Articles 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
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 inci...
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| Veröffentlicht in: | The lancet. Diabetes & endocrinology 2017, Vol.5 (12), p.965-974 |
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| creator | Wu, Y Marklund, Matti Imamura, Fumiaki Tintle, Nathan Korat, Ardisson de Goede, Janette Zhou, Xia Yang, Wei-Sin de Oliveira Otto, Marcia C Kröger, Janine Qureshi, Waqas Virtanen, Jyrki K Bassett, Julie K Frazier-Wood, Alexis C Lankinen, Maria Murphy, Rachel A Rajaobelina, Kalina Gobbo, Del Forouhi, Nita G Luben, Robert Khaw, Kay-Tee Wareham, Nick Kalsbeek, Anya Veenstra, Jenna Luo, Juhua Hu, Frank B Lin, Hung-Ju Siscovick, David S Boeing, Heiner Chen, Tzu-An Steffen, Brian Steffen, Lyn M Hodge, Allison Eriksdottir, Gudny Smith, Albert V Gudnason, Vilmunder Harris, Tamara B Brouwer, Ingeborg A Berr, Claudine Helmer, Catherine Samieri, Cecilia Laakso, Markku Tsai, Michael y Giles, Graham G Nurmi, Tarja Wagenknecht, Lynne Schulze, Matthias B Lemaitre, Rozenn N Chien, Kuo-Liong Soedamah-Muthu, Sabita S Geleijnse, Johanna M Sun, Qi Harris, William S Lind, Lars Ärnlöv, Johan Riserus, Ulf Micha, Renata Mozaffarian, Dariush |
| description | 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/m2, 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 |
| doi_str_mv | 10.1016/S2213-8587(17)30307-8 |
| format | Article |
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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/m2, 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; I2=53·9%, pheterogeneity=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; I2=63·0%, pheterogeneity<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 pheterogeneity≥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.FUNDING:Funders are shown in the appendix.</description><identifier>ISSN: 2213-8587</identifier><identifier>EISSN: 2213-8595</identifier><identifier>DOI: 10.1016/S2213-8587(17)30307-8</identifier><identifier>PMID: 29032079</identifier><language>eng</language><publisher>Elsevier</publisher><subject>Life Sciences ; Santé publique et épidémiologie</subject><ispartof>The lancet. Diabetes & endocrinology, 2017, Vol.5 (12), p.965-974</ispartof><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-2335-8542 ; 0000-0002-6933-4637 ; 0000-0002-6841-8396 ; 0000-0003-2335-8542 ; 0000-0002-6841-8396 ; 0000-0002-6933-4637</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://inserm.hal.science/inserm-02466524$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Y</creatorcontrib><creatorcontrib>Marklund, Matti</creatorcontrib><creatorcontrib>Imamura, Fumiaki</creatorcontrib><creatorcontrib>Tintle, Nathan</creatorcontrib><creatorcontrib>Korat, Ardisson</creatorcontrib><creatorcontrib>de Goede, Janette</creatorcontrib><creatorcontrib>Zhou, Xia</creatorcontrib><creatorcontrib>Yang, Wei-Sin</creatorcontrib><creatorcontrib>de Oliveira Otto, Marcia C</creatorcontrib><creatorcontrib>Kröger, Janine</creatorcontrib><creatorcontrib>Qureshi, Waqas</creatorcontrib><creatorcontrib>Virtanen, Jyrki K</creatorcontrib><creatorcontrib>Bassett, Julie K</creatorcontrib><creatorcontrib>Frazier-Wood, Alexis