Erythritol, Erythronate, and Cardiovascular Outcomes in Older Adults in the ARIC Study

作者：Layla A. Abushamat, Bing Yu, Ron C. Hoogeveen, Caroline Sun, Chao Cheng, Sean M. Hartig, Mark A. Herman, Ashok Balasubramanyam, Jane E.B. Reusch, Elizabeth Selvin, Chiadi E. Ndumele, Vijay Nambi, Christie M. Ballantyne · 发表于：JACC Advances · 年份：2025 · DOI：10.1016/j.jacadv.2025.101605 · 被引用次数：7 · 研究领域：Metabolomics and Mass Spectrometry Studies、Biochemical Analysis and Sensing Techniques、Metabolism and Genetic Disorders

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 ...