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 -
SDG 3 Good Health and Well-being