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Association of Plasma Phospholipid n-3 and n-6 Polyunsaturated Fatty Acids with Type 2 Diabetes: The EPIC-InterAct Case-Cohort Study.

Forouhi, NG and Imamura, F and Sharp, SJ and Koulman, A and Schulze, MB and Zheng, J and Ye, Z and Sluijs, I and Guevara, M and Huerta, JM and Kröger, J and Wang, LY and Summerhill, K and Griffin, JL and Feskens, EJM and Affret, A and Amiano, P and Boeing, H and Dow, C and Fagherazzi, G and Franks, PW and Gonzalez, C and Kaaks, R and Key, TJ and Khaw, KT and Kühn, T and Mortensen, LM and Nilsson, PM and Overvad, K and Pala, V and Palli, D and Panico, S and Quirós, JR and Rodriguez-Barranco, M and Rolandsson, O and Sacerdote, C and Scalbert, A and Slimani, N and Spijkerman, AMW and Tjonneland, A and Tormo, M-J and Tumino, R and van der A, DL and van der Schouw, YT and Langenberg, C and Riboli, E and Wareham, NJ (2016) Association of Plasma Phospholipid n-3 and n-6 Polyunsaturated Fatty Acids with Type 2 Diabetes: The EPIC-InterAct Case-Cohort Study. PLoS Med, 13. e1002094-e1002094.

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BACKGROUND: Whether and how n-3 and n-6 polyunsaturated fatty acids (PUFAs) are related to type 2 diabetes (T2D) is debated. Objectively measured plasma PUFAs can help to clarify these associations. METHODS AND FINDINGS: Plasma phospholipid PUFAs were measured by gas chromatography among 12,132 incident T2D cases and 15,919 subcohort participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study across eight European countries. Country-specific hazard ratios (HRs) were estimated using Prentice-weighted Cox regression and pooled by random-effects meta-analysis. We also systematically reviewed published prospective studies on circulating PUFAs and T2D risk and pooled the quantitative evidence for comparison with results from EPIC-InterAct. In EPIC-InterAct, among long-chain n-3 PUFAs, α-linolenic acid (ALA) was inversely associated with T2D (HR per standard deviation [SD] 0.93; 95% CI 0.88-0.98), but eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were not significantly associated. Among n-6 PUFAs, linoleic acid (LA) (0.80; 95% CI 0.77-0.83) and eicosadienoic acid (EDA) (0.89; 95% CI 0.85-0.94) were inversely related, and arachidonic acid (AA) was not significantly associated, while significant positive associations were observed with γ-linolenic acid (GLA), dihomo-GLA, docosatetraenoic acid (DTA), and docosapentaenoic acid (n6-DPA), with HRs between 1.13 to 1.46 per SD. These findings from EPIC-InterAct were broadly similar to comparative findings from summary estimates from up to nine studies including between 71 to 2,499 T2D cases. Limitations included potential residual confounding and the inability to distinguish between dietary and metabolic influences on plasma phospholipid PUFAs. CONCLUSIONS: These large-scale findings suggest an important inverse association of circulating plant-origin n-3 PUFA (ALA) but no convincing association of marine-derived n3 PUFAs (EPA and DHA) with T2D. Moreover, they highlight that the most abundant n6-PUFA (LA) is inversely associated with T2D. The detection of associations with previously less well-investigated PUFAs points to the importance of considering individual fatty acids rather than focusing on fatty acid class.

Item Type: Article
Divisions: Div F > Machine Intelligence
Depositing User: Cron Job
Date Deposited: 17 Jul 2017 19:07
Last Modified: 21 Jun 2018 02:27