Evidence map›Paper›PMID 25107467›Full record

Trial reportThe lancet. Diabetes & endocrinology2014

Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study.

Nita G Forouhi, Albert Koulman, Stephen J Sharp, Fumiaki Imamura, Janine Kröger, Matthias B Schulze, Francesca L Crowe, José María Huerta, Marcela Guevara, Joline W J Beulens and 37 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The lancet. Diabetes & endocrinology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 292 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
292citing papers in PubMed, 15 pooled it
30.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

292 citing papers in PubMed, 15 syntheses or guidelines pooled it, 544 citations in OpenAlex.

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232 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

47 authors at 20 institutions in 8 countries.

Nita G ForouhiMRC Epidemiology Unit, University of Cambridge, Cambridge, UK. Electronic address: nita.forouhi@mrc-epid.cam.ac.uk.
Albert KoulmanMRC Human Nutrition Research, Cambridge, UK.
Stephen J SharpMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Fumiaki ImamuraMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Janine KrögerGerman Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany.
Matthias B SchulzeGerman Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany.
Francesca L CroweNuffield Department of Medicine, University of Oxford, Oxford, UK.
José María HuertaDepartment of Epidemiology, Murcia Regional Health Council, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain.
Marcela GuevaraCIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain; Navarre Public Health Institute (ISPN), Pamplona, Spain.
Joline W J BeulensUniversity Medical Center Utrecht, Utrecht, Netherlands.
Geertruida J van WoudenberghWageningen University, Wageningen, Netherlands.
Laura WangMRC Human Nutrition Research, Cambridge, UK.
Keith SummerhillMRC Human Nutrition Research, Cambridge, UK.
Julian L GriffinMRC Human Nutrition Research, Cambridge, UK.
Edith J M FeskensWageningen University, Wageningen, Netherlands.
Pilar AmianoCIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain; Public Health Division of Gipuzkoa, San Sebastian, Spain; Instituto BIO-Donostia, Basque Government, San Sebastian, Spain.
Heiner BoeingGerman Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany.
Françoise Clavel-ChapelonInserm, CESP, U1018, Villejuif, France; Univ Paris-Sud, UMRS 1018, Villejuif, France; Gustave Roussy Institute, F-94800 Villejuif, France.
Laureen DartoisInserm, CESP, U1018, Villejuif, France; Univ Paris-Sud, UMRS 1018, Villejuif, France; Gustave Roussy Institute, F-94800 Villejuif, France.
Guy FagherazziInserm, CESP, U1018, Villejuif, France; Univ Paris-Sud, UMRS 1018, Villejuif, France; Gustave Roussy Institute, F-94800 Villejuif, France.
Paul W FranksLund University, Malmö, Sweden; Umeå University, Umeå, Sweden.
Carlos GonzalezCatalan Institute of Oncology (ICO), Barcelona, Spain.
Marianne Uhre JakobsenDepartment of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
Rudolf KaaksGerman Cancer Research Centre (DKFZ), Heidelberg, Germany.
Timothy J KeyNuffield Department of Medicine, University of Oxford, Oxford, UK.
Kay-Tee KhawDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Tilman KühnGerman Cancer Research Centre (DKFZ), Heidelberg, Germany.
Amalia MattielloDipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
Peter M NilssonLund University, Malmö, Sweden.
Kim OvervadDepartment of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark; Aalborg University Hospital, Aalborg, Denmark.
Valeria PalaEpidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Domenico PalliCancer Research and Prevention Institute (ISPO), Florence, Italy.
J Ramón QuirósPublic Health Directorate, Asturias, Spain.
Olov RolandssonUmeå University, Umeå, Sweden.
Nina RoswallDanish Cancer Society, Copenhagen, Denmark.
Carlotta SacerdoteUnit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital-University of Turin and Centre for Cancer Prevention (CPO), Turin, Italy; Human Genetics Foundation (HuGeF), Turin, Italy.
María-José SánchezCIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain; Andalusian School of Public Health, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain.
Nadia SlimaniInternational Agency for Research on Cancer, Lyon, France.
Annemieke M W SpijkermanNational Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
Anne TjonnelandDanish Cancer Society Research Center, Copenhagen, Denmark.
Maria-José TormoDepartment of Epidemiology, Murcia Regional Health Council, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain; Department of Health and Social Sciences, Universidad de Murcia, Spain.
Rosario TuminoAssociazione Italiana Registri Tumori, Dipartimento di Prevenzione Medica, Azienda Sanitaria Provinciale, Ragusa, Italy; Aire Onlus, Ragusa, Italy.
Daphne L van der ANational Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
Yvonne T van der SchouwUniversity Medical Center Utrecht, Utrecht, Netherlands.
Claudia LangenbergMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Elio RiboliSchool of Public Health, Imperial College London, London, UK.
Nicholas J WarehamMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
MRC Human Nutrition Research · GBCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública · ESGerman Institute of Human Nutrition · DEMRC Epidemiology Unit · GBUniversity of Cambridge · GBAarhus University · DKDanish Cancer Society · DKLund University · SENational Institute for Public Health and the Environment · NLUniversity Medical Center Utrecht · NLUniversity of Oxford · GBWageningen University & Research · NLAgenzia Regionale Sanitaria della Puglia · ITAndalusian School of Public Health · ESBasque Government · ESCentre International de Recherche sur le Cancer · FRFederico II University Hospital · ITFondazione IRCCS Istituto Nazionale dei Tumori · ITGerman Cancer Research Center · DEGobierno del Principado de Asturias · ES

