A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study
Year: 2017
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Combinations of multiple fatty acids may influence cardiometabolic risk more than single fatty acids. The association of a combination of fatty acids with incident type 2 diabetes (T2D) has not been evaluated. METHODS AND FINDINGS: We measured plasma phospholipid fatty acids by gas chromatography in 27,296 adults, including 12,132 incident cases of T2D, over the follow-up period between baseline (1991-1998) and 31 December 2007 in 8 European countries in EPIC-InterAct, a nested case-cohort study. The first principal component derived by principal component analysis of 27 individual fatty acids (mole percentage) was the main exposure (subsequently called the fatty acid pattern score [FA-pattern score]). The FA-pattern score was partly characterised by high concentrations of linoleic acid, stearic acid, odd-chain fatty acids, and very-long-chain saturated fatty acids and low concentrations of γ-linolenic acid, palmitic acid, and long-chain monounsaturated fatty acids, and it explained 16.1% of the overall variability of the 27 fatty acids. Based on country-specific Prentice-weighted Cox regression and random-effects meta-analysis, the FA-pattern score was associated with lower incident T2D. Comparing the top to the bottom fifth of the score, the hazard ratio of incident T2D was 0.23 (95% CI 0.19-0.29) adjusted for potential confounders and 0.37 (95% CI 0.27-0.50) further adjusted for metabolic risk factors. The association changed little after adjustment for individual fatty acids or fatty acid subclasses. In cross-sectional analyses relating the FA-pattern score to metabolic, genetic, and dietary factors, the FA-pattern score was inversely associated with adiposity, triglycerides, liver enzymes, C-reactive protein, a genetic score representing insulin resistance, and dietary intakes of soft drinks and alcohol and was positively associated with high-density-lipoprotein cholesterol and intakes of polyunsaturated fat, dietary fibre, and coffee (p < 0.05 each). Limitations include potential measurement error in the fatty acids and other model covariates and possible residual confounding. CONCLUSIONS: A combination of individual fatty acids, characterised by high concentrations of linoleic acid, odd-chain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D. The specific fatty acid pattern may be influenced by metabolic, genetic, and dietary factors.
Source: PLoS Medicine
Authors: Fumiaki Imamura, Stephen J. Sharp, Albert Koulman, Matthias B. Schulze, Janine Kröger, Julian L. Griffin, José M. Huerta, Marcela Guevara, Ivonne Sluijs, Antonio Agudo, Eva Ardanaz, Beverley Balkau, Heiner Boeing, Veronique Chajes, Christina C. Dahm, Courtney Dow, Guy Fagherazzi, Edith J. M. Feskens, Paul W. Franks, Diana Gavrila, Marc Gunter, Rudolf Kaaks, Timothy J. Key, Kay-Tee Khaw, Tilman Kühn, Olle Melander, Elena Molina-Portillo, Peter M. Nilsson, Anja Olsen, Kim Overvad, Domenico Palli, Salvatore Panico, Olov Rolandsson, Sabina Sieri, Carlotta Sacerdote, Nadia Slimani, Annemieke M. W. Spijkerman, Anne Tjønneland, Rosario Tumino, Yvonne T. van der Schouw, Claudia Langenberg, Elio Riboli, Nita G. Forouhi, Nick J. Wareham
Institutions: University of Cambridge, MRC Epidemiology Unit, MRC Elsie Widdowson Laboratory, National Institute for Health and Care Research, Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Medical Research Council, German Institute of Human Nutrition, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Navarre Institute of Health Research, Utrecht University, University Medical Center Utrecht, Institut Català d'Oncologia, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Centre de recherche en Epidémiologie et Santé des Populations, Centre international de recherche sur le cancer, Aarhus University, Institut Gustave Roussy, Wageningen University & Research, Lund University, Skåne University Hospital, Umeå University, Hospital Universitario Virgen de la Arrixaca, German Cancer Research Center, University of Oxford, Universidad de Granada, Instituto de Investigación Biosanitaria de Granada, Andalusian School of Public Health, Danish Cancer Society, Aalborg University Hospital, Federico II University Hospital, University of Naples Federico II, Fondazione IRCCS Istituto Nazionale dei Tumori, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, National Institute for Public Health and the Environment, Imperial College London
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $6,460
Funders: World Health Organization, Kræftens Bekæmpelse, NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research, Cancer Research UK, National Institute for Health and Care Research, Imperial College London, European Commission, Bundesministerium für Bildung und Forschung, Cambridge University Hospitals, Universitair Medisch Centrum Utrecht, Hjärt-Lungfonden, Novo Nordisk, Vetenskapsrådet, Deutsche Krebshilfe, Novo Nordisk Fonden, Medical Research Council, World Cancer Research Fund, Instituto de Salud Carlos III, Deutsches Zentrum für Diabetesforschung
Awards: G1063100621, G1075599542, Aetiology of type 2 diabetes and related metabolic disorders, Nutritional epidemiology, G1192877484, G1251683846, G1547781643, G1551068933, G1552113921, G1983572049, G2409987178, G2531204615, G263035233, G2742323354, G2826529823, G2892497062, G299057155, G3216658785, G3557517997, G370598735, G3803372573, G382879149, G385559569, G4015216323, G4028471796, Health of vegetarians, G5051146843, G515689015, G5384371102, G5787426001, G5870702634, G5897142711, G6085534252, NIHR Senior Investigator Award, G6206044308, G6442500046, G6594529311, G6641991021, G6723261869, G6957823285, G7597388277, G8102615189, G8247458357, G8361061312, NIHR Senior Investigator Award, G8563274388, G8585681489, G8846336397, G8959392569, G899966268
OpenAlex ID: W2761254197