03072nas a2200433 4500008004100000022001400041245012500055210006900180260001300249300001300262490000700275520183300282653000902115653001502124653003002139653002602169653003002195653002602225653001102251653001602262653001102278653000902289653001802298653002202316100001702338700002102355700001502376700001602391700002402407700001902431700001902450700001902469700002302488700002402511700001802535700002402553700002502577856003602602 2015 eng d a1935-554800aCirculating and dietary trans fatty acids and incident type 2 diabetes in older adults: the Cardiovascular Health Study.0 aCirculating and dietary trans fatty acids and incident type 2 di c2015 Jun a1099-1070 v383 a

OBJECTIVE: To investigate the effects of trans fatty acids (TFAs) on type 2 diabetes mellitus (DM) by specific TFA subtype or method of assessment.

RESEARCH DESIGN AND METHODS: In the Cardiovascular Health Study, plasma phospholipid trans (t)-16:1n9, t-18:1, and cis (c)/t-, t/c-, and t/t-18:2 were measured in blood drawn from 2,919 adults aged 74 ± 5 years and free of prevalent DM in 1992. Dietary TFA was estimated among 4,207 adults free of prevalent DM when dietary questionnaires were initially administered in 1989 or 1996. Incident DM was defined through 2010 by medication use or blood glucose levels. Risks were assessed by Cox proportional hazards.

RESULTS: In biomarker analyses, 287 DM cases occurred during 30,825 person-years. Both t-16:1n9 (extreme quartile hazard ratio 1.59 [95% CI 1.04-2.42], P-trend = 0.04) and t-18:1 (1.91 [1.20-3.03], P-trend = 0.01) levels were associated with higher incident DM after adjustment for de novo lipogenesis fatty acids. In dietary analyses, 407 DM cases occurred during 50,105 person-years. Incident DM was positively associated with consumption of total TFAs (1.38 [1.03-1.86], P-trend = 0.02), t-18:1 (1.32 [1.00-1.76], P-trend = 0.04), and t-18:2 (1.41 [1.05-1.89], P-trend = 0.02). After further adjustment for other dietary habits, however, the associations of estimated dietary TFA with DM were attenuated, and only nonsignificant positive trends remained.

CONCLUSIONS: Among older adults, plasma phospholipid t-16:1n9 and t-18:1 levels were positively related to DM after adjustment for de novo lipogenesis fatty acids. Estimated dietary TFA was not significantly associated with DM. These findings highlight the need for further observational, interventional, and experimental studies of the effects TFA on DM.

10aAged10aBiomarkers10aDiabetes Mellitus, Type 210aDiabetic Angiopathies10aDietary Fats, Unsaturated10aEpidemiologic Methods10aFemale10aFood Habits10aHumans10aMale10aPhospholipids10aTrans Fatty Acids1 aWang, Qianyi1 aImamura, Fumiaki1 aMa, Wenjie1 aWang, Molin1 aLemaitre, Rozenn, N1 aKing, Irena, B1 aSong, Xiaoling1 aBiggs, Mary, L1 aDelaney, Joseph, A1 aMukamal, Kenneth, J1 aDjoussé, Luc1 aSiscovick, David, S1 aMozaffarian, Dariush uhttps://chs-nhlbi.org/node/666402578nas a2200229 4500008004100000022001400041245010100055210006900156260001600225520185100241100001902092700002402111700003102135700001702166700002002183700002302203700002802226700001902254700002002273700001902293856003602312 2016 eng d a1524-462800aChanges in Depressive Symptoms and Subsequent Risk of Stroke in the Cardiovascular Health Study.0 aChanges in Depressive Symptoms and Subsequent Risk of Stroke in  c2016 Dec 063 a

BACKGROUND AND PURPOSE: Depression is associated with stroke, but the effects of changes in depressive symptoms on stroke risk are not well understood. This study examined whether depressive symptom changes across 2 successive annual assessments were associated with incident stroke the following year.

METHODS: We used visit data from 4319 participants of the Cardiovascular Health Study who were stroke free at baseline to examine whether changes in depressive symptoms classified across 2 consecutive annual assessments predicted incident first stroke during the subsequent year. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression scale (high versus low at ≥10). Survival models were inverse probability weighted to adjust for demographics, health behaviors, medical conditions, past depressive symptoms, censoring, and survival.

RESULTS: During follow-up, 334 strokes occurred. Relative to stable low scores of depressive symptoms, improved depression symptoms were associated with almost no excess risk of stroke (adjusted hazards ratio, 1.02; 95% confidence interval, 0.66-1.58). New-onset symptoms were nonsignificantly associated with elevated stroke risk (adjusted hazards ratio, 1.44; 95% confidence interval, 0.97-2.14), whereas persistently high depressive symptoms were associated with elevated adjusted hazard of all-cause stroke (adjusted hazards ratio, 1.65; 95% confidence interval, 1.06-2.56). No evidence for effect modification by race, age, or sex was found.

CONCLUSIONS: Persistently high symptoms of depression predicted elevated hazard of stroke. Participants with improved depressive symptoms had no elevation in stroke risk. Such findings suggest that strategies to reduce depressive symptoms may ameliorate stroke risk.

1 aGilsanz, Paola1 aKubzansky, Laura, D1 aTchetgen, Eric, J Tchetgen1 aWang, Qianyi1 aKawachi, Ichiro1 aPatton, Kristen, K1 aFitzpatrick, Annette, L1 aKop, Willem, J1 aLongstreth, W T1 aGlymour, Maria uhttps://chs-nhlbi.org/node/7245