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

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.

This research has been supported by the Comisión Interministerial de Ciencia y Tecnología [PID2020-114022RB-I00], CIBEROBN from the Instituto de Salud Carlos III from the Ministerio de Ciencia, Innovación y Universidades, National Institutes of Health (NIH) [2R01HL118264-09 and 5R01HL118264-08], (Agencia Estatal de Investigación/Fondo Europeo de Desarrollo Regional, European Union) and Generalitat de Catalunya (GC) [2017SGR 196] and FIVIN (FB 600390), and Interprofesional del vino de España-OIVE (FB 600390). INSA-UB is Maria de Maeztu Unit of Excellence (grant CEX2021-001234-M funded by Ministerio de Ciencia e Innovación (MICIN)/AEI/FEDER, UE). M.Á.M.-G. is the PI of the European Research Grant #101097681 (AdRG UNATI, 2023-2028) for a large non-inferiority trial on moderate alcohol vs. abstention. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.