Health associations of liver enzymes and inflammatory scores with urinary citrus flavonoid metabolites

Vanessa Bullón-Vela, Yifan Xu, Cristina Razquin, Itziar Abete, Maria Angeles Zulet, Miguel A Martínez-González, Pilar Buil-Corsiales, Facundo Vitelli-Storelli, Vicente Martín Sánchez, Zenaida Vazquez-Ruíz, Carmen Sayón-Orea, Maite Domínguez-Fernández, Concepción Cid, Ramon Estruch, Rosa María Lamuela-Raventós, Montserrat Fitó, Gemma Blanchart, Nancy Babio, Jordi Salas-Salvadó, Francisco J TinahonesJosep A Tur, Dora Romaguera, Jadwiga Konieczna, Xavier Pintó, Lidia Daimiel, Ana Rodriguez-Mateos, José Alfredo Martínez

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Background: Dietary flavonoid intake is associated with a reduced risk of some cardiometabolic disorders, attributed in part to their claimed anti-inflammatory activity. Our aim was to investigate the potential association between specific urine flavonoid metabolites, liver enzymes, and inflammatory status in individuals with metabolic syndrome (MetS). Methods: In this cross-sectional study, clinical and dietary data from 267 participants, aged 55 to 75 years, participating in the PREDIMED Plus study (PREvención con DIeta MEDiterránea) were analyzed. At the baseline, spot urine samples were collected and seven urinary flavonoid metabolites were quantified using ultra-performance liquid chromatography coupled to triple quadrupole mass spectrometry (UPLC-Q-q-Q MS). Liver enzymes, inflammatory scores, and urinary flavonoid concentrations were inverse normally transformed. Results: Adjusted linear regression models showed an inverse association between urinary citrus flavanone concentrations and gamma-glutamyl transferase (GGT) (all p-values <0.05). Naringenin 7'-GlcUA was significantly associated with a lower aggregate index of systemic inflammation (AISI) (Bper 1SD = -0.14; 95% CI: -0.27 to -0.02; p-value = 0.025) and systemic inflammation index (SII) (Bper 1SD = -0.14; 95% CI: -0.27 to -0.02; p-value = 0.028). To investigate the relationship between flavanone subclasses and GGT levels, we fitted a score of citrus-flavanones, and subjects were stratified into quartiles. The highest values of the citrus-flavanone score (per 1-SD increase) were associated with lower GGT levels (Bper 1SD = -0.41; 95% CI: -0.74 to -0.07), exhibiting a linear trend across quartiles (p-trend = 0.015). Conclusion: This cross-sectional study showed that higher urinary excretion of citrus-flavanone metabolites was associated with lower GGT levels in subjects diagnosed with MetS and obesity.

Original languageEnglish
JournalFood & Function
Early online date23 Dec 2022
Publication statusE-pub ahead of print - 23 Dec 2022


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