%0 Journal Article
%A Imamura, Fumiaki
%A Sharp, Stephen J
%A Koulman, Albert
%A Schulze, Matthias B
%A Kröger, Janine
%A Griffin, Julian L
%A Huerta, José M
%A Guevara, Marcela
%A Sluijs, Ivonne
%A Agudo, Antonio
%A Ardanaz, Eva
%A Balkau, Beverley
%A Boeing, Heiner
%A Chajes, Veronique
%A Dahm, Christina C
%A Dow, Courtney
%A Fagherazzi, Guy
%A Feskens, Edith J M
%A Franks, Paul W
%A Gavrila, Diana
%A Gunter, Marc
%A Kaaks, Rudolf
%A Key, Timothy J
%A Khaw, Kay-Tee
%A Kühn, Tilman
%A Melander, Olle
%A Molina-Portillo, Elena
%A Nilsson, Peter M
%A Olsen, Anja
%A Overvad, Kim
%A Palli, Domenico
%A Panico, Salvatore
%A Rolandsson, Olov
%A Sieri, Sabina
%A Sacerdote, Carlotta
%A Slimani, Nadia
%A Spijkerman, Annemieke M W
%A Tjønneland, Anne
%A Tumino, Rosario
%A van der Schouw, Yvonne T
%A Langenberg, Claudia
%A Riboli, Elio
%A Forouhi, Nita G
%A Wareham, Nick J
%T A combination of plasma phospholipid fatty acids and its association with incidence of type 2 diabetes: The EPIC-InterAct case-cohort study.
%D 2017
%U http://hdl.handle.net/10668/11666
%X Combinations of multiple fatty acids may influence cardiometabolic risk more than single fatty acids. The association of a combination of fatty acids with incident type 2 diabetes (T2D) has not been evaluated. We measured plasma phospholipid fatty acids by gas chromatography in 27,296 adults, including 12,132 incident cases of T2D, over the follow-up period between baseline (1991-1998) and 31 December 2007 in 8 European countries in EPIC-InterAct, a nested case-cohort study. The first principal component derived by principal component analysis of 27 individual fatty acids (mole percentage) was the main exposure (subsequently called the fatty acid pattern score [FA-pattern score]). The FA-pattern score was partly characterised by high concentrations of linoleic acid, stearic acid, odd-chain fatty acids, and very-long-chain saturated fatty acids and low concentrations of γ-linolenic acid, palmitic acid, and long-chain monounsaturated fatty acids, and it explained 16.1% of the overall variability of the 27 fatty acids. Based on country-specific Prentice-weighted Cox regression and random-effects meta-analysis, the FA-pattern score was associated with lower incident T2D. Comparing the top to the bottom fifth of the score, the hazard ratio of incident T2D was 0.23 (95% CI 0.19-0.29) adjusted for potential confounders and 0.37 (95% CI 0.27-0.50) further adjusted for metabolic risk factors. The association changed little after adjustment for individual fatty acids or fatty acid subclasses. In cross-sectional analyses relating the FA-pattern score to metabolic, genetic, and dietary factors, the FA-pattern score was inversely associated with adiposity, triglycerides, liver enzymes, C-reactive protein, a genetic score representing insulin resistance, and dietary intakes of soft drinks and alcohol and was positively associated with high-density-lipoprotein cholesterol and intakes of polyunsaturated fat, dietary fibre, and coffee (p  A combination of individual fatty acids, characterised by high concentrations of linoleic acid, odd-chain fatty acids, and very long-chain fatty acids, was associated with lower incidence of T2D. The specific fatty acid pattern may be influenced by metabolic, genetic, and dietary factors.
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