Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra Navarra Institute for Health Research (IdiSNA) Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition Sciences, University of Navarra, Pamplona CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Curr Opin Clin Nutr Metab Care. 2020 Jan;23(1):35-50. doi: 10.1097/MCO.0000000000000614.
Branched-chain amino acids (BCAAs) are essential amino acids derived from diet. BCAA supplementation has been recommended in elderly and athletes, but recent studies suggest an association between high dietary BCAAs and blood levels of BCAAs with greater risk of cardiometabolic diseases (CMD). This review aims to integrate current epidemiological evidence analyzing the association between BCAAs and related-CMD risk factors.
Most epidemiological studies consistently show that dietary BCAAs are associated with higher risk of type-2 diabetes (T2D) whereas there is limited evidence related with other cardiovascular risk factors. Evidence also exists showing an association between higher circulating BCAA levels and risk of T2D and cardiovascular disease, and also probably with metabolic syndrome and overweight/obesity. Several clinical trials suggest beneficial cardiometabolic effect of BCAAs supplementation, although with a small sample size and short follow-up. Studies show a weak correlation between dietary BCAAs and circulating BCAA levels. Protein quality sources and whole dietary pattern are key aspects to improve our understanding of the effect of BCAAs as well as factors associated with higher protein needs, such as age or frailty.
Dietary and circulating BCAAs exhibit possible detrimental cardiometabolic effects, but BCAA supplementation may have some positive influence on target groups with nutritional deficiencies.
支链氨基酸（BCAAs）是一种从饮食中获得的必需氨基酸。BCAA 补充剂已被推荐用于老年人和运动员，但最近的研究表明，高饮食 BCAAs 和血液中 BCAAs 水平与更高的心血管代谢疾病（CMD）风险之间存在关联。本综述旨在整合当前分析 BCAAs 与相关 CMD 风险因素之间关联的流行病学证据。
大多数流行病学研究一致表明，饮食中的 BCAAs 与 2 型糖尿病（T2D）的风险增加有关，而与其他心血管风险因素相关的证据有限。还有证据表明，较高的循环 BCAA 水平与 T2D 和心血管疾病的风险相关，也可能与代谢综合征和超重/肥胖相关。几项临床试验表明，BCAA 补充剂对代谢有益，但样本量小，随访时间短。研究表明，饮食中 BCAAs 与循环 BCAA 水平之间存在微弱相关性。蛋白质质量来源和整个饮食模式是深入了解 BCAAs 作用以及与更高蛋白质需求相关的因素（如年龄或虚弱）的关键方面。
饮食和循环中的 BCAAs 可能对心血管代谢有不良影响，但 BCAA 补充剂可能对营养缺乏的目标人群有一些积极的影响。