C</creatorcontrib><creatorcontrib>Lankinen, Maria</creatorcontrib><creatorcontrib>Murphy, Rachel A</creatorcontrib><creatorcontrib>Rajaobelina, Kalina</creatorcontrib><creatorcontrib>Gobbo, Del</creatorcontrib><creatorcontrib>Forouhi, Nita G</creatorcontrib><creatorcontrib>Luben, Robert</creatorcontrib><creatorcontrib>Khaw, Kay-Tee</creatorcontrib><creatorcontrib>Wareham, Nick</creatorcontrib><creatorcontrib>Kalsbeek, Anya</creatorcontrib><creatorcontrib>Veenstra, Jenna</creatorcontrib><creatorcontrib>Luo, Juhua</creatorcontrib><creatorcontrib>Hu, Frank B</creatorcontrib><creatorcontrib>Lin, Hung-Ju</creatorcontrib><creatorcontrib>Siscovick, David S</creatorcontrib><creatorcontrib>Boeing, Heiner</creatorcontrib><creatorcontrib>Chen, Tzu-An</creatorcontrib><creatorcontrib>Steffen, Brian</creatorcontrib><creatorcontrib>Steffen, Lyn M</creatorcontrib><creatorcontrib>Hodge, Allison</creatorcontrib><creatorcontrib>Eriksdottir, Gudny</creatorcontrib><creatorcontrib>Smith, Albert V</creatorcontrib><creatorcontrib>Gudnason, Vilmunder</creatorcontrib><creatorcontrib>Harris, Tamara B</creatorcontrib><creatorcontrib>Brouwer, Ingeborg A</creatorcontrib><creatorcontrib>Berr, Claudine</creatorcontrib><creatorcontrib>Helmer, Catherine</creatorcontrib><creatorcontrib>Samieri, Cecilia</creatorcontrib><creatorcontrib>Laakso, Markku</creatorcontrib><creatorcontrib>Tsai, Michael y</creatorcontrib><creatorcontrib>Giles, Graham G</creatorcontrib><creatorcontrib>Nurmi, Tarja</creatorcontrib><creatorcontrib>Wagenknecht, Lynne</creatorcontrib><creatorcontrib>Schulze, Matthias B</creatorcontrib><creatorcontrib>Lemaitre, Rozenn N</creatorcontrib><creatorcontrib>Chien, Kuo-Liong</creatorcontrib><creatorcontrib>Soedamah-Muthu, Sabita S</creatorcontrib><creatorcontrib>Geleijnse, Johanna M</creatorcontrib><creatorcontrib>Sun, Qi</creatorcontrib><creatorcontrib>Harris, William S</creatorcontrib><creatorcontrib>Lind, Lars</creatorcontrib><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Riserus, Ulf</creatorcontrib><creatorcontrib>Micha, Renata</creatorcontrib><creatorcontrib>Mozaffarian, Dariush</creatorcontrib><title>Articles 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</title><title>The lancet. Diabetes & endocrinology</title><description>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/m2, 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; I2=53·9%, pheterogeneity=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; I2=63·0%, pheterogeneity<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 pheterogeneity≥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.FUNDING:Funders are shown in the appendix.</description><subject>Life Sciences</subject><subject>Santé publique et épidémiologie</subject><issn>2213-8587</issn><issn>2213-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqVjs1Kw0AURgdRbNE-gnCXCkZvZpo_d0UqXQgudB9uMzd2dJIJM9NAXscnNYvi3tV3OJzFJ8RNig8ppvnju5SpSsqsLG7T4k6hwiIpz8TypKvs_I_LYiFWIXwhYoqZyku8FAtZoZJYVEvxs_HRNJYDvHX8SUkOLcU4ATVGw964jvw3-wDUazD9LLmPEKeBQYI2tOfI4QkG5yzrOSI7BRPAtXOszWj0kWxieWQLmiJB6zyoCoo1AumjjQFa7zqQCIN3YeAmmpGhcQfnI4R41IbDtbhoyQZenfZK3L9sP553yYFsPXgzX5xqR6bebV5r0wf2XY1yneeZXI-p-mf-C48Qa6k</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Wu, Y</creator><creator>Marklund, Matti</creator><creator>Imamura, Fumiaki</creator><creator>Tintle, Nathan</creator><creator>Korat, Ardisson</creator><creator>de