Courtney Dennis, Lluis Serra-Majem, José Lapetra, Estefanía Toledo, Enrique Gómez-Gracia, Montserrat Fitó, Fernando Arós, Liming Liang, Emilio Ros, Miguel Ángel Martínez-González, Adela Hruby, Ramon Estruch, Miquel Fiol, Frank B. Hu, Miguel Ruiz-Canela, Dolores Corella, Clary B. Clish, Yan Zheng, Jordi Salas-Salvadó, Alimentació, Nutrició, Creixement i Salut Mental, Bioquímica i Biotecnologia, Universitat Rovira i Virgili, [Zheng, Yan] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hu, Frank B.] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hruby, Adela] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hu, Frank B.] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA, [Liang, Liming] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA, [Liang, Liming] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA, [Hu, Frank B.] Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA USA, [Hu, Frank B.] Harvard Med Sch, Boston, MA USA, [Ruiz-Canela, Miguel] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Toledo, Estefania] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Martinez-Gonzalez, Miguel A.] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Ruiz-Canela, Miguel] IDISNA Inst Invest Sanitaria Navarra, Pamplona, Spain, [Toledo, Estefania] IDISNA Inst Invest Sanitaria Navarra, Pamplona, Spain, [Martinez-Gonzalez, Miguel A.] IDISNA Inst Invest Sanitaria Navarra, Pamplona, Spain, [Ruiz-Canela, Miguel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Salas-Salvado, Jordi] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Toledo, Estefania] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Corella, Dolores] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Ros, Emilio] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Fito, Montserrat] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Gomez-Gracia, Enrique] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Aros, Fernando] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Fiol, Miquel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Lapetra, Jose] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Serra-Majem, Lluis] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Estruch, Ramon] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Martinez-Gonzalez, Miguel A.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Clish, Clary B.] Broad Inst MIT & Harvard Univ, Cambridge, MA USA, [Dennis, Courtney] Broad Inst MIT & Harvard Univ, Cambridge, MA USA, [Salas-Salvado, Jordi] Univ Rovira & Virgili, Dept Human Nutr, IISPV, Reus, Spain, [Corella, Dolores] Univ Valencia, Dept Prevent Med, Valencia, Spain, [Ros, Emilio] Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Endocrinol & Nutr, Lipid Clin,Hosp Clin, Barcelona, Spain, [Estruch, Ramon] Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Internal Med, Hosp Clin, Barcelona, Spain, [Fito, Montserrat] Hosp del Mar, Inst Recerca, Cardiovasc & Nutr Res Grp, Barcelona, Spain, [Gomez-Gracia, Enrique] Univ Malaga, Dept Prevent Med, Malaga, Spain, [Aros, Fernando] Univ Hosp Alava, Dept Cardiol, Vitoria, Spain, [Fiol, Miquel] Hosp Son Espases, Palma Inst Hlth Res IdISPa, Palma De Mallorca, Spain, [Lapetra, Jose] Dist Sanitario Atenc Primaria Sevilla, Res Unit, Dept Family Med, Seville, Spain, [Serra-Majem, Lluis] Univ Las Palmas Gran Canaria, Res Inst Biomed & Hlth Sci IUIBS, Las Palmas Gran Canaria, Spain, National Institutes of Health, Biomedical Research of the Spanish Government, Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares, Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional, Consejeria de Salud de la Junta de Andalucia, Ministerio de Ciencia e Innovacion, Fundacion Mapfre, Agencia Canaria de Investigacion, Innovacion y Sociedad de la Informacion-EU FEDER, Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana, Ministerio de Economia, NATIONAL HEART, LUNG, AND BLOOD INSTITUTE, and NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Background-Glutamate metabolism may play a role in the pathophysiology of cardiometabolic disorders. However, there is limited evidence of an association between glutamate-related metabolites and, moreover, changes in these metabolites, and risk of cardiovascular disease (CVD). Methods and Results-Plasma levels of glutamate and glutamine were measured at baseline and 1-year follow-up in a case-cohort study including 980 participants (mean age 68 years; 46% male) from the PREvencion con DIeta MEDiterranea (PREDIMED) randomized trial, which assessed a Mediterranean diet intervention in the primary prevention of CVD. During median 4.8 years of follow-up, there were 229 incident CVD events (nonfatal stroke, nonfatal myocardial infarction, or CVD death). In fully adjusted models, per 1-SD, baseline glutamate was associated with 43% (95% CI: 16% to 76%) and 81% (39% to 137%) increased risk of composite CVD and stroke alone, respectively, and baseline glutamine-to-glutamate ratio with 25% (6% to 40%) and 44% (25% to 58%) decreased risk of composite CVD and stroke alone, respectively. Associations appeared linear for stroke (both P-linear trend, This work was supported by the National Institutes of Health, 1R01HL118264. The PREDIMED trial was supported by the official funding agency for Biomedical Research of the Spanish Government, Instituto de Salud Carlos III, through grants provided to research networks specifically developed for the trial: RTIC G03/140 (Period 2003-2006, Coordinator: R. Estruch, MD, PhD), and RTIC RD 06/0045 (Period 2007-2013, Coordinator: M. A. Martinez-Gonzalez, MD, PhD). We also acknowledge the grants from Centro Nacional de Investigaciones Cardiovasculares CNIC06/2007, Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (PI04-2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI08/1259, PI10/01407, PI11/01647, PI11/01791), and Consejeria de Salud de la Junta de Andalucia (PI0105/2007). Ministerio de Ciencia e Innovacion (AGL-2009-13906-C02, AGL2010-22319-C03), Fundacion Mapfre 2010, Consejeria de Salud de la Junta de Andalucia (PI0105/2007), Agencia Canaria de Investigacion, Innovacion y Sociedad de la Informacion-EU FEDER (PI 2007/050), Public Health Division of the Department of Health of the Autonomous Government of Catalonia and Generalitat Valenciana (ACOMP06109, GVA-COMP2010-181, GVACOMP2011-151, CS2010-AP-111, CS2011-AP-042, AP-042/11 and BEST11-263) and Ministerio de Economia (PI07-0954, CNIC-06, AGL2010-22319-C03-03, PI11/02505). CIBEROBN is an initiative of ISCIII, Spain.