The association between types of seafood intake and the risk of type2 diabetes: a systematic review and metaanalysis of prospective cohort studies

Background: Seafood is the main source of longchain n3 polyunsaturated fatty acids (n3PUFAs) with beneficial health effects; however, findings on the association between the consumption of different types of seafood and type 2 diabetes mellitus (T2DM) are conflicting. Our objective was to perform a systematic review and metaanalysis examining the relationship between different types of fish/seafood and the risk of T2DM in adult populations. Methods: A systematic search of PubMed/Medline, Scopus, and Web of Science (ISI) databases was performed for cohort studies, published in English, before 1 September 2017. Multivariate adjusted relative risk (RR) estimates with 95% confidence intervals (CIs) for each category of seafood were pooled to examine the association. Results: Comparing the highest vs. lowest fatty fish intake categories indicated that there was a significant inverse association between the consumption of fatty fish and onset of T2DM (RR:0.89; 95 % CI: 0.82, 0.98; I2: 0%, P=0.54). However, after performing sensitivity analysis, we found that eliminating one study resulted in a nonsignificant association (RR: 0.93; 95 % CI:0.80, 1.09). There were no significant associations between lean fish (RR: 1.03; 95% CI: 0.87,1.22, I2: 51.0%, P=0.08), seafood other than fish (RR: 0.95; 95% CI: 0.83, 1.10, I2: 71.2%,P=0.002), fish products (RR: 0.96; 95% CI: 0.82, 1.13, I2:0%, P=0.62), and fried fish (RR: 1.02;95% CI: 0.83, 1.26, I2:71.2%, P=0.06) and T2DM risk. Conclusion: The risk of T2DM was not associated with the intake of lean fish, seafood other than fish, and fish products. However, due to the low robustness of findings regarding protective roles of oily fish, more longitudinal studies are needed to clarify this association.