Omega-6 fatty acid biomarkers and incident type 2 diabetes: pooled analysis of individual-level data for 39 740 adults from 20 prospective cohort studies

被引：1

作者：

Wu, Jason H. Y. ^{[1
]}

Marklund, Matti ^{[2
]}

Imamura, Fumiaki ^{[4
]}

Tintle, Nathan ^{[6
]}

Korat, Andres V. Ardisson ^{[8
]}

de Goede, Janette ^{[9
]}

Zhou, Xia ^{[10
]}

Yang, Wei-Sin ^{[12
]}

Otto, Marcia C. de Oliveira ^{[13
]}

Kroger, Janine ^{[14
]}

Qureshi, Waqas ^{[15
]}

Virtanen, Jyrki K. ^{[16
]}

Bassett, Julie K. ^{[18
]}

Frazier-Wood, Alexis C. ^{[19
]}

Lankinen, Maria ^{[16
]}

Murphy, Rachel A. ^{[20
]}

Rajaobelina, Kalina ^{[21
]}

Del Gobbo, Liana C. ^{[22
]}

Forouhi, Nita G. ^{[4
]}

Luben, Robert ^{[5
]}

Khaw, Kay-Tee ^{[5
,6
]}

Wareham, Nick ^{[4
]}

Kalsbeek, Anya ^{[6
,7
]}

Veenstra, Jenna ^{[6
,7
]}

Luo, Juhua ^{[23
]}

Hu, Frank B. ^{[8
]}

Lin, Hung-Ju ^{[24
]}

Siscovick, David S. ^{[25
]}

Boeing, Heiner ^{[14
]}

Chen, Tzu-An ^{[19
]}

Steffen, Brian ^{[11
]}

Steffen, Lyn M. ^{[10
]}

Hodge, Allison ^{[18
]}

Eriksdottir, Gudny ^{[26
]}

Smith, Albert V. ^{[26
]}

Gudnason, Vilmunder ^{[26
]}

Harris, Tamara B. ^{[27
]}

Brouwer, Ingeborg A. ^{[28
]}

Berr, Claudine ^{[29
,30
]}

Helmer, Catherine ^{[21
]}

Samieri, Cecilia ^{[21
]}

Laakso, Markku ^{[17
]}

Tsai, Michael Y. ^{[11
]}

Giles, Graham G. ^{[18
]}

Nurmi, Tarja ^{[16
]}

Wagenknecht, Lynne ^{[15
]}

Schulze, Matthias B. ^{[14
]}

Lemaitre, Rozenn N. ^{[31
]}

Chien, Kuo-Liong ^{[12
,24
]}

Soedamah-Muthu, Sabita S. ^{[9
]}

机构：

[1] Univ New South Wales, George Inst Global Hlth, Fac Med, Sydney, NSW 2050, Australia

[2] Uppsala Univ, Dept Publ Hlth & Caring Sci, Clin Nutr & Metab, Uppsala, Sweden

[3] Uppsala Univ, Dept Med Sci, Uppsala, Sweden

[4] Univ Cambridge, MRC, Epidemiol Unit, Cambridge, England

[5] Univ Cambridge, Dept Publ Hlth & Primary Care, Sch Clin Med, Cambridge, England

[6] Dordt Coll, Dept Math & Stat, Sioux Ctr, IA USA

[7] Dordt Coll, Dept Biol, Sioux Ctr, IA USA

[8] Harvard TH Chan Sch Publ Hlth, Dept Nutr & Epidemiol, Boston, MA USA

[9] Wageningen Univ, Div Human Nutr, Wageningen, Netherlands

[10] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[11] Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA

[12] Natl Taiwan Univ, Inst Epidemiol & Prevent Med, Coll Publ Hlth, Taipei, Taiwan

[13] Univ Texas Hlth Sci Ctr Houston, Sch Publ Hlth, Div Epidemiol Human Genet & Environm Sci, Houston, TX USA

[14] German Inst Human Nutr, Potsdam, Germany

[15] Wake Forest Univ, Winston Salem, NC 27109 USA

[16] Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland

[17] Univ Eastern Finland, Inst Clin Med, Kuopio, Finland

[18] Canc Council Victoria, Melbourne, Vic, Australia

[19] ARS, USDA, Childrens Nutr Res Ctr, Houston, TX USA

[20] Univ British Columbia, Vancouver, BC, Canada

[21] Univ Bordeaux, INSERM, Bordeaux Populat Hlth Res Ctr, UMR 1219, Bordeaux, France

