engagement Activity | 2023 |
Description | Talk: The Mexico City Prospective Study: a cohort of 150,000 adults with mortality, metabolomics, and genomics data |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Undergraduate students |
Results and Impact | Presentation at Universidad Panamericana, Faculty of Health Sciences: The Mexico City Prospective Study: a cohort of 150,000 adults with mortality, metabolomics, and genomics data |
Year(s) Of Engagement Activity | 2023 |