• Marta Guasch-Ferré, Yan Zheng, Miguel Ruiz-Canela, Adela Hruby, Miguel A Martínez-González, Clary B Clish, Dolores Corella, Ramon Estruch, Emilio Ros, Montserrat Fitó, Courtney Dennis, Isabel M Morales-Gil, Fernando Arós, Miquel Fiol, José Lapetra, Lluís Serra-Majem, Frank B Hu, and Jordi Salas-Salvadó.
• Departments of Nutrition and Human Nutrition Department, Pere Virgili Research Institute, University Hospital of Sant Joan de Reus, Rovira i Virgili University, Reus, Spain; The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain;
• Am. J. Clin. Nutr. 2016 Jun 1; 103 (6): 1408-16.

BackgroundPrevious studies have suggested that metabolite profiles of elevated acylcarnitines were associated with increased risk of cardiovascular disease (CVD) in populations with established coronary disease. However, to our knowledge, this association has not been evaluated in the context of primary cardiovascular prevention.ObjectivesWe evaluated the association between 28 plasma acylcarnitine species and risk of incident CVD and the potential modifying effect of Mediterranean diet (MedDiet) interventions.DesignWe measured plasma acylcarnitines with the use of high-throughput liquid chromatography-tandem mass spectrometry at baseline and after 1 y of follow-up, both individually and classified into short-, medium-, or long-chain scores, in a case-cohort study within the Prevención con Dieta Mediterránea (PREDIMED) study, which is a randomized Mediterranean dietary intervention for primary cardiovascular prevention. A randomly selected subcohort (n = 751) and all available incident CVD cases (n = 229) after 4.8 y of follow-up were included in the current study.ResultsAfter adjustment for age, sex, body mass index, and other CVD risk factors, participants in the highest quartile of baseline short- and medium-chain acylcarnitines had a higher risk of CVD than did participants in the lowest quartile [HRs: 1.80 (95% CI: 1.11, 2.91; P-trend 0.01) and 1.55 (95% CI: 1.01, 2.48; P-trend = 0.04), respectively]. Increased short-chain acylcarnitines after 1 y were associated with higher risks of total CVD and stroke. Participants with higher baseline concentrations of short-, medium-, and long-chain acylcarnitines who were randomly assigned to the control group had a higher risk of CVD than did subjects with lower concentrations of acylcarnitines who were assigned to the MedDiet group.ConclusionsOur data support the conclusion that metabolite profiles characterized by elevated concentrations of acylcarnitines are independently associated with risks of total CVD and stroke alone in participants at high risk of CVD. MedDiet interventions may mitigate the adverse associations shown between higher concentrations of acylcarnitines and CVD. This trial was registered at www.controlled-trials.com as ISRCTN35739639.© 2016 American Society for Nutrition.

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