High-throughput quantification of circulating metabolites improves prediction of subclinical atherosclerosis.


AIMS High-throughput metabolite quantification holds promise for cardiovascular risk assessment. Here, we evaluated whether metabolite quantification by nuclear magnetic resonance (NMR) improves prediction of subclinical atherosclerosis in comparison to conventional lipid testing. METHODS AND RESULTS Circulating lipids, lipoprotein subclasses, and small molecules were assayed by NMR for 1595 individuals aged 24-39 years from the population-based Cardiovascular Risk in Young Finns Study. Carotid intima-media thickness (IMT), a marker of subclinical atherosclerosis, was measured in 2001 and 2007. Baseline conventional risk factors and systemic metabolites were used to predict 6-year incidence of high IMT (≥ 90 th percentile) or plaque. The best prediction of high intima-media thickness was achieved when total and HDL cholesterol were replaced by NMR-determined LDL cholesterol and medium HDL, docosahexaenoic acid, and tyrosine in prediction models with risk factors from the Framingham risk score. The extended prediction model improved risk stratification beyond established risk factors alone; area under the receiver operating characteristic curve 0.764 vs. 0.737, P =0.02, and net reclassification index 17.6%, P =0.0008. Higher docosahexaenoic acid levels were associated with decreased risk for incident high IMT (odds ratio: 0.74; 95% confidence interval: 0.67-0.98; P = 0.007). Tyrosine (1.33; 1.10-1.60; P = 0.003) and glutamine (1.38; 1.13-1.68; P = 0.001) levels were associated with 6-year incident high IMT independent of lipid measures. Furthermore, these amino acids were cross-sectionally associated with carotid IMT and the presence of angiographically ascertained coronary artery disease in independent populations. CONCLUSION High-throughput metabolite quantification, with new systemic biomarkers, improved risk stratification for subclinical atherosclerosis in comparison to conventional lipids and could potentially be useful for early cardiovascular risk assessment.

DOI: 10.1093/eurheartj/ehs020

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@article{Wrtz2012HighthroughputQO, title={High-throughput quantification of circulating metabolites improves prediction of subclinical atherosclerosis.}, author={Peter W{\"{u}rtz and Juho R Raiko and Costan G Magnussen and Pasi Soininen and Antti J Kangas and Tuulia Tynkkynen and Russell Thomson and Reino Laatikainen and Markku J Savolainen and Jari Laurikka and Pekka Kuukasj{\"a}rvi and Matti Tarkka and Pekka J Karhunen and Antti Jula and Jorma S Viikari and Mika K{\"a}h{\"{o}nen and Terho Lehtim{\"a}ki and Markus Juonala and Mika Ala-Korpela and Olli T Raitakari}, journal={European heart journal}, year={2012}, volume={33 18}, pages={2307-16} }