USA: Study on Cardiovascular Disease Risk Prediction

A recent study showed that future risk of cardiovascular disease (CVD) can be predicted by a metabolite-based distress score derived from measurements of molecular biomarkers in women related to chronic distress. The study was published in medRxiv.org as a preprint and has not yet been peer-reviewed.

"The study sheds light on the key molecular alterations that characterize chronic distress and predicts subsequent CVD risk in men and women. The findings provide additional evidence for the role of distress in the development of CVD," Raji Balasubramanian, University of Massachusetts Amherst, Amherst, MA, USA, and colleagues wrote in their study.

Chronic psychological distress has been linked with an increased CVD risk. However, there is limited mechanistic evidence explaining the observed associations, and data is specifically scarce among women. Dr. Balasubramanian and colleagues, therefore, aimed to examine if a metabolite profile linked with distress would be associated with an increased risk of CVD.

For this purpose, the researchers derived a plasma metabolite-based distress score (MDS) of twenty metabolites in a cross-sectional, 1:1 matched case-control dataset (n=558 women) in the Nurses' Health Study (NHS). Then, this score was calculated in two other cohorts, the Women's Health Initiative Observational Cohort (WHI-OS) and the Prevención con Dieta Mediterránea (PREDIMED) trial, and tested association with risk of developing adjudicated measures of CVD in each cohort.

Incident coronary heart disease (CHD) was considered in the WHI-OS dataset which included 944 postmenopausal women (472 CHD cases; mean time to event of 5.8 years), and incident CVD (including myocardial infarction, stroke, and CVD death) in the PREDIMED dataset which included 980 men and women (224 CVD cases, mean time to event of 3.1 years).

Key Findings of the Study

• In the WHI-OS, a 1-SD increase in the plasma MDS was associated with a 14% increased risk of incident CHD (odds ratio [OR]=1.14), adjusting for known CVD risk factors excluding total and HDL cholesterol. This association was attenuated after including total and HDL cholesterol (OR=1.09).
• Of the component metabolites in the MDS, tryptophan, and threonine were inversely associated with incident CHD risk.
• In PREDIMED, each one SD increase in the MDS was associated with a 17% increased incident CVD risk (OR=1.17), after adjusting for risk factors including total and HDL cholesterol. Similar associations were observed in men and women.
• Four individual metabolites in the MDS were associated with incident CVD risk in fully adjusted models in PREDIMED.
• Biliverdin and C36:5 PC plasmalogen had inverse associations, whereas C16:0 ceramide and C18:0 LPE each had positive associations with CVD risk.

"It is known that depression and other psychologic distress are linked to a higher risk for cardiovascular disease," wrote the authors. "Identifying metabolites that are increased with both chronic distress and cardiovascular disease might be helpful to clarify their associated underlying mechanisms. A scoring system based on these alterations might predict future risk for CVD, with a variety of potential uses."

Reference

The preprint research study titled, "Metabolomic profiles of chronic distress predict future cardiovascular disease risk," was published in medRxiv.org.

DOI: https://doi.org/10.1101/2022.02.26.22271549

Keywords

medRxiv.org, chronic distress, cardiovascular disease, metabolomic profiles, psychological distress, anxiety, score, Raji Balasubramanian, CVD, distress, molecular biomarkers