Abstract
ObjectivesThis study aimed to explore associations between plasma free amino acids (PFAA) and risk of cardiovascular disease (CVD) in Chinese with Type 2 diabetes (T2D).MethodsWe retrieved 741 inpatients with T2D consecutively from tertiary hospital. Twenty-three PFAA were measured. CVD was defined as having coronary heart disease (CHD) or stroke. Principal component analysis was used to extract factors of PFAA. Factors and their components were introduced into binary logistic regressions as continuous and tertiles to obtain OR (odds ratio) and 95% confidence interval (CI) for CVD (or its components) risk.ResultsOf 741 inpatients, 282 (38.1%) had CVD (CHD alone: 122, stroke alone: 109, both: 51). Five factors were extracted, accounting for 65% of the total variance. Factor 3 composed of glutamate and tryptophan was associated with increased CVD risk (ORs, 95%CI of top vs. bottom tertiles: 1.60, 1.02–2.50 for CVD; 2.19, 1.17–4.07 for stroke, 1.51, 0.83–2.73 for CHD); the ORs (top vs. bottom tertiles) of glutamate were 2.62 (95%CI, 1.18–5.84) for stroke and 1.44 (0.80–2.61) for CHD; the ORs (top vs. bottom tertiles) of tryptophan were 1.50 (0.81–2.75) for stroke and 1.07 (0.58–1.97) for CHD. Comparable results were observed according to important confounders (all P for interaction >0.05).ConclusionsElevated factor 3 composed of glutamate and tryptophan was associated with increased CVD, especially stroke in T2D in China.
Highlights
Cardiovascular disease (CVD) is one of the most severe complications of type 2 diabetes mellitus (T2D), which accounted for more than 20% all-cause death among patients with T2D in China [1]
Factor 3 composed of glutamate and tryptophan was associated with increased CVD risk (ORs, 95%confidence interval (CI) of top vs. bottom tertiles: 1.60, 1.02–2.50 for CVD; 2.19, 1.17–4.07 for stroke, 1.51, 0.83–2.73 for coronary heart disease (CHD)); the odds ratio (OR) of glutamate were 2.62 for stroke and 1.44 (0.80–2.61) for CHD; the ORs of tryptophan were 1.50 (0.81–2.75) for stroke and 1.07 (0.58–1.97) for CHD
Elevated factor 3 composed of glutamate and tryptophan was associated with increased CVD, especially stroke in T2D in China
Summary
Cardiovascular disease (CVD) is one of the most severe complications of type 2 diabetes mellitus (T2D), which accounted for more than 20% all-cause death among patients with T2D in China [1]. Researchers had attempted to identify potential modifiable risk factors to improve this situation. In this connection, a prospective study in Hong Kong revealed that optimal control of glycemia, blood pressure, and lipid control could only partially reduce risk of CVD and the residual risk of CVD was still substantial [2]. Abnormal amino acids metabolism has been related to vascular function in general population inconsistently, suggesting a subtle and complex relationship between amino acids metabolism and CVD [4, 5]. A prospective study measured several amino acids in diabetic cohorts and found no associations between these amino acids and macrovascular diseases [8]. The relationship of AA with CVD in T2D was largely unknown
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