title: Is There an Interplay Between Adherence to Mediterranean Diet, Antioxidant Status, and Vascular Disease in Atrial Fibrillation Patients?
abstract: Mediterranean Diet (Med-Diet) is associated with reduced incidence of vascular events (VEs) in atrial fibrillation (AF), but the mechanism accounting for its beneficial effect is only partially known. We hypothesized that Med-Diet may reduce VEs by improving antioxidant status, as assessed by glutathione peroxidase 3 (GPx3) and superoxide dismutase (SOD). We performed a prospective cohort study investigating the relationship between adherence to Med-Diet, serum baseline GPx3 and SOD activities, and the occurrence of VEs in 690 AF patients. GPx3 activity was directly associated with Med-Diet score (B = 0.192, p < 0.001) and inversely with age (B = -0.124, p = 0.001), after adjustment for potential confounders; Med-Diet weakly affected SOD levels. During a mean follow-up of 46.1 ± 28.2 months, 89 VEs were recorded; patients with VEs had lower GPx3 levels compared with those without VEs (p = 0.002); and no differences regarding SOD activity were found. Multivariable Cox regression analysis showed that age (Hazard ratio [HR]:1.065, p < 0.001), logGPx3 (above median, HR: 0.629, p < 0.05), and Med-Diet score (HR: 0.547, p < 0.05) predicted VEs. Med-Diet favorably modulates antioxidant activity of GPx3 in AF, resulting in reduced VEs rate. We hypothesize that the modulation of GPx3 levels by Med-Diet could represent an additional nutritional strategy to prevent VEs in AF patients. Antioxid. Redox Signal. 25, 751-755.
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Daniele
authors: D
authors: Pastori
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .|2 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome , Latina, Italy .
authors: Roberto
authors: R
authors: Carnevale
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Danilo
authors: D
authors: Menichelli
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Cristina
authors: C
authors: Nocella
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Simona
authors: S
authors: Bartimoccia
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Marta
authors: M
authors: Novo
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Isabella
authors: I
authors: Leo
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Francesco
authors: F
authors: Violi
authors: 1 Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University of Rome , Rome, Italy .
authors: Pasquale
authors: P
authors: Pignatelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000378:metabolism*; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood*; D006801:Humans; D015994:Incidence; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D012044:Regression Analysis; D013482:Superoxide Dismutase / Q000097:blood*; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: C486484:GPX3 protein, human; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase
keywords: Mediterranean diet; atrial fibrillation; cardiovascular events; gluthatione peroxidase