Division of Nutritional Sciences.
Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, Ithaca, NY.
Am J Clin Nutr. 2018 Sep 1;108(3):622-632. doi: 10.1093/ajcn/nqy165.
Insulin regulates fatty acids (FAs) in the blood; conversely, FAs may mediate insulin sensitivity and are potentially modifiable risk factors of the diabetogenic state.
The objective of our study was to examine the associations between plasma concentrations of FAs, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) among individuals (n = 1433) in the NHANES (2003-2004).
Plasma concentrations of 24 individual FAs were considered individually and in subgroups, per chemical structure. Study participants were categorized in diabetogenic groups: Group 1 (HbA1c ≥6.5% or FPG ≥126 mg/dL), Group 2 (HbA1c 5.7% to <6.5% or FPG 100 to <126 mg/dL), and Group 3 (HbA1c <5.7% and FPG <100 mg/dL). We assessed associations between diabetogenic groups and plasma FAs in multivariate multinomial regressions (with Group 3 as the reference).
Overall, 7.0% of study participants were in Group 1; 33.3% were in Group 2. Plasma concentrations of several individual FAs, including even-chain saturated FAs (SFAs; myristic, palmitic, stearic acids) and monounsaturated FAs (MUFAs; cis-vaccenic, oleic acids), were respectively associated with greater odds of Groups 1 and 2 status, adjusting for covariates. Higher concentrations of SFA and MUFA subgroups (highest compared with lowest quartile) were associated with increased odds of Group 2 status [SFAs adjusted OR (aOR): 1.51 (95% CI: 1.05, 2.18); MUFAs aOR: 1.78 (95% CI: 1.11, 2.85)]. Higher eicosapentaenoic acid plasma concentration was associated with decreased odds of Group 1 status [quartile 4 aOR: 0.41 (95% CI: 0.17, 0.95)].
Higher plasma concentrations of SFAs and MUFAs, primary de novo lipogenesis products, were associated with elevated FPG and HbA1c in a nationally representative study population in the United States. Additional studies are necessary to elucidate potential causal relationships between FAs (from endogenous production and dietary consumption) and diabetogenic indicators, as well as clinical implications for managing diabetes and prediabetes.
胰岛素调节血液中的脂肪酸 (FA)；相反，FA 可能介导胰岛素敏感性，并且是糖尿病状态的潜在可改变的危险因素。
我们的研究目的是在 NHANES（2003-2004 年）中检查个体（n=1433）的血浆 FA 浓度、空腹血糖 (FPG) 和糖化血红蛋白 (HbA1c) 之间的关联。
单独和按化学结构分组考虑 24 种个体 FA 的血浆浓度。研究参与者被分为糖尿病组：第 1 组（HbA1c≥6.5%或 FPG≥126mg/dL）、第 2 组（HbA1c5.7%至<6.5%或 FPG100 至<126mg/dL）和第 3 组（HbA1c<5.7%且 FPG<100mg/dL）。我们在多元多项回归中评估了糖尿病组与血浆 FA 之间的关联（以第 3 组为参考）。
总体而言，7.0%的研究参与者属于第 1 组；33.3%的人属于第 2 组。几种个体 FA 的血浆浓度，包括偶数链饱和 FA（饱和脂肪酸；肉豆蔻酸、棕榈酸、硬脂酸）和单不饱和 FA（MUFA；顺式蓖麻酸、油酸），与调整协变量后的第 1 组和第 2 组状态的更高几率分别相关。较高的 SFA 和 MUFA 亚组（与最低四分位数相比）浓度与第 2 组状态的几率增加相关[饱和脂肪酸调整后的比值比（aOR）：1.51（95%CI：1.05,2.18）；MUFA aOR：1.78（95%CI：1.11,2.85）]。较高的二十碳五烯酸血浆浓度与第 1 组状态的几率降低相关[四分位数 4 aOR：0.41（95%CI：0.17,0.95）]。
在美国具有代表性的研究人群中，较高的血浆 SFAs 和 MUFAs 浓度，主要是从头合成的产物，与空腹血糖和糖化血红蛋白升高有关。需要进一步研究以阐明 FA（来自内源性产生和饮食摄入）与糖尿病指标之间的潜在因果关系，以及管理糖尿病和糖尿病前期的临床意义。
