Branched-Chain Amino Acids and Cardiovascular Disease: Does Diet Matter?

[摘要] Cardiovascular diseases (CVDs)2 account for a substantial worldwide burden of mortality and morbidity. Although numerous known risk factors increase the risk of CVD, including obesity, sedentary behavior, smoking, low-quality diet, dyslipidemia, and hypertension, these are imperfect predictors of disease. Indeed, a large proportion of cardiovascular events occur in individuals with low predicted risk based on traditional risk factors (1). Thus, there remains a considerable opportunity to improve the identification of individuals most likely to experience a CVD event and facilitate preemptive treatments.Particular interest has been shown in identifying novel biomarkers of cardiovascular or metabolic risk. Biomarkers not only may aid in risk stratification, but also could highlight which pathways can be targeted to lower the risk. The availability of “less biased” molecular profiling technologies, such as metabolomics and proteomics, has advanced such biomarker discovery efforts. Metabolomic profiling, in particular, has revealed multiple circulating metabolites associated with cardiovascular and metabolic risk. For instance, studies have found intriguing associations between branched-chain amino acids (BCAAs) and cardiometabolic risk (2), with increased concentrations of circulating BCAAs in coronary artery disease patients compared with control subjects (3) and increased BCAAs predicting risk of future diabetes (4, 5). Nonetheless, many questions remain as to whether these biomarkers are causal or correlative, and if causal, what the underlying mechanisms may be.BCAAs include leucine, isoleucine, and valine and constitute an important class of essential amino acids. As with all essential amino acids, dietary protein intake provides the predominant source, and apart from cases of rare mendelian mutations, deficiencies rarely occur in well-nourished individuals. However, the relation between dietary intake and amino …

[学科分类] 过敏症与临床免疫学