Circulating ketone bodies and cardiovascular outcomes: the MESA study

Area of Science:

• Cardiovascular Science
• Metabolic Research
• Epidemiology

Background:

• Ketone bodies (KB) are an alternative myocardial fuel source.
• Previous research suggests potential protective effects of KB in heart failure.
• The association of KB with cardiovascular outcomes in a healthy population was unclear.

Purpose of the Study:

• To investigate the relationship between endogenous ketone bodies (KB) and cardiovascular outcomes and mortality.
• To assess KB as a potential biomarker for cardiovascular risk in an ethnically diverse population without pre-existing cardiovascular disease (CVD).

Main Methods:

• Analysis of 6796 participants from the Multi-Ethnic Study of Atherosclerosis.
• Measurement of total KB using nuclear magnetic resonance spectroscopy.
• Application of multivariable-adjusted Cox proportional hazard models to assess associations over a mean follow-up of 13.6 years.

Main Results:

• Increasing total KB was associated with higher rates of hard CVD (myocardial infarction, cardiac arrest, stroke, CVD death) and all CVD (including angina).
• A 10-fold increase in total KB correlated with significantly increased CVD mortality (87%) and all-cause mortality (81%).
• Higher KB levels were also linked to an increased rate of incident heart failure.

Conclusions:

• Elevated endogenous KB in a healthy population is associated with increased cardiovascular disease (CVD) and mortality risk.
• Ketone bodies may serve as a valuable biomarker for cardiovascular risk assessment.
• Further research is warranted to understand the mechanisms underlying this association.