| Autor: |
Li L; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA., Alonso A; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA., Romaguera D; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain., Alonso-Gómez AM; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, 48013 Bilbao, Spain., Razquin C; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31009 Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain., Tojal-Sierra L; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, 48013 Bilbao, Spain., Fiol M; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain., Martínez-González MA; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31009 Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.; Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA., Subramanya V; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA., Salas-Salvadó J; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d'Investigacions Sanitàries Pere i Virgili, Rovira i Virigili University, 43201 Reus, Spain., Fito M; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Hospital del Mar Research Institute, 08003 Barcelona, Spain., Toledo E; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31009 Pamplona, Spain.; Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain. |
| Abstrakt: |
Background : Lifestyles influence atrial fibrillation (AF) risk. Determining the effect of lifestyle interventions on blood concentrations of biomarkers of AF-related pathways could help understand AF pathophysiology and contribute to AF prevention. Methods : We studied 532 participants enrolled in the PREDIMED-Plus trial, a Spanish randomized trial conducted in adults (55-75 years) with metabolic syndrome and body mass index between 27-40 kg/m 2 . Eligible participants were randomized 1:1 to an intensive lifestyle intervention, emphasizing physical activity, weight loss, and adherence to an energy-reduced Mediterranean diet or to a control group. Serum biomarkers [carboxy-terminal propeptide of procollagen type I (PICP), high-sensitivity troponin T (hsTnT), high-sensitivity C reactive protein (hsCRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)] were measured at baseline, 3 and 5 years after randomization. Mixed models were used to evaluate the effect of intervention on changes in biomarkers through year 5. Mediation analysis was performed to examine the proportion mediated by each component of the intervention. Results : At baseline, participants' mean age was 65, 40% were female, and 50% were assigned to the intervention. After five years, mean changes in log-transformed biomarkers were -0.01 (PICP), 0.20 (hsTnT), -0.17 (hsCRP), 0.12 (3-NT), and 0.27 (NT-proBNP). Compared to the control group, participants in the intervention group experienced greater decreases in hsCRP (-14%, 95% confidence interval (CI) -26%, 0%) or smaller increases in 3-NT (-16%, 95% CI -25%, -5%) and NT-proBNP (-12%, 95% CI -23%, 1%). The intervention had minimal impact on hsTnT (-3%, 95% CI -7%, 2%) or PICP concentrations (-2%, 95% CI -9%, 6%). The effect of the intervention on hsCRP was primarily mediated by weight loss (89% at year 5). Conclusions : Over five years, a dietary and lifestyle intervention for weight-loss favorably affected concentrations of hsCRP, 3-NT, and NT-proBNP, pointing to specific mechanisms in pathways linking lifestyles and AF. |
