Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study

Nita G Forouhi; Albert Koulman; Stephen J Sharp; Fumiaki Imamura; Janine Kröger; Matthias B Schulze; Francesca L Crowe; José María Huerta; Marcela Guevara; Joline Wj Beulens; Geertruida J van Woudenbergh; Laura Wang; Keith Summerhill; Julian L Griffin; Edith Jm Feskens; Pilar Amiano; Heiner Boeing; Françoise Clavel-Chapelon; Laureen Dartois; Guy Fagherazzi; Paul W Franks; Carlos Gonzalez; Marianne Uhre Jakobsen; Rudolf Kaaks; Timothy J Key; Kay-Tee Khaw; Tilman Kühn; Amalia Mattiello; Peter M Nilsson; Kim Overvad; Valeria Pala; Domenico Palli; J Ramón Quirós; Olov Rolandsson; Nina Roswall; Carlotta Sacerdote; María-José Sánchez; Nadia Slimani; Annemieke Mw Spijkerman; Anne Tjonneland; Maria-José Tormo; Rosario Tumino; Daphne L van der A; Yvonne T van der Schouw; Claudia Langenberg; Elio Riboli; Nicholas J Wareham

doi:10.1016/S2213-8587(14)70146-9

Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study

Nita G Forouhi, Albert Koulman, Stephen J Sharp, Fumiaki Imamura, Janine Kröger, Matthias B Schulze, Francesca L Crowe, José María Huerta, Marcela Guevara, Joline Wj Beulens, Geertruida J van Woudenbergh, Laura Wang, Keith Summerhill, Julian L Griffin, Edith Jm Feskens, Pilar Amiano, Heiner Boeing, Françoise Clavel-Chapelon, Laureen Dartois, Guy FagherazziPaul W Franks, Carlos Gonzalez, Marianne Uhre Jakobsen, Rudolf Kaaks, Timothy J Key, Kay-Tee Khaw, Tilman Kühn, Amalia Mattiello, Peter M Nilsson, Kim Overvad, Valeria Pala, Domenico Palli, J Ramón Quirós, Olov Rolandsson, Nina Roswall, Carlotta Sacerdote, María-José Sánchez, Nadia Slimani, Annemieke Mw Spijkerman, Anne Tjonneland, Maria-José Tormo, Rosario Tumino, Daphne L van der A, Yvonne T van der Schouw, Claudia Langenberg, Elio Riboli, Nicholas J Wareham

Research output: Contribution to journal › Journal article › Research › peer-review

410 Citations (Scopus)

Abstract

BACKGROUND: Conflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2 diabetes in EPIC-InterAct participants.

METHODS: The EPIC-InterAct case-cohort study includes 12 403 people with incident type 2 diabetes and a representative subcohort of 16 154 individuals who were selected from a cohort of 340 234 European participants with 3·99 million person-years of follow-up (the EPIC study). Incident type 2 diabetes was ascertained until Dec 31, 2007, by a review of several sources of evidence. Gas chromatography was used to measure the distribution of fatty acids in plasma phospholipids (mol%); samples from people with type 2 diabetes and subcohort participants were processed in a random order by centre, and laboratory staff were masked to participant characteristics. We estimated country-specific hazard ratios (HRs) for associations per SD of each SFA with incident type 2 diabetes using Prentice-weighted Cox regression, which is weighted for case-cohort sampling, and pooled our findings using random-effects meta-analysis.

FINDINGS: SFAs accounted for 46% of total plasma phospholipid fatty acids. In adjusted analyses, different individual SFAs were associated with incident type 2 diabetes in opposing directions. Even-chain SFAs that were measured (14:0 [myristic acid], 16:0 [palmitic acid], and 18:0 [stearic acid]) were positively associated with incident type 2 diabetes (HR [95% CI] per SD difference: myristic acid 1·15 [95% CI 1·09-1·22], palmitic acid 1·26 [1·15-1·37], and stearic acid 1·06 [1·00-1·13]). By contrast, measured odd-chain SFAs (15:0 [pentadecanoic acid] and 17:0 [heptadecanoic acid]) were inversely associated with incident type 2 diabetes (HR [95% CI] per 1 SD difference: 0·79 [0·73-0·85] for pentadecanoic acid and 0·67 [0·63-0·71] for heptadecanoic acid), as were measured longer-chain SFAs (20:0 [arachidic acid], 22:0 [behenic acid], 23:0 [tricosanoic acid], and 24:0 [lignoceric acid]), with HRs ranging from 0·72 to 0·81 (95% CIs ranging between 0·61 and 0·92). Our findings were robust to a range of sensitivity analyses.

