Table 2.
RRs of n-3 fatty acid biomarkers and incident T2D
| Exposure | Studies, n† | Cases, n† | Analysis per interquintile range | Analysis comparing Q5 vs. Q1 | ||||
|---|---|---|---|---|---|---|---|---|
| RR (95% CI), fixed effect‡ | RR (95% CI), random effect‡ | I2 (%) | RR (95% CI), fixed effect‡ | RR (95% CI), random effect‡ | I2 (%) | |||
| ALA | ||||||||
| Phospholipids | 13 | 14,633 | 0.96 (0.91, 1.02) | 0.99 (0.88, 1.11) | 55.3 | 0.90 (0.80, 1.02) | 0.94 (0.80, 1.12) | 31.2 |
| Total plasma/serum | 7 | 1,967 | 1.03 (0.93, 1.14) | 1.06 (0.90, 1.25) | 52.8 | 1.07 (0.92, 1.24) | 1.07 (0.92, 1.24) | 0.0 |
| Cholesterol esters | 3 | 503 | 0.91 (0.72, 1.16) | 0.91 (0.72, 1.16) | 0.0 | 0.81 (0.60, 1.10) | 0.81 (0.60, 1.10) | 0.0 |
| Triglycerides | 1 | 101 | 0.92 (0.46, 1.83) | 0.92 (0.46, 1.83) | — | 0.80 (0.36, 1.75) | 0.80 (0.36, 1.75) | — |
| Adipose tissue | 1 | 99 | 0.65 (0.36, 1.16) | 0.65 (0.36, 1.16) | — | 0.52 (0.24, 1.10) | 0.52 (0.24, 1.10) | — |
| Overall | 20 | 16,693 | 0.97 (0.92, 1.02) | 0.98 (0.90, 1.08) | 48.6 | 0.94 (0.85, 1.03) | 0.96 (0.87, 1.07) | 16.7 |
| EPA | ||||||||
| Phospholipids | 13 | 14,633 | 0.92 (0.86, 0.97) | 0.94 (0.83, 1.07) | 50.2 | 0.82 (0.73, 0.92) | 0.81 (0.72, 0.92) | 0.0 |
| Total plasma/serum | 7 | 1,967 | 0.93 (0.86, 1.00) | 0.90 (0.79, 1.02) | 42.8 | 0.81 (0.70, 0.94) | 0.81 (0.64, 1.03) | 54.4 |
| Cholesterol esters | 3 | 503 | 0.91 (0.72, 1.17) | 0.92 (0.72, 1.17) | 0.0 | 0.90 (0.66, 1.25) | 0.90 (0.66, 1.25) | 0.0 |
| Triglycerides | 1 | 101 | 1.05 (0.79, 1.39) | 1.05 (0.79, 1.39) | — | 0.92 (0.49, 1.72) | 0.92 (0.49, 1.72) | — |
| Adipose tissue | 1 | 99 | 1.12 (0.59, 2.13) | 1.12 (0.59, 2.13) | — | 0.91 (0.44, 1.89) | 0.91 (0.44, 1.89) | — |
| Overall | 20 | 16,693 | 0.92 (0.87, 0.96) | 0.92 (0.85, 0.996) | 39.0 | 0.82 (0.74, 0.89) | 0.81 (0.74, 0.89) | 0.0 |
| DPA | ||||||||
| Phospholipids | 13 | 14,633 | 0.78 (0.71, 0.85) | 0.83 (0.72, 0.94) | 32.1 | 0.78 (0.70, 0.87) | 0.78 (0.70, 0.87) | 0.0 |
| Total plasma/serum | 6 | 1,316 | 0.93 (0.84, 1.04) | 0.80 (0.62, 1.03) | 75.9 | 0.73 (0.61, 0.88) | 0.73 (0.60, 0.89) | 9.1 |
| Triglycerides | 1 | 101 | 0.62 (0.31, 1.24) | 0.62 (0.31, 1.24) | — | 0.54 (0.27, 1.05) | 0.54 (0.27, 1.05) | — |
