TY - THES A1 - Prada, Marcela T1 - Fatty acid biomarkers of intake and metabolism and their association with type 2 diabetes N2 - Background: The role of fatty acid (FA) intake and metabolism in type 2 diabetes (T2D) incidence is controversial. Some FAs are not synthesised endogenously and, therefore, these circulating FAs reflect dietary intake, for example, the trans fatty acids (TFAs), saturated odd chain fatty acids (OCFAs), and linoleic acid, an n-6 polyunsaturated fatty acids (PUFA). It remains unclear if intake of TFA influence T2D risk and whether industrial TFAs (iTFAs) and ruminant TFAs (rTFAs) exert the same effect. Unlike even chain saturated FAs, the OCFAs have been inversely associated with T2D risk, but this association is poorly understood. Furthermore, the associations of n-6 PUFAs intake with T2D risk are still debated, while delta-5 desaturase (D5D), a key enzyme in the metabolism of PUFAs, has been consistently related to T2D risk. To better understand these relationships, the FA composition in circulating lipid fractions can be used as biomarkers of dietary intake and metabolism. The exploration of TFAs subtypes in plasma phospholipids and OCFAs and n-6 PUFAs within a wide range of lipid classes may give insights into the pathophysiology of T2D. Aim: This thesis aimed mainly to analyse the association of TFAs, OCFAs and n-6 PUFAs with self-reported dietary intake and prospective T2D risk, using seven types of TFAs in plasma phospholipids and deep lipidomics profiling data from fifteen lipid classes. Methods: A prospective case-cohort study was designed within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study, including all the participants who developed T2D (median follow-up 6.5 years) and a random subsample of the full cohort (subcohort: n=1248; T2D cases: n=820). The main analyses included two lipid profiles. The first was an assessment of seven TFA in plasma phospholipids, with a modified method for analysis of FA with very low abundances. The second lipid profile was derived from a high-throughout lipid profiling technology, which identified 940 distinct molecular species and allowed to quantify OCFAs and PUFAs composition across 15 lipid classes. Delta-5 desaturase (D5D) activity was estimated as 20:4/20:3-ratio. Using multivariable Cox regression models, we examined the associations of TFA subtypes with incident T2D and class-specific associations of OCFA and n-6 PUFAs with T2D risk. Results: 16:1n-7t, 18:1n-7t, and c9t11-CLA were positively correlated with the intake of fat-rich dairy foods. iTFA 18:1 isomers were positively correlated with margarine. After adjustment for confounders and other TFAs, higher plasma phospholipid concentrations of two rTFAs were associated with a lower incidence of T2D: 18:1n-7t and t10c12-CLA. In contrast, the rTFA c9t11-CLA was associated with a higher incidence of T2D. rTFA 16:1n-7t and iTFAs (18:1n-6t, 18:1n-9t, 18:2n-6,9t) were not statistically significantly associated with T2D risk. We observed heterogeneous integration of OCFA in different lipid classes, and the contribution of 15:0 versus 17:0 to the total OCFA abundance differed across lipid classes. Consumption of fat-rich dairy and fiber-rich foods were positively and red meat inversely correlated to OCFA abundance in plasma phospholipid classes. In women only, higher abundances of 15:0 in phosphatidylcholines (PC) and diacylglycerols (DG), and 17:0 in PC, lysophosphatidylcholines (LPC), and cholesterol esters (CE) were inversely associated with T2D risk. In men and women, a higher abundance of 15:0 in monoacylglycerols (MG) was also inversely associated with T2D. Conversely, a higher 15:0 concentration in LPC and triacylglycerols (TG) was associated with higher T2D risk in men. Women with a higher concentration of 17:0 as free fatty acids (FFA) also had higher T2D incidence. The integration of n-6 PUFAs in lipid classes was also heterogeneous. 