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In another study, it was reported that male mice consuming a low-protein diet produced offspring with increased level of cytosine methylation in trans -acting regulatory sequences of key genes involved in lipid and cholesterol biosynthetic pathways such as Ppar (Carone et al., In different models, it was however shown that a diet-induced stress indeed provokes changes in the DNA methylation profile of the father's sperm cells (Fullston et al., 2014) reported that a situation of diet-induced paternal prediabetes modifies the sperm methylation status of several genes such as the phosphatidylinositol (PI) 3-kinase subunits Pik3ca and Pik3r1 of the insulin pathway

Strengths of our study include the relatively large sample size, its prospective design with multiple standardised annual measurements for each patient, and a constant time between follow-up measurements

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Not getting better no progress, 6 months