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

被引：171

作者：

Forouhi, Nita G. ^{[1
]}

Imamura, Fumiaki ^{[1
]}

Sharp, Stephen J. ^{[1
]}

Koulman, Albert ^{[2
]}

Schulze, Matthias B. ^{[3
]}

Zheng, Jusheng ^{[1
]}

Ye, Zheng ^{[1
]}

Sluijs, Ivonne ^{[4
]}

Guevara, Marcela ^{[5
,6
]}

Maria Huerta, Jose ^{[6
,7
]}

Kroeger, Janine ^{[3
]}

Wang, Laura Yun ^{[2
]}

Summerhill, Keith ^{[2
]}

Griffin, Julian L. ^{[2
]}

Feskens, Edith J. M. ^{[8
]}

Affret, Aurelie ^{[9
,10
,11
]}

Amiano, Pilar ^{[6
,12
,13
]}

Boeing, Heiner ^{[14
]}

Dow, Courtney ^{[9
,10
,11
]}

Fagherazzi, Guy ^{[9
,10
,11
]}

Franks, Paul W. ^{[15
,16
]}

Gonzalez, Carlos ^{[17
]}

Kaaks, Rudolf ^{[18
]}

Key, Timothy J. ^{[19
]}

Khaw, Kay Tee ^{[20
]}

Kuehn, Tilman ^{[18
]}

Mortensen, Lotte Maxild ^{[21
,22
]}

Nilsson, Peter M. ^{[15
]}

Overvad, Kim ^{[22
,23
]}

Pala, Valeria ^{[24
]}

Palli, Domenico ^{[25
]}

Panico, Salvatore ^{[26
]}

Ramon Quiros, J. ^{[27
]}

Rodriguez-Barranco, Miguel ^{[6
,28
]}

Rolandsson, Olov ^{[16
]}

Sacerdote, Carlotta ^{[29
,30
,31
]}

Scalbert, Augustin ^{[32
]}

Slimani, Nadia ^{[32
]}

Spijkerman, Annemieke M. W. ^{[33
]}

Tjonneland, Anne ^{[34
]}

Tormo, Maria-Jose ^{[6
,7
,35
]}

Tumino, Rosario ^{[36
]}

van der A, Daphne L. ^{[33
]}

van der Schouw, Yvonne T. ^{[4
]}

Langenberg, Claudia ^{[1
]}

Riboli, Elio ^{[37
]}

Wareham, Nicholas J. ^{[1
]}

机构：

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

[2] MRC Human Nutr Res, Cambridge, England

[3] German Inst Human Nutr Potsdam Rehbrucke, Dept Mol Epidemiol, Potsdam, Germany

[4] Univ Med Ctr Utrecht, Utrecht, Netherlands

[5] Navarre Publ Hlth Inst ISPN, Pamplona, Spain

[6] CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain

[7] IMIB Arrixaca, Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain

[8] Wageningen Univ, Wageningen, Netherlands

[9] INSERM, CESP, U1018, Villejuif, France

[10] Univ Paris 11, UMRS 1018, Villejuif, France

[11] Inst Gustave Roussy, Villejuif, France

[12] Publ Hlth Div Gipuzkoa, San Sebastian, Spain

[13] Basque Govt, Inst BIODonostia, San Sebastian, Spain

[14] German Inst Human Nutr Potsdam Rehbrucke, Potsdam, Germany

[15] Lund Univ, Malmo, Sweden

[16] Umea Univ, Umea, Sweden

[17] Catalan Inst Oncol ICO, Barcelona, Spain

[18] German Canc Res Ctr, Heidelberg, Germany

[19] Univ Oxford, Oxford, England

[20] Univ Cambridge, Cambridge, England

[21] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[22] Aarhus Univ, Epidemiol Sect, Dept Publ Hlth, Aarhus, Denmark

[23] Aalborg Univ Hosp, Aalborg, Denmark

[24] Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, Milan, Italy

[25] Canc Res & Prevent Inst ISPO, Florence, Italy

[26] Univ Naples Federico II, Dipartimento Med Clin & Chirurg, Naples, Italy

[27] Publ Hlth Directorate, Asturias, Spain

[28] Univ Granada, Hosp Univ Granada, GRANADA, Escuela Andaluza Salud Publ,Inst Invest Biosanita, Granada, Spain

[29] Univ Turin, Citta Salute & Sci Hosp, Canc Epidemiol Unit, Turin, Italy

[30] Ctr Canc Prevent CPO, Turin, Italy

[31] Human Genet Fdn HuGeF, Turin, Italy

[32] Int Agcy Res Canc, Lyon, France

[33] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands

[34] Danish Canc Soc, Res Ctr, Copenhagen, Denmark

[35] Univ Murcia, Dept Hlth & Social Sci, Murcia, Spain

[36] Civ & MP Arezzo Hosp, Canc Registry & Histopathol Unit, Asp Ragusa, Italy

[37] Imperial Coll London, Sch Publ Hlth, London, England

来源：

PLOS MEDICINE | 2016年 / 13卷 / 07期

基金：

瑞典研究理事会; 英国医学研究理事会;

关键词：

CARDIOVASCULAR-DISEASE; LINOLEIC-ACID; INSULIN SENSITIVITY; FISH CONSUMPTION; DIETARY-FAT; RISK; SUPPLEMENTATION; METAANALYSIS; FLAXSEED; CANCER;

D O I：

10.1371/journal.pmed.1002094

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

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, a-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.-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.

引用

页数：17

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