Associations of linoleic acid with markers of glucose metabolism and liver function in South African adults

Kamalita Pertiwi, Leanne K Küpers, Johanna M Geleijnse, Peter L Zock, Anne J Wanders, Herculina S Kruger, Tertia van Zyl, Iolanthé M Kruger, Cornelius M Smuts, Kamalita Pertiwi, Leanne K Küpers, Johanna M Geleijnse, Peter L Zock, Anne J Wanders, Herculina S Kruger, Tertia van Zyl, Iolanthé M Kruger, Cornelius M Smuts

Abstract

Background: The relation between dietary and circulating linoleic acid (18:2 n-6, LA), glucose metabolism and liver function is not yet clear. Associations of dietary and circulating LA with glucose metabolism and liver function markers were investigated.

Methods: Cross-sectional analyses in 633 black South Africans (aged > 30 years, 62% female, 51% urban) without type 2 diabetes at baseline of the Prospective Urban Rural Epidemiology study. A cultural-sensitive 145-item food-frequency questionnaire was used to collect dietary data, including LA (percentage of energy; en%). Blood samples were collected to measure circulating LA (% total fatty acids (FA); plasma phospholipids), plasma glucose, glycosylated hemoglobin (HbA1c), serum gamma-glutamyl transferase (GGT), alanine (ALT) and aspartate aminotransferase (AST). Associations per 1 standard deviation (SD) and in tertiles were analyzed using multivariable regression.

Results: Mean (±SD) dietary and circulating LA was 6.8 (±3.1) en% and 16.0 (±3.5) % total FA, respectively. Dietary and circulating LA were not associated with plasma glucose or HbA1c (β per 1 SD: - 0.005 to 0.010, P > 0.20). Higher dietary LA was generally associated with lower serum liver enzymes levels. One SD higher circulating LA was associated with 22% lower serum GGT (β (95% confidence interval): - 0.25 (- 0.31, - 0.18), P < 0.001), but only ≤9% lower for ALT and AST. Circulating LA and serum GGT associations differed by alcohol use and locality.

Conclusion: Dietary and circulating LA were inversely associated with markers of impaired liver function, but not with glucose metabolism. Alcohol use may play a role in the association between LA and liver function.

Trial registration: PURE North-West Province South Africa study described in this manuscript is part of the PURE study. The PURE study is registered in ClinicalTrials.gov (Identifier: NCT03225586; URL).

Keywords: African; Alcohol intake; Gamma-glutamyl transferase; Glycemia; Linoleic acid; Liver enzymes; Polyunsaturated fatty acids.

Conflict of interest statement

This research was supported in part by Upfield. AJW and PLZ are employed by Unilever, the Netherlands. Unilever is a producer of food consumer products. It divested its spreads business, which has operated since July 2018 under the name Upfield. JMG received financial support from Unilever for epidemiological studies of dietary and circulating fatty acids. The funders had no role in the design of the study, collection and analysis of data and decision to publish. No other potential conflicts of interest relevant to this article were reported.

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