Metabolites of Glutamate Metabolism Are Associated With Incident Cardiovascular Events in the PREDIMED PREvencion con DIeta MEDiterranea (PREDIMED) Trial

Background: Glutamate metabolism may play a role in the pathophysiology of cardiometabolic disorders. However, there is limited evidence of an association between glutamate-related metabolites and, moreover, changes in these metabolites, and risk of cardiovascular disease (CVD). Methods and Results:...

Descripción completa

Detalles Bibliográficos
Autores: Zheng, Yan, Hu, Frank B, Ruiz-Canela, Miguel, Clish, Clary B, Dennis, Courtney, Salas-Salvado, Jordi, Hruby, Adela, Liang, Liming, Toledo, Estefanía, Corella, Dolores, Ros, Emilio, Fito, Montserrat, Gomez-Gracia, Enrique, Aros, Fernando, Lapetra, Jose, Serra-Majem, Lluis, Estruch, Ramon, Martinez-Gonzalez, Miguel A
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/20240
Acceso en línea:http://hdl.handle.net/20.500.12105/20240
Access Level:acceso abierto
Palabra clave:Cardiovascular disease
Diet
Dietary clinical trial
Epidemiology
Glutamate
Glutamine
Incidence
Stroke
Dieta Mediterránea
Incidencia
Modelos de Riesgos Proporcionales
Ácido Glutámico
Accidente Cerebrovascular
LDL-Colesterol
Femenino
Infarto del Miocardio
Fumar Tabaco
HDL-Colesterol
Masculino
Glutamina
Hipertensión
Fumar
Factores de Riesgo
Dislipidemias
Humanos
Persona de Mediana Edad
Anciano
Anciano de 80 o más Años
Diabetes Mellitus Tipo 2
Enfermedades Cardiovasculares
Ensayos Clínicos Controlados Aleatorios como Asunto
España
Cardiovascular Diseases
Diabetes Mellitus, Type 2
Descripción
Sumario:Background: Glutamate metabolism may play a role in the pathophysiology of cardiometabolic disorders. However, there is limited evidence of an association between glutamate-related metabolites and, moreover, changes in these metabolites, and risk of cardiovascular disease (CVD). Methods and Results: Plasma levels of glutamate and glutamine were measured at baseline and 1-year follow-up in a case-cohort study including 980 participants (mean age 68 years; 46% male) from the PREvencion con DIeta MEDiterranea (PREDIMED) randomized trial, which assessed a Mediterranean diet intervention in the primary prevention of CVD. During median 4.8 years of follow-up, there were 229 incident CVD events (nonfatal stroke, nonfatal myocardial infarction, or CVD death). In fully adjusted models, per 1-SD, baseline glutamate was associated with 43% (95% CI: 16% to 76%) and 81% (39% to 137%) increased risk of composite CVD and stroke alone, respectively, and baseline glutamine-to-glutamate ratio with 25% (6% to 40%) and 44% (25% to 58%) decreased risk of composite CVD and stroke alone, respectively. Associations appeared linear for stroke (both P-linear trend <= 0.005). Among participants with high baseline glutamate, the interventions lowered CVD risk by 37% compared to the control diet; the intervention effects were not significant when baseline glutamate was low (P-interaction=0.02). No significant effect of the intervention on year-1 changes in metabolites was observed, and no effect of changes themselves on CVD risk was apparent. Conclusions: Baseline glutamate was associated with increased CVD risk, particularly stroke, and glutamine-to-glutamate ratio was associated with decreased risk. Participants with high glutamate levels may obtain greater benefits from the Mediterranean diet than those with low levels.