TY - JOUR

T1 - Quality of dietary fat and genetic risk of type 2 diabetes

T2 - individual participant data meta-analysis

AU - Merino, Jordi

AU - Guasch-Ferré, Marta

AU - Ellervik, Christina

AU - Dashti, Hassan S

AU - Sharp, Stephen J

AU - Wu, Peitao

AU - Overvad, Kim

AU - Sarnowski, Chloé

AU - Kuokkanen, Mikko

AU - Lemaitre, Rozenn N

AU - Justice, Anne E

AU - Ericson, Ulrika

AU - Braun, Kim V E

AU - Mahendran, Yuvaraj

AU - Frazier-Wood, Alexis C

AU - Sun, Dianjianyi

AU - Chu, Audrey Y

AU - Tanaka, Toshiko

AU - Luan, Jian'an

AU - Hong, Jaeyoung

AU - Tjønneland, Anne

AU - Ding, Ming

AU - Lundqvist, Annamari

AU - Mukamal, Kenneth

AU - Rohde, Rebecca

AU - Schulz, Christina-Alexandra

AU - Franco, Oscar H

AU - Grarup, Niels

AU - Chen, Yii-Der Ida

AU - Bazzano, Lydia

AU - Franks, Paul W

AU - Buring, Julie E

AU - Langenberg, Claudia

AU - Liu, Ching-Ti

AU - Hansen, Torben

AU - Jensen, Majken K

AU - Sääksjärvi, Katri

AU - Psaty, Bruce M

AU - Young, Kristin L

AU - Hindy, George

AU - Sandholt, Camilla Helene

AU - Ridker, Paul M

AU - Ordovas, Jose M

AU - Meigs, James B

AU - Pedersen, Oluf

AU - Kraft, Peter

AU - Perola, Markus

AU - North, Kari E

AU - Orho-Melander, Marju

AU - Voortman, Trudy

AU - Toft, Ulla

AU - Rotter, Jerome I

AU - Qi, Lu

AU - Forouhi, Nita G

AU - Mozaffarian, Dariush

AU - Sørensen, Thorkild I A

AU - Stampfer, Meir J

AU - Männistö, Satu

AU - Selvin, Elizabeth

AU - Imamura, Fumiaki

AU - Salomaa, Veikko

AU - Hu, Frank B

AU - Wareham, Nick J

AU - Dupuis, Josée

AU - Smith, Caren E

AU - Kilpeläinen, Tuomas O

AU - Chasman, Daniel I

AU - Florez, Jose C

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2019

Y1 - 2019

N2 - OBJECTIVE: To investigate whether the genetic burden of type 2 diabetes modifies the association between the quality of dietary fat and the incidence of type 2 diabetes.DESIGN: Individual participant data meta-analysis.DATA SOURCES: Eligible prospective cohort studies were systematically sourced from studies published between January 1970 and February 2017 through electronic searches in major medical databases (Medline, Embase, and Scopus) and discussion with investigators.REVIEW METHODS: Data from cohort studies or multicohort consortia with available genome-wide genetic data and information about the quality of dietary fat and the incidence of type 2 diabetes in participants of European descent was sought. Prospective cohorts that had accrued five or more years of follow-up were included. The type 2 diabetes genetic risk profile was characterized by a 68-variant polygenic risk score weighted by published effect sizes. Diet was recorded by using validated cohort-specific dietary assessment tools. Outcome measures were summary adjusted hazard ratios of incident type 2 diabetes for polygenic risk score, isocaloric replacement of carbohydrate (refined starch and sugars) with types of fat, and the interaction of types of fat with polygenic risk score.RESULTS: Of 102 305 participants from 15 prospective cohort studies, 20 015 type 2 diabetes cases were documented after a median follow-up of 12 years (interquartile range 9.4-14.2). The hazard ratio of type 2 diabetes per increment of 10 risk alleles in the polygenic risk score was 1.64 (95% confidence interval 1.54 to 1.75, I2=7.1%, τ2=0.003). The increase of polyunsaturated fat and total omega 6 polyunsaturated fat intake in place of carbohydrate was associated with a lower risk of type 2 diabetes, with hazard ratios of 0.90 (0.82 to 0.98, I2=18.0%, τ2=0.006; per 5% of energy) and 0.99 (0.97 to 1.00, I2=58.8%, τ2=0.001; per increment of 1 g/d), respectively. Increasing monounsaturated fat in place of carbohydrate was associated with a higher risk of type 2 diabetes (hazard ratio 1.10, 95% confidence interval 1.01 to 1.19, I2=25.9%, τ2=0.006; per 5% of energy). Evidence of small study effects was detected for the overall association of polyunsaturated fat with the risk of type 2 diabetes, but not for the omega 6 polyunsaturated fat and monounsaturated fat associations. Significant interactions between dietary fat and polygenic risk score on the risk of type 2 diabetes (P>0.05 for interaction) were not observed.CONCLUSIONS: These data indicate that genetic burden and the quality of dietary fat are each associated with the incidence of type 2 diabetes. The findings do not support tailoring recommendations on the quality of dietary fat to individual type 2 diabetes genetic risk profiles for the primary prevention of type 2 diabetes, and suggest that dietary fat is associated with the risk of type 2 diabetes across the spectrum of type 2 diabetes genetic risk.

