We determined whether plasma phospholipid fatty acid levels, an indicator of fatty acid composition in the diet, are associated with fasting serum insulin concentrations (a marker of insulin resistance). We examined cross- sectionally 4,304 middle-aged adults free of diabetes. Plasma fatty acid composition was quantified by gas chromatography. Fasting insulin was strongly and positively associated with the saturated fatty acid percentage in plasma phospholipids, moderately and inversely associated with the monounsaturated percentage, and not appreciably associated with the polyunsaturated percentage. Fasting insulin adjusted for age, smoking status, alcohol consumption, and sports participation, for example, was 29% higher in men and 33% higher in women per 1.9% greater level of saturated fatty acids (the interquartile range). After adjustment for body mass index (BMI) and other covariates, these estimates were 12% and 15% (P < .01 for the difference from zero). A 1.9% greater increment in saturated fatty acid level was also associated with a 2.4-fold higher odds of hyperinsulinemia (fasting insulin ≥ 143.5 pmol/L). These data are consistent with studies showing that fatty acid composition of cell membranes modulates insulin action, and support the hypothesis that increased habitual saturated fat intake or a related dietary pattern is a risk factor for hyperinsulinemia.
Bibliographical noteFunding Information:
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN. Submitted March 9, 1995; accepted June 5, 1995. Supported by Grant No. RO1-HL-48048 and Contracts No. NO1-HC-55015, NO1-HC-55016, NO1-HC-55018, NO1-HC-55019, NO1-HC-55020, NO1-HC-55021, and NO1-HC-55022 from the US National Heart, Lung, and Blood Institute. Address reprint requests to Aaron R. Folsom, MD, Professor, Division of Epidemiology, School of Public Health, University of Minnesota, Suite 300, 1300 S Second St, Minneapolis, MN 55454-1015. Copyright © 1996 by W.B. Saunders Company 0026-0495/96/4502-0016503.00/0
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