[22] Stanford Univ, Dept Med, Div Cardiovasc Med, Sch Med, Stanford, CA 94305 USA

[23] Indiana Univ, Dept Epidemiol & Biostat, Bloomington, IN USA

[24] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan

[25] New York Acad Med, New York, NY USA

[26] Iceland Heart Inst, Kopavogur, Iceland

[27] NIA, Bethesda, MD 20892 USA

[28] Vrije Univ Amsterdam, Hlth Sci, Amsterdam, Netherlands

[29] Montpellier Univ, INSERM, U1061, Neuropsychiat Epidemiol & Clin Res, Montpellier, France

[30] Montpellier Univ, Montpellier Univ Hosp, Montpellier, France

[31] Univ Washington, Cardiovasc Hlth Res Unit, Dept Med, Seattle, WA 98195 USA

[32] Univ South Dakota, Sanford Sch Med, Dept Internal Med, Sioux Falls, SD USA

[33] OmegaQuant Analyt, Sioux Falls, SD USA

[34] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Stockholm, Sweden

[35] Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden

[36] Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA

来源：

LANCET DIABETES & ENDOCRINOLOGY | 2017年 / 5卷 / 12期

关键词：

CARDIOVASCULAR-DISEASE; LINOLEIC-ACID; RISK; ASSOCIATION; DIETARY; METAANALYSIS; PLASMA; TRIALS; HEART; EPIDEMIOLOGY;

D O I：

10.1016/S2213-8587(17)30307-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The metabolic effects of omega-6 polyunsaturated fatty acids (PUFAs) remain contentious, and little evidence is available regarding their potential role in primary prevention of type 2 diabetes. We aimed to assess the associations of linoleic acid and arachidonic acid biomarkers with incident type 2 diabetes. Methods We did a pooled analysis of new, harmonised, individual-level analyses for the biomarkers linoleic acid and its metabolite arachidonic acid and incident type 2 diabetes. We analysed data from 20 prospective cohort studies from ten countries (Iceland, the Netherlands, the USA, Taiwan, the UK, Germany, Finland, Australia, Sweden, and France), with biomarkers sampled between 1970 and 2010. Participants included in the analyses were aged 18 years or older and had data available for linoleic acid and arachidonic acid biomarkers at baseline. We excluded participants with type 2 diabetes at baseline. The main outcome was the association between omega-6 PUFA biomarkers and incident type 2 diabetes. We assessed the relative risk of type 2 diabetes prospectively for each cohort and lipid compartment separately using a prespecified analytic plan for exposures, covariates, effect modifiers, and analysis, and the findings were then pooled using inverse-variance weighted meta-analysis. Findings Participants were 39 740 adults, aged (range of cohort means) 49-76 years with a BMI (range of cohort means) of 23.3-28.4 kg/m(2), who did not have type 2 diabetes at baseline. During a follow-up of 366 073 person-years, we identified 4347 cases of incident type 2 diabetes. In multivariable-adjusted pooled analyses, higher proportions of linoleic acid biomarkers as percentages of total fatty acid were associated with a lower risk of type 2 diabetes overall (risk ratio [RR] per interquintile range 0.65, 95% CI 0.60-0.72, p<0.0001; I-2=53.9%, p(heterogeneity) = 0.002). The associations between linoleic acid biomarkers and type 2 diabetes were generally similar in different lipid compartments, including phospholipids, plasma, cholesterol esters, and adipose tissue. Levels of arachidonic acid biomarker were not significantly associated with type 2 diabetes risk overall (RR per interquintile range 0.96, 95% CI 0.88-1.05; p=0.38; I-2 = 63.0%, p(heterogeneity) < 0.0001). The associations between linoleic acid and arachidonic acid biomarkers and the risk of type 2 diabetes were not significantly modified by any prespecified potential sources of heterogeneity (ie, age, BMI, sex, race, aspirin use, omega-3 PUFA levels, or variants of the FADS gene; all p(heterogeneity) >= 0-13). Interpretation Findings suggest that linoleic acid has long-term benefits for the prevention of type 2 diabetes and that arachidonic acid is not harmful.

引用

页码：965 / 974

页数：10

共 36 条

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