Journal Article Ppublish 6 citations
PubMed: 39983608 DOI: 10.1016/j.jacadv.2025.101605
Erythritol, Erythronate, and Cardiovascular Outcomes in Older Adults in the ARIC Study.
JACC Adv 4(3):101605
Authors: Layla A Abushamat, Bing Yu, Ron C Hoogeveen, Caroline Sun, Chao Cheng, Sean M Hartig, Mark A Herman, Ashok Balasubramanyam, Jane Eb Reusch, Elizabeth Selvin, Chiadi E Ndumele, Vijay Nambi, Christie M Ballantyne
Affiliations
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
- Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
- Section of Epidemiology and Population Science, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Rocky Mountain Regional VAMC, Aurora, Colorado, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Abstract
BACKGROUND
Circulating erythritol, an endogenously produced metabolite and an artificial sweetener, is associated with cardiovascular outcomes.
OBJECTIVES
The authors assessed associations of erythritol and its downstream metabolite, erythronate, with cardiovascular risk factors and events in older adults in the ARIC (Atherosclerosis Risk In Communities) study (visit 5, 2011-2013).
METHODS
We included 4,006 participants without prevalent cardiovascular disease and with metabolomic profiling. Erythritol and erythronate were measured by mass spectrometry. We analyzed associations of log-transformed erythritol and erythronate with cardiovascular risk factors and events using Cox proportional hazard models.
RESULTS
Participants in the highest tertiles of erythritol or erythronate were older, more likely to have diabetes, hypertension, hyperlipidemia, or microalbuminuria, and had higher body mass index and cardiac biomarkers and lower estimated glomerular filtration rate (P < 0.001). Over median follow-up of 8.41 (7.62, 8.93) years, higher erythritol and erythronate concentrations were significantly associated with heart failure (HF) hospitalization, HF with preserved ejection fraction, cardiovascular death, and total mortality after adjustment for demographics and traditional cardiovascular risk factors. Erythronate was additionally significantly associated with coronary heart disease (HR: 1.30 [95% CI: 1.04-1.61], P = 0.02), stroke (1.40 [95% CI: 1.08-1.83], P = 0.012), and HF with reduced ejection fraction (1.38 [95% CI: 1.09-1.74], P = 0.007). Diabetes status did not modify any of these associations (P for interaction >0.20).
CONCLUSIONS
Circulating erythritol and erythronate levels are markers of cardiometabolic health and cardiovascular outcomes in an older adult population. In particular, erythronate is associated with all cardiovascular outcomes assessed. Future studies should assess the role of erythronate and its related pathways in cardiovascular disease.
MeSH
Stroke, Heart Failure, Heart, Cardiovascular Diseases, Erythritol, Obesity, Risk Factors, Heart Disease Risk Factors, Diabetes Mellitus, Type 2