Table 3.
Associations between total n-6 PUFAs and LA and type 2 diabetes risk in NHS, NHSII, and HPFS*
| Quintiles of fatty acid intake (% energy) |
P for trend | |||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | ||
| n-6 PUFAs | ||||||
| NHS | ||||||
| Median (range) | 2.62 (0.66, 3.09) | 3.47 (3.09, 3.82) | 4.16 (3.82, 4.53) | 4.95 (4.53, 5.49) | 6.32 (5.49, 20.8) | |
| Cases/person-years | 1,800/447,983 | 1,780/448,767 | 1,922/448,995 | 1,882/448,948 | 1,991/448,694 | |
| Model 1 | 1 | 1.01 (0.94, 1.07) | 1.10 (1.03, 1.17) | 1.08 (1.01, 1.15) | 1.16 (1.08, 1.23) | <0.001 |
| Model 2 | 1 | 0.96 (0.90, 1.03) | 1.02 (0.95, 1.09) | 0.97 (0.90, 1.03) | 1.01 (0.95, 1.08) | 0.71 |
| Model 3 | 1 | 0.95 (0.89, 1.02) | 1.00 (0.93, 1.07) | 0.94 (0.87, 1.01) | 0.97 (0.90, 1.06) | 0.53 |
| NHSII | ||||||
| Median (range) | 3.41 (0.87, 3.84) | 4.17 (3.84, 4.46) | 4.76 (4.46, 5.08) | 5.43 (5.08, 5.88) | 6.60 (5.88, 24.77) | |
| Cases/person-years | 953/355,884 | 996/357,336 | 1,061/358,269 | 1,189/358,491 | 1,261/358,163 | |
| Model 1 | 1 | 1.04 (0.95, 1.13) | 1.09 (0.99, 1.19) | 1.19 (1.09, 1.30) | 1.22 (1.12, 1.33) | <0.001 |
| Model 2 | 1 | 0.96 (0.88, 1.05) | 0.95 (0.86, 1.03) | 0.99 (0.91, 1.08) | 0.98 (0.90, 1.07) | >0.99 |
| Model 3 | 1 | 0.93 (0.85, 1.02) | 0.91 (0.82, 1.00) | 0.94 (0.85, 1.04) | 0.91 (0.80, 1.02) | 0.21 |
| HPFS | ||||||
| Median (range) | 3.53 (0.94, 4.04) | 4.43 (4.04, 4.79) | 5.13 (4.79, 5.50) | 5.91 (5.50, 6.43) | 7.24 (6.43, 21.1) | |
| Cases/person-years | 691/179,560 | 688/181,090 | 756/181,399 | 743/181,415 | 729/180,777 | |
| Model 1 | 1 | 1.00 (0.90, 1.11) | 1.12 (1.01, 1.24) | 1.09 (0.98, 1.21) | 1.07 (0.96, 1.19) | 0.11 |
| Model 2 | 1 | 0.94 (0.84, 1.04) | 1.03 (0.92, 1.14) | 0.98 (0.88, 1.09) | 0.97 (0.87, 1.08) | 0.83 |
| Model 3 | 1 | 0.86 (0.77, 0.96) | 0.90 (0.80, 1.01) | 0.82 (0.73, 0.92) | 0.74 (0.65, 0.85) | <0.001 |
| Pooled† | ||||||
| Model 2 | 1 | 0.96 (0.91, 1.00) | 1.00 (0.95, 1.05) | 0.98 (0.93, 1.02) | 0.99 (0.95, 1.04) | 0.87 |
| Model 3 | 1 | 0.93 (0.88, 0.97) | 0.95 (0.91, 1.00) | 0.92 (0.87, 0.97) | 0.91 (0.85, 0.96) | 0.001 |
| LA | ||||||
| NHS | ||||||
| Median (range) | 2.54 (0.65, 3.01) | 3.39 (3.01, 3.73) | 4.07 (3.73, 4.44) | 4.86 (4.44, 5.40) | 6.23 (5.40, 20.8) | |
| Cases/person-years | 1,800/447,964 | 1,792/448,793 | 1,907/448,907 | 1,898/449,043 | 1,978/448,681 | |
| Model 1 | 1 | 1.01 (0.95, 1.08) | 1.09 (1.02, 1.16) | 1.09 (1.02, 1.16) | 1.15 (1.08, 1.22) | <0.001 |
| Model 2 | 1 | 0.97 (0.91, 1.04) | 1.02 (0.95, 1.08) | 0.98 (0.92, 1.05) | 1.01 (0.95, 1.08) | 0.65 |
