Repository logo
 

Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies.

Accepted version
Peer-reviewed

No Thumbnail Available

Type

Article

Change log

Authors

Fretts, Amanda M 
Ardisson Korat, Andres V  ORCID logo  https://orcid.org/0000-0003-4599-2245
Yang, Wei-Sin 

Abstract

BACKGROUND: De novo lipogenesis (DNL) is the primary metabolic pathway synthesizing fatty acids from carbohydrates, protein, or alcohol. Our aim was to examine associations of in vivo levels of selected fatty acids (16:0, 16:1n7, 18:0, 18:1n9) in DNL with incidence of type 2 diabetes (T2D). METHODS AND FINDINGS: Seventeen cohorts from 12 countries (7 from Europe, 7 from the United States, 1 from Australia, 1 from Taiwan; baseline years = 1970-1973 to 2006-2010) conducted harmonized individual-level analyses of associations of DNL-related fatty acids with incident T2D. In total, we evaluated 65,225 participants (mean ages = 52.3-75.5 years; % women = 20.4%-62.3% in 12 cohorts recruiting both sexes) and 15,383 incident cases of T2D over the 9-year follow-up on average. Cohort-specific association of each of 16:0, 16:1n7, 18:0, and 18:1n9 with incident T2D was estimated, adjusted for demographic factors, socioeconomic characteristics, alcohol, smoking, physical activity, dyslipidemia, hypertension, menopausal status, and adiposity. Cohort-specific associations were meta-analyzed with an inverse-variance-weighted approach. Each of the 4 fatty acids positively related to incident T2D. Relative risks (RRs) per cohort-specific range between midpoints of the top and bottom quintiles of fatty acid concentrations were 1.53 (1.41-1.66; p < 0.001) for 16:0, 1.40 (1.33-1.48; p < 0.001) for 16:1n-7, 1.14 (1.05-1.22; p = 0.001) for 18:0, and 1.16 (1.07-1.25; p < 0.001) for 18:1n9. Heterogeneity was seen across cohorts (I2 = 51.1%-73.1% for each fatty acid) but not explained by lipid fractions and global geographical regions. Further adjusted for triglycerides (and 16:0 when appropriate) to evaluate associations independent of overall DNL, the associations remained significant for 16:0, 16:1n7, and 18:0 but were attenuated for 18:1n9 (RR = 1.03, 95% confidence interval (CI) = 0.94-1.13). These findings had limitations in potential reverse causation and residual confounding by imprecisely measured or unmeasured factors. CONCLUSIONS: Concentrations of fatty acids in the DNL were positively associated with T2D incidence. Our findings support further work to investigate a possible role of DNL and individual fatty acids in the development of T2D.

Description

Keywords

Aged, Diabetes Mellitus, Type 2, Fatty Acids, Female, Humans, Incidence, Lipogenesis, Male, Metabolic Networks and Pathways, Middle Aged, Prospective Studies

Journal Title

PLoS Med

Conference Name

Journal ISSN

1549-1277
1549-1676

Volume Title

17

Publisher

Public Library of Science (PLoS)

Rights

All rights reserved
Sponsorship
Medical Research Council (MC_UU_12015/5)
Medical Research Council (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
MRC (MC_UU_00006/3)
MRC (MC_UU_00014/5)
National Institute for Health and Care Research (IS-BRC-1215-20014)
FI, NGF, and NJW were funded by the United Kingdom Medical Research Council Epidemiology Unit core grant (MC_UU_12015/5 and MC_UU_12015/1); NJW, NGF and AK acknowledge National Institute for Health Research (NIHR) Biomedical Research Centre Cambridge (IS-BRC-1215-20014); NJW is an NIHR Senior Investigator;