Circulating branched-chain amino acids and incident heart failure in type 2 diabetes: The Hong Kong Diabetes Register
Publication in refereed journal

替代計量分析
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其它資訊
摘要Aim
Levels of branched‐chain amino acids (BCAAs, namely, isoleucine, leucine, and valine) are modulated by dietary intake and metabolic/genetic factors. BCAAs are associated with insulin resistance and increased risk of type 2 diabetes (T2D). Although insulin resistance predicts heart failure (HF), the relationship between BCAAs and HF in T2D remains unknown.

Methods
In this prospective observational study, we measured BCAAs in fasting serum samples collected at inception from 2139 T2D patients free of cardiovascular‐renal diseases. The study outcome was the first hospitalization for HF.

Results
During 29 103 person‐years of follow‐up, 115 primary events occurred (age: 54.8 ± 11.2 years, 48.2% men, median [interquartile range] diabetes duration: 5 years [1‐10]). Patients with incident HF had 5.6% higher serum BCAAs than those without HF (median 639.3 [561.3‐756.3] vs 605.2 [524.8‐708.7] μmol/L; P = .01). Serum BCAAs had a positive linear association with incident HF (per‐SD increase in logarithmically transformed BCAAs: hazard ratio [HR] 1.22 [95% CI 1.07‐1.39]), adjusting for age, sex, and diabetes duration. The HR remained significant after sequential adjustment of risk factors including incident coronary heart disease (1.24, 1.09‐1.41); blood pressure, low‐density lipoprotein cholesterol, and baseline use of related medications (1.31, 1.14‐1.50); HbA1c, waist circumference, triglyceride, and baseline use of related medications (1.28, 1.11‐1.48); albuminuria and estimated glomerular filtration rate (1.28, 1.11‐1.48). The competing risk of death analyses showed similar results.

Conclusions
Circulating levels of BCAAs are independently associated with incident HF in patients with T2D. Prospective cohort analysis and randomized trials are needed to evaluate the long‐term safety and efficacy of using different interventions to optimize BCAAs levels in these patients.
出版社接受日期19.11.2019
著者Lim LL, Lau ESH, Fung E, Lee HM, Ma RCW, Tam CHT, Wong WKK, Ng ACW, Chow E, Luk AOY, Jenkins A, Chan JCN, Kong APS
期刊名稱Diabetes/Metabolism Research and Reviews
出版年份2020
月份3
卷號36
期次3
出版社Wiley
文章號碼e3253
國際標準期刊號1520-7552
語言英式英語

上次更新時間 2020-11-10 於 23:36