Plasma Phospholipid Trans‐Fatty Acids Levels, Cardiovascular Diseases, and Total Mortality: The Cardiovascular Health Study

Published on Aug 15, 2014in Journal of the American Heart Association4.66
· DOI :10.1161/JAHA.114.000914
Qianyi Wang4
Estimated H-index: 4
(Harvard University),
Fumiaki Imamura27
Estimated H-index: 27
(University of Cambridge)
+ 6 AuthorsDariush Mozaffarian113
Estimated H-index: 113
Background While self-reported trans– fatty acid (TFA) consumption is linked to coronary heart disease (CHD), relationships between objective biomarkers of TFA subtypes ( t- 16:1n9, total t- 18:1, and cis / trans- ( c / t- ), t / c- and t / t- 18:2) and cardiovascular disease (CVD) or total mortality are not well established. Methods and Results We evaluated 2742 adults in the Cardiovascular Health Study, aged 74±5 years and free of prevalent CVD, with plasma phospholipid TFA measures in 1992. Incident fatal and nonfatal CHD events, CVD and non-CVD mortality, and total mortality were centrally adjudicated through 2010. Risks were assessed using Cox proportional hazards. During 31 494 person-years, 1735 total deaths and 639 total CHD events occurred. In the multivariate model including mutual adjustment for the 5 TFA subtypes, circulating t / t- 18:2 was associated with higher total mortality (extreme quintile hazard ratio (HR)=1.23, 95% CI=1.04 to 1.44, P -trend=0.01), CVD mortality (HR=1.40, 95% CI=1.05 to 1.86, P -trend=0.02), and total CHD (HR=1.39, 95% CI=1.06 to 1.83, P -trend=0.01). t / c- 18:2 was positively related to total mortality (HR=1.19, P -trend=0.05), total CHD (HR=1.67, P -trend=0.002), and nonfatal CHD (HR=2.06, P -trend=0.002) after mutual adjustment; these associations were insignificant without mutual adjustment. Neither t- 16:1n9 nor t- 18:1 was significantly associated with total mortality or CVD, nor was c / t -18:2 if we excluded early cases. Conclusions Among circulating TFAs, t / t- 18:2 was most adversely associated with total mortality, mainly due to the increased risk of CVD. t / c- 18:2 was also positively associated with total mortality and CHD, but only after adjustment for other TFAs. These results highlight the need for further investigation of dietary sources, nondietary determinants, and health effects of specific TFA subtypes, especially t -18:2 isomers.
  • References (62)
  • Citations (35)
#1Shauna Downs (USYD: University of Sydney)H-Index: 13
#2Anne Marie Thow (USYD: University of Sydney)H-Index: 16
Last.Stephen Leeder (USYD: University of Sydney)H-Index: 53
view all 6 authors...
#1Naomi G. Iwata (UW: University of Washington)H-Index: 1
#2Matilda Pham (UW: University of Washington)H-Index: 6
Last.Francis Kim (UW: University of Washington)H-Index: 26
view all 6 authors...
#1Dariush Mozaffarian (Harvard University)H-Index: 113
#2Haiming Cao (NIH: National Institutes of Health)H-Index: 12
Last.Gökhan S. Hotamisligil (Harvard University)H-Index: 99
view all 7 authors...
Cited By35
#1Samia Hadj Ahmed (University of Monastir)H-Index: 2
#2Wafa Kharroubi (University of Monastir)H-Index: 3
Last.Mohamed Hammami (University of Monastir)H-Index: 32
view all 10 authors...
#1Ilse G. Pranger (UMCG: University Medical Center Groningen)H-Index: 2
#2Monica L. Joustra (UMCG: University Medical Center Groningen)H-Index: 2
Last.Stephan J. L. Bakker (UMCG: University Medical Center Groningen)H-Index: 59
view all 8 authors...
#1Sunni L. Mumford (NIH: National Institutes of Health)H-Index: 27
#2Richard W. Browne (SUNY: State University of New York System)H-Index: 39
Last.Ukpebo R. Omosigho (NIH: National Institutes of Health)H-Index: 1
view all 10 authors...
#1Naohiro Gotoh (Tokyo University of Marine Science and Technology)H-Index: 19
#2Satoshi Kagiono (Tokyo University of Marine Science and Technology)H-Index: 1
Last.Koji Nagao (Saga University)H-Index: 27
view all 8 authors...
#1Mohsen Mazidi (CAS: Chinese Academy of Sciences)H-Index: 20
#2Hong-kai GaoH-Index: 6
Last.Andre Pascal Kengne (South African Medical Research Council)H-Index: 32
view all 6 authors...
View next paperTrans fatty acids and cardiovascular disease.