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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 and Agudo, Antonio , et al. (2017) In PLoS Medicine 14(10).
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... (More)

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.

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Contribution to journal
publication status
published
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PLoS Medicine
volume
14
issue
10
article number
e1002409
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85031815217
  • pmid:29020051
  • wos:000414064100013
ISSN
1549-1277
DOI
10.1371/journal.pmed.1002409
language
English
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yes
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e121d8bd-6565-4e17-b9ed-14776c97f608
date added to LUP
2017-11-20 13:09:51
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2025-01-08 00:51:28
@article{e121d8bd-6565-4e17-b9ed-14776c97f608,
  abstract     = {{<p>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 &lt; 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.</p>}},
  author       = {{Imamura, Fumiaki and Sharp, Stephen J. and Koulman, Albert and Schulze, Matthias B. and Kröger, Janine and Griffin, Julian L. and Huerta, José María and Guevara, Marcela and Sluijs, Ivonne and Agudo, Antonio and Ardanaz, Eva and Balkau, Beverley and Boeing, Heiner and Chajes, Veronique and Dahm, Christina C. and Dow, Courtney and Fagherazzi, Guy and Feskens, Edith J.M. and Franks, Paul W. and Gavrila, Diana and Gunter, Marc and Kaaks, Rudolf and Key, Timothy J. and Khaw, Kay Tee and Kühn, Tilman and Melander, Olle and Molina-Portillo, Elena and Nilsson, Peter M. and Olsen, Anja and Overvad, Kim and Palli, Domenico and Panico, Salvatore and Rolandsson, Olov and Sieri, Sabina and Sacerdote, Carlotta and Slimani, Nadia and Spijkerman, Annemieke M.W. and Tjønneland, Anne and Tumino, Rosario and van der Schouw, Yvonne T. and Langenberg, Claudia and Riboli, Elio and Forouhi, Nita G. and Wareham, Nick J.}},
  issn         = {{1549-1277}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{10}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS Medicine}},
  title        = {{A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes : The EPIC-InterAct case-cohort study}},
  url          = {{http://dx.doi.org/10.1371/journal.pmed.1002409}},
  doi          = {{10.1371/journal.pmed.1002409}},
  volume       = {{14}},
  year         = {{2017}},
}