AB - OBJECTIVE: To investigate whether the genetic burden of type 2 diabetes modifies the association between the quality of dietary fat and the incidence of type 2 diabetes.DESIGN: Individual participant data meta-analysis.DATA SOURCES: Eligible prospective cohort studies were systematically sourced from studies published between January 1970 and February 2017 through electronic searches in major medical databases (Medline, Embase, and Scopus) and discussion with investigators.REVIEW METHODS: Data from cohort studies or multicohort consortia with available genome-wide genetic data and information about the quality of dietary fat and the incidence of type 2 diabetes in participants of European descent was sought. Prospective cohorts that had accrued five or more years of follow-up were included. The type 2 diabetes genetic risk profile was characterized by a 68-variant polygenic risk score weighted by published effect sizes. Diet was recorded by using validated cohort-specific dietary assessment tools. Outcome measures were summary adjusted hazard ratios of incident type 2 diabetes for polygenic risk score, isocaloric replacement of carbohydrate (refined starch and sugars) with types of fat, and the interaction of types of fat with polygenic risk score.RESULTS: Of 102 305 participants from 15 prospective cohort studies, 20 015 type 2 diabetes cases were documented after a median follow-up of 12 years (interquartile range 9.4-14.2). The hazard ratio of type 2 diabetes per increment of 10 risk alleles in the polygenic risk score was 1.64 (95% confidence interval 1.54 to 1.75, I2=7.1%, τ2=0.003). The increase of polyunsaturated fat and total omega 6 polyunsaturated fat intake in place of carbohydrate was associated with a lower risk of type 2 diabetes, with hazard ratios of 0.90 (0.82 to 0.98, I2=18.0%, τ2=0.006; per 5% of energy) and 0.99 (0.97 to 1.00, I2=58.8%, τ2=0.001; per increment of 1 g/d), respectively. Increasing monounsaturated fat in place of carbohydrate was associated with a higher risk of type 2 diabetes (hazard ratio 1.10, 95% confidence interval 1.01 to 1.19, I2=25.9%, τ2=0.006; per 5% of energy). Evidence of small study effects was detected for the overall association of polyunsaturated fat with the risk of type 2 diabetes, but not for the omega 6 polyunsaturated fat and monounsaturated fat associations. Significant interactions between dietary fat and polygenic risk score on the risk of type 2 diabetes (P>0.05 for interaction) were not observed.CONCLUSIONS: These data indicate that genetic burden and the quality of dietary fat are each associated with the incidence of type 2 diabetes. The findings do not support tailoring recommendations on the quality of dietary fat to individual type 2 diabetes genetic risk profiles for the primary prevention of type 2 diabetes, and suggest that dietary fat is associated with the risk of type 2 diabetes across the spectrum of type 2 diabetes genetic risk.

KW - Adult

KW - Alleles

KW - Diabetes Mellitus, Type 2/epidemiology

KW - Diet/adverse effects

KW - Dietary Fats/adverse effects

KW - Female

KW - Genome-Wide Association Study

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Risk Factors

U2 - 10.1136/bmj.l4292

DO - 10.1136/bmj.l4292

M3 - Journal article

C2 - 31345923

VL - 366

SP - l4292

JO - The BMJ

JF - The BMJ

SN - 0959-8146

ER -