Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, L. Pasteur 4, Wroclaw, 50-367, Poland.
Laboratory of Medical Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigl 12, Wroclaw, 53-114, Poland.
Endocrine. 2017 Dec;58(3):553-562. doi: 10.1007/s12020-017-1460-9. Epub 2017 Oct 26.
The primary objective of the present study was to examine the association between branched chain and aromatic amino acid profiles (BCAA and AAA respectively) and the metabolic syndrome (MS), and to evaluate the clinical utility of these associations in the diagnostic process.
Two hundred and sixty three healthy men with MS [MS(+): n = 165] and without MS [MS(-): n = 98] were enrolled in the observational study. Anthropometrical, biochemical, and amino acid measurements were performed. The ability of the BCAA and AAA to discriminate subjects with MS and insulin resistance was tested. Based on logistic discrimination, a multivariate early MS diagnostic model was built, and its discrimination properties were evaluated.
Two functionally independent amino acid clusters were identified. BCAA and phenylalanine differed significantly between MS(+) and MS(-) participants (P = 0.003). These factors were also found to be indicators of MS(+) individuals (AUC: 0.66; 95% CI: 0.5757-0.7469), and correlated with cardiometabolic factors. No statistically significant differences in amino acid concentrations between those with and without insulin resistance were noted, and none of the amino groups were indicators of insulin resistance. The proposed MS multivariate diagnostic model consisted of phenylalanine, insulin, leptin, and adiponectin, and had good discrimination properties [AUC 0.79; 95% CI: 0.7239-0.8646].
MS is associated with selective BCAA and AAA profile disturbances, which could be part of cardiometabolic disease pathogenesis and derive neither directly from insulin sensitivity impairment, nor obesity or muscle mass. The MS diagnostic model developed and described herein should be validated in future studies.
本研究的主要目的是研究支链氨基酸(BCAA)和芳香族氨基酸(AAA)谱与代谢综合征(MS)之间的相关性,并评估这些相关性在诊断过程中的临床应用价值。
本观察性研究纳入了 263 名健康男性,其中 165 名患有 MS(MS(+)),98 名无 MS(MS(-))。进行了人体测量学、生化和氨基酸测量。测试了 BCAA 和 AAA 区分 MS 患者和胰岛素抵抗的能力。基于逻辑判别,构建了一个多变量早期 MS 诊断模型,并评估了其判别特性。
确定了两个功能独立的氨基酸簇。MS(+)和 MS(-)参与者之间的 BCAA 和苯丙氨酸差异显著(P = 0.003)。这些因素也被发现是 MS(+)个体的指标(AUC:0.66;95%CI:0.5757-0.7469),并与心血管代谢因素相关。未观察到氨基酸浓度在胰岛素抵抗者和无胰岛素抵抗者之间存在统计学差异,且氨基酸组均不是胰岛素抵抗的指标。提出的 MS 多变量诊断模型由苯丙氨酸、胰岛素、瘦素和脂联素组成,具有良好的判别特性(AUC 0.79;95%CI:0.7239-0.8646)。
MS 与选择性 BCAA 和 AAA 谱紊乱相关,这可能是心血管代谢疾病发病机制的一部分,既不是直接来自胰岛素敏感性受损,也不是来自肥胖或肌肉量。本文所描述的 MS 诊断模型应在未来的研究中进行验证。