| Adipose tissue | 1 | 99 | 1.69 (1.03, 2.77) | 1.69 (1.03, 2.77) | — | 1.87 (0.92, 3.79) | 1.87 (0.92, 3.79) | — |
| Overall | 18 | 15,793 | 0.79 (0.73, 0.85) | 0.83 (0.74, 0.94) | 44.5 | 0.77 (0.70, 0.85) | 0.77 (0.70, 0.85) | 0.0 |
| DHA | ||||||||
| Phospholipids | 13 | 14,633 | 0.80 (0.72, 0.89) | 0.80 (0.72, 0.89) | 0.0 | 0.76 (0.66, 0.87) | 0.76 (0.66, 0.88) | 3.6 |
| Total plasma/serum | 7 | 1,967 | 0.81 (0.72, 0.91) | 0.81 (0.70, 0.93) | 17.3 | 0.76 (0.65, 0.88) | 0.76 (0.65, 0.88) | 0.0 |
| Cholesterol esters | 3 | 503 | 0.93 (0.73, 1.17) | 0.93 (0.73, 1.17) | 0.0 | 0.85 (0.64, 1.15) | 0.85 (0.64, 1.15) | 0.0 |
| Triglycerides | 1 | 101 | 1.00 (0.69, 1.46) | 1.00 (0.69, 1.46) | — | 0.67 (0.37, 1.19) | 0.67 (0.37, 1.19) | — |
| Adipose tissue | 1 | 99 | 1.53 (0.99, 2.37) | 1.53 (0.99, 2.37) | — | 1.81 (0.89, 3.67) | 1.81 (0.89, 3.67) | — |
| Overall | 20 | 16,693 | 0.82 (0.76, 0.89) | 0.83 (0.75, 0.92) | 27.8 | 0.77 (0.70, 0.85) | 0.78 (0.70, 0.88) | 14.7 |
| EPA + DPA + DHA§ | ||||||||
| Phospholipids | 13 | 14,633 | 0.78 (0.70, 0.87) | 0.78 (0.70, 0.87) | 0.0 | 0.71 (0.62, 0.80) | 0.71 (0.62, 0.81) | 0.0 |
| Total plasma/serum | 7 | 1,967 | 0.84 (0.75, 0.94) | 0.83 (0.71, 0.97) | 31.1 | 0.77 (0.66, 0.89) | 0.77 (0.66, 0.91) | 7.4 |
| Cholesterol esters | 3 | 503 | 0.90 (0.71, 1.16) | 0.90 (0.71, 1.16) | 0.0 | 0.87 (0.64, 1.20) | 0.87 (0.64, 1.20) | 0.0 |
| Triglycerides | 1 | 101 | 0.98 (0.66, 1.48) | 0.98 (0.66, 1.48) | — | 0.68 (0.36, 1.26) | 0.68 (0.36, 1.26) | — |
| Adipose tissue | 1 | 99 | 1.55 (0.96, 2.48) | 1.55 (0.96, 2.48) | — | 2.11 (1.01, 4.41) | 2.11 (1.01, 4.41) | — |
| Overall | 20 | 16,693 | 0.81 (0.75, 0.88) | 0.82 (0.75, 0.90) | 19.3 | 0.74 (0.67, 0.82) | 0.77 (0.68, 0.86) | 20.0 |
†
Q, quintile. Multiple lipid fractions were available for some studies, but only one lipid fraction was used for the overall analysis.
‡
Effect estimates were pooled with use of inverse variance–weighted fixed-effects or random-effects meta-analysis.
§
For Uppsala Longitudinal Study of Adult Men-50 (ULSAM-50) and Chin-Shan Community Cardiovascular Cohort study (CCCC), DPA measurements were not available. The risk estimates for EPA + DHA were included in this pooled result.