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

Published version
Peer-reviewed

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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

Funder: Dutch Scientific Organization


Funder: Foundation Plan Alzheimer


Funder: Icelandic Heart Association


Funder: Academy of Finland


Funder: VicHealth and Cancer Council Victoria


Funder: Juselius Foundation


Funder: Uppsala University Hospital and the Swedish Research Council for Health, Working Life and Welfare


Funder: the Institut National de la Sante et de la Recherche Medicale


Funder: , the University Bordeaux 2 Victor Segalen


Funder: Sanofi; funder-id: http://dx.doi.org/10.13039/100004339


Funder: Fondation pour la Recherche Medicale, the Caisse Nationale Maladie des Travailleurs Salaries, Direction Generale de la Sante, MGEN, Institut de la Longevite, Conseils Regionaux d’Aquitaine et Bourgogne, Fondation de France, Ministry of Research–Institut National de la Sante and de la Recherche Medicale Programme Cohortes


Funder: Caisse Nationale pour la Solidarite et l’Autonomie


Funder: Swedish Research Council for Health, Working Life and Welfare, Uppsala City Council, Swedish Research Council, and Swedish Diabetes Foundation

Keywords

Research Article, Biology and life sciences, Medicine and health sciences, Research and analysis methods, Physical sciences, People and places

Journal Title

PLOS Medicine

Conference Name

Journal ISSN

1549-1277
1549-1676

Volume Title

17

Publisher

Public Library of Science
Sponsorship
Medical Research Council Epidemiology Unit core grant (MC_UU_12015/5 and MC_UU_12015/1)
National Institute for Health Research (NIHR) Biomedical Research Centre Cambridge (IS-BRC-1215-20014)
Seventh Framework Programme (FP7 and Horizon2020)
NIH (3T32DK007703 and T32CA009001)
Netherlands Heart Foundation (2000T401)
NIH (R01HL-076200, N01-AG012100, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, R01-HL-085710, U01HL080295, U01HL130114, R01AG023629, UM1 CA167552)
NIH (R01 HL35464, AA11181, HL35464, CA55075, HL60712, P30 DK46200, grants U01-HL-47892, U01-HL-47902, DK-29867, R01-58329, DK-079888, M01-RR-43, HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169)
NIH (UL1-TR-000040 UL1-TR-001079, CA186107, CA87969, CA49449, HL34594, HL35464, CA167552, HL60712, HL088521, HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C)
Michael Smith Foundation for Medical Research (17644)
Canadian Cancer Society (704735)
Ministry of Science and Technology and National Taiwan University (MOST 103-2314-B-002 -135 –MY3, NSC 100-2314-B-002 -113 –MY3, NTUH 105-S3120, NTUH 106-S3453)
European Commission (LSHM_CT_2006_037197)
Australia’s National Health and Medical Research Council (209057 and 126403)
Agence Nationale de la Recherche (COGINUT ANR-06-PNRA-005)
the Fondation Plan Alzheimer (FCS 2009-2012)