Bianca de Almeida-Pititto1, Patrícia M Dualib2, Martha C Jordão3, Marília Izar Helfenstein Fonseca4, Steven R Jones5, Michael J Blaha6, Peter P Toth7, Raul D Santos8, Isabela M Bensenor9, Sandra Roberta G Ferreira10, Paulo A Lotufo11. 1. Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu 740, CEP 04023900 São Paulo, Brazil; Programa de Pós-Graduação em Endocrinologia e Metabologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Estado de Israel 639, CEP 04023900, São Paulo, Brazil. Electronic address: bapititto@unifesp.br. 2. Programa de Pós-Graduação em Endocrinologia e Metabologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Estado de Israel 639, CEP 04023900, São Paulo, Brazil. Electronic address: patricia.dualib@uol.com.br. 3. Programa de Pós-Graduação em Endocrinologia e Metabologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Estado de Israel 639, CEP 04023900, São Paulo, Brazil. Electronic address: mcjordao@unifesp.br. 4. Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. Electronic address: marilia_fonseca@yahoo.com.br. 5. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Blalock 524 D1, 600 N. Wolfe St, Baltimore, MD, USA. Electronic address: sjones64@jhmi.edu. 6. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Blalock 524 D1, 600 N. Wolfe St, Baltimore, MD, USA. Electronic address: mblaha1@jhmi.edu. 7. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Blalock 524 D1, 600 N. Wolfe St, Baltimore, MD, USA; Department of Preventive Cardiology, CGH Medical Center, 100 E. Le Fevre Road 61081 Sterling, IL, USA. Electronic address: Peter.Toth@cghmc.com. 8. Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr. Enéas de Carvalho Aguiar, 44, CEP 01246-000 São Paulo, Brazil. Electronic address: raul.santos@incor.usp.br. 9. Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, Av. Lineu Prestes 2565 - 4° floor, CEP: 05508-000 São Paulo, SP, Brazil; Centro de Pesquisa do Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, 3rd floor, CEP 05508-000 São Paulo, SP, Brazil. 10. Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. Electronic address: sandrafv@usp.br. 11. Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, Av. Lineu Prestes 2565 - 4° floor, CEP: 05508-000 São Paulo, SP, Brazil; Centro de Pesquisa do Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, 3rd floor, CEP 05508-000 São Paulo, SP, Brazil. Electronic address: palotufo@usp.br.
Abstract
AIMS: To evaluate the role of branch chain amino acid (BCAA) concentrations as a predictor for incident type 2 diabetes (DM). METHODS: Participants from ELSA-Brasil without diabetes at baseline and followed for 3.9 ± 0.6 years were included in the analysis. The determinations of BCAA (valine, leucine, isoleucine) were performed by proton nuclear magnetic resonance spectroscopy. Cardiometabolic profile and incidence of DM were evaluated according to quartiles of BCAA at baseline, stratified by sex. RESULTS: From 3,828 participants (56% female, 50.5 ± 8.7 years) 299 (8.5%) were diagnosed with DM. For both sexes, a worsening of cardiometabolic profile was observed across increasing BCAA quartiles. In survival analysis, incidence rates of DM for the entire period were highest in participants in the third and fourth quartile of BCAA (log Rank analysis < 0.001 for both sexes). In Cox regression analysis, for men, the HR (95%CI) for risk of DM was 2.24 (1.24-4.03) for those from the fourth quartile of BCAA, while in women it was 1.94 (1.07-3.50), comparing to first quartile of BCAA after adjustments for age, BMI, physical activity, family history of DM, pre-diabetes, blood pressure, total cholesterol and HOMA-IR. CONCLUSIONS: Higher levels of BCAA were independently predictors of DM.
AIMS: To evaluate the role of branch chain amino acid (BCAA) concentrations as a predictor for incident type 2 diabetes (DM). METHODS:Participants from ELSA-Brasil without diabetes at baseline and followed for 3.9 ± 0.6 years were included in the analysis. The determinations of BCAA (valine, leucine, isoleucine) were performed by proton nuclear magnetic resonance spectroscopy. Cardiometabolic profile and incidence of DM were evaluated according to quartiles of BCAA at baseline, stratified by sex. RESULTS: From 3,828 participants (56% female, 50.5 ± 8.7 years) 299 (8.5%) were diagnosed with DM. For both sexes, a worsening of cardiometabolic profile was observed across increasing BCAA quartiles. In survival analysis, incidence rates of DM for the entire period were highest in participants in the third and fourth quartile of BCAA (log Rank analysis < 0.001 for both sexes). In Cox regression analysis, for men, the HR (95%CI) for risk of DM was 2.24 (1.24-4.03) for those from the fourth quartile of BCAA, while in women it was 1.94 (1.07-3.50), comparing to first quartile of BCAA after adjustments for age, BMI, physical activity, family history of DM, pre-diabetes, blood pressure, total cholesterol and HOMA-IR. CONCLUSIONS: Higher levels of BCAA were independently predictors of DM.