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27-03-2018 | Type 2 diabetes | Article

Interplay between genetic predisposition, macronutrient intake and type 2 diabetes incidence: analysis within EPIC-InterAct across eight European countries

Journal: Diabetologia

Authors: Sherly X. Li, Fumiaki Imamura, Matthias B. Schulze, Jusheng Zheng, Zheng Ye, Antonio Agudo, Eva Ardanaz, Dagfinn Aune, Heiner Boeing, Miren Dorronsoro, Courtney Dow, Guy Fagherazzi, Sara Grioni, Marc J. Gunter, José María Huerta, Daniel B. Ibsen, Marianne Uhre Jakobsen, Rudolf Kaaks, Timothy J. Key, Kay-Tee Khaw, Cecilie Kyrø, Francesca Romana Mancini, Elena Molina-Portillo, Neil Murphy, Peter M. Nilsson, N. Charlotte Onland-Moret, Domenico Palli, Salvatore Panico, Alaitz Poveda, J. Ramón Quirós, Fulvio Ricceri, Ivonne Sluijs, Annemieke M. W. Spijkerman, Anne Tjonneland, Rosario Tumino, Anna Winkvist, Claudia Langenberg, Stephen J. Sharp, Elio Riboli, Robert A. Scott, Nita G. Forouhi, Nicholas J. Wareham

Publisher: Springer Berlin Heidelberg

Abstract

Aims/hypothesis

Gene–macronutrient interactions may contribute to the development of type 2 diabetes but research evidence to date is inconclusive. We aimed to increase our understanding of the aetiology of type 2 diabetes by investigating potential interactions between genes and macronutrient intake and their association with the incidence of type 2 diabetes.

Methods

We investigated the influence of interactions between genetic risk scores (GRSs) for type 2 diabetes, insulin resistance and BMI and macronutrient intake on the development of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct, a prospective case-cohort study across eight European countries (N = 21,900 with 9742 incident type 2 diabetes cases). Macronutrient intake was estimated from diets reported in questionnaires, including proportion of energy derived from total carbohydrate, protein, fat, plant and animal protein, saturated, monounsaturated and polyunsaturated fat and dietary fibre. Using multivariable-adjusted Cox regression, we estimated country-specific interaction results on the multiplicative scale, using random-effects meta-analysis. Secondary analysis used isocaloric macronutrient substitution.

Results

No interactions were identified between any of the three GRSs and any macronutrient intake, with low-to-moderate heterogeneity between countries (I2 range 0–51.6%). Results were similar using isocaloric macronutrient substitution analyses and when weighted and unweighted GRSs and individual SNPs were examined.

Conclusions/interpretation

Genetic susceptibility to type 2 diabetes, insulin resistance and BMI did not modify the association between macronutrient intake and incident type 2 diabetes. This suggests that macronutrient intake recommendations to prevent type 2 diabetes do not need to account for differences in genetic predisposition to these three metabolic conditions.
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