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

F. Imamura; S. J. Sharp; A. Koulman; M. B. Schulze; J. Kroger; J. M. Huerta; M. Guevara; I. Sluijs; A. Agudo; E. Ardanaz; B. Balkau; H. Boeing; V. Chajes; C. C. Dahm; C. Dow; G. Fagherazzi; E. J. M. Feskens; P. W. Franks; D. Gavrila; M. Gunter; R. Kaaks; T. J. Key; K. T. Khaw; T. Kuhn; O. Melander; E. Molina-Portillo; P. M. Nilsson; A. Olsen; K. Overvad; D. Palli; S. Panico; O. Rolandsson; S. Sieri; C. Sacerdote; N. Slimani; A. M. W. Spijkerman; A. Tjonneland; R. Tumino; Y. T. van der Schouw; C. Langenberg; E. Riboli; N. G. Forouhi; N. J. Wareham

doi:10.1371/journal.pmed.1002409

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

F. Imamura, S. J. Sharp, A. Koulman, M. B. Schulze, J. Kroger, J. M. Huerta, M. Guevara, I. Sluijs, A. Agudo, E. Ardanaz, B. Balkau, H. Boeing, V. Chajes, C. C. Dahm, C. Dow, G. Fagherazzi, E. J. M. Feskens, P. W. Franks, D. Gavrila, M. GunterR. Kaaks, T. J. Key, K. T. Khaw, T. Kuhn, O. Melander, E. Molina-Portillo, P. M. Nilsson, A. Olsen, K. Overvad, D. Palli, S. Panico, O. Rolandsson, S. Sieri, C. Sacerdote, N. Slimani, A. M. W. Spijkerman, A. Tjonneland, R. Tumino, Y. T. van der Schouw, C. Langenberg, E. Riboli, N. G. Forouhi, N. J. Wareham

School of Biological Sciences

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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 casecohort 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-longchain 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, oddchain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D

Original language	Undefined/Unknown
Article number	e1002409
Number of pages	19
Journal	PLoS Medicine
Volume	14
Issue number	10
DOIs	https://doi.org/10.1371/journal.pmed.1002409
Publication status	Published - 11 Oct 2017

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A combination of plasma phospholipid fatty acids
© 2017 The Authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
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Cite this

Imamura, F., Sharp, S. J., Koulman, A., Schulze, M. B., Kroger, J., Huerta, J. M., Guevara, M., Sluijs, I., Agudo, A., Ardanaz, E., Balkau, B., Boeing, H., Chajes, V., Dahm, C. C., Dow, C., Fagherazzi, G., Feskens, E. J. M., Franks, P. W., Gavrila, D., ... Wareham, N. J. (2017). A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study. PLoS Medicine, 14(10), Article e1002409. https://doi.org/10.1371/journal.pmed.1002409

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

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 casecohort 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-longchain 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, oddchain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D",

author = "F. Imamura and Sharp, {S. J.} and A. Koulman and Schulze, {M. B.} and J. Kroger and Huerta, {J. M.} and M. Guevara and I. Sluijs and A. Agudo and E. Ardanaz and B. Balkau and H. Boeing and V. Chajes and Dahm, {C. C.} and C. Dow and G. Fagherazzi and Feskens, {E. J. M.} and Franks, {P. W.} and D. Gavrila and M. Gunter and R. Kaaks and Key, {T. J.} and Khaw, {K. T.} and T. Kuhn and O. Melander and E. Molina-Portillo and Nilsson, {P. M.} and A. Olsen and K. Overvad and D. Palli and S. Panico and O. Rolandsson and S. Sieri and C. Sacerdote and N. Slimani and Spijkerman, {A. M. W.} and A. Tjonneland and R. Tumino and {van der Schouw}, {Y. T.} and C. Langenberg and E. Riboli and Forouhi, {N. G.} and Wareham, {N. J.}",

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doi = "10.1371/journal.pmed.1002409",

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Imamura, F, Sharp, SJ, Koulman, A, Schulze, MB, Kroger, J, Huerta, JM, Guevara, M, Sluijs, I, Agudo, A, Ardanaz, E, Balkau, B, Boeing, H, Chajes, V, Dahm, CC, Dow, C, Fagherazzi, G, Feskens, EJM, Franks, PW, Gavrila, D, Gunter, M, Kaaks, R, Key, TJ, Khaw, KT, Kuhn, T, Melander, O, Molina-Portillo, E, Nilsson, PM, Olsen, A, Overvad, K, Palli, D, Panico, S, Rolandsson, O, Sieri, S, Sacerdote, C, Slimani, N, Spijkerman, AMW, Tjonneland, A, Tumino, R, van der Schouw, YT, Langenberg, C, Riboli, E, Forouhi, NG & Wareham, NJ 2017, 'A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study', PLoS Medicine, vol. 14, no. 10, e1002409. https://doi.org/10.1371/journal.pmed.1002409

TY - JOUR

T1 - A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study

AU - Imamura, F.

AU - Sharp, S. J.

AU - Koulman, A.

AU - Schulze, M. B.

AU - Kroger, J.

AU - Huerta, J. M.

AU - Guevara, M.

AU - Sluijs, I.

AU - Agudo, A.

AU - Ardanaz, E.

AU - Balkau, B.

AU - Boeing, H.

AU - Chajes, V.

AU - Dahm, C. C.

AU - Dow, C.

AU - Fagherazzi, G.

AU - Feskens, E. J. M.

AU - Franks, P. W.

AU - Gavrila, D.

AU - Gunter, M.

AU - Kaaks, R.

AU - Key, T. J.

AU - Khaw, K. T.

AU - Kuhn, T.

AU - Melander, O.

AU - Molina-Portillo, E.

AU - Nilsson, P. M.

AU - Olsen, A.

AU - Overvad, K.

AU - Palli, D.

AU - Panico, S.

AU - Rolandsson, O.

AU - Sieri, S.

AU - Sacerdote, C.

AU - Slimani, N.

AU - Spijkerman, A. M. W.

AU - Tjonneland, A.

AU - Tumino, R.

AU - van der Schouw, Y. T.

AU - Langenberg, C.

AU - Riboli, E.

AU - Forouhi, N. G.

AU - Wareham, N. J.

PY - 2017/10/11

Y1 - 2017/10/11

N2 - 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 casecohort 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-longchain 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, oddchain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D

AB - 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 casecohort 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-longchain 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, oddchain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D

U2 - 10.1371/journal.pmed.1002409

DO - 10.1371/journal.pmed.1002409

M3 - Article

SN - 1549-1277

VL - 14

JO - PLoS Medicine

JF - PLoS Medicine

IS - 10

M1 - e1002409

ER -