Fatty Acid Biomarkers and Incidence of Type 2 diabetes: A Systematic Review and Dose–Response Meta-analysis of Prospective Observational Studies

IF 12.7 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI:10.1016/j.advnut.2025.100565

Edyta Schaefer , Manuela Neuenschwander , Tim Schiemann , Nadine Iser , Christina Baechle , Nafiseh Shokri-Mashhadi , Lukas Schwingshackl , Matthias B Schulze , Sabrina Schlesinger

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引用次数: 0

Abstract

The role of dietary fat in type 2 diabetes (T2D) development remains debated. Fatty acid (FA) biomarkers may better reflect bioavailable FAs than self-reported dietary intake. We conducted a systematic review and dose–response meta-analysis investigating associations between FA biomarkers and risk of T2D, considering different biospecimens of FA measurement. PubMed and Web of Science were searched until 9 November, 2022, and a search alert was followed until 17 February, 2025. Prospective cohort studies investigating FA biomarkers and T2D risk were included. Summary relative risks (SRR) and 95% confidence intervals (CIs) for all biospecimens combined and separately were estimated using a random-effects model. Risk of bias was assessed with the Risk Of Bias In Non-randomized Studies of Interventions tool, and the certainty of evidence (CoE) was rated with the Grades of Recommendations, Assessment, Development, and Evaluation approach. We included 27 articles. Analyses of plasma phospholipids (PPL) and red blood cells (RBC) provided inverse associations between higher concentrations of specific saturated FAs (SFAs) [15:0: SRR 0.68 (95% CI: 0.56, 0.81); 17:0: 0.64 (0.41, 0.78)], n−3 polyunsaturated FAs (PUFAs) [20:5: 0.97 (0.95, 0.99), 22:6: 0.92 (0.88, 0.96)], and n−6 PUFA [18:2: 0.93 (0.91, 0.95)] and risk of T2D, with moderate CoE. In the same biospecimens, higher levels of specific monounsaturated FAs (MUFAs) [16:1n−7: 1.06 (1.03, 1.10), 18:1n−9: 1.04 (1.01, 1.06)], and n−6 PUFAs [γ−20:3: 1.07 (1.03, 1.11), γ−18:3: 2.23 (1.42, 3.50), and 20:4: 1.02 (1.01, 1.04)] were associated with higher risk of T2D. Although combined analyses across biospecimens were consistent, stronger associations were observed in PPL and RBC. Associations of specific FAs within the same class (SFAs, MUFAs, PUFAs) varied in direction regarding risk of T2D. Certain SFAs, n−3 PUFAs, and 18:2 were inversely associated with T2D risk, whereas certain MUFAs and n−6 PUFAs were positively associated. Stronger associations in PPL and RBC highlight the importance of biospecimen selection. The protocol of this study was registered a priori in PROSPERO (CRD42020184575).

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脂肪酸生物标志物和2型糖尿病的发病率：前瞻性观察性研究的系统回顾和剂量反应荟萃分析

背景：膳食脂肪在2型糖尿病（T2D）发展中的作用仍有争议。脂肪酸（FA）生物标志物可能比自我报告的饮食摄入量更能反映生物可利用脂肪酸。目的：我们进行了一项系统综述和剂量反应荟萃分析，研究了FA生物标志物与T2D风险之间的关系，考虑了不同的FA测量生物标本。方法：检索PubMed和Web of Science，截止到2022年11月9日；搜索警报一直持续到2025年2月17日。包括调查FA生物标志物和T2D风险的前瞻性队列研究。使用随机效应模型估计所有生物标本联合和单独的总相对风险（SRR）和95%置信区间（CI）。使用ROBINS-I工具评估偏倚风险，使用GRADE方法评估证据的确定性（CoE）。结果：我们纳入了27篇文章。血浆磷脂（PPL）和红细胞（RBC）的分析显示，高浓度的特异性饱和脂肪酸（sfa）之间呈负相关(15:0:SRR 0.68 (95% CI 0.56; 0.81)；17:0: 0.64 (0.41; 0.78))， n-3多不饱和脂肪酸（PUFAs）(20:5: 0.97（0.95; 0.99), 22:6: 0.92(0.88; 0.96)）和n-6 PUFA（18:2: 0.93(0.91; 0.95)）与T2D风险的关系，CoE适中。在相同的生物标本中，较高水平的特异性单不饱和脂肪酸（MUFAs） (16:1n-7: 1.06 （1.03; 1.10), 18:1n-9: 1.04(1.01; 1.06)）和n-6 PUFAs (γ-20:3: 1.07 （1.03; 1.11), γ-18:3: 2.23（1.42; 3.50）和20:4:1.02(1.01;1.04)）与较高的T2D风险相关。尽管整个生物标本的综合分析是一致的，但在PPL和RBC中观察到更强的相关性。结论：同一类型的特定FAs （sfa, MUFAs, PUFAs）在T2D风险方面的关联方向不同。某些sfa、n-3 PUFAs和18:2与T2D风险呈负相关，而某些mufa和n-6 PUFAs呈正相关。PPL和RBC之间更强的关联强调了生物标本选择的重要性。系统评价或荟萃分析的注册和注册号：本研究的方案在PROSPERO （CRD42020184575）中进行了先验注册。意义声明：该系统综述和荟萃分析首次调查了不同生物标本中FA生物标志物与T2D风险之间的剂量-反应相关性，并首次评估了这些相关性的CoE。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.