Association of Alzheimer disease pathology with abnormal lipid metabolism: the Hisayama Study
Matsuzaki T, Sasaki K, Hata J, Hirakawa Y, Fujimi K, Ninomiya T, Suzuki SO, Kanba S et al.. Neurology, 2011-09-01
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Objective The relationship between lipid profiles and Alzheimer disease (AD) pathology at the population level is unclear. We searched for evidence of AD-related pathologic risk of abnormal lipid metabolism. Methods This study included brain specimens from a series of 147 autopsies performed between 1998 and 2003 of residents in Hisayama town, Japan (76 men and 71 women), who underwent clinical examinations in 1988. Lipid profiles, such as total cholesterol (TC), triglycerides, and high-density lipoprotein cholesterol (HDLC), were measured in 1988. Low-density lipoprotein cholesterol (LDLC) was calculated using the Friedewald formula. Neuritic plaques (NPs) were assessed according to the Consortium to Establish a Registry for Alzheimer's Disease guidelines (CERAD) and neurofibrillary tangles (NFTs) were assessed according to Braak stage. Associations between each lipid profile and AD pathology were examined by analysis of covariance and logistic regression analyses. Results Adjusted means of TC, LDLC, TC/HDLC, LDLC/HDLC, and non-HDLC (defined as TC-HDLC) were significantly higher in subjects with NPs, even in sparse to moderate stages (CERAD = 1 or 2), compared to subjects without NPs in multivariate models including APOE ε4 carrier and other confounding factors. The subjects in the highest quartiles of these lipid profiles had significantly higher risks of NPs compared to subjects in the lower respective quartiles, which may suggest a threshold effect. Conversely, there was no relationship between any lipid profile and NFTs. Conclusion The results of this study suggest that dyslipidemia increases the risk of plaque-type pathology.
What this study adds
Evidence grade: Low
The study found "no relationship between any lipid profile" and tangles, the other hallmark of Alzheimer's. It is an association in one community and does not show that lowering cholesterol prevents plaques or dementia.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Matsuzaki, T., Sasaki, K., Hata, J., Hirakawa, Y., Fujimi, K., Ninomiya, T., et al. (2011). Association of Alzheimer disease pathology with abnormal lipid metabolism: the Hisayama Study. Neurology. https://doi.org/10.1212/wnl.0b013e31822e145d
Vancouver
Matsuzaki T, Sasaki K, Hata J, Hirakawa Y, Fujimi K, Ninomiya T, et al. Association of Alzheimer disease pathology with abnormal lipid metabolism: the Hisayama Study. Neurology. 2011. doi:10.1212/wnl.0b013e31822e145d. PMID: 21911734.
BibTeX
@article{matsuzaki2011-21911734,
author = {Matsuzaki, T. and Sasaki, K. and Hata, J. and Hirakawa, Y. and Fujimi, K. and Ninomiya, T. and Suzuki, S. O. and Kanba, S. and others},
title = {{Association of Alzheimer disease pathology with abnormal lipid metabolism: the Hisayama Study}},
journal = {Neurology},
year = {2011},
doi = {10.1212/wnl.0b013e31822e145d},
pmid = {21911734},
url = {https://doi.org/10.1212/wnl.0b013e31822e145d}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Results Adjusted means of TC, LDLC, TC/HDLC, LDLC/HDLC, and non-HDLC (defined as TC-HDLC) were significantly higher in subjects with NPs, even in sparse to moderate stages (CERAD = 1 or 2), compared to subjects without NPs in multivariate models including APOE ε4 carrier and other confounding factors.
- The subjects in the highest quartiles of these lipid profiles had significantly higher risks of NPs compared to subjects in the lower respective quartiles, which may suggest a threshold effect.
- Conclusion The results of this study suggest that dyslipidemia increases the risk of plaque-type pathology.
Why it matters
Among 147 residents of Hisayama, Japan, whose cholesterol was measured in 1988 and whose brains were examined at autopsy in 1998–2003, people with brain plaques had had higher total and LDL cholesterol and related ratios, even when plaques were sparse to moderate and after accounting for APOE ε4. The study found "no relationship between any lipid profile" and tangles, the other hallmark of Alzheimer's. It is an association in one community and does not show that lowering cholesterol prevents plaques or dementia.
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Study details
- Evidence strengthLow
How this study scored 44/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 107 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.3 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 3 / 6 | Cited 7.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Toru Iwaki: h-index 60 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Kyushu University: institution h-index 721 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21911734) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 44 / 100 | — |
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