Markers of arterial stifness and urinary metabolomics in young adults with early cardiovascular risk: the African‑PREDICT study

Abstract

Introduction Increased exposure to risk factors in the young and healthy contributes to arterial changes, which may be accompanied by an altered metabolism. Objectives To increase our understanding of early metabolic alterations and how they associate with markers of arterial stifness, we profled urinary metabolites in young adults with cardiovascular disease (CVD) risk factor(s) and in a control group without CVD risk factors. Methods We included healthy black and white women and men (N=1202), aged 20–30 years with a detailed CVD risk factor profle, refecting obesity, physical inactivity, smoking, excessive alcohol intake, masked hypertension, hyperglycemia, dyslipidemia and low socio-economic status, forming the CVD risk group (N=1036) and the control group (N=166). Markers of arterial stifness, central systolic blood pressure (BP) and pulse wave velocity were measured. A targeted metabolomics approach was followed by measuring amino acids and acylcarnitines using a liquid chromatography-tandem mass spectrometry method. Results In the CVD risk group, central systolic BP (adjusted for age, sex, ethnicity) was negatively associated with histidine, arginine, asparagine, serine, glutamine, dimethylglycine, threonine, GABA, proline, methionine, pyroglutamic acid, aspartic acid, glutamic acid, branched chain amino acids (BCAAs) and butyrylcarnitine (all P≤0.048). In the same group, pulse wave velocity (adjusted for age, sex, ethnicity, mean arterial pressure) was negatively associated with histidine, lysine, threonine, 2-aminoadipic acid, BCAAs and aromatic amino acids (AAAs) (all P≤0.044). In the control group, central systolic BP was negatively associated with pyroglutamic acid, glutamic acid and dodecanoylcarnitine (all P≤0.033). Conclusion In a group with increased CVD risk, markers of arterial stifness were negatively associated with metabolites related to AAA and BCAA as well as energy metabolism and oxidative stress. Our fndings may suggest that metabolic adaptations may be at play in response to increased CVD risk to maintain cardiovascular integrity