Body mass index determines the response of plasma sulfur amino acids to methionine loading

Evidence from human, animal and cellular studies suggests that high plasma total cysteine (tCys) is causally linked to human obesity, but determinants of population tCys variability are unknown. We hypothesized that tCys elevation in obesity may be mediated by an altered tCys response to intake of its precursor, methionine. We investigated whether BMI influences the change in plasma tCys, total homocysteine (tHcy) and total cysteinylglycine (tCysGly) 6h following a 100 mg/kg oral methionine load in 800 healthy subjects and 750 cardiovascular disease (CVD) cases. Methionine loading decreased tCys from mean 275 (95% CI, 273, 277) μmol/L to 253 (251,255) μmol/L. The decline in tCys was less in overweight (-8%) and obese (-6%) compared to normal weight (-9%) subjects, adjusting for age, gender and CVD (P-_ANOVA = 0.006). Compared to normal weight subjects, individuals with obesity had a 2.8-fold likelihood (95% CI, 1.52, 5.01) of experiencing a rise (rather than decline), in tCys postload, after multiple adjustments. tCysGly also decreased postload, and the decline was similarly smaller in overweight (-18%) and obese (-15%) compared to normal weight (-21%) individuals (P-_ANOVA <0.001). The tHcy response was modified by CVD status, with an increase in tHcy postload being BMI-dependent in controls (P-_ANOVA<0.001) but not in CVD cases (P-_interaction = 0.07). Although the methionine dose used was supraphysiologic, these data suggest that an altered tCys response to ingested methionine occurs in obesity, whereby tCys might rise in response to dietary methionine. This may contribute to explaining why human obesity is consistently associated with elevated tCys.