Branched-chain amino acids are associated with cardiometabolic risk profiles found already in lean, overweight and obese young

Cardiovascular risk is increased in obese subjects. Nevertheless, some overweight and obese remain cardiometabolically healthy (CMH), and normal-weight persons develop cardiovascular disease (CVD). Herein, we investigate the potential of branched-chain amino acids (BCAAs) to identify an increased CVD risk in a cross-sectional study of 666 adults and juveniles (age 25.3 ± 12.8 years), classified as lean, overweight or obese. Cardiometabolic groups were defined by cutoffs of systolic blood pressure < 130 mmHg, diastolic blood pressure < 85 mmHg, glucose < 125 mg/dl, triglycerides < 150 mg/dl, HDL-cholesterol > 40 mg/dl (males), HDL-cholesterol > 50 mg/dl (females) and HOMA-IR < 5. CMH had ≤ 1 cutoff, and cardiometabolically abnormal (CMA) had ≥ 2 cutoffs. Amino acids were measured by high-pressure lipid chromatography after precipitation of serum with perchloric acid and derivatization with o-phthalaldehyde. Valine correlated with 5, leucine correlated with 3 and isoleucine correlated with 5 of the cardiac risk classification factors. Valine and leucine were significantly higher in the obese (P < .001, P = .015, respectively), overweight (P < .001, P = .015, respectively) and lean (P = .024, P = .012, respectively) CMA compared to CMH subjects. Isoleucine showed except of the lean group the same results. Taken together, BCAAs, especially valine and leucine, are proposed as a cardiometabolic risk marker independent of body mass index (BMI) category.