Funding

Cancer Research UK 16491Medical Research Council G0401527Medical Research Council G1000143Medical Research Council MC_U106179471Medical Research Council MC_UD99999906Medical Research Council MC_UP_A090_1006Medical Research Council MC_UP_A100_1003Medical Research Council MC_UU_12015/1Medical Research Council MC_UU_12015/5World Health Organization 001
6 · The paper itself

Abstract

backgroundConflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2 diabetes in EPIC-InterAct participants.

methodsThe EPIC-InterAct case-cohort study includes 12,403 people with incident type 2 diabetes and a representative subcohort of 16,154 individuals who were selected from a cohort of 340.234 European participants with 3·99 million person-years of follow-up (the EPIC study). Incident type 2 diabetes was ascertained until Dec 31, 2007, by a review of several sources of evidence. Gas chromatography was used to measure the distribution of fatty acids in plasma phospholipids (mol%); samples from people with type 2 diabetes and subcohort participants were processed in a random order by centre, and laboratory staff were masked to participant characteristics. We estimated country-specific hazard ratios (HRs) for associations per SD of each SFA with incident type 2 diabetes using Prentice-weighted Cox regression, which is weighted for case-cohort sampling, and pooled our findings using random-effects meta-analysis.

findingsSFAs accounted for 46% of total plasma phospholipid fatty acids. In adjusted analyses, different individual SFAs were associated with incident type 2 diabetes in opposing directions. Even-chain SFAs that were measured (14:0 [myristic acid], 16:0 [palmitic acid], and 18:0 [stearic acid]) were positively associated with incident type 2 diabetes (HR [95% CI] per SD difference: myristic acid 1·15 [95% CI 1·09-1·22], palmitic acid 1·26 [1·15-1·37], and stearic acid 1·06 [1·00-1·13]). By contrast, measured odd-chain SFAs (15:0 [pentadecanoic acid] and 17:0 [heptadecanoic acid]) were inversely associated with incident type 2 diabetes (HR [95% CI] per 1 SD difference: 0·79 [0·73-0·85] for pentadecanoic acid and 0·67 [0·63-0·71] for heptadecanoic acid), as were measured longer-chain SFAs (20:0 [arachidic acid], 22:0 [behenic acid], 23:0 [tricosanoic acid], and 24:0 [lignoceric acid]), with HRs ranging from 0·72 to 0·81 (95% CIs ranging between 0·61 and 0·92). Our findings were robust to a range of sensitivity analyses.

interpretationDifferent individual plasma phospholipid SFAs were associated with incident type 2 diabetes in opposite directions, which suggests that SFAs are not homogeneous in their effects. Our findings emphasise the importance of the recognition of subtypes of these fatty acids. An improved understanding of differences in sources of individual SFAs from dietary intake versus endogenous metabolism is needed.

fundingEU FP6 programme, Medical Research Council Epidemiology Unit, Medical Research Council Human Nutrition Research, and Cambridge Lipidomics Biomarker Research Initiative.

Indexed as

Case-Control StudiesDiabetes Mellitus, Type 2Fatty AcidsFemaleHumansMaleMiddle AgedPhospholipidsProspective StudiesFatty AcidsPhospholipids

Identifiers

PMID25107467
PMCPMC4196248
OpenAlexW2168530080

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.