Higher plasma levels of phenylacetylglutamine (PAGln) are associated with an increased risk of coronary heart disease (CHD), particularly among women with diets higher in animal foods and lower in plant foods, according to a study published in the Journal of Clinical Endocrinology & Metabolism.
The study investigated the association between plasma PAGln levels, cardiometabolic risk factors, and dietary patterns in two groups of women:
A prospective nested case-control study of 1,520 women from the Nurses’ Health Study (NHS), which examined the risk of non-fatal myocardial infarction or fatal CHD over 11 to 16 years. Participants were stratified based on their adherence to a plant-based diet index.
A cross-sectional study of 725 women from the Women’s Lifestyle Validation Study (WLVS), which assessed the relationship between dietary intake and PAGln levels.
Key findings from the study:
In the WLVS, higher intakes of dietary protein and phenylalanine were positively associated with PAGln levels, particularly from red and processed meat, but not from poultry or fish/seafood. Higher vegetable intake was linked to lower PAGln levels.
A 1-standard deviation (SD) increment in log-transformed PAGln was associated with higher triglycerides, lower high-density lipoprotein (HDL) cholesterol, lower low-density lipoprotein (LDL) cholesterol, and higher levels of proinsulin, C-peptide, and insulin.
Among the NHS participants, a 1-SD increment in PAGln was associated with an 11% increased risk of CHD. The risk was particularly elevated (22% increased risk) among women with low adherence to a plant-based diet, while no significant risk increase was observed among those with high adherence.
The study authors concluded that adherence to plant-based diets may attenuate the unfavorable association between PAGln and CHD risk, highlighting the importance of the interplay between diet and this novel microbial metabolite in relation to long-term CHD risk.
The findings suggest that higher PAGln levels are linked to a greater risk of CHD in women, especially those with dietary patterns characterized by higher intake of animal foods and lower intake of plant-based foods. Promoting a plant-based diet may help mitigate the adverse effects of elevated PAGln levels on cardiovascular health.