Effect of Relative Protein Intake on Hypertension and Mediating Role of Physical Fitness and Circulating Fatty Acids

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings Pub Date : 2024-10-01 DOI:10.1016/j.mayocp.2024.02.019

Chaojie Ye MD, Dong Liu MD, Lijie Kong MD, Yiying Wang MD, Chun Dou MD, Min Xu MD, PhD, Jie Zheng MD, PhD, Ruizhi Zheng MD, PhD, Mian Li MD, PhD, Zhiyun Zhao MD, PhD, Jieli Lu MD, PhD, Yuhong Chen MD, PhD, Weiqing Wang MD, PhD, Yufang Bi MD, PhD, Yu Xu MD, PhD, Tiange Wang MD, PhD, Guang Ning MD, PhD

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引用次数: 0

Abstract

Objective

To investigate the causal effect of protein intake on hypertension and the related mediating pathways.

Patients and Methods

Using genome-wide association study summary statistics of European ancestry, we applied univariable and multivariable Mendelian randomization to estimate the bidirectional associations of relative protein intake and related metabolomic signatures with hypertension (FinnGen: Ncase=42,857/Ncontrol=162,837; UK Biobank: Ncase=77,723/Ncontrol=330,366) and blood pressure (International Consortium of Blood Pressure: N=757,601) and two-step Mendelian randomization to assess the mediating roles of 40 cardiometabolic factors therein. Mendelian randomization estimates of hypertension from FinnGen and UK Biobank were meta-analyzed without heterogeneity. We performed the study from May 15, 2023, to September 15, 2023.

Results

Each 1-SD higher relative protein intake was causally associated with 69% (odds ratio, 0.31; 95% CI, 0.11 to 0.89) lower hypertension risk independent of the effects of other macronutrients, and was the only macronutrient associated with 2.21 (95% CI, 0.52 to 3.91) mm Hg lower pulse pressure, in a unidirectional manner. Higher plant protein–related metabolomic signature (glycine) was associated with lower hypertension risk and pulse pressure, whereas higher animal protein–related metabolomic signatures (leucine, isoleucine, valine, and isovalerylcarnitine [only systolic blood pressure]) were associated with higher hypertension risk, pulse pressure, and systolic blood pressure. The effect of relative protein intake on hypertension was causally mediated by frailty index (mediation proportion, 40.28%), monounsaturated fatty acids (13.81%), saturated fatty acids (11.39%), grip strength (5.34%), standing height (3.99%), and sitting height (3.61%).

Conclusion

Higher relative protein intake causally reduces the risk of hypertension, partly mediated by physical fitness and circulating fatty acids.

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相对蛋白质摄入量对高血压的影响以及体能和循环脂肪酸的中介作用：孟德尔随机研究。

目的研究蛋白质摄入量对高血压的因果效应及相关中介途径：利用欧洲血统的全基因组关联研究汇总统计数据，我们采用单变量和多变量孟德尔随机法估算了相对蛋白质摄入量和相关代谢组特征与高血压的双向关联（FinnGen：Ncase=42,857/Ncontrol=162,837；UK Biobank：该研究采用两步孟德尔随机法评估了 40 种心脏代谢因素在其中的中介作用，并得出了相对蛋白质摄入量和相关代谢组特征与高血压（芬兰基因组：样本数=42,857/对照数=162,837；英国生物库：样本数=77,723/对照数=330,366）和血压（国际血压联合会：样本数=757,601）的关系。对来自 FinnGen 和英国生物库的高血压孟德尔随机估计值进行了荟萃分析，无异质性。我们从2023年5月15日至2023年9月15日进行了这项研究：相对蛋白质摄入量每增加 1 个标准差，高血压风险就会降低 69%（几率比，0.31；95% CI，0.11 至 0.89），与其他宏量营养素的影响无关，并且是唯一与脉压降低 2.21（95% CI，0.52 至 3.91）毫米汞柱相关的宏量营养素，且是单向的。较高的植物蛋白相关代谢组学特征（甘氨酸）与较低的高血压风险和脉压相关，而较高的动物蛋白相关代谢组学特征（亮氨酸、异亮氨酸、缬氨酸和异戊酰肉碱[仅收缩压]）与较高的高血压风险、脉压和收缩压相关。相对蛋白质摄入量对高血压的影响与虚弱指数（调解比例为 40.28%）、单不饱和脂肪酸（13.81%）、饱和脂肪酸（11.39%）、握力（5.34%）、站立身高（3.99%）和坐位身高（3.61%）有因果关系：结论：相对蛋白质摄入量越高，患高血压的风险就越低，这部分是由体能和循环脂肪酸介导的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mayo Clinic proceedings 医学-医学：内科

CiteScore

16.80

自引率

1.10%

发文量

383

审稿时长

37 days

期刊介绍： Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.