Fatty acid biomarkers of dairy fat consumption and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies

Fumiaki Imamura, Amanda Fretts, Matti Marklund, Andres V. Ardisson Korat, Wei-sin Yang, Maria Lankinen, Waqas Qureshi, Catherine Helmer, Tzu-an Chen, Kerry Wong, Julie K. Bassett, Rachel Murphy, Nathan Tintle, Chaoyu Ian Yu, Ingeborg A. Brouwer, Kuo-liong Chien, Alexis C. Frazier-wood, Liana C. Del Gobbo, Luc Djoussé, Johanna M. GeleijnseGraham G. Giles, Janette De Goede, Vilmundur Gudnason, William S. Harris, Allison Hodge, Frank Hu, Albert Koulman, Markku Laakso, Lars Lind, Hung-ju Lin, Barbara Mcknight, Kalina Rajaobelina, Ulf Risérus, Jennifer G. Robinson, Cécilia Samieri, David S. Siscovick, S.S. Soedamah-Muthu, Nona Sotoodehnia, Qi Sun, Michael Y. Tsai, Matti Uusitupa, Lynne E. Wagenknecht, Nick J. Wareham, Jason Hy Wu, Renata Micha, Nita G. Forouhi, Rozenn N. Lemaitre, Dariush Mozaffarian, Andrew T Hattersley

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Abstract

Background
We aimed to investigate prospective associations of circulating or adipose tissue odd-chain fatty acids 15:0 and 17:0 and trans-palmitoleic acid, t16:1n-7, as potential biomarkers of dairy fat intake, with incident type 2 diabetes (T2D).
Methods and Findings
Sixteen prospective cohorts from 12 countries (7 from the United States, 7 from Europe, 1 from Australia, 1 from Taiwan) performed new harmonised individual-level analysis for the prospective associations according to a standardised plan. In total, 63,682 participants with a broad range of baseline ages and BMIs and 15,180 incident cases of T2D over the average of 9 years of follow-up were evaluated. Study-specific results were pooled using inverse-variance-weighted meta-analysis. Prespecified interactions by age, sex, BMI, and race/ethnicity were explored in each cohort and were meta-analysed. Potential heterogeneity by cohort-specific characteristics (regions, lipid compartments used for fatty acid assays) was assessed with metaregression. After adjustment for potential confounders, including measures of adiposity (BMI, waist circumference) and lipogenesis (levels of palmitate, triglycerides), higher levels of 15:0, 17:0, and t16:1n-7 were associated with lower incidence of T2D. In the most adjusted model, the hazard ratio (95% CI) for incident T2D per cohort-specific 10th to 90th percentile range of 15:0 was 0.80 (0.73-0.87); of 17:0, 0.65 (0.59-0.72); of t16:1n7, 0.82 (0.70-0.96); and of their sum, 0.71 (0.63-0.79). In exploratory analyses, similar associations for 15:0, 17:0, and the sum of all three fatty acids were present in both genders but stronger in women than in men (pinteraction < 0.001). Whereas studying associations with biomarkers has several advantages, as limitations, the biomarkers do not distinguish between different food sources of dairy fat (e.g., cheese, yogurt, milk), and residual confounding by unmeasured or imprecisely measured confounders may exist.
Conclusions
In a large meta-analysis that pooled the findings from 16 prospective cohort studies, higher levels of 15:0, 17:0, and t16:1n-7 were associated with a lower risk of T2D
Original languageEnglish
Article numbere1002670
JournalPLOS Medicine
Volume15
Issue number10
DOIs
Publication statusPublished - 2018

Keywords

  • ADIPOSE-TISSUE
  • BRANCHED-CHAIN
  • CONTROLLED-TRIALS
  • DIETARY RECOMMENDATIONS
  • DOSE-RESPONSE METAANALYSIS
  • EPIC-INTERACT
  • POOLING PROJECT
  • PRODUCT INTAKE
  • TRANS-PALMITOLEIC ACID
  • UNITED-STATES

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  • Cite this

    Imamura, F., Fretts, A., Marklund, M., Ardisson Korat, A. V., Yang, W., Lankinen, M., Qureshi, W., Helmer, C., Chen, T., Wong, K., Bassett, J. K., Murphy, R., Tintle, N., Yu, C. I., Brouwer, I. A., Chien, K., Frazier-wood, A. C., Del Gobbo, L. C., Djoussé, L., ... Hattersley, A. T. (Ed.) (2018). Fatty acid biomarkers of dairy fat consumption and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies. PLOS Medicine, 15(10), [e1002670]. https://doi.org/10.1371/journal.pmed.1002670