Dow Courtney, Mangin Marie, Balkau Beverley, Affret Aurélie, Boutron-Ruault Marie-Christine, Clavel-Chapelon Françoise, Bonnet Fabrice, Fagherazzi Guy
Gustave Roussy, F-94805, Villejuif, France.
Université Paris-Saclay, Université Paris-Sud, UVSQ, Inserm U1018, CESP, Health Across Generations Team, F-94805, Villejuif, France.
Br J Nutr. 2016 Nov 28;116(10):1807-1815. doi: 10.1017/S0007114516003883. Epub 2016 Nov 15.
We evaluated the association between dietary estimates of fatty acid (FA) consumption and type 2 diabetes (T2D) risk in the French E3N (Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale) cohort. In total, 71 334 women without diabetes at baseline were followed up from 1993 to 2011. Diabetes was identified using questionnaires and drug-reimbursement claims, and incident cases were validated. FA consumption in 1993 was estimated from a validated dietary questionnaire. Cox regression estimated hazard ratios (HR) and 95 % CI of diabetes risk, comparing the upper tertile group with the lowest. High -3 PUFA consumption was associated with T2D even after adjustment for confounders, including other FA and BMI (HR 1·26; 95 % CI 1·13, 1·41; upper tertile compared with lowest). Upon stratification by overweight (BMI≥25 kg/m)/non-overweight, a positive association between total PUFA consumption and T2D was observed, but it was restricted to non-overweight women (HR 1·22; 95 % CI 1·05, 1·42), whereas -3 PUFA consumption was associated with increased T2D risk in both BMI strata (BMI<25 kg/m: HR 1·19; 95 % CI 1·01, 1·40 and BMI≥25 kg/m: HR 1·38; 95 % CI 1·20, 1·59). Within the -3 PUFA, high DPA (HR 1·41; 95 % CI 1·23, 1·63) and -linolenic acid (ALA) intakes were associated with increased T2D risk, but the effects of ALA were restricted to overweight women (HR 1·17; 95 % CI 1·01, 1·36). Within the -6 PUFA, only arachidonic acid (AA) intake was associated with T2D risk (HR 1·49; 95 % CI 1·33, 1·66). The associations with DPA and AA persisted even after adjustment of their principal source in this cohort, the consumption of meat. The effects of PUFA are heterogeneous within the FA group. Intake of DPA and AA may contribute to T2D development.
我们在法国E3N(全国教育互助会女性流行病学研究)队列中评估了膳食脂肪酸(FA)摄入量与2型糖尿病(T2D)风险之间的关联。1993年至2011年期间,对71334名基线时无糖尿病的女性进行了随访。通过问卷和药物报销记录确定糖尿病情况,并对新发病例进行了验证。1993年的FA摄入量通过一份经验证的膳食问卷进行估算。Cox回归分析估算了糖尿病风险的风险比(HR)和95%置信区间(CI),比较了最高三分位数组与最低三分位数组。即使在对包括其他FA和体重指数(BMI)在内的混杂因素进行调整后,高-3多不饱和脂肪酸(PUFA)摄入量仍与T2D相关(HR 1.26;95%CI 1.13,1.41;最高三分位数组与最低三分位数组相比)。按超重(BMI≥25 kg/m²)/非超重分层后,观察到总PUFA摄入量与T2D之间存在正相关,但仅限于非超重女性(HR 1.22;95%CI 1.05,1.42),而-3 PUFA摄入量在两个BMI分层中均与T2D风险增加相关(BMI<25 kg/m²:HR 1.19;95%CI 1.01,1.40;BMI≥25 kg/m²:HR 1.38;95%CI 1.20,1.59)。在-3 PUFA中,高二十二碳五烯酸(DPA)(HR 1.41;95%CI 1.23,1.63)和α-亚麻酸(ALA)摄入量与T2D风险增加相关,但ALA的影响仅限于超重女性(HR 1.17;95%CI 1.01,1.36)。在-6 PUFA中,只有花生四烯酸(AA)摄入量与T2D风险相关(HR 1.49;95%CI 1.33,1.66)。即使在调整了该队列中它们的主要来源(肉类消费)后,与DPA和AA的关联仍然存在。PUFA在FA组内的影响是异质性的。DPA和AA的摄入可能有助于T2D的发展。