Trans-Palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in U.S. Adults: A Cohort Study
Publication: Annals of Internal Medicine
Volume 153, Number 12
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Abstract
Background:
Palmitoleic acid (cis-16:1n-7), which is produced by endogenous fat synthesis, has been linked to both beneficial and deleterious metabolic effects, potentially confounded by diverse determinants and tissue sources of endogenous production. Trans-palmitoleate (trans-16:1n-7) represents a distinctly exogenous source of 16:1n-7, unconfounded by endogenous synthesis or its determinants, that may be uniquely informative.
Objective:
To investigate whether circulating trans-palmitoleate is independently related to lower metabolic risk and incident type 2 diabetes.
Design:
Prospective cohort study from 1992 to 2006.
Setting:
Four U.S. communities.
Patients:
3736 adults in the Cardiovascular Health Study.
Measurements:
Anthropometric characteristics and levels of plasma phospholipid fatty acids, blood lipids, inflammatory markers, and glucose–insulin measured at baseline in 1992 and dietary habits measured 3 years earlier. Multivariate-adjusted models were used to investigate how demographic, clinical, and lifestyle factors independently related to plasma phospholipid trans-palmitoleate; how trans-palmitoleate related to major metabolic risk factors; and how trans-palmitoleate related to new-onset diabetes (304 incident cases). Findings were validated for metabolic risk factors in an independent cohort of 327 women.
Results:
In multivariate analyses, whole-fat dairy consumption was most strongly associated with higher trans-palmitoleate levels. Higher trans-palmitoleate levels were associated with slightly lower adiposity and, independently, with higher high-density lipoprotein cholesterol levels (1.9% across quintiles; P = 0.040), lower triglyceride levels (−19.0%; P < 0.001), a lower total cholesterol–HDL cholesterol ratio (−4.7%; P < 0.001), lower C-reactive protein levels (−13.8%; P = 0.05), and lower insulin resistance (−16.7%, P < 0.001). Trans-palmitoleate was also associated with a substantially lower incidence of diabetes, with multivariate hazard ratios of 0.41 (95% CI, 0.27 to 0.64) and 0.38 (CI, 0.24 to 0.62) in quintiles 4 and 5 versus quintile 1 (P for trend < 0.001). Findings were independent of estimated dairy consumption or other fatty acid dairy biomarkers. Protective associations with metabolic risk factors were confirmed in the validation cohort.
Limitation:
Results could be affected by measurement error or residual confounding.
Conclusion:
Circulating trans-palmitoleate is associated with lower insulin resistance, presence of atherogenic dyslipidemia, and incident diabetes. Our findings may explain previously observed metabolic benefits of dairy consumption and support the need for detailed further experimental and clinical investigation.
Primary Funding Source:
National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.
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Information & Authors
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Published In
Annals of Internal Medicine
Volume 153 • Number 12 • 21 December 2010
Pages: 790 - 799
History
Published online: 21 December 2010
Published in issue: 21 December 2010
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© 2010 American College of Physicians.
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Trans-Palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in U.S. Adults: A Cohort Study. Ann Intern Med.2010;153:790-799. [Epub 21 December 2010]. doi:10.7326/0003-4819-153-12-201012210-00005
Trans-Palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in U.S. Adults: A Cohort Study. Ann Intern Med.2010;153:790-799. [Epub 21 December 2010]. doi:10.7326/0003-4819-153-12-201012210-00005
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