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Background: Consumption of whole-grain, coffee, and red meat were consistently related to the risk of developing type 2 diabetes in prospective cohort studies, but potentially underlying biological mechanisms are not well understood. Metabolomics profiles were shown to be sensitive to these dietary exposures, and at the same time to be informative with respect to the risk of type 2 diabetes. Moreover, graphical network-models were demonstrated to reflect the biological processes underlying high-dimensional metabolomics profiles.
Aim: The aim of this study was to infer hypotheses on the biological mechanisms that link consumption of whole-grain bread, coffee, and red meat, respectively, to the risk of developing type 2 diabetes. More specifically, it was aimed to consider network models of amino acid and lipid profiles as potential mediators of these risk-relations.
Study population: Analyses were conducted in the prospective EPIC-Potsdam cohort (n = 27,548), applying a nested case-cohort design (n = 2731, including 692 incident diabetes cases). Habitual diet was assessed with validated semiquantitative food-frequency questionnaires. Concentrations of 126 metabolites (acylcarnitines, phosphatidylcholines, sphingomyelins, amino acids) were determined in baseline-serum samples. Incident type 2 diabetes cases were assed and validated in an active follow-up procedure. The median follow-up time was 6.6 years.
Analytical design: The methodological approach was conceptually based on counterfactual causal inference theory. Observations on the network-encoded conditional independence structure restricted the space of possible causal explanations of observed metabolomics-data patterns. Given basic directionality assumptions (diet affects metabolism; metabolism affects future diabetes incidence), adjustment for a subset of direct neighbours was sufficient to consistently estimate network-independent direct effects. Further model-specification, however, was limited due to missing directionality information on the links between metabolites. Therefore, a multi-model approach was applied to infer the bounds of possible direct effects. All metabolite-exposure links and metabolite-outcome links, respectively, were classified into one of three categories: direct effect, ambiguous (some models indicated an effect others not), and no-effect.
Cross-sectional and longitudinal relations were evaluated in multivariable-adjusted linear regression and Cox proportional hazard regression models, respectively. Models were comprehensively adjusted for age, sex, body mass index, prevalence of hypertension, dietary and lifestyle factors, and medication.
Results: Consumption of whole-grain bread was related to lower levels of several lipid metabolites with saturated and monounsaturated fatty acids. Coffee was related to lower aromatic and branched-chain amino acids, and had potential effects on the fatty acid profile within lipid classes. Red meat was linked to lower glycine levels and was related to higher circulating concentrations of branched-chain amino acids. In addition, potential marked effects of red meat consumption on the fatty acid composition within the investigated lipid classes were identified.
Moreover, potential beneficial and adverse direct effects of metabolites on type 2 diabetes risk were detected. Aromatic amino acids and lipid metabolites with even-chain saturated (C14-C18) and with specific polyunsaturated fatty acids had adverse effects on type 2 diabetes risk. Glycine, glutamine, and lipid metabolites with monounsaturated fatty acids and with other species of polyunsaturated fatty acids were classified as having direct beneficial effects on type 2 diabetes risk.
Potential mediators of the diet-diabetes links were identified by graphically overlaying this information in network models. Mediation analyses revealed that effects on lipid metabolites could potentially explain about one fourth of the whole-grain bread effect on type 2 diabetes risk; and that effects of coffee and red meat consumption on amino acid and lipid profiles could potentially explain about two thirds of the altered type 2 diabetes risk linked to these dietary exposures.
Conclusion: An algorithm was developed that is capable to integrate single external variables (continuous exposures, survival time) and high-dimensional metabolomics-data in a joint graphical model. Application to the EPIC-Potsdam cohort study revealed that the observed conditional independence patterns were consistent with the a priori mediation hypothesis: Early effects on lipid and amino acid metabolism had the potential to explain large parts of the link between three of the most widely discussed diabetes-related dietary exposures and the risk of developing type 2 diabetes.
Die vorliegende Arbeit mit dem Titel „Eine Frage der Zeit. Wie Einflüsse individueller Merkmale auf Einkommen bei Frauen über ihre familiären Verpflichtungen vermittelt werden“ geht der Frage der Heterogenität bei weiblichen Einkommensergebnissen nach. Dabei steht die Thematik der individuellen Investitionen in die familiäre Arbeit als erklärender Faktor im Vordergrund und es wird der Frage nachgegangen, warum die einen Frauen viele und andere weniger häusliche Verpflichtungen übernehmen. Hierfür werden das individuelle Humankapital der Frauen, ihre Werteorientierungen und individuelle berufliche Motivationen aus der Jugendzeit und im Erwachsenenalter herangezogen. Die analysierten Daten (Daten der LifE-Studie) repräsentieren eine Langzeitperspektive vom 16. bis zum 45. Lebensjahr der befragten Frauen. Zusammenfassend kann im Ergebnis gezeigt werden, dass ein Effekt familiärer Verpflichtungen auf Einkommensergebnisse bei Frauen im frühen und mittleren Erwachsenenalter als Zeiteffekt über die investierte Erwerbsarbeitszeit vermittelt wird. Die Relevanz privater Routinearbeiten für Berufserfolge von Frauen und insbesondere Müttern stellt somit eine Frage der Zeit dar. Weiterhin kann für individuelle Einflüsse auf Einkommen bei Frauen gezeigt werden, dass höhere zeitliche Investitionen in den Beruf von Frauen mit hohem Bildungsniveau als indirect-only-Mediation nur über die Umverteilung häuslicher Arbeiten erklärbar werden. Frauen sind demnach zwar Gewinnerinnen der Bildungsexpansion. Die Bildungsexpansion stellt jedoch auch die Geschichte der Entstehung eines Vereinbarkeitskonflikts für eben diese Frauen dar, weil die bis heute virulenten Beharrungskräfte hinsichtlich der Frauen zugeschriebenen familiären Verpflichtungen mit ihren gestiegenen beruflichen Erwartungen und Chancen kollidieren. Die Arbeit leistet in ihren Analyseresultaten einen wichtigen Beitrag zur Erklärung heterogener Investitionen von Frauen in den Beruf und ihrer Einkommensergebnisse aus dem Privaten heraus.