Plasma Branched-Chain Amino Acids and Incident Cardiovascular Disease in the PREDIMED Trial.
Plasma Branched-Chain Amino Acids and Incident Cardiovascular Disease in the PREDIMED Trial.
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DOI：
10.1373/clinchem.2015.251710
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发表时间：
2016-04
影响因子：
9.3
通讯作者：
Hu FB
中科院分区：
文献类型：
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作者：
Ruiz-Canela M;Toledo E;Clish CB;Hruby A;Liang L;Salas-Salvadó J;Razquin C;Corella D;Estruch R;Ros E;Fitó M;Gómez-Gracia E;Arós F;Fiol M;Lapetra J;Serra-Majem L;Martínez-González MA;Hu FB
支链氨基酸（BCAA）在心血管疾病（CVD）中的作用仍然知之甚少。我们假设基线BCAA浓度预测未来CVD的风险，地中海饮食（MedDiet）干预可能会抵消这种影响。我们在“PREDIMED”中开展了一项病例队列研究，其中包括226例CVD病例和781例非病例。我们使用LC-MS/MS测量基线和1年随访后的血浆BCAA（亮氨酸、异亮氨酸和缬氨酸）。主要结局是卒中、心肌梗死或心血管死亡的复合事件。校正潜在混杂因素后，基线亮氨酸和异亮氨酸浓度与较高的CVD风险相关：最高与最低四分位数的风险比（HR）分别为1.70（95%置信区间，1.05-2.76）和2.09（1.27-3.44）。与中风的关联性更强。对于CVD和中风，我们发现对照组中连续四分位数的BCAAs的HR高于MedDiet组。使用中风作为结果，观察到基线BCAA评分和MedDiet干预之间的显著相互作用（P=0.009）。没有观察到干预对1年BCAAs变化的显著影响，也没有观察到1年BCAAs变化与CVD之间的任何关联。在高心血管风险人群中，较高浓度的基线支链氨基酸与心血管疾病（尤其是卒中）风险增加相关。地中海式饮食对BCAAs的1年变化的影响可以忽略不计，但它可能会抵消BCAAs对中风的有害影响。
The role of branched-chain amino acids (BCAAs) in cardiovascular disease (CVD) remains poorly understood. We hypothesized that baseline BCAA concentrations predict future risk of CVD and that a Mediterranean Diet (MedDiet) intervention may counteract this effect. We developed a case-cohort study within the “PREvención con DIeta MEDiterránea” (PREDIMED), with 226 incident CVD cases and 781 non-cases. We used LC-MS/MS to measure plasma BCAAs (leucine, isoleucine and valine), both at baseline and after 1-year follow-up. The primary outcome was a composite of incident stroke, myocardial infarction, or cardiovascular death. After adjustment for potential confounders, baseline leucine and isoleucine concentrations were associated with higher CVD risk: the hazard ratios (HRs) for the highest vs. lowest quartile were 1.70 (95% confidence interval, 1.05–2.76) and 2.09 (1.27–3.44), respectively. Stronger associations were found for stroke. For both CVD and stroke, we found higher HRs across successive quartiles of BCAAs in the control group than in the MedDiet groups. Using stroke as the outcome, a significant interaction (P=0.009) between the baseline BCAA score and the intervention with MedDiet was observed. No significant effect of the intervention on 1-yr changes in BCAAs nor any association between 1-year changes in BCAAs and CVD were observed. Higher concentrations of baseline BCAAs were associated with increased risk of CVD, especially stroke, in a high cardiovascular risk population. A Mediterranean-style diet had a negligible effect on 1-year changes in BCAAs, but it may counteract the harmful effects of BCAAs on stroke.