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Updated: Jan 9, 2026

Measuring Oral Fatty Acid Thresholds, Fat Perception, Fatty Food Liking, and Papillae Density in Humans
Published on: June 4, 2014
Fatty Acid Biomarkers and Incidence of Type 2 diabetes: A Systematic Review and Dose-Response Meta-analysis of
Edyta Schaefer1, Manuela Neuenschwander1, Tim Schiemann2
1Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research, Neuherberg, Germany.
Abstract:
The role of dietary fat in type 2 diabetes (T2D) development remains debated. Fatty acid (FA) biomarkers may better reflect bioavailable FAs than self-reported dietary intake. We conducted a systematic review and dose-response meta-analysis investigating associations between FA biomarkers and risk of T2D, considering different biospecimens of FA measurement. PubMed and Web of Science were searched until 9 November, 2022, and a search alert was followed until 17 February, 2025. Prospective cohort studies investigating FA biomarkers and T2D risk were included. Summary relative risks (SRR) and 95% confidence intervals (CIs) for all biospecimens combined and separately were estimated using a random-effects model. Risk of bias was assessed with the Risk Of Bias In Non-randomized Studies of Interventions tool, and the certainty of evidence (CoE) was rated with the Grades of Recommendations, Assessment, Development, and Evaluation approach. We included 27 articles. Analyses of plasma phospholipids (PPL) and red blood cells (RBC) provided inverse associations between higher concentrations of specific saturated FAs (SFAs) [15:0: SRR 0.68 (95% CI: 0.56, 0.81); 17:0: 0.64 (0.41, 0.78)], n-3 polyunsaturated FAs (PUFAs) [20:5: 0.97 (0.95, 0.99), 22:6: 0.92 (0.88, 0.96)], and n-6 PUFA [18:2: 0.93 (0.91, 0.95)] and risk of T2D, with moderate CoE. In the same biospecimens, higher levels of specific monounsaturated FAs (MUFAs) [16:1n-7: 1.06 (1.03, 1.10), 18:1n-9: 1.04 (1.01, 1.06)], and n-6 PUFAs [γ-20:3: 1.07 (1.03, 1.11), γ-18:3: 2.23 (1.42, 3.50), and 20:4: 1.02 (1.01, 1.04)] were associated with higher risk of T2D. Although combined analyses across biospecimens were consistent, stronger associations were observed in PPL and RBC. Associations of specific FAs within the same class (SFAs, MUFAs, PUFAs) varied in direction regarding risk of T2D. Certain SFAs, n-3 PUFAs, and 18:2 were inversely associated with T2D risk, whereas certain MUFAs and n-6 PUFAs were positively associated. Stronger associations in PPL and RBC highlight the importance of biospecimen selection. The protocol of this study was registered a priori in PROSPERO (CRD42020184575).
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