The association between dietary branched-chain amino acids and the risk of cardiovascular diseases in Chinese patients with type 2 diabetes: A hospital-based case–control study

Abstract

BackgroundPrevious studies showed conflicting evidence on the association between the intake of dietary branched-chain amino acid (BCAA) and the risk of cardiovascular disease (CVD). However, this relationship has not been studied in patients with type 2 diabetes. Therefore, we evaluated the effects of total and individual dietary BCAA (leucine, isoleucine, and valine) intake on CVD risk among individuals with type 2 diabetes in China.Materials and methodsA total of 419 patients with type 2 diabetes who have been diagnosed with CVD (within 2 weeks) were recruited between March 2013 and September 2015 in China. Cases with CVD were 1:1 matched to controls with type 2 diabetes but without CVD by age (±5 years) and sex. A validated 79-item semiquantitative food frequency questionnaire (FFQ) was administered to assess the participants' dietary data. Total dietary BCAA per individual was the summation of the daily intake of isoleucine, leucine, and valine. OR and corresponding CIs were computed by conditional logistic regression models adjusted for potential confounders.ResultsMedian values of the daily intake of total BCAA were 11.87 g, with an interquartile range of 10.46–13.15 g for cases, and 12.47 g, with an interquartile range of 11.08–13.79 g for controls (P = 0.001). Dietary BCAA was inversely related to CVD risk after multivariable adjustment (OR Q4−Q1 = 0.23, 95%CI = 0.10, 0.51, P trend <0.001 for total BCAA; OR Q4−Q1 = 0.20, 95%CI = 0.07, 0.53, P trend = 0.001 for leucine). For each 1-S.D. increase in total dietary BCAA, leucine or valine intake was associated with 54% (95%CI = 29%, 70%, P = 0.001), 64% (95%CI = 29%, 82%, P = 0.003), or 54% (95%CI = 1%, 79%, P = 0.049) decrease in the risk of CVD, respectively. Whole grains, starchy vegetables, mushrooms, fruit, eggs, and dairy and dairy product-derived BCAA were found to attenuate CVD risk (P ranged: = 0.002–0.027).ConclusionHigher BCAA intake, in particular leucine and valine, might be associated with a lower risk of CVD.

Circulatory Metabolite Ratios as Indicators of Lifestyle Risk Factors Based on a Greek NAFLD Case–Control Study

“…The low concentration of BCAAs may be the result of a decreased consumption of red and processed meat. Consistent evidence documents that the increased consumption of red meat and processed meat can be attributed to an increased risk of diabetes and cardiovascular disease (CVD) [ 37 ]. BCAAs have been related to the risk of diabetes or CVD in previous studies [ 38 ].…”

1H‐NMR‐based metabolomics reveals the preventive effect of Enteromorpha prolifera polysaccharides on diabetes in Zucker diabetic fatty rats

“…BCAAs are primarily catabolized in mitochondria through the involvement of BCAA aminotransferase and branched‐chain α‐ketoacid dehydrogenase. Increased BCAAs degradation results in increased BCAAs catabolism intermediates, which may disrupt mitochondrial glucose oxidation, leading to mitochondrial stress and impaired insulin secretion (Zheng et al., 2022 ). 3‐Methyl‐2‐oxovalerate, a branched ketoacid derivative of isoleucine, was identified as the strongest predictor of impaired fasting glucose in a clinical study (Menni et al., 2013 ).…”

“…This abnormal increase was reversed by EP, demonstrating that the prevention of diabetes by EP was partially dependent on changes in serum tryptophan concentrations. Moreover, tryptophan is a ketogenic amino acid that is metabolized to be degraded into acetyl‐CoA or acetoacetic acid and can therefore be converted into fatty acids or ketone bodies (Zheng et al., 2022 ). In this work, the decrease in the serum tryptophan levels observed in the EP group was consistent with its degradation and accompanying increase in 3‐hydroxybutyrate levels.…”

Cardiovascular protection of YiyiFuzi powder and the potential mechanisms through modulating mitochondria-endoplasmic reticulum interactions

“…In addition, Fuzi has been studied for its potential anti-MI effects, including mitigating mitochondrial dysfunction caused by MI and restoring energy metabolism in the heart (Wu H. et al, 2019). This effect maintains mitochondrial health and function (Table 2; Figure 3), improves blood flow and oxygen delivery to the body's tissues, and ensures an adequate supply of energy for the heart (Wang N. N. et al, 2021;Liu X. et al, 2022). SAL, a bioactive component of Fuzi, has been identified as a cardiotonic component (Zhou, 2011).…”

“…Traditional Chinese medicine (TCM), an essential complementary and alternative medicine, has been used for thousands of years to treat various diseases with multitarget effects and reported clinical benefits (Lu et al, 2004;Meng et al, 2021;Lv S. et al, 2022;Liu Y. J. et al, 2022). YiyiFuzi Powder (YYFZ), composed of Coicis semen and Fuzi (Figure 1), is a classical prescription from the Synopsis of Golden Chamber by Zhang Zhongjing in the Han Dynasty, which historically relieved cardiothoracic pain.…”