Introduction & Objective: Erythritol, an endogenously produced sugar alcohol, is a commonly used artificial sweetener since 2002. However, circulating erythritol is associated with cardiovascular (CV) disease at visit 1 (1987-89) of the Atherosclerosis Risk in Communities (ARIC) study. The objective was to assess the association of erythritol and its metabolite erythronate with CV outcomes in older adults at ARIC visit 5 (2011-13).
Methods: Fasting erythritol and erythronate were measured in ARIC participants by mass spectrometry and were analyzed continuously and by tertiles. Cox proportional hazard models assessed associations with CV outcomes and death.
Results: Top tertile erythritol or erythronate levels were associated with older age, diabetes, hypertension, hyperlipidemia, higher body mass index, lower estimated glomerular filtration rate, microalbuminuria, and higher cardiac biomarkers (p<0.001). Over mean follow-up of 7.7±2 years, higher erythritol and erythronate relative concentrations were associated with CV events after adjustment for covariates (Figure). Erythronate associated more strongly than erythritol.
Conclusion: Erythritol and erythronate may serve as biomarkers of poor cardiac-kidney-metabolic syndrome (CKM) health and CV outcomes. Future studies should assess the contribution of endogenous production via the pentose phosphate pathway versus exogenous intake.
L.A. Abushamat: None. C.W. Sun: None. B. Yu: None. R.C. Hoogeveen: Consultant; Denka Seiken. Research Support; Denka Seiken. C. Cheng: None. S.M. Hartig: None. M.A. Herman: Research Support; Eli Lilly and Company. J.E.B. Reusch: Advisory Panel; Medtronic. E. Selvin: None. C.E. Ndumele: None. V. Nambi: Board Member; American Society of Preventive Cardiology. Stock/Shareholder; Insera. Other Relationship; American College of Cardiology. C.M. Ballantyne: Research Support; Abbott Diagnostics. Consultant; Abbott Diagnostics. Research Support; Akcea Thearpeutics, Inc., Amgen Inc. Consultant; Amgen Inc. Research Support; Arrowhead Pharmaceuticals, Inc. Consultant; Arrowhead Pharmaceuticals, Inc., AstraZeneca, Denka Seiken, Eli Lilly and Company, ESPERION Therapeutics, Inc., Genentech, Inc., Illumina. Research Support; Ionis Pharmaceuticals. Consultant; Ionis Pharmaceuticals. Research Support; Merck & Co., Inc. Consultant; Merck & Co., Inc. Research Support; New Amsterdam. Consultant; New Amsterdam. Research Support; Novartis Pharmaceuticals Corporation. Consultant; Novartis Pharmaceuticals Corporation. Research Support; Novo Nordisk. Consultant; Novo Nordisk. Research Support; Regeneron Pharmaceuticals Inc., Roche Diagnostics. Consultant; Roche Diagnostics, TenSixteen Bio, Alnylam Pharmaceuticals, Inc.
