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February 09, 2023
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Gluconic acid level may predict hypertension, stroke in Black adults

Fact checked byRichard Smith
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Elevated gluconic acid, a plasma metabolite, could be a potential race-specific indicator of hypertension and ischemic stroke among Black adults, according to a study presented at the International Stroke Conference.

Lifestyle factors associated with elevated gluconic acid among Black adults included Southern diet, lower educational attainment and lack of exercise, a speaker reported.

Graphical depiction of data presented in article
Elevated gluconic acid could be a potential race-specific indicator of hypertension and ischemic stroke among Black adults.
Data were derived from Kijpaisalratana N, et al. Abstract 83. Presented at: International Stroke Conference; Feb. 8-10, 2023; Dallas (hybrid meeting).

“We have identified a biomarker called gluconic acid that we believe is a lifestyle-related biomarker, providing a direct link to diet and exercise,” Naruchorn Kijpaisalratana, MD, PhD, research fellow in neurology at Massachusetts General Hospital, said in a press release. “Gluconic acid may be considered as a dietary-related oxidative stress marker due to its availability in food, potentially produced by the gut microbiome, and related to diseases with oxidative stress. We think that this biomarker may provide a pathway to improve diet and exercise habits to help prevent a future stroke.”

The present analysis was a case-cohort evaluation of participants in the REGARDS study, which included 30,239 Black and white participants aged 45 years and older. Kijpaisalratana and colleagues compared metabolites measured by liquid chromatography-tandem mass spectrometry in 1,075 patients with ischemic stroke with those of a random cohort of 968 REGARDS participants.

The researchers utilized weighted logistic regression and Cox proportional hazard models to identify race-specific metabolites associated with hypertension and incident stroke and assessed mediation between the two.

The researchers quantified a total of 162 plasma metabolites, and, of these, gluconic acid was associated hypertension in Black adults (OR = 1.86; 95% CI, 1.39-2.47; P < .0001) but not white adults (OR = 1; 95% CI, 0.8-1.24; P = .97; P for interaction < .001).

Gluconic acid was also associated with risk for incident ischemic stroke among Black (HR = 1.53; 95% CI, 1.28-1.81; P < .0001) but not white adults (HR = 1.16; 95% CI, 1-1.34; P = .057; P for interaction = .019).

Moreover, gluconic acid mediated around one-fourth of the association between hypertension and ischemic stroke among Black adults (25.4%; 95% CI, 4.1-46.8; P = .02), according to the study.

After multivariable analyses, Kijpaisalratana and colleagues determined that lifestyle factors associated with increased gluconic acid in Black adults included Southern diet (beta = 0.18; 95% CI, 0.08-0.28; P < .001), lower educational attainment (beta = 0.45; 95% CI, 0.19-0.72; P = .001) and lack of exercise (beta = 0.26; 95% CI, 0.01-0.51; P = .045).

“In the future, we envision that a metabolite-like gluconic acid may be used as a biomarker to inform health care professionals whether the patient is eating healthy enough or exercising enough,” Kijpaisalratana said in the release. “A biomarker like gluconic acid may point individuals toward more targeted guidance for stroke prevention.”

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