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Title: Plasma lipidomic profiles and cardiovascular events in a randomized intervention trial with the Mediterranean diet
Authors: Toledo, Estefania
Wang, Dong D.
Ruiz-Canela, Miguel
Clish,Clary B.
Razquin, Cristina
Zheng, Yan
Guasch-Ferré, Marta
Hruby, Adela
Corella, Dolores
Gómez-Gracia, Enrique
Fiol, Miquel
Estruch, Ramón
Ros, Emilio
Lapetra, José
Fitó, Montse
Arós, Fernando
Serra-Majem, Lluis 
Liang, Liming
Salas-Salvadó, Jordi
Hu, Frank B.
Martínez-González, Miguel Ángel
UNESCO Clasification: 3206 Ciencias de la nutrición
32 Ciencias médicas
Keywords: Mediterranean diet
Randomized trial, et al
Issue Date: 2017
Journal: The American journal of clinical nutrition 
Abstract: Background: Lipid metabolites may partially explain the inverse association between the Mediterranean diet (MedDiet) and cardiovascular disease (CVD). Objective: We evaluated the associations between 1) lipid species and the risk of CVD (myocardial infarction, stroke, or cardiovascular death); 2) a MedDiet intervention [supplemented with extra virgin olive oil (EVOO) or nuts] and 1-y changes in these molecules; and 3) 1-y changes in lipid species and subsequent CVD. Design: With the use of a case-cohort design, we profiled 202 lipid species at baseline and after 1 y of intervention in the PREDIMED (PREvencion con DIeta MEDiterranea) trial in 983 participants [230 cases and a random subcohort of 790 participants (37 overlapping cases)]. Results: Baseline concentrations of cholesterol esters (CEs) were inversely associated with CVD. A shorter chain length and higher saturation of some lipids were directly associated with CVD. After adjusting for multiple testing, direct associations remained significant for 20 lipids, and inverse associations remained significant for 6 lipids. When lipid species were weighted by the number of carbon atoms and double bonds, the strongest inverse association was found for CEs [HR: 0.39 (95% CI: 0.22, 0.68)] between extreme quintiles (P-trend = 0.002). Participants in the MedDiet + EVOO and MedDiet + nut groups experienced significant (P < 0.05) 1-y changes in 20 and 17 lipids, respectively, compared with the control group. Of these changes, only those in CE(20:3) in the MedDiet + nuts group remained significant after correcting for multiple testing. None of the 1-y changes was significantly associated with CVD risk after correcting for multiple comparisons. Conclusions: Although the MedDiet interventions induced some significant 1-y changes in the lipidome, they were not significantly associated with subsequent CVD risk. Lipid metabolites with a longer acyl chain and higher number of double bonds at baseline were significantly and inversely associated with the risk of CVD.
ISSN: 0002-9165
DOI: 10.3945/ajcn.116.151159
Source: American Journal of Clinical Nutrition [ISSN 0002-9165], v. 106 (4), p. 973-983
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