INTERPRETATION: Different individual plasma phospholipid SFAs were associated with incident type 2 diabetes in opposite directions, which suggests that SFAs are not homogeneous in their effects. Our findings emphasise the importance of the recognition of subtypes of these fatty acids. An improved understanding of differences in sources of individual SFAs from dietary intake versus endogenous metabolism is needed.

FUNDING: EU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative.

Original language	English
Journal	The Lancet Diabetes & Endocrinology
Volume	2
Issue number	10
Pages (from-to)	810-818
Number of pages	9
ISSN	2213-8587
DOIs	https://doi.org/10.1016/S2213-8587(14)70146-9
Publication status	Published - 5 Aug 2014

Access to Document

10.1016/S2213-8587(14)70146-9

AUB Link

Search for the material in Aalborg University Library's search engine

Cite this

Forouhi, N. G., Koulman, A., Sharp, S. J., Imamura, F., Kröger, J., Schulze, M. B., Crowe, F. L., Huerta, J. M., Guevara, M., Beulens, J. W., van Woudenbergh, G. J., Wang, L., Summerhill, K., Griffin, J. L., Feskens, E. J., Amiano, P., Boeing, H., Clavel-Chapelon, F., Dartois, L., ... Wareham, N. J. (2014). Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study. The Lancet Diabetes & Endocrinology, 2(10), 810-818. https://doi.org/10.1016/S2213-8587(14)70146-9

@article{c068f36938df419290e40f3a881f5d8e,

title = "Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study",

abstract = "BACKGROUND: Conflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2 diabetes in EPIC-InterAct participants.METHODS: The EPIC-InterAct case-cohort study includes 12 403 people with incident type 2 diabetes and a representative subcohort of 16 154 individuals who were selected from a cohort of 340 234 European participants with 3·99 million person-years of follow-up (the EPIC study). Incident type 2 diabetes was ascertained until Dec 31, 2007, by a review of several sources of evidence. Gas chromatography was used to measure the distribution of fatty acids in plasma phospholipids (mol%); samples from people with type 2 diabetes and subcohort participants were processed in a random order by centre, and laboratory staff were masked to participant characteristics. We estimated country-specific hazard ratios (HRs) for associations per SD of each SFA with incident type 2 diabetes using Prentice-weighted Cox regression, which is weighted for case-cohort sampling, and pooled our findings using random-effects meta-analysis.FINDINGS: SFAs accounted for 46% of total plasma phospholipid fatty acids. In adjusted analyses, different individual SFAs were associated with incident type 2 diabetes in opposing directions. Even-chain SFAs that were measured (14:0 [myristic acid], 16:0 [palmitic acid], and 18:0 [stearic acid]) were positively associated with incident type 2 diabetes (HR [95% CI] per SD difference: myristic acid 1·15 [95% CI 1·09-1·22], palmitic acid 1·26 [1·15-1·37], and stearic acid 1·06 [1·00-1·13]). By contrast, measured odd-chain SFAs (15:0 [pentadecanoic acid] and 17:0 [heptadecanoic acid]) were inversely associated with incident type 2 diabetes (HR [95% CI] per 1 SD difference: 0·79 [0·73-0·85] for pentadecanoic acid and 0·67 [0·63-0·71] for heptadecanoic acid), as were measured longer-chain SFAs (20:0 [arachidic acid], 22:0 [behenic acid], 23:0 [tricosanoic acid], and 24:0 [lignoceric acid]), with HRs ranging from 0·72 to 0·81 (95% CIs ranging between 0·61 and 0·92). Our findings were robust to a range of sensitivity analyses.INTERPRETATION: Different individual plasma phospholipid SFAs were associated with incident type 2 diabetes in opposite directions, which suggests that SFAs are not homogeneous in their effects. Our findings emphasise the importance of the recognition of subtypes of these fatty acids. An improved understanding of differences in sources of individual SFAs from dietary intake versus endogenous metabolism is needed.FUNDING: EU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative.",

author = "Forouhi, {Nita G} and Albert Koulman and Sharp, {Stephen J} and Fumiaki Imamura and Janine Kr{\"o}ger and Schulze, {Matthias B} and Crowe, {Francesca L} and Huerta, {Jos{\'e} Mar{\'i}a} and Marcela Guevara and Beulens, {Joline Wj} and {van Woudenbergh}, {Geertruida J} and Laura Wang and Keith Summerhill and Griffin, {Julian L} and Feskens, {Edith Jm} and Pilar Amiano and Heiner Boeing and Fran{\c c}oise Clavel-Chapelon and Laureen Dartois and Guy Fagherazzi and Franks, {Paul W} and Carlos Gonzalez and Jakobsen, {Marianne Uhre} and Rudolf Kaaks and Key, {Timothy J} and Kay-Tee Khaw and Tilman K{\"u}hn and Amalia Mattiello and Nilsson, {Peter M} and Kim Overvad and Valeria Pala and Domenico Palli and Quir{\'o}s, {J Ram{\'o}n} and Olov Rolandsson and Nina Roswall and Carlotta Sacerdote and Mar{\'i}a-Jos{\'e} S{\'a}nchez and Nadia Slimani and Spijkerman, {Annemieke Mw} and Anne Tjonneland and Maria-Jos{\'e} Tormo and Rosario Tumino and {van der A}, {Daphne L} and {van der Schouw}, {Yvonne T} and Claudia Langenberg and Elio Riboli and Wareham, {Nicholas J}",