18:2 was highly abundant in phospholipids (particularly PC), CE, and TG; 20:3 represented a small fraction of FA in most lipid classes, and 20:4 accounted for a large proportion of circulating phosphatidylinositol (PI) and phosphatidylethanolamines (PE). Higher concentrations of 18:2 were inversely associated with T2D risk, especially within DG, TG, and LPC. However, 18:2 as part of MG was positively associated with T2D risk. Higher concentrations of 20:3 in phospholipids (PC, PE, PI), FFA, CE, and MG were linked to higher T2D incidence. 20:4 was unrelated to risk in most lipid classes, except positive associations were observed for 20:4 enriched in FFA and PE. The estimated D5D activities in PC, PE, PI, LPC, and CE were inversely associated with T2D and explained variance of estimated D5D activity by genomic variation in the FADS locus was only substantial in those lipid classes. Conclusion: The TFAs' conformation is essential in their relationship to diabetes risk, as indicated by plasma rTFA subtypes concentrations having opposite directions of associations with diabetes risk. Plasma OCFA concentration is linked to T2D risk in a lipid class and sex-specific manner. Plasma n-6 PUFA concentrations are associated differently with T2D incidence depending on the specific FA and the lipid class. Overall, these results highlight the complexity of circulating FAs and their heterogeneous association with T2D risk depending on the specific FA structure, lipid class, and sex. My results extend the evidence of the relationship between diet, lipid metabolism, and subsequent T2D risk. In addition, my work generated several potential new biomarkers of dietary intake and prospective T2D risk. N2 - Die Rolle der Fettsäureaufnahme und des Fettsäurestoffwechsels bei der Prävention von Typ-2-Diabetes (T2D) ist nach wie vor umstritten. Die Fettsäure (FS)-Zusammensetzung in den Blutfettfraktionen kann als Biomarker für die Nahrungsaufnahme und den Stoffwechsel verwendet werden, um die Beziehung zwischen den FS und dem T2D-Risiko besser zu verstehen. Das Hauptziel dieser Arbeit war es, den Zusammenhang zwischen zirkulierenden trans-FS (TFS), ungeradkettigen gesättigten FS (UGFS) und n-6 poly ungesättigte FS (PUFS), die in verschiedenen Lipidklassen angereichert sind, mit dem T2D-Risiko zu untersuchen. Mit einer eingebetten Fall-Kohorten-Studie, die im Rahmen der prospektiven EPIC-Potsdam-Studie konzipiert wurde, untersuchte diese Arbeit zwei Lipidprofile im Hinblick auf das T2D-Risiko: (1) Sieben TFS-Subtypen in Plasma-Phospholipiden und (2) die Zusammensetzung von UGFS und PUFA in 15 Plasma-Lipidklassen. Die Aktivität der Delta-5-Desaturase (D5D) wurde als 20:4/20:3-Verhältnis geschätzt. Assoziationen mit dem Auftreten von T2D wurden mit multivariablen Cox-Regressionsmodellen untersucht. Von den üblicherweise aus Milchprodukten stammenden TFS waren 18:1n-7t und t10c12-CLA mit einer geringeren T2D-Inzidenz, c9t11-CLA mit einer höheren Inzidenz und 16:1n-7t nicht mit dem T2D-Risiko assoziiert. TFS aus industriellen Quellen (18:1n-6t, 18:1n-9t, 18:2n-6t) zeigten keinen statistisch signifikanten Zusammenhang mit dem T2D-Risiko. Die UGFS-Konzentration im Plasma war mit dem T2D-Risiko auf lipidklassen- und geschlechtsspezifische Weise assoziiert, wobei bei Frauen stärkere inverse Zusammenhänge für 15:0 in Monoacylglycerinen (MG), Phosphatidylcholinen (PC) und Diacylglycerinen (DG) sowie für 17:0 in PC, Lysophosphatidylcholinen (LPC) und Cholesterinestern (CE) beobachtet wurden. Höhere Konzentrationen von 18:2 waren in DG, TG und LPC invers mit dem T2D-Risiko assoziiert, während MG(18:2) positiv mit dem T2D-Risiko assoziiert war. Höhere Konzentrationen von 20:3 in Phospholipiden (PC, PE, Phosphatidylinositole (PI)), Fettsäuren (FFS), CE und MG waren mit einer höheren T2D-Inzidenz verbunden. 