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

Diabetologia. 2018 Jun;61(6):1325-1332. doi: 10.1007/s00125-018-4586-2. Epub 2018 Mar 17.

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.

Keywords: BMI; Body mass index; Diabetes; Diet; Dietary fibre; GRS; Genetic risk score; Insulin resistance; Interaction; Macronutrient.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alleles
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / genetics*
  • Diet*
  • Dietary Fiber
  • Energy Intake
  • Europe
  • European Continental Ancestry Group
  • Female
  • Follow-Up Studies
  • Genetic Predisposition to Disease*
  • Humans
  • Insulin Resistance
  • International Cooperation
  • Male
  • Middle Aged
  • Nutrients / administration & dosage*
  • Nutrition Assessment
  • Polymorphism, Single Nucleotide
  • Proportional Hazards Models
  • Prospective Studies
  • Surveys and Questionnaires

Substances

  • Dietary Fiber