Branched-chain amino acids and insulin metabolism: the Insulin Resistance Atherosclerosis Study (IRAS)

CC Lee, SM Watkins, C Lorenzo… - Diabetes …, 2016 - Am Diabetes Assoc
CC Lee, SM Watkins, C Lorenzo, LE Wagenknecht, D Il'yasova, YDI Chen, SM Haffner…
Diabetes care, 2016Am Diabetes Assoc
OBJECTIVE Recent studies using untargeted metabolomics approaches have suggested
that plasma branched-chain amino acids (BCAAs) are associated with incident diabetes.
However, little is known about the role of plasma BCAAs in metabolic abnormalities
underlying diabetes and whether these relationships are consistent across ethnic
populations at high risk for diabetes. We investigated the associations of BCAAs with insulin
sensitivity (SI), acute insulin response (AIR), and metabolic clearance of insulin (MCRI) in a …
OBJECTIVE
Recent studies using untargeted metabolomics approaches have suggested that plasma branched-chain amino acids (BCAAs) are associated with incident diabetes. However, little is known about the role of plasma BCAAs in metabolic abnormalities underlying diabetes and whether these relationships are consistent across ethnic populations at high risk for diabetes. We investigated the associations of BCAAs with insulin sensitivity (SI), acute insulin response (AIR), and metabolic clearance of insulin (MCRI) in a multiethnic cohort.
RESEARCH DESIGN AND METHODS
In 685 participants without diabetes of the Insulin Resistance Atherosclerosis Study (IRAS) (290 Caucasians, 165 African Americans, and 230 Hispanics), we measured plasma BCAAs (sum of valine, leucine, and isoleucine) by mass spectrometry and SI, AIR, and MCRI by frequently sampled intravenous glucose tolerance tests.
RESULTS
Elevated plasma BCAAs were inversely associated with SI and MCRI and positively associated with fasting insulin in regression models adjusted for potential confounders (β = −0.0012 [95% CI −0.0018, −0.00059], P < 0.001 for SI; β = −0.0013 [95% CI −0.0018, −0.00082], P < 0.001 for MCRI; and β = 0.0015 [95% CI 0.0008, 0.0023], P < 0.001 for fasting insulin). The association of BCAA with SI was significantly modified by ethnicity, with the association only being significant in Caucasians and Hispanics. Elevated plasma BCAAs were associated with incident diabetes in Caucasians and Hispanics (multivariable-adjusted odds ratio per 1-SD increase in plasma BCAAs: 1.67 [95% CI 1.21, 2.29], P = 0.002) but not in African Americans. Plasma BCAAs were not associated with SI-adjusted AIR.
CONCLUSIONS
Plasma BCAAs are associated with incident diabetes and underlying metabolic abnormalities, although the associations were generally stronger in Caucasians and Hispanics.
Am Diabetes Assoc