20:4 stand in den meisten Lipidklassen in keinem statistisch singifikanten Zusammenhang mit dem Risiko, außer bei in FFS und PE angereichertem 20:4, das positiv assoziiert war. Die geschätzten D5D-Aktivitäten in PC, PE, PI, LPC und CE waren invers mit dem T2D-Risiko assoziiert. Zusammenfassend ist die Konformation der TFS für ihren Zusammenhang mit dem Diabetesrisiko entscheidend. Die Assoziationen der UGFS-Plasma-Konzentrationen mit dem T2D-Risiko zeigten lipidklassen- und geschlechtsspezifische Unterschiede. Die Plasma-Konzentrationen der n-6-PUFA waren je nach spezifischer FA und Lipidklasse unterschiedlich mit der T2D-Inzidenz assoziiert. Insgesamt unterstreichen diese Ergebnisse die Komplexität der zirkulierenden FAs und ihren heterogenen Zusammenhang mit dem T2D-Risiko in Abhängigkeit der spezifischen FA-Struktur, der Lipidklasse und des Geschlechtes. KW - fatty acids KW - lipidomics KW - type 2 diabetes KW - trans fatty acids KW - odd chain fatty acids KW - polyunsaturated fatty acids KW - Fettsäuren KW - Lipidomics KW - Typ-2-Diabetes KW - Biomarker KW - Lipidstoffwechsel KW - Trans-Fettsäuren KW - ungeradkettige Fettsäuren KW - poly ungesättigte Fettsäuren Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-581598 ER - TY - JOUR A1 - Eichelmann, Fabian A1 - Sellem, Laury A1 - Wittenbecher, Clemens A1 - Jäger, Susanne A1 - Kuxhaus, Olga A1 - Prada, Marcela A1 - Cuadrat, Rafael A1 - Jackson, Kim G. A1 - Lovegrove, Julie A. A1 - Schulze, Matthias Bernd T1 - Deep lipidomics in human plasma: cardiometabolic disease risk and effect of dietary fat modulation JF - Circulation N2 - Background: In blood and tissues, dietary and endogenously generated fatty acids (FAs) occur in free form or as part of complex lipid molecules that collectively represent the lipidome of the respective tissue. We assessed associations of plasma lipids derived from high-resolution lipidomics with incident cardiometabolic diseases and subsequently tested if the identified risk-associated lipids were sensitive to dietary fat modification. Methods: The EPIC Potsdam cohort study (European Prospective Investigation into Cancer and Nutrition) comprises 27 548 participants recruited within an age range of 35 to 65 years from the general population around Potsdam, Germany. We generated 2 disease-specific case cohorts on the basis of a fixed random subsample (n=1262) and all respective cohort-wide identified incident primary cardiovascular disease (composite of fatal and nonfatal myocardial infarction and stroke; n=551) and type 2 diabetes (n=775) cases. We estimated the associations of baseline plasma concentrations of 282 class-specific FA abundances (calculated from 940 distinct molecular species across 15 lipid classes) with the outcomes in multivariable-adjusted Cox models. We tested the effect of an isoenergetic dietary fat modification on risk-associated lipids in the DIVAS randomized controlled trial (Dietary Intervention and Vascular Function; n=113). Participants consumed either a diet rich in saturated FAs (control), monounsaturated FAs, or a mixture of monounsaturated and n-6 polyunsaturated FAs for 16 weeks. Results: Sixty-nine lipids associated (false discovery rate<0.05) with at least 1 outcome (both, 8; only cardiovascular disease, 49; only type 2 diabetes, 12). In brief, several monoacylglycerols and FA16:0 and FA18:0 in diacylglycerols were associated with both outcomes; cholesteryl esters, free fatty acids, and sphingolipids were largely cardiovascular disease specific; and several (glycero)phospholipids were type 2 diabetes specific. In addition, 19 risk-associated lipids were affected (false discovery rate<0.05) by the diets rich in unsaturated dietary FAs compared with the saturated fat diet (17 in a direction consistent with a potential beneficial effect on long-term cardiometabolic risk). For example, the monounsaturated FA-rich diet decreased diacylglycerol(FA16:0) by 0.4 (95% CI, 0.5-0.3) SD units and increased triacylglycerol(FA22:1) by 0.5 (95% CI, 0.4-0.7) SD units. Conclusions: We identified several lipids associated with cardiometabolic disease risk. A subset was beneficially altered by a dietary fat intervention that supports the substitution of dietary saturated FAs with unsaturated FAs as a potential tool for primary disease prevention. KW - cardiovascular diseases KW - cholesterol KW - diabetes mellitus KW - type 2 KW - diet KW - food KW - and nutrition KW - epidemiology KW - lipids Y1 - 2022 U6 - https://doi.org/10.1161/CIRCULATIONAHA.121.056805 SN - 0009-7322 SN - 1524-4539 VL - 146 IS - 1 SP - 21 EP - 35 PB - Lippincott Williams & Wilkins CY - Philadelphia ER -