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Meta-Analysis
. 2016 Oct;45(5):1482-1492.
doi: 10.1093/ije/dyw143. Epub 2016 Jul 13.

Cumulative consumption of branched-chain amino acids and incidence of type 2 diabetes

Yan Zheng  1 , Yanping Li  1 , Qibin Qi  2 , Adela Hruby  1 , JoAnn E Manson  3   4   5 , Walter C Willett  1   3   4 , Brian M Wolpin  6 , Frank B Hu  1   3   4 , Lu Qi  7   8
Affiliations
Meta-Analysis

Cumulative consumption of branched-chain amino acids and incidence of type 2 diabetes

Yan Zheng et al. Int J Epidemiol. 2016 Oct.

Abstract

Background: Plasma branched-chain amino acids (BCAAs, including leucine, isoleucine and valine) were recently related to risk of type 2 diabetes (T2D). Dietary intake is the only source of BCAAs; however, little is known about whether habitual dietary intake of BCAAs affects risk of T2D.

Methods: We assessed associations between cumulative consumption of BCAAs and risk of T2D among participants from three prospective cohorts: the Nurses' Health Study (NHS; followed from 1980 to 2012); NHS II (followed from 1991 to 2011); and the Health Professionals Follow-up Study (HPFS; followed from 1986 to 2010).

Results: We documented 16 097 incident T2D events during up to 32 years of follow-up. After adjustment for demographics and traditional risk factors, higher total BCAA intake was associated with an increased risk of T2D in men and women. In the meta-analysis of all cohorts, comparing participants in the highest quintile with those in the lowest quintile of intake, hazard ratios (95%confidence intervals) were for leucine 1.13 (1.07-1.19), for isoleucine 1.13 (1.07-1.19) and for valine 1.11 (1.05-1.17) (all P for trend < 0.001). In a healthy subsample, higher dietary BCAAs were significantly associated with higher plasma levels of these amino acids (P for trend = 0.01).

Conclusions: Our data suggest that high consumption of BCAAs is associated with an increased risk of T2D.

Keywords: Diet; branched-chain amino acids; cohort study; type 2 diabetes.

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Figures

Figure 1.
Figure 1.
Relative risk of type 2 diabetes according to quintiles of intakes of energy-adjusted BCAAs based on meta-analysed hazard ratios from NHS, NHS II and HPFS (A: leucine; B: isoleucine; C: valine; D: total BCAAs; all P for trend across quintiles < 0.0001). Hazard ratios were adjusted for age (months, continuous), smoking status (never, past, current cigarettes/day: 1–14, 15–24, ≥ 25, missing), alcohol intake (g/day: 0, 0.1–4.9, 5.0–14.9, ≥ 15), physical activity (metabolic equivalent task hours/week: < 3, 3–8.9, 9–17.9, 18–26.9, ≥ 27, missing), menopausal status and postmenopausal hormone use in women (premenopausal, and postmenopausal with never, past, current hormone use), family history of diabetes (yes/no), history of hypertension (yes/no), hypercholesterolaemia (yes/no), total energy intake (kcal/day: in quintiles), diabetes diet score (in quintiles), BMI (kg/m2, continuous) and BMI2.
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