title: Circulating and dietary trans fatty acids and incident type 2 diabetes in older adults: the Cardiovascular Health Study.
abstract: OBJECTIVE
  To investigate the effects of trans fatty acids (TFAs) on type 2 diabetes mellitus (DM) by specific TFA subtype or method of assessment.
  
  
  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.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA qiw586@mail.harvard.edu.
authors.forename: Qianyi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, U.K.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Imamura
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Ma
authors.affiliation: Department of Biostatistics, Harvard School of Public Health, Boston, MA.
authors.forename: Molin
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, WA.
authors.forename: Rozenn N
authors.initials: RN
authors.lastname: Lemaitre
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, NM.
authors.forename: Irena B
authors.initials: IB
authors.lastname: King
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Biggs
authors.affiliation: Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Delaney
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.affiliation: Division of Aging, Brigham and Women's Hospital, Boston, MA Boston Veterans Affairs Healthcare System, Boston, MA.
authors.forename: Luc
authors.initials: L
authors.lastname: Djousse
authors.affiliation: New York Academy of Medicine, New York, NY.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003925:Diabetic Angiopathies / Q000097:blood*; D004042:Dietary Fats, Unsaturated / Q000378:metabolism*; D004812:Epidemiologic Methods; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D010743:Phospholipids / Q000378:metabolism; D044242:Trans Fatty Acids / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D004042:Dietary Fats, Unsaturated; D010743:Phospholipids; D044242:Trans Fatty Acids