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Omega-6 fatty acid biomarkers and incident type 2 diabetes: pooled analysis of individual-level data for 39 740 adults from 20 prospective cohort studies

Accepted version
Peer-reviewed

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Authors

Wu, JHY 
Marklund, M 
et al 

Abstract

BACKGROUND: Metabolic effects of omega-6 polyunsaturated fatty acids (n-6 PUFA) remain contentious, and evidence is limited regarding their potential role in primary prevention of type 2 diabetes (T2D). METHODS: Global consortium of 20 prospective cohort studies with new, harmonized, individual-level analyses. Each study measured biomarker linoleic acid (LA, the major dietary PUFA) and arachidonic acid (AA, a precursor of metabolic- and inflammation-mediating metabolites) at baseline among adults without prevalent T2D. Associations of n-6 PUFA biomarkers with T2D risk were assessed prospectively using a pre-specified analytic plan for exposures, covariates, and effect modifiers. Findings were pooled using inverse-variance weighted meta-analysis. FINDINGS: This study comprised 39,740 adults from 10 countries, with age (range of cohort means) 49-76yrs and BMI, 23∙3-28∙4kg/m2, including 4,347 incident T2D cases during 366,073 person-years of follow-up. In multivariable-adjusted pooled analyses, higher LA biomarker associated with 35% lower risk of T2D (RR per interquintile range: 0∙65, 95%CI: 0∙60-0∙72, P<0∙001, I2=54%). Findings for LA biomarker were generally similar in different lipid compartments including phospholipids, plasma, cholesterol esters, and adipose tissue. Levels of AA biomarker were not significantly associated with T2D risk overall (RR per interquintile range: 0∙96, 95%CI: 0∙88-1∙05, P=0∙38, I2=63%). Relations of LA and AA biomarker with T2D were not significantly modified by age, BMI, sex, race, aspirin use, n-3 PUFA levels, or FADS genetic variants (all P-interaction≥0∙13). INTERPRETATION: Findings suggest long-term benefit of LA, and no harms of AA, for the prevention of T2D.

Description

Keywords

Adult, Arachidonic Acid, Biomarkers, Cohort Studies, Diabetes Mellitus, Type 2, Fatty Acids, Omega-6, Humans, Incidence, Linoleic Acid, Prospective Studies, Risk Factors, Statistics as Topic

Journal Title

The Lancet Diabetes and Endocrinology

Conference Name

Journal ISSN

2213-8587
2213-8595

Volume Title

5

Publisher

Elsevier
Sponsorship
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MC_UU_12015/5)
Medical Research Council (unknown)
European Commission (37197)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0512-10135)
Medical Research Council (MR/N003284/1)
Medical Research Council (G0401527)
Medical Research Council (G1000143)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Medical Research Council (G0401527/1)
Cohort specific funding is outlined in the appendix. Unilever also provided Tufts University (Massachusetts, MA, USA) with a restricted grant (‘epidemiological research on circulating polyunsaturated fatty acids in relation to cardiometabolic health within the CHARGE-consortium’) to partly support this analysis.