Goede, Janette</creator><creator>Zhou, Xia</creator><creator>Yang, Wei-Sin</creator><creator>de Oliveira Otto, Marcia C</creator><creator>Kröger, Janine</creator><creator>Qureshi, Waqas</creator><creator>Virtanen, Jyrki K</creator><creator>Bassett, Julie K</creator><creator>Frazier-Wood, Alexis C</creator><creator>Lankinen, Maria</creator><creator>Murphy, Rachel A</creator><creator>Rajaobelina, Kalina</creator><creator>Gobbo, Del</creator><creator>Forouhi, Nita G</creator><creator>Luben, Robert</creator><creator>Khaw, Kay-Tee</creator><creator>Wareham, Nick</creator><creator>Kalsbeek, Anya</creator><creator>Veenstra, Jenna</creator><creator>Luo, Juhua</creator><creator>Hu, Frank B</creator><creator>Lin, Hung-Ju</creator><creator>Siscovick, David S</creator><creator>Boeing, Heiner</creator><creator>Chen, Tzu-An</creator><creator>Steffen, Brian</creator><creator>Steffen, Lyn M</creator><creator>Hodge, Allison</creator><creator>Eriksdottir, Gudny</creator><creator>Smith, Albert V</creator><creator>Gudnason, Vilmunder</creator><creator>Harris, Tamara B</creator><creator>Brouwer, Ingeborg A</creator><creator>Berr, Claudine</creator><creator>Helmer, Catherine</creator><creator>Samieri, Cecilia</creator><creator>Laakso, Markku</creator><creator>Tsai, Michael y</creator><creator>Giles, Graham G</creator><creator>Nurmi, Tarja</creator><creator>Wagenknecht, Lynne</creator><creator>Schulze, Matthias B</creator><creator>Lemaitre, Rozenn N</creator><creator>Chien, Kuo-Liong</creator><creator>Soedamah-Muthu, Sabita S</creator><creator>Geleijnse, Johanna M</creator><creator>Sun, Qi</creator><creator>Harris, William S</creator><creator>Lind, Lars</creator><creator>Ärnlöv, Johan</creator><creator>Riserus, Ulf</creator><creator>Micha, Renata</creator><creator>Mozaffarian, Dariush</creator><general>Elsevier</general><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0003-2335-8542</orcidid><orcidid>https://orcid.org/0000-0002-6933-4637</orcidid><orcidid>https://orcid.org/0000-0002-6841-8396</orcidid><orcidid>https://orcid.org/0000-0003-2335-8542</orcidid><orcidid>https://orcid.org/0000-0002-6841-8396</orcidid><orcidid>https://orcid.org/0000-0002-6933-4637</orcidid></search><sort><creationdate>2017</creationdate><title>Articles 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</title><author>Wu, Y ; Marklund, Matti ; Imamura, Fumiaki ; Tintle, Nathan ; Korat, Ardisson ; de Goede, Janette ; Zhou, Xia ; Yang, Wei-Sin ; de Oliveira Otto, Marcia C ; Kröger, Janine ; Qureshi, Waqas ; Virtanen, Jyrki K ; Bassett, Julie K ; Frazier-Wood, Alexis C ; Lankinen, Maria ; Murphy, Rachel A ; Rajaobelina, Kalina ; Gobbo, Del ; Forouhi, Nita G ; Luben, Robert ; Khaw, Kay-Tee ; Wareham, Nick ; Kalsbeek, Anya ; Veenstra, Jenna ; Luo, Juhua ; Hu, Frank B ; Lin, Hung-Ju ; Siscovick, David S ; Boeing, Heiner ; Chen, Tzu-An ; Steffen, Brian ; Steffen, Lyn M ; Hodge, Allison ; Eriksdottir, Gudny ; Smith, Albert V ; Gudnason, Vilmunder ; Harris, Tamara B ; Brouwer, Ingeborg A ; Berr, Claudine ; Helmer, Catherine ; Samieri, Cecilia ; Laakso, Markku ; Tsai, Michael y ; Giles, Graham G ; Nurmi, Tarja ; Wagenknecht, Lynne ; Schulze, Matthias B ; Lemaitre, Rozenn N ; Chien, Kuo-Liong ; Soedamah-Muthu, Sabita S ; Geleijnse, Johanna M ; Sun, Qi ; Harris, William S ; Lind, Lars ; Ärnlöv, Johan ; Riserus, Ulf ; Micha, Renata ; Mozaffarian, Dariush</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-hal_primary_oai_HAL_inserm_02466524v13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Life Sciences</topic><topic>Santé publique et épidémiologie</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Y</creatorcontrib><creatorcontrib>Marklund, Matti</creatorcontrib><creatorcontrib>Imamura, Fumiaki</creatorcontrib><creatorcontrib>Tintle, Nathan</creatorcontrib><creatorcontrib>Korat, Ardisson</creatorcontrib><creatorcontrib>de Goede, Janette</creatorcontrib><creatorcontrib>Zhou, Xia</creatorcontrib><creatorcontrib>Yang, Wei-Sin</creatorcontrib><creatorcontrib>de Oliveira Otto, Marcia C</creatorcontrib><creatorcontrib>Kröger, Janine</creatorcontrib><creatorcontrib>Qureshi, Waqas</creatorcontrib><creatorcontrib>Virtanen, Jyrki K</creatorcontrib><creatorcontrib>Bassett, Julie K</creatorcontrib><creatorcontrib>Frazier-Wood, Alexis C</creatorcontrib><creatorcontrib>Lankinen, Maria</creatorcontrib><creatorcontrib>Murphy, Rachel A</creatorcontrib><creatorcontrib>Rajaobelina, Kalina</creatorcontrib><creatorcontrib>Gobbo, Del</creatorcontrib><creatorcontrib>Forouhi, Nita G</creatorcontrib><creatorcontrib>Luben, Robert</creatorcontrib><creatorcontrib>Khaw, Kay-Tee</creatorcontrib><creatorcontrib>Wareham, Nick</creatorcontrib><creatorcontrib>Kalsbeek, Anya</creatorcontrib><creatorcontrib>Veenstra, Jenna</creatorcontrib><creatorcontrib>Luo, Juhua</creatorcontrib><creatorcontrib>Hu, Frank B</creatorcontrib><creatorcontrib>Lin, Hung-Ju</creatorcontrib><creatorcontrib>Siscovick, David S</creatorcontrib><creatorcontrib>Boeing, Heiner</creatorcontrib><creatorcontrib>Chen, Tzu-An</creatorcontrib><creatorcontrib>Steffen, Brian</creatorcontrib><creatorcontrib>Steffen, Lyn M</creatorcontrib><creatorcontrib>Hodge, Allison</creatorcontrib><creatorcontrib>Eriksdottir, Gudny</creatorcontrib><creatorcontrib>Smith, Albert V</creatorcontrib><creatorcontrib>Gudnason, Vilmunder</creatorcontrib><creatorcontrib>Harris, Tamara B</creatorcontrib><creatorcontrib>Brouwer, Ingeborg A</creatorcontrib><creatorcontrib>Berr, Claudine</creatorcontrib><creatorcontrib>Helmer, Catherine</creatorcontrib><creatorcontrib>Samieri, Cecilia</creatorcontrib><creatorcontrib>Laakso, Markku</creatorcontrib><creatorcontrib>Tsai, Michael y</creatorcontrib><creatorcontrib>Giles, Graham G</creatorcontrib><creatorcontrib>Nurmi, Tarja</creatorcontrib><creatorcontrib>Wagenknecht, Lynne</creatorcontrib><creatorcontrib>Schulze, Matthias B</creatorcontrib><creatorcontrib>Lemaitre, Rozenn N</creatorcontrib><creatorcontrib>Chien, Kuo-Liong</creatorcontrib><creatorcontrib>Soedamah-Muthu, Sabita S</creatorcontrib><creatorcontrib>Geleijnse, Johanna M</creatorcontrib><creatorcontrib>Sun, Qi</creatorcontrib><creatorcontrib>Harris, William S</creatorcontrib><creatorcontrib>Lind, Lars</creatorcontrib><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Riserus, Ulf</creatorcontrib><creatorcontrib>Micha, Renata</creatorcontrib><creatorcontrib>Mozaffarian, Dariush</creatorcontrib><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>The