RT Journal Article T1 A multi-metabolite signature robustly predicts long-term mortality in the PREDIMED trial and several US cohorts A1 Fernández-Duval, Gonzalo A1 Razquin, Cristina A1 Wang, Fenglei A1 Yun, Huan A1 Hu, Jie A1 Guasch-Ferré, Marta A1 Rexrode, Kathryn A1 Balasubramanian, Raji A1 García-Gavilán, Jesús F A1 Ruiz-Canela, Miguel A1 Clish, Clary B A1 Corella, Dolores A1 Gómez-Gracia, Enrique A1 Fiol, Miquel A1 Estruch, Ramón A1 Lapetra, José A1 Fito, Montse A1 Serra-Majem, Luis A1 Ros, Emilio A1 Liang, Liming A1 Dennis, Courtney A1 Asensio, Eva M. A1 Castañer, Olga A1 Planes, Francisco J. A1 Salas-Salvadó, Jordi A1 Hu, Frank B. A1 Toledo, Estefanía A1 Martínez-González, Miguel A. K1 Metabolitos AB Metabolome-based biomarkers contribute to identify mechanisms of disease and to a better understanding of overall mortality. In a long-term follow-up subsample (n = 1878) of the PREDIMED trial, among 337 candidate baseline plasma metabolites repeatedly assessed at baseline and after 1 year, 38 plasma metabolites were identified as predictors of all-cause mortality. Gamma-amino-butyric acid (GABA), homoarginine, serine, creatine, 1-methylnicotinamide and a set of sphingomyelins, plasmalogens, phosphatidylethanolamines and cholesterol esters were inversely associated with all-cause mortality, whereas plasma dimethylguanidino valeric acid (DMGV), choline, short and long-chain acylcarnitines, 4-acetamidobutanoate, pseudouridine, 7-methylguanine, N6-acetyllysine, phenylacetylglutamine and creatinine were associated with higher mortality. The multimetabolite signature created as a linear combination of these selected metabolites, also showed a strong association with all-cause mortality using plasma samples collected at 1-year follow-up in PREDIMED. This association was subsequently confirmed in 4 independent American cohorts, validating the signature as a consistent predictor of all-cause mortality across diverse populations. PB Elsevier YR 2025 FD 2025-09 LK https://hdl.handle.net/10630/44696 UL https://hdl.handle.net/10630/44696 LA eng NO Fernández-Duval G, Razquin C, Wang F, Yun H, Hu J, Guasch-Ferré M, Rexrode K, Balasubramanian R, García-Gavilán J, Ruiz-Canela M, Clish CB, Corella D, Gómez-Gracia E, Fiol M, Estruch R, Lapetra J, Fitó M, Serra-Majem L, Ros E, Liang L, Dennis C, Asensio EM, Castañer O, Planes FJ, Salas-Salvadó J, Hu FB, Toledo E, Martínez-González MA. A multi-metabolite signature robustly predicts long-term mortality in the PREDIMED trial and several US cohorts. Metabolism. 2025 Sep;170:156195. doi: 10.1016/j.metabol.2025.156195. Epub 2025 Mar 17. PMID: 40107652; PMCID: PMC12245597. DS RIUMA. Repositorio Institucional de la Universidad de Málaga RD 1 mar 2026