year = "2014",

month = aug,

day = "5",

doi = "10.1016/S2213-8587(14)70146-9",

language = "English",

volume = "2",

pages = "810--818",

journal = "The Lancet Diabetes & Endocrinology",

issn = "2213-8587",

publisher = "The Lancet Publishing Group",

number = "10",

}

Forouhi, NG, Koulman, A, Sharp, SJ, Imamura, F, Kröger, J, Schulze, MB, Crowe, FL, Huerta, JM, Guevara, M, Beulens, JW, van Woudenbergh, GJ, Wang, L, Summerhill, K, Griffin, JL, Feskens, EJ, Amiano, P, Boeing, H, Clavel-Chapelon, F, Dartois, L, Fagherazzi, G, Franks, PW, Gonzalez, C, Jakobsen, MU, Kaaks, R, Key, TJ, Khaw, K-T, Kühn, T, Mattiello, A, Nilsson, PM, Overvad, K, Pala, V, Palli, D, Quirós, JR, Rolandsson, O, Roswall, N, Sacerdote, C, Sánchez, M-J, Slimani, N, Spijkerman, AM, Tjonneland, A, Tormo, M-J, Tumino, R, van der A, DL, van der Schouw, YT, Langenberg, C, Riboli, E & Wareham, NJ 2014, 'Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study', The Lancet Diabetes & Endocrinology, vol. 2, no. 10, pp. 810-818. https://doi.org/10.1016/S2213-8587(14)70146-9

Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study. / Forouhi, Nita G; Koulman, Albert; Sharp, Stephen J et al.
In: The Lancet Diabetes & Endocrinology, Vol. 2, No. 10, 05.08.2014, p. 810-818.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes

