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Imamura F, Fretts A, Marklund M, Ardisson Korat AV, Yang WS, Lankinen M, Qureshi W, Helmer C, Chen TA, Wong K, Bassett JK, Murphy R, Tintle N, Yu CI, Brouwer IA, Chien KL, Frazier-Wood AC, del Gobbo LC, Djoussé L, Geleijnse JM, Giles GG, de Goede J, Gudnason V, Harris WS, Hodge A, Hu F, Koulman A, Laakso M, Lind L, Lin HJ, McKnight B, Rajaobelina K, Risérus U, Robinson JG, Samieri C, Siscovick DS, Soedamah-Muthu SS, Sotoodehnia N, Sun Q, Tsai MY, Uusitupa M, Wagenknecht LE, Wareham NJ, Wu JHY, Micha R, Forouhi NG, Lemaitre RN, Mozaffarian D. Fatty acid biomarkers of dairy fat consumption and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies. PLoS Med 2018; 15:e1002670. [PMID: 30303968 PMCID: PMC6179183 DOI: 10.1371/journal.pmed.1002670] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/07/2018] [Indexed: 01/03/2023] Open
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.
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Affiliation(s)
- Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Amanda Fretts
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Matti Marklund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Sweden
| | - Andres V. Ardisson Korat
- Department of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Wei-Sin Yang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Maria Lankinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Waqas Qureshi
- Section of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Bowman Gray Center, Winston-Salem, North Carolina, United States of America
| | - Catherine Helmer
- INSERM, UMR 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Tzu-An Chen
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Kerry Wong
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
| | - Julie K. Bassett
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
| | - Rachel Murphy
- Centre of Excellence in Cancer Prevention, School of Population & Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Nathan Tintle
- Department of Mathematics and Statistics, Dordt College, Sioux Center, Iowa, United States of America
| | - Chaoyu Ian Yu
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Alexis C. Frazier-Wood
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Liana C. del Gobbo
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Luc Djoussé
- Divisions of Aging, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Graham G. Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, Australia
| | - Janette de Goede
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Holtasmári 1, Kópavogur, Iceland, Iceland
| | - William S. Harris
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, United States of America
- OmegaQuant Analytics LLC, Sioux Falls, South Dakota, United States of America
| | - Allison Hodge
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, Australia
| | - Frank Hu
- Department of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - InterAct Consortium
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Albert Koulman
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- National Institute for Health Research Biomedical Research Centres Core Nutritional Biomarker Laboratory, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
- National Institute for Health Research Biomedical Research Centres Core Metabolomics and Lipidomics Laboratory, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Medical Research Council Elsie Widdowson Laboratory, Cambridge, United Kingdom
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Laakso
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Zhongzheng District, Taipei City, Taiwan
| | - Barbara McKnight
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Kalina Rajaobelina
- INSERM, UMR 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Sweden
| | - Jennifer G. Robinson
- Departments of Epidemiology and Medicine at the University of Iowa College of Public Health, Iowa City, Iowa, United States of America
| | - Cécilia Samieri
- INSERM, UMR 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - David S. Siscovick
- The New York Academy of Medicine, New York, New York, United States of America
| | - Sabita S. Soedamah-Muthu
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
- Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Qi Sun
- Department of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Lynne E. Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Nick J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Jason HY Wu
- The George Institute for Global Health and the Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Rozenn N. Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
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