Association of Plasma Branched Chain Amino Acid with Biomarkers of Inflammation and Lipid Metabolism in Women
Backgrounds - Branched-chain amino acids (BCAAs; isoleucine, leucine and valine) correlate with insulin resistance and poor glucose control, which may in part explain associations between type 2 diabetes (T2D) and cardiovascular disease (CVD). However, the relationships of BCAAs with other cardiometabolic pathways, including inflammation and dyslipidemia, are unclear. We hypothesized that plasma BCAAs would correlate with multiple pathways of cardiometabolic dysfunction. Methods - We conducted a cross-sectional analysis among 19,472 participants (mean age=54.9 years, SD=7.2 years) in the Women's Health Study without a history of T2D, CVD, or cancer. We quantified the concentrations of individual biomarkers of inflammation and lipids, across quartiles of BCAAs, adjusting for age, smoking, BMI, physical activity, and other established CVD risk factors at blood draw. Results - Women in the highest vs. lowest quartiles of plasma BCAAs had higher inflammatory markers including high-sensitivity C-reactive protein (multivariable-adjusted means: 1.96 vs. 1.43 mg/L), fibrinogen (367 vs. 362 mg/dL), soluble intercellular cell adhesion molecule-1 (361 vs. 353 ng/mL), and glycoprotein acetylation (407 vs. 371 µmol/L) (p-trend=0.0002 for fibrinogen; p<0.0001 for others). Similarly for lipids, women with higher BCAAs had lower HDL-c (49.0 vs. 55.0 mg/dL), and higher triglycerides (143 vs. 114 mg/dL), LDL-c (133 vs. 124 mg/dL), and lipoprotein insulin resistance score (52.6 vs. 37.3) (all: p<0.0001). Similar associations with these biomarkers were observed in isoleucine, leucine and valine, respectively. Conclusions - Higher circulating BCAA concentrations are associated with adverse profiles of biomarkers of inflammation and dyslipidemia independent of established CVD risk factors, and thus may reflect poorer cardiometabolic health through multiple pathways.