A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study
Imamura, Fumiaki; Sharp, Stephen J.; Koulman, Albert; Schulze, Matthias B.; Kröger, Janine; Griffin, Julian L.; Huerta, José María; Guevara, Marcela; Sluijs, Ivonne; Agudo, Antonio; Ardanaz, Eva; Balkau, Beverley; Boeing, Heiner; Chajes, Veronique; Dahm, Christina C.; Dow, Courtney; Fagherazzi, Guy; Feskens, Edith J. M.; Franks, Paul W.; Gavrila, Diana; Gunter, Marc J.; Kaaks, Rudolf; Key, Timothy J.; Khaw, Kay Tee; Kühn, Tilman; Melander, Olle; Molina-Portillo, Elena; Nilsson, Peter M.; Olsen, Anja; Overvad, Kim; Palli, Domenico; Panico, Salvatore; Rolandsson, Olov; Sieri, Sabina; Sacerdote, Carlotta; Slimani, Nadia; Spijkerman, Annemieke M. W.; Tjønneland, Anne; Tumino, Rosario; van der Schouw, Yvonne T; Langenberg, Claudia; Riboli, Elio; Forouhi, Nita G.; Wareham, Nick J.
(2017) PLoS Medicine, volume 14, issue 10
(Article)
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
... read more
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.
show less
Download/Full Text
Keywords: Journal Article
ISSN: 1549-1277
Publisher: Public Library of Science
Note: Publisher Copyright: © 2017 Imamura et al.
(Peer reviewed)