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Randomized Controlled Trial
. 2025 Jan 7;46(2):161-172.
doi: 10.1093/eurheartj/ehae804.

Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial

Inés Domínguez-López  1   2   3 , Rosa M Lamuela-Raventós  1   2   3 , Cristina Razquin  3   4 , Camila Arancibia-Riveros  1   2 , Polina Galkina  1   2   3 , Jordi Salas-Salvadó  3   5 , Ángel M Alonso-Gómez  3   6 , Montserrat Fitó  3   7 , Miquel Fiol  3   8 , José Lapetra  3   9 , Enrique Gómez-Gracia  10 , José V Sorlí  11 , Miguel Ruiz-Canela  3   4 , Olga Castañer  3   7 , Liming Liang  12   13 , Lluis Serra-Majem  14 , Frank B Hu  13   15   16 , Emilio Ros  3   17 , Miguel Ángel Martínez-González  3   4 , Ramon Estruch  3   18
Affiliations
Randomized Controlled Trial

Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial

Inés Domínguez-López et al. Eur Heart J. .

Abstract

Background and aims: Moderate wine consumption has been associated with lower cardiovascular disease (CVD) risk in older populations. However, wine consumption information through self-reports is prone to measurement errors inherent to subjective assessments. The aim of this study was to evaluate the association between urinary tartaric acid, an objective biomarker of wine consumption, and the rate of a composite clinical CVD event.

Methods: A case-cohort nested study was designed within the PREDIMED trial with 1232 participants: 685 incident cases of CVD and a random subcohort of 625 participants (including 78 overlapping cases). Wine consumption was registered using validated food frequency questionnaires. Liquid chromatography-tandem mass spectrometry was used to measure urinary tartaric acid at baseline and after one year of intervention. Weighted Cox regression models were used to estimate hazard ratios (HRs) of CVD.

Results: Tartaric acid was correlated with self-reported wine consumption at baseline [r = 0.46 (95% CI 0.41; 0.50)]. Five categories of post hoc urinary tartaric acid excretion were used for better representation of risk patterns. Concentrations of 3-12 and 12-35 μg/mL, which reflect ∼3-12 and 12-35 glasses/month of wine, were associated with lower CVD risk [HR 0.62 (95% CI 0.38; 1.00), P = .050 and HR 0.50 (95% CI 0.27; 0.95), P = .035, respectively]. Less significant associations between self-reported wine consumption and CVD risk were observed.

Conclusions: Light-to-moderate wine consumption, measured through an objective biomarker (tartaric acid), was prospectively associated with lower CVD rate in a Mediterranean population at high cardiovascular risk.

Keywords: Biomarker; Cardiovascular disease; Mediterranean diet; Tartaric acid; Wine.

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Figures

Structured Graphical Abstract
Structured Graphical Abstract
Overview of the experimental determination of tartaric acid and design of the nested case-cohort study. Main findings of the relationship between tartaric acid and CVD risk. CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio.
Figure 1
Figure 1
Multivariable adjusted HRs (95% CI) of CVD by categories of baseline urinary tartaric acid. CI, confidence interval; HR, hazard ratio; CVD, cardiovascular disease
Figure 2
Figure 2
Multivariate-adjusted relation of baseline tartaric acid with CVD risk. Associations were evaluated with the use of restricted cubic splines. The solid lines represent the central risk estimate and the dotted lines represent the 95% confidence intervals (CIs)
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References

    1. World Health Organization . Cardiovascular diseases 2023. https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1 (accessed 21 November 2023).
    1. Trichopoulou A, Bamia C, Norat T, Overvad K, Schmidt EB, Tjønneland A, et al. Modified Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly study. Eur J Epidemiol 2007;22:871–81. 10.1007/s10654-007-9190-6 - DOI - PubMed
    1. Guallar-Castillón P, Rodríguez-Artalejo F, Tormo MJ, Sánchez MJ, Rodríguez L, Quirós JR, et al. Major dietary patterns and risk of coronary heart disease in middle-aged persons from a Mediterranean country: the EPIC-Spain cohort study. Nutr Metab Cardiovasc Dis 2012;22:192–9. 10.1016/j.numecd.2010.06.004 - DOI - PubMed
    1. Martínez-González MÁ, Corella D, Salas-salvadó J, Ros E, Covas MI, Fiol M, et al. Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol 2012;41:377–85. 10.1093/ije/dyq250 - DOI - PubMed
    1. Shen J, Wilmot KA, Ghasemzadeh N, Molloy DL, Burkman G, Mekonnen G, et al. Mediterranean dietary patterns and cardiovascular health. Annu Rev Nutr 2015;35:425–49. 10.1146/annurev-nutr-011215-025104 - DOI - PubMed

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