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Serum branched amino acids and the risk of all-cause mortality: a meta-analysis and systematic review

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Abstract

Recently, the serum levels of branched-chain amino acids (BCAAs) have been considered as an indicator to evaluate health status and predict chronic diseases risk. This systematic review and meta-analysis aimed to assess the relationship between Serum BCAAs and the risk of all-cause mortality. We carried out a comprehensive and systematic search in various important databases, including PubMed, Scopus, and Web of Science databases to find the relevant studies published up to October 2022 with no language, design, or time limitation. We extracted the reported hazard ratio (HR) with 95% confidence interval (CI) and odds ratio (OR) with 95%CI in cohorts and case–control studies, respectively, and computed the log HR or OR and its standard error. Then, we used the random-effects model with inverse variance weighting method for the present meta-analysis, to calculate the pooled effect size. Ten observational studies, including nine cohort studies and one case–control study, were included in the present meta-analysis. The number of participants ranges from 53 to 26,711, with an age range of 18–99 years. During 6 months to 24 years of follow-up, 3599 deaths were ascertained. The pooled results indicated that there was no significant association between serum BCAAs (RR: 1.17; 95% CI 0.85–1.60), isoleucine (RR: 1.41; 95%CI 0.92–2.17), leucine (RR: 1.13; 95% CI 0.94–1.36), and valine (RR: 1.02; 95%CI 0.86–1.22) and all-cause mortality. Also, there was significant heterogeneity between studies for serum BCAAs (I2 = 74.1% and P-heterogeneity = 0.021), isoleucine (I2 = 89.4% and P-heterogeneity < 0.001), leucine (I2 = 87.8% and P-heterogeneity < 0.001), and valine (I2 = 86.6% and P-heterogeneity < 0.001). Our results suggested that the serum BCAAs and its components, including isoleucine, leucine, and valine, were not associated with the risk of all-cause mortality.

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Data availability

The data used and/ or analyzed in the present study are available from the corresponding author on reasonable request.

Abbreviations

BCAAs:

Branched-chain amino acids

CI:

Confidence intervals

CNS:

Central nervous system

ICU:

Intensive-care unit

CVD:

Cardiovascular disease

HR:

Hazard ratio

NAFLD:

Non-alcoholic fatty liver disease

NOS:

Newcastle–Ottawa Scales

OR:

Odds ratio

PRISMA:

Preferred Reporting Items for Systematic Review and Meta-analysis

RCTs:

Randomized-controlled trials

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

T2D:

Type 2 diabetes

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Acknowledgements

The authors express our appreciation to the Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran for their valuable cooperation.

Funding

This study was supported by the Research Institute of Endocrine Sciences, Shahid Beheshti University Medical Sciences, Tehran, Iran.

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Author notes

  1. Farshad Teymoori and Hamid Ahmadirad have contributed equally to this work.

Authors and Affiliations

  1. Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Farshad Teymoori, Hamid Ahmadirad, Ebrahim Mokhtari, Hossein Farhadnejad, Tahere Shahrokhtabar & Parvin Mirmiran

  2. Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Farshad Teymoori

  3. Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

    Mitra Kazemi Jahromi

  4. Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

    Ebrahim Mokhtari

  5. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Milad Mohammadzadeh & Mitra Babrpanjeh

  6. Imam Ali Hospital, Shiraz University of Medical Sciences, Kazerun, Iran

    Sanaz Jamshidi

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Contributions

FT and HA contributed to the study concept and design. FT, HA, and HF developed the overall research plan and study oversight. FT, SJ, and HA conducted the research. EM and HA independently screened all records based on their titles and abstracts. FT and MM performed the data extraction, data analyses, and interpretation of data. MKJ, FT, HF, SJ, MB, EM, and TS drafted the manuscript. All authors provided intellectual comments and performed the critical revision of the manuscript. PM supervised the study. All authors approved the final version of the manuscript.

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Correspondence to Sanaz Jamshidi or Parvin Mirmiran.

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Teymoori, F., Ahmadirad, H., Jahromi, M.K. et al. Serum branched amino acids and the risk of all-cause mortality: a meta-analysis and systematic review. Amino Acids 55, 1475–1486 (2023). https://doi.org/10.1007/s00726-023-03329-7

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