| Model 3 | 1 | 0.96 (0.89, 1.02) | 0.99 (0.93, 1.07) | 0.96 (0.89, 1.03) | 0.98 (0.91, 1.06) | 0.70 |
| NHSII | ||||||
| Median (range) | 3.33 (0.86, 3.76) | 4.08 (3.76, 4.38) | 4.68 (4.38, 4.99) | 5.35 (4.99, 5.80) | 6.51 (5.80, 24.7) | |
| Cases/person-years | 957/355,840 | 1,012/357,413 | 1,057/358,191 | 1,175/358,537 | 1,259/358,161 | |
| Model 1 | 1 | 1.05 (0.96, 1.14) | 1.08 (0.99, 1.18) | 1.17 (1.08, 1.28) | 1.22 (1.12, 1.33) | <0.001 |
| Model 2 | 1 | 0.97 (0.89, 1.07) | 0.94 (0.86, 1.03) | 0.99 (0.91, 1.08) | 0.98 (0.90, 1.07) | 0.93 |
| Model 3 | 1 | 0.95 (0.87, 1.04) | 0.91 (0.82, 1.00) | 0.94 (0.85, 1.04) | 0.93 (0.82, 1.05) | 0.33 |
| HPFS | ||||||
| Median (range) | 3.45 (0.77, 3.96) | 4.35 (3.96, 4.71) | 5.05 (4.71, 5.42) | 5.83 (5.42, 6.35) | 7.16 (6.35, 21.0) | |
| Cases/person-years | 698/179,551 | 694/181,094 | 741/181,452 | 745/181,349 | 729/180,794 | |
| Model 1 | 1 | 1.00 (0.90, 1.11) | 1.08 (0.97, 1.20) | 1.08 (0.97, 1.20) | 1.06 (0.95, 1.17) | 0.15 |
| Model 2 | 1 | 0.94 (0.84, 1.05) | 1.00 (0.90, 1.11) | 0.98 (0.88, 1.09) | 0.97 (0.87, 1.08) | 0.80 |
| Model 3 | 1 | 0.87 (0.78, 0.97) | 0.88 (0.79, 0.99) | 0.83 (0.74, 0.94) | 0.77 (0.67, 0.88) | <0.001 |
| Pooled | ||||||
| Model 2 | 1 | 0.97 (0.92, 1.01) | 0.99 (0.94, 1.04) | 0.98 (0.94, 1.03) | 0.99 (0.95, 1.04) | 0.87 |
| Model 3 | 1 | 0.94 (0.89, 0.98) | 0.95 (0.90, 1.00) | 0.93 (0.88, 0.98) | 0.92 (0.87, 0.98) | 0.005 |
*HRs and 95% CIs were calculated through the use of a Cox proportional hazards model. Model 1 was adjusted for age. Model 2 was adjusted for the model 1 variable as well as ethnicity (Caucasian, African American, Asian, or other ethnicity), smoking status (never, former, current [1–14, 15–24, or ≥25 cigarettes/day], or missing), alcohol intake ( 0.0, 0.1–4.9, 5.0–14.9, or >15.0 g/day in women and 0.0, 0.1–4.9, 5.0–29.9, or >30.0 g/day in men, or missing), family history of diabetes (yes/no), menopausal status and postmenopausal hormone use (premenopause, postmenopause [never, former, or current hormone use], or missing; for women only), physical activity (<3.0, 3.0–8.9, 9.0–17.9, 18.0–26.9, or ≥27.0 MET h/week or missing), multivitamin use (yes/no), baseline hypertension, baseline hypercholesterolemia, updated BMI (<23.0, 23.0–24.9, 25.0–29.9, 30.0–34.9, or >35.0 kg/m2 or missing), total energy intake, and intake of fruits and vegetables. Model 3 was adjusted for the model 1 and 2 variables as well as total fats, trans fats, MUFAs, and other PUFAs.
†Study estimates from three cohorts were pooled by using a fixed effects model.