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PLoS Med. 2017 Oct 11;14(10):e1002409. doi: 10.1371/journal.pmed.1002409. eCollection 2017 Oct.

A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study.

Author information

1
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
2
National Institute for Health Research Biomedical Research Centres Core Nutritional Biomarker Laboratory, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom.
3
National Institute for Health Research Biomedical Research Centres Core Metabolomics and Lipidomics Laboratory, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom.
4
Medical Research Council Epidemiology Unit Elsie Widdowson Laboratory, Cambridge, United Kingdom.
5
Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam, Germany.
6
Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom.
7
Department of Epidemiology, Consejería de Sanidad y Política Social, CIBER de Epidemiología y Salud Pública, Murcia, Spain.
8
CIBER Epidemiología y Salud Pública, Madrid, Spain.
9
Navarre Public Health Institute, Pamplona, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
10
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
11
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain.
12
Center for Research in Epidemiology and Population Health, Inserm U1018, Paris-Sud University, University Versailles Saint-Quentin-en-Yvelines, Paris Saclay University, Villejuif, France.
13
International Agency for Research on Cancer, Lyon, France.
14
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
15
Gustave Roussy Institute, Villejuif, France.
16
Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, Netherlands.
17
Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
18
Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden.
19
Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
20
Murcia BioHealth Research Institute-Hospital Virgen de la Arrixaca, Murcia, Spain.
21
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
22
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
23
Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
24
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
25
Danish Cancer Society Research Center, Copenhagen, Denmark.
26
Department of Cardiology, Aalborg University Hospital, Aarhus, Denmark.
27
Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy.
28
Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Federico II University, Naples, Italy.
29
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
30
Unit of Cancer Epidemiology, Città della Salute e della Scienza Hospital-University of Turin and Center for Cancer Prevention, Torino, Italy.
31
National Institute for Public Health and the Environment, Bilthoven, Netherlands.
32
Affiliation Cancer Registry, Department of Prevention, Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy.
33
School of Public Health, Imperial College London, London, United Kingdom.

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.

PMID:
29020051
PMCID:
PMC5636062
DOI:
10.1371/journal.pmed.1002409
[Indexed for MEDLINE]
Free PMC Article

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