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Diabetes Care:反式脂肪酸生物标志物与2型糖尿病发病:脂肪酸和结果研究联盟(FORCE)中12个前瞻性队列研究的汇总分析

2022-02-20 从医路漫漫 MedSci原创

反式脂肪酸(Trans fatty acids, TFAs)具有有害的生物学效应,可增加2型糖尿病(type 2 diabetes, T2D)的风险,但证据尚不确定。

目的:反式脂肪酸(Trans fatty acids, TFAs)具有有害的生物学效应,可增加2型糖尿病(type 2 diabetes, T2D)的风险,但证据尚不确定。我们的目的是通过进行个体参与者水平的汇总分析来研究TFA生物标记物和T2D的前瞻性关联。

研究设计和方法:我们的数据来自一个由12个前瞻性队列和6个国家的嵌套病例对照研究组成的国际联盟。在1990年至2008年间,25,126名年龄≥18岁且无糖尿病的参与者的血液中检测了TFA生物标志物。每个队列使用预先指定的方案进行了从头协调分析,并使用反方差加权meta分析汇总研究结果。通过预先规定的研究间和研究内特征来探讨异质性。

结果:在平均13.5年的随访期间,共发现2843例T2D病例。在多变量调整的汇总分析中,反式-18:2与T2D无显著相关性,相对风险(RR)为1.09 (95% CI 0.94-1.25);反式-18:2, 0.89 (0.73 - -1.07);反式-18:2, 0.87 (0.73-1.03)、反式-16:1n-9、全反式-18:1和全反式-18:2与T2D呈负相关(RR分别为0.81 [95% CI 0.67-0.99]、0.86[0.75-0.99]和0.84[0.74-0.96])。根据预先指定的潜在异质性来源,结果没有显著差异(每个P≥0.1)。

表1 10个前瞻性队列研究中2型糖尿病的确定

图1将2型糖尿病的相对风险按五分位区间(反式-16:1n9号文献中第1和第5分位中点的差值)进行汇总。trans-16:1n-9和2型糖尿病之间的关联通过多变量模型进行评估,调整了年龄、性别、种族、场地(如果适用)、教育程度、职业、体育活动、吸烟、饮酒、高血压、血脂异常、冠心病、体重指数、腰围、循环的棕榈酸,循环的硬脂酸,循环的亚油酸和甘油三酯。使用反方差加权固定效应荟萃分析对结果进行汇总。

图2将2型糖尿病的相对风险按总反式-18:1的五分位数区间(第1和第5分位数中点的差值)汇总。全反式-18:1和2型糖尿病之间的关系通过多变量模型进行评估,调整了年龄、性别、种族、场地(如适用)、教育程度、职业、体育活动、吸烟、饮酒、高血压、血脂异常、冠心病、体重指数、腰围、循环的棕榈酸,循环的硬脂酸,循环的亚油酸和甘油三酯。使用反方差加权固定效应荟萃分析对结果进行汇总。如果研究中有多种生物标志物,则根据其反映长期膳食摄入的能力(按偏好顺序)选择一种进行整体分析:红细胞膜磷脂(RBC)、血浆磷脂(PL)和总血浆(TP)。

结论:循环中的个体反式-18:2 TFA生物标志物与T2D风险无关,而反式-16:1n-9、全反式-18:1和全反式-18:2呈负相关。研究结果可能反映了混合TFA来源(工业反刍动物与自然反刍动物)的影响、这一时期由于政策变化导致TFA暴露量普遍下降,或者TFA水平范围相对有限。

原文出处:Lai HTM,  Imamura F,  Korat AVA,et al.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 2022 Feb 10

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  8. 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    2022-02-22 zexyw04
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