Branched-Chain Amino Acids
The Metabolic Link Between Type 2 Diabetes Mellitus and Cardiovascular Disease?
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
See Article by Tobias et al
Cardiovascular disease (CVD) is the leading cause of death worldwide. Type 2 diabetes mellitus (T2D) is an independent risk factor for CVD, including stroke and heart disease.1,2 Both CVD and T2D share many risk factors, such as obesity, insulin resistance, dyslipidemia, inflammation, and hypertension, which led to the hypothesis that both conditions have common genetic and environmental origins,3 but the biological underpinnings establishing the link have not been fully elucidated. Despite the number of traditional risk factors used in current prediction models, a large proportion of CVD events occur in individuals with low predicted risk.4 Therefore, novel biomarkers are needed to improve risk stratification and enhance the opportunity for early intervention.
Emerging technologies, such as high-throughput metabolomics and proteomics, can now provide unique insights into mechanisms underlying T2D and CVD by quantifying hundreds of metabolites or proteins across multiple pathways in a single measurement. Recently, these platforms have garnered much attention in the area of CVD biomarker discovery. Comprehensive metabolomic profiling led to the identification of a branched-chain amino acid (BCAA) signature (isoleucine, leucine, valine) with insulin resistance.5 The association of BCAAs with T2D has been confirmed in multiple epidemiological studies.6,7 In addition, BCAAs have been associated with CVD.8,9 However, it is unknown whether …