The Wynn Database holds information on metabolic risk factors for cardiovascular disease, diabetes and cancer recorded between 1965 and 2000 by Professor Victor Wynn’s group, working initially at the Department of Metabolic Medicine, St Mary’s Hospital Medical School and then at the Wynn Institute of the National Heart and Lung Institute. The Wynn database has been preserved and is currently managed by Dr Ian Godsland. Work on the data is in collaboration with Professor Desmond Johnston and Professor Nick Oliver.
The Wynn Database comprises 29,244 records of metabolic information for 14,615 individuals. Adiposity, blood pressure, and serum lipid and plasma glucose and insulin concentrations measured during a range of investigative procedures are recorded, as well as more specialised measurements in limited numbers.
Data has been acquired in a variety of contexts including:
- healthy volunteers
- different ethnic groups
- anabolic steroid therapy
- anti-androgen therapy
- oral contraceptive users
- HRT users
- coronary heart disease patients
- heart failure patients
- lipid clinic patients
- obesity clinic patients
- endocrine clinic patients
Currently, applications are being developed to enable mortality status and cause of death to be incorporated into the Database.
The Wynn Database is a unique research resource with which important questions regarding metabolic risk factors can be explored. With mortality status and cause of death information, our team will be able to investigate in depth the long-term implications of risk factor variation.
To date, work with data being incorporated into the Wynn Database has focused on the occupational cohort studied between 1971 and 2000 - the Heart Disease and Diabetes Research Indicators in a Screened Cohort (HDDRISC) study. With completion of the full Wynn Database, including mortality information, a number of further analyses will be possible, five of which are summarised below.
Wynn Database Analyses
- The HDDRISC Study
- Insulin Sensitivity
- Metabolic Risk Factors
- OGTT and Insulin Profile
- Oral Contraceptives
Until now, research investigations employing the Wynn Database information have concentrated primarily on a sub-set of the data that relates to an occupational cohort of 1192 individuals, studied between 1971 and 2000 - the Heart Disease and Diabetes Research Indicators in a Screened Cohort (HDDRISC) study. Analyses of HDDRISC study data have resulted in 25 peer-reviewed, published studies of relationships between metabolic risk factors and of their relationships to cardiovascular and cancer mortality and diabetes outcomes (1-25). Key findings from analyses of HDDRISC sub-study data include: 1) demonstration of the marked decline in beta cell insulin output as fasting plasma glucose increases towards diabetic levels (9); 2) discovery of associations between instability and progressive change in HDL cholesterol, uric acid, erythrocyte sedimentation rate and insulin sensitivity and cardiovascular disease outcomes (14, 15); and 3) prediction of death from either cardiovascular disease or cancer by inflammation markers measured over 20 years prior to death (20).
Wynn
Assembling the data records generated by the Wynn group into a unified coherent structure has been an on-going task since the inception of data recording in 1965. Since the early 2000's, attention has focused on the subset of the data that relates to the Heart Disease and Diabetes Research Indicators in a Screened Cohort (HDDRISC) study and, between 2000 and 2018, that work generated a number of published paper.
From 2018 onwards there has been a concerted effort to incorporate all Wynn group data records into a single, fully audited, readily accessible, de-identified data file with a separate, supplementary file that contains personally identifiable information. This process was completed in November 2021 and a full description of the Wynn Database files is provided in the dedicated Wynn Database Data Manual.
Also, from 2018 onwards we have worked towards gaining Health Research Authority approvals for our holding of personally indentifiable information and for provision by NHS England of Civil Registration of Deaths information for Wynn Database participants. HRA Research Ethics Approval came through in April 2021 and full Confidentiality Advisory Group approval was confirmed in September 2021.
With approvals in place we were able to submit, in September 2021, our application to NHS England for provision of year and cause of death information for Wynn Database participants and the data sharing agreement for this work was finalised in January 2023.
With regard to our planned mortality studies, we are currently in discussion with the Imperial College Research Facility Secure Enclaves managers exploring logistic and financial ways forward for uploading our personally identifiable information to NHS England for linkage to NHS number and Civil Registration of Deaths information.
While preparations for mortality analyses are still under way, we have, nevertheless, been able to undertake a number of informative analyses using the finalised, de-identified Wynn data file. From January 2022 onwards, in-depth analyses of relationships between glucose distribution space, adiposity and weight have been undertaken using the extensive intravenous glucose tolerance test data held in the Wynn Database. These analyses are an essential preliminary for our planned mortality analysis but are of interest in there own right for the interpretation of excursions in insulin concentrations during glucose tolerance testing. A manuscript describing these analyses is currently under review with Nature Scientific reports and a further manuscript focused on these issues in oral glucose tolerance test data is in develoment. Further work analysing oral glucose tolerance test insulin and glucose profiles using cluster analysis is progressing and a uniquely comprehensive analysis of oral contraceptive steroid effects on glucose and insulin metabolism is planned for 2024.