Abstract:
We evaluated the association between dietary estimates of fatty acid (FA) consumption and type 2 diabetes (T2D) risk in the French E3N (Etude Epidémiologique auprès des femmes de la Mutuelle Générale 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≥25 kg/m2)/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/m2: HR 1·19; 95 % CI 1·01, 1·40 and BMI≥25 kg/m2: 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 α-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.
摘要:
我们评估了在法国E3N(EtudeEpidémiologiqueauprèsdesfemmesdelaMutuelleGénéraledel'Education/Nationale)队列中脂肪酸(FA)消耗的饮食估计与2型糖尿病(T2D)风险之间的关系。总的来说,从1993年到2011年,对71334名基线无糖尿病的妇女进行了随访。糖尿病是通过问卷调查和药物报销申请确定的,和事件病例得到验证。1993年的FA消费量是根据经过验证的饮食问卷估算的。Cox回归估计的糖尿病风险风险比(HR)和95%CI,比较上三分位数与最低位数组。即使在校正混杂因素后,高n-3PUFA消耗也与T2D相关,包括其他FA和BMI(HR1·26;95%CI1·13,1·41;与最低相比,上限)。按超重(BMI≥25kg/m2)/非超重进行分层,观察到PUFA总消耗量与T2D呈正相关,但仅限于非超重女性(HR1·22;95%CI1·05,1·42),而n-3PUFA消耗与两个BMI等级的T2D风险增加相关(BMI<25kg/m2:HR1·19;95%CI1·01,1·40和BMI≥25kg/m2:HR1·38;95%CI1·20,1·59)。在n-3PUFA内,高DPA(HR1·41;95%CI1·23,1·63)和α-亚麻酸(ALA)摄入量与T2D风险增加有关,但ALA的作用仅限于超重女性(HR1·17;95%CI1·01,1·36)。在n-6PUFA内,只有花生四烯酸(AA)摄入与T2D风险相关(HR1·49;95%CI1·33,1·66)。即使在调整了该队列的主要来源后,与DPA和AA的关联仍然存在,肉类的消费。PUFA的作用在FA组内是异质的。摄入DPA和AA可能有助于T2D的发展。