Association of branched-chain amino acids with mortality-the Ludwigshafen Risk and Cardiovascular Health (LURIC) study
Angela P. Moissl,
Stefan Lorkowski,
Andreas Meinitzer,
Stefan Pilz,
Hubert Scharnagl,
Graciela E. Delgado,
Marcus E. Kleber,
Bernhard K. Krämer,
Burkert Pieske,
Martin R. Grübler,
Helmut Brussee,
Dirk von Lewinski,
Hermann Toplak,
Astrid Fahrleitner-Pammer,
Winfried März,
Andreas Tomaschitz
Affiliations
Angela P. Moissl
Institute of Nutritional Sciences Friedrich Schiller University Jena, Jena, Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany; Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology, Pneumology), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Stefan Lorkowski
Institute of Nutritional Sciences Friedrich Schiller University Jena, Jena, Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany
Andreas Meinitzer
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
Stefan Pilz
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
Hubert Scharnagl
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
Graciela E. Delgado
Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology, Pneumology), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Marcus E. Kleber
Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany; Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology, Pneumology), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Synlab Human Genetics Laboratory, SYNLAB AG, Mannheim, Germany
Bernhard K. Krämer
Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology, Pneumology), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; European Center for Angioscience ECAS, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany
Burkert Pieske
Department of Internal Medicine and Cardiology, Charitè Campus Virchow Klinikum, Berlin, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Germany
Martin R. Grübler
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
Helmut Brussee
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
Dirk von Lewinski
Medical University of Graz, Department of Internal Medicine, Division of Cardiology, Graz, Austria
Hermann Toplak
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
Astrid Fahrleitner-Pammer
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
Winfried März
Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany; Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology, Pneumology), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany; Corresponding author
Summary: Branched-chain amino acids (BCAAs) are effectors of metabolic diseases, but their impact on mortality is largely unknown. We investigated the association of BCAA with risk factors and mortality in 2,236 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study using linear and Cox regression. Adiponectin, hemoglobin, C-peptide, hemoglobin A1c, and homoarginine showed the strongest association with BCAA concentration (all p < 0.001). During a median follow-up of 10.5 years, 715 participants died, including 450 cardiovascular-related deaths. BCAA concentrations were inversely associated with the risk of all-cause and cardiovascular mortality (HR [95% CI] per 1-SD increase in log-BCAA: 0.75 [0.69–0.82] and 0.72 [0.65–0.80], respectively) after adjustment for potential confounders. BCAAs are directly associated with metabolic risk but inversely with mortality in persons with intermediate-to-high cardiovascular risk. Further studies are warranted to evaluate the diagnostic and therapeutic utility of BCAA in the context of cardiovascular diseases.
