Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study
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Background The results of some epidemiologic studies conducted by using questionnaires suggest that dietary fat composition influences diabetes risk. Confirmation of this finding with use of a biomarker is warranted.Objective We prospectively investigated the relation of plasma cholesterol ester (CE) and phospholipid (PL) fatty acid composition with the incidence of diabetes mellitus.Design In 2909 adults aged 45-64 y, plasma fatty acid composition was quantified by using gas-liquid chromatography and was expressed as a percentage of total fatty acids. Incident diabetes (n = 252) was identified during 9 y of follow-up.Results After adjustment for age, sex, baseline body mass index, waist-to-hip ratio, alcohol intake, cigarette smoking, physical activity, education, and parental history of diabetes, diabetes incidence was significantly and positively associated with the proportions of total saturated fatty acids in plasma CE and PL. The rate ratios of incident diabetes across quintiles of saturated fatty acids were 1.00, 1.36, 1.16, 1.60, and 2.08 (P = 0.0013) in CE and 1.00, 1.75, 1.87, 2.40, and 3.37 (P < 0.0001) in PL. In CE, the incidence of diabetes was also positively associated with the proportions of palmitic (16:0), palmitoleic (16:1n-7), and dihomo-gamma-linolenic (20:3n-6) acids and inversely associated with the proportion of linoleic acid (18:2n-6). In PL, incident diabetes was positively associated with the proportions of 16:0 and stearic acid (18:0).Conclusions The proportional saturated fatty acid composition of plasma is positively associated with the development of diabetes. Our findings with the use of this biomarker suggest indirectly that the dietary fat profile, particularly that of saturated fat, may contribute to the etiology of diabetes.
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Combination therapy with any two glucose-lowering agents is effective for lowering glucose levels.
“While combination therapy with any two agents has been shown to be effective for lowering glucose levels 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , combination therapy with three or more agents (other than SU/glinide or DPP‐4 inhibitor/GLP‐1 receptor agonist combinations) has also been shown to be effective for lowering glucose levels 47 , 48 , 49 , 50 , 51 .”
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Poor working environments or social environments may constitute an important risk factor for type 2 diabetes.
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From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [35]
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- Authors
- Wang, L., Folsom, A. R., Zheng, Z.-J., Pankow, J. S., & Eckfeldt, J. H.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 78
- Issue
- 1
- Pages
- 91-98
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W1955662609
- Cited by
- 364
- References
- 48
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 12 · 2023: 9 · 2022: 15 · 2021: 22 · 2020: 26 · 2019: 15 · 2018: 13 · 2017: 16 · 2016: 22 · 2015: 21 · 2014: 17 · 2013: 26 · 2012: 21
- FWCI
- 8.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc55020-39-0-0, n01hc55016-37-0-0, n01hc055022-024, 5r01hl040848-04, n01hc55019-35-0-1, n01hc55018-38-0-1, n01hc55015-48-0-1)
- National Heart, Lung, and Blood Institute (N01-HC55022, N01-HC-55018, N01 HC 55020, N01 HC 55019, R01-HL-40848, N01-HC55016, N01‐HC‐55015)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- plasma fatty acid composition, diabetes incidence, saturated fatty acids, phospholipid fatty acids, dietary fat, middle-aged adults, linoleic acid, palmitic acid, stearic acid, dihomo-gamma-linolenic acid, palmitoleic acid
- MeSH terms
- Cholesterol Esters, Chromatography, Gas, Diabetes Mellitus, Dietary Fats, Fatty Acids, Female, Follow-Up Studies, Humans, Male, Middle Aged, Phospholipids, Prospective Studies, Incidence
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