lancet. Diabetes & endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Y</au><au>Marklund, Matti</au><au>Imamura, Fumiaki</au><au>Tintle, Nathan</au><au>Korat, Ardisson</au><au>de Goede, Janette</au><au>Zhou, Xia</au><au>Yang, Wei-Sin</au><au>de Oliveira Otto, Marcia C</au><au>Kröger, Janine</au><au>Qureshi, Waqas</au><au>Virtanen, Jyrki K</au><au>Bassett, Julie K</au><au>Frazier-Wood, Alexis C</au><au>Lankinen, Maria</au><au>Murphy, Rachel A</au><au>Rajaobelina, Kalina</au><au>Gobbo, Del</au><au>Forouhi, Nita G</au><au>Luben, Robert</au><au>Khaw, Kay-Tee</au><au>Wareham, Nick</au><au>Kalsbeek, Anya</au><au>Veenstra, Jenna</au><au>Luo, Juhua</au><au>Hu, Frank B</au><au>Lin, Hung-Ju</au><au>Siscovick, David S</au><au>Boeing, Heiner</au><au>Chen, Tzu-An</au><au>Steffen, Brian</au><au>Steffen, Lyn M</au><au>Hodge, Allison</au><au>Eriksdottir, Gudny</au><au>Smith, Albert V</au><au>Gudnason, Vilmunder</au><au>Harris, Tamara B</au><au>Brouwer, Ingeborg A</au><au>Berr, Claudine</au><au>Helmer, Catherine</au><au>Samieri, Cecilia</au><au>Laakso, Markku</au><au>Tsai, Michael y</au><au>Giles, Graham G</au><au>Nurmi, Tarja</au><au>Wagenknecht, Lynne</au><au>Schulze, Matthias B</au><au>Lemaitre, Rozenn N</au><au>Chien, Kuo-Liong</au><au>Soedamah-Muthu, Sabita S</au><au>Geleijnse, Johanna M</au><au>Sun, Qi</au><au>Harris, William S</au><au>Lind, Lars</au><au>Ärnlöv, Johan</au><au>Riserus, Ulf</au><au>Micha, Renata</au><au>Mozaffarian, Dariush</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Articles 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</atitle><jtitle>The lancet. Diabetes & endocrinology</jtitle><date>2017</date><risdate>2017</risdate><volume>5</volume><issue>12</issue><spage>965</spage><epage>974</epage><pages>965-974</pages><issn>2213-8587</issn><eissn>2213-8595</eissn><abstract>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/m2, 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; I2=53·9%, pheterogeneity=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; I2=63·0%, pheterogeneity<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 pheterogeneity≥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.FUNDING:Funders are shown in the appendix.</abstract><pub>Elsevier</pub><pmid>29032079</pmid><doi>10.1016/S2213-8587(17)30307-8</doi><orcidid>https://orcid.org/0000-0003-2335-8542</orcidid><orcidid>https://orcid.org/0000-0002-6933-4637</orcidid><orcidid>https://orcid.org/0000-0002-6841-8396</orcidid><orcidid>https://orcid.org/0000-0003-2335-8542</orcidid><orcidid>https://orcid.org/0000-0002-6841-8396</orcidid><orcidid>https://orcid.org/0000-0002-6933-4637</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2213-8587 |
| ispartof | The lancet. Diabetes & endocrinology, 2017, Vol.5 (12), p.965-974 |
| issn | 2213-8587 2213-8595 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_inserm_02466524v1 |
| source | Alma/SFX Local Collection |
| subjects | Life Sciences Santé publique et épidémiologie |
| title | Articles 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 |
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