Associations of equol-producing status with white matter lesion and amyloid-β deposition in cognitively normal elderly Japanese

Introduction: Equol, a metabolite of a soy isoflavone transformed by the gut microbiome, is anti-oxidant and anti-amyloidogenic. We assessed the associations of equol with white matter lesion normalized to total brain volume (WML%) and amyloid beta (A beta) deposition. Methods: From 2016 to 2018, 91 cognitively normal elderly Japanese aged 75 to 89 underwent brain magnetic resonance imaging and positron emission tomography using C-11-Pittsburgh compound-B. Serum equol was measured using stored samples from 2008 to 2012. Equol producers were defined as individuals with serum levels >0. Producers were further divided into high (> the median) and low (<= the median) producers. Results: The median (interquartile range) WML% was 1.10 (0.59 to 1.61); 24.2% were A beta positive, and 51% were equol producers. Equol-producing status (non-producers, low and high) was significantly inversely associated with WML%: 1.19, 0.89, and 0.58, respectively (trend P <.01). Equol-producing status was not associated with A beta status. Discussion: A randomized-controlled trial of equol targeting WML volume is warranted.