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Serum carbon and nitrogen stable isotopes as potential biomarkers of dietary intake and their relation with incident type 2 diabetes: the EPIC-Norfolk study.


Type

Article

Change log

Authors

Patel, Pinal S 
Cooper, Andrew JM 
O'Connell, Tamsin C 
Kuhnle, Gunter GC 
Kneale, Catherine K 

Abstract

BACKGROUND: Stable-isotope ratios of carbon (¹³C/¹²C, expressed as δ¹³C) and nitrogen (¹⁵N/¹⁴N, or δ¹⁵N) have been proposed as potential nutritional biomarkers to distinguish between meat, fish, and plant-based foods. OBJECTIVE: The objective was to investigate dietary correlates of δ¹³C and δ¹⁵N and examine the association of these biomarkers with incident type 2 diabetes in a prospective study. DESIGN: Serum δ¹³C and δ¹⁵N (‰) were measured by using isotope ratio mass spectrometry in a case-cohort study (n = 476 diabetes cases; n = 718 subcohort) nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population-based cohort. We examined dietary (food-frequency questionnaire) correlates of δ¹³C and δ¹⁵N in the subcohort. HRs and 95% CIs were estimated by using Prentice-weighted Cox regression. RESULTS: Mean (±SD) δ¹³C and δ¹⁵N were -22.8 ± 0.4‰ and 10.2 ± 0.4‰, respectively, and δ¹³C (r = 0.22) and δ¹⁵N (r = 0.20) were positively correlated (P < 0.001) with fish protein intake. Animal protein was not correlated with δ¹³C but was significantly correlated with δ¹⁵N (dairy protein: r = 0.11; meat protein: r = 0.09; terrestrial animal protein: r = 0.12, P ≤ 0.013). δ¹³C was inversely associated with diabetes in adjusted analyses (HR per tertile: 0.74; 95% CI: 0.65, 0.83; P-trend < 0.001], whereas δ¹⁵N was positively associated (HR: 1.23; 95% CI: 1.09, 1.38; P-trend = 0.001). CONCLUSIONS: The isotope ratios δ¹³C and δ¹⁵N may both serve as potential biomarkers of fish protein intake, whereas only δ¹⁵N may reflect broader animal-source protein intake in a European population. The inverse association of δ¹³C but a positive association of δ¹⁵N with incident diabetes should be interpreted in the light of knowledge of dietary intake and may assist in identifying dietary components that are associated with health risks and benefits.

Description

Keywords

Adult, Aged, Biomarkers, Carbon Isotopes, Case-Control Studies, Cohort Studies, Diabetes Mellitus, Type 2, Diet, Dietary Proteins, England, Female, Fish Proteins, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Nitrogen Isotopes, Risk Factors, Surveys and Questionnaires

Journal Title

Am J Clin Nutr

Conference Name

Journal ISSN

0002-9165
1938-3207

Volume Title

Publisher

Elsevier BV
Sponsorship
Medical Research Council (G1000143)
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MC_UU_12015/3)
Medical Research Council (MC_UU_12015/5)
Wellcome Trust (074229/Z/04/Z)
Medical Research Council (G0801534)
Medical Research Council (G0401527)
Medical Research Council (MC_U106179471)
Medical Research Council (MC_U106179473)
Medical Research Council (G0401527/1)
The EPIC-Norfolk study is supported by program grants from the Medical Research Council UK and Cancer Research UK. MRC Epidemiology Unit core support is acknowledged (MC_UU_12015/1 and MC_UU_12015/5). TCO and CKK were supported by the Wellcome Trust (grant no. 074229/Z/04/Z).