Study Finds 10 Metabolites Associated With Risk of Stroke

December 8, 2020
The levels of 10 metabolites detected in the blood are associated with a person’s risk of stroke, according to a study published in Neurology. “With stroke being a leading cause of death and serious long-term disability worldwide, researchers are looking for new ways to identify high-risk patients, determine the causes of stroke and develop prevention strategies,” said Dina Vojinovic, PhD, Erasmus University Medical Center, Rotterdam, the Netherlands. “For our analysis, we examined a large series of metabolites to gain new insights into the metabolic changes that may happen leading up to a stroke.” For the meta-analysis, researchers pooled the data of 7 studies and identified 38,797 people who did not have a stroke at the start of the study. Participants provided health histories, had medical exams, and gave blood samples. Blood samples were analyzed with nuclear magnetic resonance technology to examine the levels of 147 metabolites. The researchers then determined how many people had a stroke from 2 years later to up to 15 years later, depending on the study. A total of 1,791 people had a stroke during the follow-up period, and 10 metabolites were associated with risk of stroke. The strongest association was found with the amino acid histidine, which comes from protein sources like meat, eggs, dairy, and grains. Histidine was associated with a lower risk of ischaemic stroke. “Histidine can be converted to histamine, which has been shown to have a strong effect on the dilation of the blood vessels,” said Dr. Vojinovic. “It also functions as a neurotransmitter in the brain and has been shown in some studies to reduce blood pressure and inflammation, so this finding is not surprising.” With every 1 standard deviation increase in levels of histidine, people had a 10% lower risk of stroke. These were not explained by other factors that could affect risk of stroke, such as high blood pressure, diabetes, smoking, and body mass index. The researchers also found the high-density lipoprotein cholesterols were associated with a lower risk of ischaemic stroke. Low-density lipoprotein cholesterols and triglycerides were associated with a higher risk of stroke. A metabolite called pyruvate, which is produced when cells break down glucose, increased a person’s risk of stroke. With every 1 standard deviation increase in levels of pyruvate, people had a 13% higher risk of ischaemic stroke. “Pyruvate is critical for supplying energy to a cell and has been shown in previous studies to decrease inflammation, while in contrast, to also increase a person’s risk for cardiovascular disease, so more research is needed,” said Dr. Vojinovic. “Our analysis provides new insights into how the risk of stroke may be affected on the molecular level. It also raises new questions. Future studies are needed to further research the biological mechanisms underlying these associations between metabolites and risk of stroke.” A limitation of the study was the small number of participants who had haemorrhagic stroke, reducing researchers’ abilities to detect associations for this stroke type. Reference: https://n.neurology.org/content/early/2020/12/02/WNL.0000000000011236 SOURCE: American Academy of Neurology