Alpha-Linolenic Acid and Mortality Among Adults With Type 2 Diabetes: Findings From Two National Cohorts

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-06-22 DOI:10.1111/1753-0407.70110

Boyang Chen, Qi Wu, Sibo Liu, Hongkun Di, Wen Hu, Tianzhu Qin, Yushuang Wang, Rong Chen, Han Wang, Ying Chen, Xiang Cheng, Jiawei Yin, Liegang Liu, Zhilei Shan

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Abstract

Background

Dietary alpha-linolenic acid (ALA) regulates lipid metabolism and insulin sensitivity, but few studies have investigated the association between ALA and the risk of mortality among adults with type 2 diabetes (T2D). This study examines whether increasing dietary ALA intake contributes to the long-term survival of adults with T2D.

Methods

This cohort study included 9603 participants with T2D, including 7953 adults from the National Health and Nutrition Examination Survey (NHANES; 1999–2018) and 1650 adults from the China Health and Nutrition Survey (CHNS; 1997–2011). Dietary information was collected through 24-h dietary recalls. Cox proportional hazards regression was employed to estimate hazard ratios (HRs) and 95% CIs for mortality from all-cause and cardiovascular disease (CVD).

Results

During 75 535 person-years of follow-up, a total of 2468 deaths were documented. After multivariate adjustment, the pooled HRs (95% CIs) of all-cause mortality were 1.00, 0.87 (0.76–0.99), and 0.79 (0.67–0.94) across tertiles of ALA (p_trend = 0.01). There was a linear inverse relationship between ALA intake and all-cause mortality, demonstrating a 9% (HR: 0.91;95% CI: 0.85_0.97) lower risk of all-cause mortality with each 1 g/day increase of dietary ALA intake in the pooled analysis (p_nonlinear > 0.05). In addition, ALA intake was inversely associated with CVD mortality, and HR comparing the highest with the lowest tertile was 0.68 (0.50–0.91; p_trend = 0.01). Consistent results were observed in both the stratified and sensitivity analyses.

Conclusions

Higher dietary ALA intake was associated with a lower risk of all-cause and CVD mortality among adults with T2D.

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α -亚麻酸与成人2型糖尿病患者的死亡率：来自两个国家队列的研究结果

膳食α -亚麻酸（ALA）调节脂质代谢和胰岛素敏感性，但很少有研究调查ALA与成人2型糖尿病（T2D）患者死亡风险之间的关系。本研究探讨了增加饮食中ALA的摄入量是否有助于成年T2D患者的长期生存。方法本队列研究纳入9603例T2D患者，包括7953名来自国家健康与营养检查调查(NHANES；1999-2018年)和来自中国健康与营养调查(CHNS；1997 - 2011)。通过24小时饮食回顾收集饮食信息。采用Cox比例风险回归估计全因死亡率和心血管疾病死亡率的风险比（hr）和95% ci。结果在75 535人年的随访中，共有2468人死亡。多因素调整后，ALA各分位数全因死亡率的合并hr （95% ci）分别为1.00、0.87（0.76 ~ 0.99）和0.79 (0.67 ~ 0.94)（p趋势= 0.01）。ALA摄入量与全因死亡率呈线性负相关，合并分析显示，每增加1 g/天的ALA摄入量，全因死亡率降低9% (HR: 0.91;95% CI: 0.85 ~ 0.97) （p非线性>； 0.05）。此外，ALA摄入量与CVD死亡率呈负相关，最高和最低的比值为0.68 (0.50-0.91；p趋势= 0.01)。在分层分析和敏感性分析中观察到一致的结果。结论：较高的饮食ALA摄入量与T2D成人全因死亡率和心血管疾病死亡率降低相关。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.