Yakoob Mohammad Y, Shi Peilin, Willett Walter C, Rexrode Kathryn M, Campos Hannia, Orav E John, Hu Frank B, Mozaffarian Dariush
From Department of Epidemiology, Harvard School of Public Health, Boston, MA (M.Y.Y., D.M.); Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (P.S., D.M.); Department of Nutrition, Harvard School of Public Health, Boston, MA (W.C.W., H.C., F.B.H.); Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (K.M.R.); and Division of General Internal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.J.O.).
Circulation. 2016 Apr 26;133(17):1645-54. doi: 10.1161/CIRCULATIONAHA.115.018410. Epub 2016 Mar 22.
In prospective studies, the relationship of self-reported consumption of dairy foods with risk of diabetes mellitus is inconsistent. Few studies have assessed dairy fat, using circulating biomarkers, and incident diabetes mellitus. We tested the hypothesis that circulating fatty acid biomarkers of dairy fat, 15:0, 17:0, and t-16:1n-7, are associated with lower incident diabetes mellitus.
Among 3333 adults aged 30 to 75 years and free of prevalent diabetes mellitus at baseline, total plasma and erythrocyte fatty acids were measured in blood collected in 1989 to 1990 (Nurses' Health Study) and 1993 to 1994 (Health Professionals Follow-Up Study). Incident diabetes mellitus through 2010 was confirmed by a validated supplementary questionnaire based on symptoms, diagnostic tests, and medications. Risk was assessed by using Cox proportional hazards, with cohort findings combined by meta-analysis. During mean±standard deviation follow-up of 15.2±5.6 years, 277 new cases of diabetes mellitus were diagnosed. In pooled multivariate analyses adjusting for demographics, metabolic risk factors, lifestyle, diet, and other circulating fatty acids, individuals with higher plasma 15:0 had a 44% lower risk of diabetes mellitus (quartiles 4 versus 1, hazard ratio, 0.56; 95% confidence interval, 0.37-0.86; P-trend=0.01); higher plasma 17:0, 43% lower risk (hazard ratio, 0.57; 95% confidence interval, 0.39-0.83; P-trend=0.01); and higher t-16:1n-7, 52% lower risk (hazard ratio, 0.48; 95% confidence interval, 0.33-0.70; P-trend <0.001). Findings were similar for erythrocyte 15:0, 17:0, and t-16:1n-7, although with broader confidence intervals that only achieved statistical significance for 17:0.
In 2 prospective cohorts, higher plasma dairy fatty acid concentrations were associated with lower incident diabetes mellitus. Results were similar for erythrocyte 17:0. Our findings highlight the need to better understand the potential health effects of dairy fat, and the dietary and metabolic determinants of these fatty acids.
在前瞻性研究中,自我报告的乳制品摄入量与糖尿病风险之间的关系并不一致。很少有研究使用循环生物标志物评估乳制品脂肪与糖尿病发病情况。我们检验了以下假设:乳制品脂肪的循环脂肪酸生物标志物15:0、17:0和反式-16:1n-7与较低的糖尿病发病率相关。
在3333名年龄在30至75岁之间且基线时无糖尿病的成年人中,于1989年至1990年(护士健康研究)和1993年至1994年(卫生专业人员随访研究)采集血液,测量血浆和红细胞中的总脂肪酸。通过基于症状、诊断测试和用药情况的有效补充问卷确认截至2010年的糖尿病发病情况。使用Cox比例风险模型评估风险,并通过荟萃分析合并队列研究结果。在平均随访15.2±5.6年期间,共诊断出277例新发糖尿病病例。在对人口统计学、代谢风险因素、生活方式、饮食和其他循环脂肪酸进行调整的汇总多变量分析中,血浆15:0水平较高的个体患糖尿病的风险降低44%(四分位数4与1相比,风险比为0.56;95%置信区间为0.37 - 0.86;P趋势 = 0.01);血浆17:0水平较高者,风险降低43%(风险比为0.57;95%置信区间为0.39 - 0.83;P趋势 = 0.01);反式-16:1n-7水平较高者,风险降低52%(风险比为0.48;95%置信区间为0.33 - 0.70;P趋势 <0.001)。红细胞中的15:0、17:0和反式-16:1n-7的结果相似,尽管置信区间更宽,仅17:0达到统计学显著性。
在两个前瞻性队列中,较高的血浆乳制品脂肪酸浓度与较低的糖尿病发病率相关。红细胞17:0的结果相似。我们的研究结果凸显了更好地了解乳制品脂肪的潜在健康影响以及这些脂肪酸的饮食和代谢决定因素的必要性。