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@ARTICLE{Tong:284609,
      author       = {T. Y. N. Tong and R. Clarke and J. A. Schmidt and I.
                      Huybrechts and U. Noor and N. G. Forouhi and F. Imamura and
                      R. C. Travis and E. Weiderpass and K. Aleksandrova and C. C.
                      Dahm and Y. T. van der Schouw and K. Overvad and C. Kyrø
                      and A. Tjønneland and R. Kaaks$^*$ and V. Katzke$^*$ and C.
                      Schiborn and M. B. Schulze and A.-L. Mayen-Chacon and G.
                      Masala and S. Sieri and M. S. de Magistris and R. Tumino and
                      C. Sacerdote and J. M. A. Boer and W. M. M. Verschuren and
                      M. Brustad and T. H. Nøst and M. Crous-Bou and D. Petrova
                      and P. Amiano and J. M. Huerta and C. Moreno-Iribas and G.
                      Engström and O. Melander and K. Johansson and K. Lindvall
                      and E. K. Aglago and A. K. Heath and A. S. Butterworth and
                      J. Danesh and T. J. Key},
      title        = {{D}ietary amino acids and risk of stroke subtypes: a
                      prospective analysis of 356,000 participants in seven
                      {E}uropean countries.},
      journal      = {European journal of nutrition},
      volume       = {63},
      number       = {1},
      issn         = {1436-6207},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2023-02029},
      pages        = {209-220},
      year         = {2024},
      note         = {2024 Feb;63(1):209-220},
      abstract     = {Previously reported associations of protein-rich foods with
                      stroke subtypes have prompted interest in the assessment of
                      individual amino acids. We examined the associations of
                      dietary amino acids with risks of ischaemic and haemorrhagic
                      stroke in the EPIC study.We analysed data from 356,142
                      participants from seven European countries. Dietary intakes
                      of 19 individual amino acids were assessed using validated
                      country-specific dietary questionnaires, calibrated using
                      additional 24-h dietary recalls. Multivariable-adjusted Cox
                      regression models were used to estimate hazard ratios (HRs)
                      and $95\%$ confidence intervals (CIs) of ischaemic and
                      haemorrhagic stroke in relation to the intake of each amino
                      acid. The role of blood pressure as a potential mechanism
                      was assessed in 267,642 $(75\%)$ participants.After a median
                      follow-up of 12.9 years, 4295 participants had an ischaemic
                      stroke and 1375 participants had a haemorrhagic stroke.
                      After correction for multiple testing, a higher intake of
                      proline (as a percent of total protein) was associated with
                      a $12\%$ lower risk of ischaemic stroke (HR per 1 SD higher
                      intake 0.88; $95\%$ CI 0.82, 0.94). The association
                      persisted after mutual adjustment for all other amino acids,
                      systolic and diastolic blood pressure. The inverse
                      associations of isoleucine, leucine, valine, phenylalanine,
                      threonine, tryptophan, glutamic acid, serine and tyrosine
                      with ischaemic stroke were each attenuated with adjustment
                      for proline intake. For haemorrhagic stroke, no
                      statistically significant associations were observed in the
                      continuous analyses after correcting for multiple
                      testing.Higher proline intake may be associated with a lower
                      risk of ischaemic stroke, independent of other dietary amino
                      acids and blood pressure.},
      keywords     = {Amino acids (Other) / Dietary protein (Other) /
                      Haemorrhagic stroke (Other) / Ischaemic stroke (Other) /
                      Nutritional epidemiology (Other) / Prospective cohort
                      (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37804448},
      doi          = {10.1007/s00394-023-03251-4},
      url          = {https://inrepo02.dkfz.de/record/284609},
}