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November 26, 2019; 93 (22) Article

Serum elaidic acid concentration and risk of dementia

The Hisayama Study

Takanori Honda, Tomoyuki Ohara, Masakazu Shinohara, Jun Hata, Ryuji Toh, Daigo Yoshida, Mao Shibata, Tatsuro Ishida, Yoichiro Hirakawa, Yasuhiro Irino, Satoko Sakata, Kazuhiro Uchida, Takanari Kitazono, Shigenobu Kanba, Ken-Ichi Hirata, Toshiharu Ninomiya
First published October 23, 2019, DOI: https://doi.org/10.1212/WNL.0000000000008464
Takanori Honda
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Tomoyuki Ohara
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Masakazu Shinohara
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Jun Hata
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Ryuji Toh
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Daigo Yoshida
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Mao Shibata
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Tatsuro Ishida
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Yoichiro Hirakawa
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Yasuhiro Irino
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Satoko Sakata
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Kazuhiro Uchida
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Takanari Kitazono
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Shigenobu Kanba
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Ken-Ichi Hirata
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Toshiharu Ninomiya
From the Departments of Epidemiology and Public Health (T.H., T.O., J.H., D.Y., M.Shibata, Y.H., S.S., T.N.), Neuropsychiatry (T.O., S.K.), Medicine and Clinical Science (J.H., Y.H., S.S., T.K.), and Psychosomatic Medicine (M.Shibata), and Center for Cohort Studies (J.H., M.Shibata, S.S., T.K., T.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Divisions of Epidemiology (M.Shinohara), Evidence-Based Laboratory Medicine (R.T., Y.I.), and Cardiovascular Medicine (T.I., K.-I.H.), and Integrated Center for Mass Spectrometry (M.Shinohara., Y.I.), Kobe University Graduate School of Medicine, Hyogo; and Department of Health Promotion (K.U.), School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan.
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Citation
Serum elaidic acid concentration and risk of dementia
The Hisayama Study
Takanori Honda, Tomoyuki Ohara, Masakazu Shinohara, Jun Hata, Ryuji Toh, Daigo Yoshida, Mao Shibata, Tatsuro Ishida, Yoichiro Hirakawa, Yasuhiro Irino, Satoko Sakata, Kazuhiro Uchida, Takanari Kitazono, Shigenobu Kanba, Ken-Ichi Hirata, Toshiharu Ninomiya
Neurology Nov 2019, 93 (22) e2053-e2064; DOI: 10.1212/WNL.0000000000008464

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Abstract

Objective The associations between trans fatty acids and dementia have been unclear. We investigated the prospective association between serum elaidic acid (trans 18:1 n-9) levels, as an objective biomarker for industrial trans fat, and incident dementia and its subtypes.

Methods In total, 1,628 Japanese community residents aged 60 and older without dementia were followed prospectively from when they underwent a screening examination in 2002–2003 to November 2012 (median 10.3 years, interquartile range 7.2–10.4 years). Serum elaidic acid levels were measured using gas chromatography/mass spectrometry and divided into quartiles. The Cox proportional hazards model was used to estimate the hazard ratios for all-cause dementia, Alzheimer disease (AD), and vascular dementia by serum elaidic acid levels.

Results During the follow-up, 377 participants developed some type of dementia (247 AD, 102 vascular dementia). Higher serum elaidic acid levels were significantly associated with greater risk of developing all-cause dementia (p for trend = 0.003) and AD (p for trend = 0.02) after adjustment for traditional risk factors. These associations remained significant after adjustment for dietary factors, including total energy intake and intakes of saturated and polyunsaturated fatty acids (both p for trend <0.05). No significant associations were found between serum elaidic acid levels and vascular dementia.

Conclusions The findings suggest that higher serum elaidic acid is a possible risk factor for the development of all-cause dementia and AD in later life. Public health policy to reduce industrially produced trans fatty acids may assist in the primary prevention of dementia.

Glossary

AD=
Alzheimer disease;
CI=
confidence interval;
DHQ=
diet history questionnaire;
DSM-III-R=
Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised;
HR=
hazard ratio;
hs-CRP=
high-sensitivity C-reactive protein;
IQR=
interquartile range;
VaD=
vascular dementia

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received November 8, 2018.
  • Accepted in final form June 28, 2019.
  • © 2019 American Academy of Neurology
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