Amino Acids Can Predict CV Disease Risk in Women

Results of a recent study supported the hypothesis that plasma BCAAs (branched-chain amino acids) were positively associated with cardiovascular disease (CVD) risk and were linked to an intermediate diagnosis of type II diabetes (T2D).

A branched-chain amino acid (BCAA) is an amino acid having aliphatic side-chains with a branch (a central carbon atom bound to three or more carbon atoms). Among the amino acids found in proteins, there are three BCAAs: leucine, isoleucine, and valine. These three BCAAs are among the nine essential amino acids for humans, accounting for 35% of the essential amino acids in muscle proteins and 40% of the preformed amino acids required by mammals.

Circulating branched-chain amino acids (isoleucine, leucine, and valine) are strong predictors of type II diabetes mellitus (T2D), but their association with cardiovascular disease (CVD) is uncertain. To determine if BCAAs have a role in CVD, investigators at Brigham and Women's Hospital (Boston, MA, USA) measured BCAA levels in blood samples using NMR spectrometry. Of the more than 27,000 women studied, 2,207 experienced a cardiovascular event over the 18-year follow up period.

BCAAs were found to be positively associated with CVD at a degree comparable to LDL-C (low-density lipoprotein cholesterol). BCAAs were associated with coronary events (myocardial infarction, revascularization, and borderline significant association with stroke). The BCAA-CVD association was greater among women who developed T2D before CVD versus women without T2D. Adjusting for LDL-C, an established CVD risk factor, did not attenuate these findings; however, adjusting for HbA1c (glycosylated hemoglobin) and insulin resistance eliminated the associations of BCAAs with CVD.

"We examined more than 27,000 women in the Women's Health Study and found that a one-time measurement of branched chain amino acids in the blood stream - a test that now can be easily done - predicted future risk of cardiovascular events to the same extent and independent of LDL cholesterol and other risk factors," said senior author Dr. Samia Mora, a researcher at the center for lipid metabolomics at Brigham and Women's Hospital. "This was particularly so for women who developed type II diabetes prior to their cardiovascular disease."

The work was published in the March 23, 2018, online edition of the journal Circulation: Genomic and Precision Medicine.

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