T2 - the EPIC-InterAct case-cohort study

AU - Forouhi, Nita G

AU - Koulman, Albert

AU - Sharp, Stephen J

AU - Imamura, Fumiaki

AU - Kröger, Janine

AU - Schulze, Matthias B

AU - Crowe, Francesca L

AU - Huerta, José María

AU - Guevara, Marcela

AU - Beulens, Joline Wj

AU - van Woudenbergh, Geertruida J

AU - Wang, Laura

AU - Summerhill, Keith

AU - Griffin, Julian L

AU - Feskens, Edith Jm

AU - Amiano, Pilar

AU - Boeing, Heiner

AU - Clavel-Chapelon, Françoise

AU - Dartois, Laureen

AU - Fagherazzi, Guy

AU - Franks, Paul W

AU - Gonzalez, Carlos

AU - Jakobsen, Marianne Uhre

AU - Kaaks, Rudolf

AU - Key, Timothy J

AU - Khaw, Kay-Tee

AU - Kühn, Tilman

AU - Mattiello, Amalia

AU - Nilsson, Peter M

AU - Overvad, Kim

AU - Pala, Valeria

AU - Palli, Domenico

AU - Quirós, J Ramón

AU - Rolandsson, Olov

AU - Roswall, Nina

AU - Sacerdote, Carlotta

AU - Sánchez, María-José

AU - Slimani, Nadia

AU - Spijkerman, Annemieke Mw

AU - Tjonneland, Anne

AU - Tormo, Maria-José

AU - Tumino, Rosario

AU - van der A, Daphne L

AU - van der Schouw, Yvonne T

AU - Langenberg, Claudia

AU - Riboli, Elio

AU - Wareham, Nicholas J

PY - 2014/8/5

Y1 - 2014/8/5

N2 - BACKGROUND: Conflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2 diabetes in EPIC-InterAct participants.METHODS: The EPIC-InterAct case-cohort study includes 12 403 people with incident type 2 diabetes and a representative subcohort of 16 154 individuals who were selected from a cohort of 340 234 European participants with 3·99 million person-years of follow-up (the EPIC study). Incident type 2 diabetes was ascertained until Dec 31, 2007, by a review of several sources of evidence. Gas chromatography was used to measure the distribution of fatty acids in plasma phospholipids (mol%); samples from people with type 2 diabetes and subcohort participants were processed in a random order by centre, and laboratory staff were masked to participant characteristics. We estimated country-specific hazard ratios (HRs) for associations per SD of each SFA with incident type 2 diabetes using Prentice-weighted Cox regression, which is weighted for case-cohort sampling, and pooled our findings using random-effects meta-analysis.FINDINGS: SFAs accounted for 46% of total plasma phospholipid fatty acids. In adjusted analyses, different individual SFAs were associated with incident type 2 diabetes in opposing directions. Even-chain SFAs that were measured (14:0 [myristic acid], 16:0 [palmitic acid], and 18:0 [stearic acid]) were positively associated with incident type 2 diabetes (HR [95% CI] per SD difference: myristic acid 1·15 [95% CI 1·09-1·22], palmitic acid 1·26 [1·15-1·37], and stearic acid 1·06 [1·00-1·13]). By contrast, measured odd-chain SFAs (15:0 [pentadecanoic acid] and 17:0 [heptadecanoic acid]) were inversely associated with incident type 2 diabetes (HR [95% CI] per 1 SD difference: 0·79 [0·73-0·85] for pentadecanoic acid and 0·67 [0·63-0·71] for heptadecanoic acid), as were measured longer-chain SFAs (20:0 [arachidic acid], 22:0 [behenic acid], 23:0 [tricosanoic acid], and 24:0 [lignoceric acid]), with HRs ranging from 0·72 to 0·81 (95% CIs ranging between 0·61 and 0·92). Our findings were robust to a range of sensitivity analyses.INTERPRETATION: Different individual plasma phospholipid SFAs were associated with incident type 2 diabetes in opposite directions, which suggests that SFAs are not homogeneous in their effects. Our findings emphasise the importance of the recognition of subtypes of these fatty acids. An improved understanding of differences in sources of individual SFAs from dietary intake versus endogenous metabolism is needed.FUNDING: EU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative.

AB - BACKGROUND: Conflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2 diabetes in EPIC-InterAct participants.METHODS: The EPIC-InterAct case-cohort study includes 12 403 people with incident type 2 diabetes and a representative subcohort of 16 154 individuals who were selected from a cohort of 340 234 European participants with 3·99 million person-years of follow-up (the EPIC study). Incident type 2 diabetes was ascertained until Dec 31, 2007, by a review of several sources of evidence. Gas chromatography was used to measure the distribution of fatty acids in plasma phospholipids (mol%); samples from people with type 2 diabetes and subcohort participants were processed in a random order by centre, and laboratory staff were masked to participant characteristics. We estimated country-specific hazard ratios (HRs) for associations per SD of each SFA with incident type 2 diabetes using Prentice-weighted Cox regression, which is weighted for case-cohort sampling, and pooled our findings using random-effects meta-analysis.FINDINGS: SFAs accounted for 46% of total plasma phospholipid fatty acids. In adjusted analyses, different individual SFAs were associated with incident type 2 diabetes in opposing directions. Even-chain SFAs that were measured (14:0 [myristic acid], 16:0 [palmitic acid], and 18:0 [stearic acid]) were positively associated with incident type 2 diabetes (HR [95% CI] per SD difference: myristic acid 1·15 [95% CI 1·09-1·22], palmitic acid 1·26 [1·15-1·37], and stearic acid 1·06 [1·00-1·13]). By contrast, measured odd-chain SFAs (15:0 [pentadecanoic acid] and 17:0 [heptadecanoic acid]) were inversely associated with incident type 2 diabetes (HR [95% CI] per 1 SD difference: 0·79 [0·73-0·85] for pentadecanoic acid and 0·67 [0·63-0·71] for heptadecanoic acid), as were measured longer-chain SFAs (20:0 [arachidic acid], 22:0 [behenic acid], 23:0 [tricosanoic acid], and 24:0 [lignoceric acid]), with HRs ranging from 0·72 to 0·81 (95% CIs ranging between 0·61 and 0·92). Our findings were robust to a range of sensitivity analyses.INTERPRETATION: Different individual plasma phospholipid SFAs were associated with incident type 2 diabetes in opposite directions, which suggests that SFAs are not homogeneous in their effects. Our findings emphasise the importance of the recognition of subtypes of these fatty acids. An improved understanding of differences in sources of individual SFAs from dietary intake versus endogenous metabolism is needed.FUNDING: EU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative.

U2 - 10.1016/S2213-8587(14)70146-9

DO - 10.1016/S2213-8587(14)70146-9

M3 - Journal article

C2 - 25107467

SN - 2213-8587

VL - 2

SP - 810

EP - 818

JO - The Lancet Diabetes & Endocrinology

JF - The Lancet Diabetes & Endocrinology

IS - 10

ER -

Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study

Abstract

Access to Document

AUB Link

Fingerprint

Cite this