Circulating Polyunsaturated Fatty Acids and Glycemic Dynamics Assessed by Continuous Glucose Monitoring: A 13‐Year Prospective Cohort Study

Polyunsaturated fatty acids (PUFA) have been proposed to be involved in the diabetes etiology, but the associations between PUFA biomarkers and glycemic dynamics are unclear. We aimed to investigate the prospective associations of PUFA with glycemic dynamics assessed by continuous glucose monitoring (CGM). A total of 1216 middle-aged and elderly participants were included. We performed a multivariable-adjusted linear regression to investigate the association between baseline measurement of erythrocyte fatty acids and follow-up CGM profiles. During a median 13.6-year follow-up, the highest (vs. lowest) quartile of γ-linoleic acid (GLA) was associated with an increment (in standard deviation unit) of 0.27 (95% CI: 0.10, 0.42) for time above range, 0.31 (0.14, 0.47) for high blood glucose index, 0.26 (0.10, 0.41) for mean of daily differences, and 0.31 (0.15, 0.46) for mean blood glucose (MBG). In contrast, higher linoleic acid (LA) was associated with lower nocturnal MBG, with beta (95% CI) -0.23 (-0.38, -0.08); higher arachidonic acid (AA) was associated with lower diurnal MBG (-0.25 [95% CI: -0.41, -0.10]). None of the n-3 PUFA biomarkers was associated with CGM measures. Circulating GLA was positively associated with high-glucose level, glycemic variability, and mean glucose measures, while LA and AA were inversely associated with nocturnal and diurnal MBG, respectively. Our findings may provide new insights into the relationship between PUFA metabolism and glycemic control.