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Title: Plasma branched-chain amino acids and incident cardiovascular disease in the PREDIMED Trial
Authors: Ruiz-Canela, Miguel
Toledo, Estefania
Clish, Clary B.
Hruby, Adela
Liang, Liming
Salas-Salvadó, Jordi
Razquin, Cristina
Corella, Dolores
Estruch, Ramón
Ros, Emilio
Fitó, Montserrat
Gómez-Gracia, Enrique
Arós, Fernando
Fiol, Miquel
Lapetra, José
Serra-Majem, L. 
Martínez-González, Miguel A.
Hu, Frank B.
UNESCO Clasification: 3206 Ciencias de la nutrición
Keywords: Coronary-Artery-Disease
Mediterranean Diet
Risk, et al
Issue Date: 2016
Journal: Clinical chemistry (Baltimore, Md.) 
Abstract: BACKGROUND: 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. METHODS: We developed a case-cohort study within the Prevención con Dieta Mediterranea (PREDIMED), with 226 incident CVD cases and 744 noncases. We used LC-MS/MS to measure plasma BCAAs (leucine, isoleucine, and valine), both at baseline and after 1 year of follow-up. The primary outcome was a composite of incident stroke, myocardial infarction, or cardiovascular death. RESULTS: 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% CI, 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. With stroke as the outcome, a significant interaction (P = 0.009) between baseline BCAA score and intervention with MedDiet was observed. No significant effect of the intervention on 1-year changes in BCAAs or any association between 1-year changes in BCAAs and CVD were observed. CONCLUSIONS: 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.
ISSN: 0009-9147
DOI: 10.1373/clinchem.2015.251710
Source: Clinical Chemistry [ISSN 0009-9147], v. 62 (4), p. 582-592
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