Associations between Dietary Phenolic Compounds and Biomarkers of Atrial Fibrillation Risk in Adults with Metabolic Syndrome: A Longitudinal Analysis

Abstract

Background

Phenolic compounds (PCs) may reduce the risk of cardiovascular disease due to their anti-inflammatory and antioxidant effects. Examining relationships between dietary intake of total PC and atrial fibrillation (AF) risk biomarkers in a Mediterranean population with metabolic syndrome may offer new insights about AF physiopathology.

Objectives

This observational study aimed to analyze the relationship between total PC intake and serum concentrations of 5 AF-related biomarkers over 5 y in 566 participants from the PREDIMED-Plus trial.

Methods

In participants with metabolic syndrome (mean age: 65.1 y; 40.4% women), the following blood biomarkers were measured at baseline and at 3 and 5 y: N-terminal pro–B-type natriuretic peptide (NT-proBNP; atrial stretch), high-sensitivity troponin T (hs-TnT; myocardial damage), high-sensitivity C-reactive protein (hs-CRP; inflammation), procollagen type 1 carboxy-terminal propeptide (PICP; fibrosis), and 3-nitrotyrosine (NT; oxidative stress). PC intake was assessed using a validated 143-item food frequency questionnaire and the Phenol-Explorer database. Changes in log-transformed biomarkers concentrations were evaluated with multivariable-adjusted mixed linear models. Sources of between-person variability in total PC intake were also evaluated.

Results

Over 5 y, participants with moderate-high baseline PC intake (quartiles 2–4) showed a 39.5% (95% CI: 27.4%, 52.6%; P < 0.001) increase in NT-proBNP concentrations compared to a 20.5% (95% CI: 3.4%, 40.3%; P = 0.03) increase in the lowest quartile (P_{time × categories} = 0.04). When PC intake was updated over follow-up, moderate-high intake showed a 32.2% (95% CI: 19.5%, 46.2%; P < 0.001) increase in NT-proBNP compared to a 27.3% (95% CI: 6.5%, 52.1%; P = 0.004) in the lowest quartile, (P_{time × categories} = 0.02). Participants with moderate-high PC intake undergoing intensive lifestyle intervention showed smaller increases in hs-TnT than those with lower intake. Chocolate was the main contributor to between-person variability in PC intake.

Conclusions

Our results show that higher PC intake was associated with larger increases in NT-proBNP concentrations. In participants undergoing an intensive lifestyle intervention and higher PC intake, a lower increase in hs-TnT concentrations was found. Future research is warranted to better understand the role of dietary intake of PC in AF-related pathways.