The EPIC-Norfolk Study
Trans Fatty Acid Biomarkers and Incident Type 2 Diabetes: Pooled Analysis of 12 Prospective Cohort Studies in the Fatty Acids and Outcomes Research Consortium (FORCE).
Diabetes care 2021
Lai HTM, Imamura F, Korat AVA, Murphy RA, Tintle N, Bassett JK, Chen J, Kröger J, Chien KL, Senn M, Wood AC, Forouhi NG, Schulze MB, Harris WS, Vasan RS, Hu F, Giles GG, Hodge A, Djoussé L, Brouwer IA, Qian F, Sun Q, Wu JHY, Marklund M, Lemaitre RN, Siscovick DS, Fretts AM, Shadyab AH, Manson JE, Howard BV, Robinson JG, Wallace RB, Wareham NJ, Chen YI, Rotter JI, Tsai MY, Micha R, Mozaffarian D, and Fatty Acids and Outcomes Research Consortium (FORCE)
DOI : 10.2337/dc21-1756
PubMed ID : 35142845
PMCID :
Abstract
Trans fatty acids (TFAs) have harmful biologic effects that could increase the risk of type 2 diabetes (T2D), but evidence remains uncertain. We aimed to investigate the prospective associations of TFA biomarkers and T2D by conducting an individual participant-level pooled analysis.
We included data from an international consortium of 12 prospective cohorts and nested case-control studies from six nations. TFA biomarkers were measured in blood collected between 1990 and 2008 from 25,126 participants aged ≥18 years without prevalent diabetes. Each cohort conducted de novo harmonized analyses using a prespecified protocol, and findings were pooled using inverse-variance weighted meta-analysis. Heterogeneity was explored by prespecified between-study and within-study characteristics.
During a mean follow-up of 13.5 years, 2,843 cases of incident T2D were identified. In multivariable-adjusted pooled analyses, no significant associations with T2D were identified for trans/trans-18:2, relative risk (RR) 1.09 (95% CI 0.94-1.25); cis/trans-18:2, 0.89 (0.73-1.07); and trans/cis-18:2, 0.87 (0.73-1.03). Trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated with T2D (RR 0.81 [95% CI 0.67-0.99], 0.86 [0.75-0.99], and 0.84 [0.74-0.96], respectively). Findings were not significantly different according to prespecified sources of potential heterogeneity (each P ≥ 0.1).
Circulating individual trans-18:2 TFA biomarkers were not associated with risk of T2D, while trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated. Findings may reflect the influence of mixed TFA sources (industrial vs. natural ruminant), a general decline in TFA exposure due to policy changes during this period, or the relatively limited range of TFA levels.
Study : EPIC-Norfolk: The European Prospective Investigation into Cancer Norfolk Cohort