Introduction: Plasma amino acids were reported to be associated with oxidative stress and cardiovascular disease (CVD) morbidity in patients with life-style related diseases. Among amino acids, recent several studies indicated that branched chain amino acid (BCAA) has relations with insulin resistance and incident CVD. We aimed to investigate whether plasma BCAA levels predict CVD-related mortality in HD patients.
Hypothesis: Plasma BCAA levels are associated with CVD - related mortality in HD patients
Methods: This was a retrospective study with follow up for 5 years. At baseline, demographic data, clinical parameters, and laboratory data were recorded for each patient. Pre-dialysis fasting blood samples were collected to examine the amino acids at the beginning session of a week. The Cox proportional hazards model was used to assess association between the BCAA levels and the risk of CVD death.
Results: A total of 132 outpatients were enrolled. At the baseline, plasma BCAA levels were significantly higher in the patients with diabetes mellitus than in those without. There were significant correlations between the plasma BCAA levels and age (r = 0.181, P = 0.038), inverse correlations between the plasma BCCA and Kt/V (r = -0.267, P = 0.001) and total cholesterol levels (r = -0.214, P = 0.014). Among the whole patients, there were 11 lethal events due to CVD. In the multivariate analysis, plasma BCAA was related independently to CVD death.
Conclusions: These results suggest that high BCAA levels predict the CVD-related prognosis in HD patients. Further study is needed to elucidate the underlying mechanisms behind the identified associations.