Journal of Nutritional Science

  • Journal of Nutritional Science / Volume 2 / 2013, e35 (8 pages)
  • Copyright © The Author(s) 2013 The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution license <>.
  • DOI: (About DOI), Published online: 19 November 2013

Dietary Surveys and Nutritional Epidemiology

Plasma phospholipid EPA and DHA are divergently associated with overall mortality in newly diagnosed diabetic patients: results from a follow-up of the Nord-Trøndelag Health (HUNT) Study, Norway

Morten Lindberga1a2, Arne Åsberga3, Kristian Midthjella4 and Kristian S. Bjervea2a3 c1

a1 Central Laboratory, Vestfold Hospital Trust, Tønsberg, Norway

a2 Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway

a3 Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

a4 HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway


Data concerning the long-term effects of n-3 and n-6 PUFA on disease control and development of complications in diabetic patients are inconsistent. The relationship between plasma phospholipid PUFA and total mortality in type 2 diabetes is unknown. The present study aims to investigate the association between plasma phospholipid fatty acid relative concentrations expressed as weight percentage and total mortality in patients with type 2 diabetes. Mortality rates were evaluated at 5, 10, 15 and 20 years in patients with newly diagnosed diabetes (n 323) and matched non-diabetic controls (n 200) recruited from the Nord-Trøndelag Health (HUNT) Study, Norway. Kaplan–Meier survival curves were constructed and Cox regression analysis was used to calculate hazard ratios (HR) adjusted for biochemical and clinical covariates. After 10 years of follow-up, EPA in the diabetic population was negatively associated with total mortality, with an HR at the fifth quintile of 0·47 (95 % CI 0·25, 0·90) compared with the first quintile. In contrast, DHA was positively associated with total mortality, with an HR at the fifth quintile of 2·87 (95 % CI 1·45, 5·66). Neither EPA nor DHA was associated with total mortality in matched non-diabetic controls. In conclusion, plasma phospholipid relative concentrations of EPA were negatively associated, while those of DHA were positively associated with total mortality in diabetics. This difference in associations suggests a differential effect of EPA and DHA in patients with type 2 diabetes.

(Received June 11 2013)

(Revised September 26 2013)

(Accepted October 03 2013)

Key words

  • Overall mortality;
  • n-3 Fatty acids;
  • n-6 Fatty acids;
  • Type 2 diabetes


  • FADS:fatty acid desaturase;
  • HR:hazard ratio;
  • HUNT:Nord-Trøndelag Health;
  • PLN3:phospholipid n-3


c1 Corresponding author: K. S. Bjerve, fax +47 725 76 426, email