Forouhi Nita G, Imamura Fumiaki, Sharp Stephen J, Koulman Albert, Schulze Matthias B, Zheng Jusheng, Ye Zheng, Sluijs Ivonne, Guevara Marcela, Huerta José María, Kröger Janine, Wang Laura Yun, Summerhill Keith, Griffin Julian L, Feskens Edith J M, Affret Aurélie, Amiano Pilar, Boeing Heiner, Dow Courtney, Fagherazzi Guy, Franks Paul W, Gonzalez Carlos, Kaaks Rudolf, Key Timothy J, Khaw Kay Tee, Kühn Tilman, Mortensen Lotte Maxild, Nilsson Peter M, Overvad Kim, Pala Valeria, Palli Domenico, Panico Salvatore, Quirós J Ramón, Rodriguez-Barranco Miguel, Rolandsson Olov, Sacerdote Carlotta, Scalbert Augustin, Slimani Nadia, Spijkerman Annemieke M W, Tjonneland Anne, Tormo Maria-Jose, Tumino Rosario, van der A Daphne L, van der Schouw Yvonne T, Langenberg Claudia, Riboli Elio, Wareham Nicholas J
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
MRC Human Nutrition Research, Cambridge, UK.
PLoS Med. 2016 Jul 19;13(7):e1002094. doi: 10.1371/journal.pmed.1002094. eCollection 2016 Jul.
Whether and how n-3 and n-6 polyunsaturated fatty acids (PUFAs) are related to type 2 diabetes (T2D) is debated. Objectively measured plasma PUFAs can help to clarify these associations.
Plasma phospholipid PUFAs were measured by gas chromatography among 12,132 incident T2D cases and 15,919 subcohort participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study across eight European countries. Country-specific hazard ratios (HRs) were estimated using Prentice-weighted Cox regression and pooled by random-effects meta-analysis. We also systematically reviewed published prospective studies on circulating PUFAs and T2D risk and pooled the quantitative evidence for comparison with results from EPIC-InterAct. In EPIC-InterAct, among long-chain n-3 PUFAs, α-linolenic acid (ALA) was inversely associated with T2D (HR per standard deviation [SD] 0.93; 95% CI 0.88-0.98), but eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were not significantly associated. Among n-6 PUFAs, linoleic acid (LA) (0.80; 95% CI 0.77-0.83) and eicosadienoic acid (EDA) (0.89; 95% CI 0.85-0.94) were inversely related, and arachidonic acid (AA) was not significantly associated, while significant positive associations were observed with γ-linolenic acid (GLA), dihomo-GLA, docosatetraenoic acid (DTA), and docosapentaenoic acid (n6-DPA), with HRs between 1.13 to 1.46 per SD. These findings from EPIC-InterAct were broadly similar to comparative findings from summary estimates from up to nine studies including between 71 to 2,499 T2D cases. Limitations included potential residual confounding and the inability to distinguish between dietary and metabolic influences on plasma phospholipid PUFAs.
These large-scale findings suggest an important inverse association of circulating plant-origin n-3 PUFA (ALA) but no convincing association of marine-derived n3 PUFAs (EPA and DHA) with T2D. Moreover, they highlight that the most abundant n6-PUFA (LA) is inversely associated with T2D. The detection of associations with previously less well-investigated PUFAs points to the importance of considering individual fatty acids rather than focusing on fatty acid class.
n-3和n-6多不饱和脂肪酸（PUFAs）与2型糖尿病（T2D）是否相关以及如何相关仍存在争议。客观测量的血浆PUFAs有助于阐明这些关联。
在欧洲癌症与营养前瞻性调查（EPIC）-InterAct研究中，对八个欧洲国家的12,132例新发T2D病例和15,919名队列参与者进行气相色谱法测量血浆磷脂PUFAs。使用Prentice加权Cox回归估计特定国家的风险比（HRs），并通过随机效应荟萃分析进行汇总。我们还系统回顾了已发表的关于循环PUFAs与T2D风险的前瞻性研究，并汇总了定量证据以与EPIC-InterAct的结果进行比较。在EPIC-InterAct研究中，在长链n-3 PUFAs中，α-亚麻酸（ALA）与T2D呈负相关（每标准差[SD]的HR为0.93；95%CI为0.88 - 0.98），但二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）无显著关联。在n-6 PUFAs中，亚油酸（LA）（0.80；95%CI为0.77 - 0.83）和二十碳二烯酸（EDA）（0.89；95%CI为0.85 - 0.94）呈负相关，花生四烯酸（AA）无显著关联，而与γ-亚麻酸（GLA）、二高-GLA、二十二碳四烯酸（DTA）和二十二碳五烯酸（n6-DPA）呈显著正相关，每SD的HR在1.13至1.46之间。EPIC-InterAct的这些发现与多达九项研究（包括71至2,499例T2D病例）的汇总估计的比较结果大致相似。局限性包括潜在的残余混杂因素以及无法区分饮食和代谢对血浆磷脂PUFAs的影响。
这些大规模研究结果表明，循环中植物来源的n-3 PUFA（ALA）与T2D存在重要的负相关，但海洋来源的n-3 PUFAs（EPA和DHA）与T2D无令人信服的关联。此外，研究结果突出了最丰富的n-6-PUFA（LA）与T2D呈负相关。检测到与先前研究较少的PUFAs的关联表明，考虑单个脂肪酸而非仅关注脂肪酸类别很重要。
Zotero 插件
