Fatty acid consumption and incident type 2 diabetes: an 18-year follow-up in the female E3N (Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale) prospective cohort study
Fatty acid consumption and incident type 2 diabetes: an 18-year follow-up in the female E3N (Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale) prospective cohort study
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DOI：
10.1017/s0007114516003883
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发表时间：
2016-11-01
影响因子：
3.6
通讯作者：
Fagherazzi, Guy
中科院分区：
文献类型：
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作者：
Dow, Courtney;Mangin, Marie;Fagherazzi, Guy
我们评估了法国E3N （Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l’education Nationale）队列中脂肪酸（FA）摄入量与2型糖尿病（T2D）风险之间的关系。从1993年到2011年，共有71 334名基线时无糖尿病的女性接受了随访。糖尿病是通过问卷调查和药物报销来确定的，并且事件病例得到了验证。1993年的FA消费量是根据一份有效的膳食调查表估计的。Cox回归估计了糖尿病风险的危险比（HR）和95% CI，将高水平组与最低水平组进行比较。高n-3 PUFA摄入量与T2D相关，即使在调整混杂因素后，包括其他FA和BMI （HR 1.26; 95% CI 1.13, 1.41；高分值与低分值相比）。在超重(BMI >= 25kg/m(2))/非超重分层后，观察到总PUFA摄入量与T2D之间存在正相关，但仅限于非超重女性（HR 1.22; 95% CI 1.05, 1.42），而n-3 PUFA摄入量与两个BMI层(BMI< 25kg/m(2): HR 1.19；95% CI 1.01, 1.40, BMI >= 25kg/m(2): HR 1.38；95% ci 1.20, 1.59)。在n-3 PUFA范围内，高DPA（风险比1.41；95%可信区间1.23,1.63）和α -亚麻酸（ALA）摄入与T2D风险增加相关，但ALA的影响仅限于超重女性（风险比1.17；95%可信区间1.01,1.36）。在n-6 PUFA中，只有花生四烯酸（AA）摄入与T2D风险相关（HR 1.49; 95% CI 1.33, 1.66）。与DPA和AA的关联即使在调整了其主要来源（肉类消费）后仍然存在。PUFA的作用在FA组内是不均匀的。摄入DPA和AA可能有助于T2D的发展。
We evaluated the association between dietary estimates of fatty acid (FA) consumption and type 2 diabetes (T2D) risk in the French E3N (Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale) cohort. In total, 71 334 women without diabetes at baseline were followed up from 1993 to 2011. Diabetes was identified using questionnaires and drug-reimbursement claims, and incident cases were validated. FA consumption in 1993 was estimated from a validated dietary questionnaire. Cox regression estimated hazard ratios (HR) and 95% CI of diabetes risk, comparing the upper tertile group with the lowest. High n-3 PUFA consumption was associated with T2D even after adjustment for confounders, including other FA and BMI (HR 1.26; 95% CI 1.13, 1.41; upper tertile compared with lowest). Upon stratification by overweight (BMI >= 25kg/m(2))/non-overweight, a positive association between total PUFA consumption and T2D was observed, but it was restricted to non-overweight women (HR 1.22; 95% CI 1.05, 1.42), whereas n-3 PUFA consumption was associated with increased T2D risk in both BMI strata (BMI< 25 kg/m(2): HR 1.19; 95% CI 1.01, 1.40 and BMI >= 25kg/m(2): HR 1.38; 95% CI 1.20, 1.59). Within the n-3 PUFA, high DPA (HR 1.41; 95% CI 1.23, 1.63) and alpha-linolenic acid (ALA) intakes were associated with increased T2D risk, but the effects of ALA were restricted to overweight women (HR 1.17; 95% CI 1.01, 1.36). Within the n-6 PUFA, only arachidonic acid (AA) intake was associated with T2D risk (HR 1.49; 95% CI 1.33, 1.66). The associations with DPA and AA persisted even after adjustment of their principal source in this cohort, the consumption of meat. The effects of PUFA are heterogeneous within the FA group. Intake of DPA and AA may contribute to T2D development.