title: Plasma phospholipid EPA and DHA are divergently associated with overall mortality in newly diagnosed diabetic patients: results from a follow-up of the Nord-Trøndelag Health (HUNT) Study, Norway.
abstract: Data concerning the long-term effects of n-3 and n-6 PUFA on disease control and development of complications in diabetic patients are inconsistent. The relationship between plasma phospholipid PUFA and total mortality in type 2 diabetes is unknown. The present study aims to investigate the association between plasma phospholipid fatty acid relative concentrations expressed as weight percentage and total mortality in patients with type 2 diabetes. Mortality rates were evaluated at 5, 10, 15 and 20 years in patients with newly diagnosed diabetes (n 323) and matched non-diabetic controls (n 200) recruited from the Nord-Trøndelag Health (HUNT) Study, Norway. Kaplan-Meier survival curves were constructed and Cox regression analysis was used to calculate hazard ratios (HR) adjusted for biochemical and clinical covariates. After 10 years of follow-up, EPA in the diabetic population was negatively associated with total mortality, with an HR at the fifth quintile of 0·47 (95 % CI 0·25, 0·90) compared with the first quintile. In contrast, DHA was positively associated with total mortality, with an HR at the fifth quintile of 2·87 (95 % CI 1·45, 5·66). Neither EPA nor DHA was associated with total mortality in matched non-diabetic controls. In conclusion, plasma phospholipid relative concentrations of EPA were negatively associated, while those of DHA were positively associated with total mortality in diabetics. This difference in associations suggests a differential effect of EPA and DHA in patients with type 2 diabetes.
authors.affiliation: Central Laboratory , Vestfold Hospital Trust , Tønsberg , Norway ; Department of Laboratory Medicine, Children's and Women's Health , Norwegian University of Science and Technology , Trondheim , Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Lindberg
authors.affiliation: Department of Medical Biochemistry , St Olavs Hospital, Trondheim University Hospital , Trondheim , Norway.
authors.forename: Arne
authors.initials: A
authors.lastname: Asberg
authors.affiliation: HUNT Research Centre, Department of Public Health and General Practice , Norwegian University of Science and Technology , Trondheim , Norway.
authors.forename: Kristian
authors.initials: K
authors.lastname: Midthjell
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health , Norwegian University of Science and Technology , Trondheim , Norway ; Department of Medical Biochemistry , St Olavs Hospital, Trondheim University Hospital , Trondheim , Norway.
authors.forename: Kristian S
authors.initials: KS
authors.lastname: Bjerve
keywords: FADS, fatty acid desaturase; HR, hazard ratio; HUNT, Nord-Trøndelag Health; Overall mortality; PLN3, phospholipid n-3; Type 2 diabetes; n-3 Fatty acids; n-6 Fatty acids