Effect of an intensive lifestyle intervention on circulating biomarkers of atrial fibrillation-related pathways among adults with metabolic syndrome: Results from a randomized trial

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  • dc.contributor.author Li, Linzi
  • dc.contributor.author Alonso, Álvaro
  • dc.contributor.author Romaguera Bosch, Dora
  • dc.contributor.author Alonso-Gómez, Ángel
  • dc.contributor.author Razquin, Cristina
  • dc.contributor.author Tojal Sierra, Lucas
  • dc.contributor.author Fiol, Miquel
  • dc.contributor.author Martínez-González, Miguel Ángel, 1957-
  • dc.contributor.author Subramanya, Vinita
  • dc.contributor.author Salas-Salvadó, Jordi
  • dc.contributor.author Fitó Colomer, Montserrat
  • dc.contributor.author Toledo, Estefania
  • dc.date.accessioned 2025-06-06T07:04:09Z
  • dc.date.available 2025-06-06T07:04:09Z
  • dc.date.issued 2024
  • dc.description.abstract 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/m2. 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.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Li L, Alonso A, Romaguera D, Alonso-Gómez AM, Razquin C, Tojal-Sierra L, et al. Effect of an intensive lifestyle intervention on circulating biomarkers of atrial fibrillation-related pathways among adults with metabolic syndrome: Results from a randomized trial. J Clin Med. 2024 Apr 7;13(7):2132. DOI: 10.3390/jcm13072132
  • dc.identifier.doi http://dx.doi.org/10.3390/jcm13072132
  • dc.identifier.issn 2077-0383
  • dc.identifier.uri http://hdl.handle.net/10230/70630
  • dc.language.iso eng
  • dc.publisher MDPI
  • dc.relation.ispartof J Clin Med. 2024 Apr 7;13(7):2132
  • dc.rights © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Atrial fibrillation
  • dc.subject.keyword Biomarker
  • dc.subject.keyword Lifestyle
  • dc.subject.keyword Randomized clinical trial
  • dc.title Effect of an intensive lifestyle intervention on circulating biomarkers of atrial fibrillation-related pathways among adults with metabolic syndrome: Results from a randomized trial
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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