Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Nutrients. 2024 Sep 14;16(18):3099. doi: 10.3390/nu16183099.
Erythritol occurs naturally in some fruits and fermented foods, and has also been used as an artificial sweetener since the 1990s. Although there have been questions and some studies regarding its potential adverse health effects, the association between serum erythritol and long-term mortality has not been evaluated. To examine the association between serum erythritol's biochemical status and risk of overall and cause-specific mortality, a prospective cohort analysis was conducted using participants in the ATBC Study (1985-1993) previously selected for metabolomic sub-studies. The analysis included 4468 participants, among whom 3377 deaths occurred during an average of 19.1 years of follow-up. Serum erythritol was assayed using an untargeted, global, high-resolution, accurate-mass platform of ultra-high-performance liquid and gas chromatography. Cause-specific deaths were identified through Statistics Finland and defined by the International Classification of Diseases. After adjustment for potential confounders, serum erythritol was associated with increased risk of overall mortality (HR = 1.50 [95% CI = 1.17-1.92]). We found a positive association between serum erythritol and cardiovascular disease mortality risk (HR = 1.86 [95% CI = 1.18-2.94]), which was stronger for heart disease mortality than for stroke mortality risk (HR = 3.03 [95% CI = 1.00-9.17] and HR = 2.06 [95% CI = 0.72-5.90], respectively). Cancer mortality risk was also positively associated with erythritol (HR = 1.54 [95% CI = 1.09-2.19]). The serum erythritol-overall mortality risk association was stronger in men ≥ 55 years of age and those with diastolic blood pressure ≥ 88 mm Hg ( for interactions 0.045 and 0.01, respectively). Our study suggests that elevated serum erythritol is associated with increased risk of overall, cardiovascular disease, and cancer mortality. Additional studies clarifying the role of endogenous production and dietary/beverage intake of erythritol in human health and mortality are warranted.
赤藓糖醇天然存在于一些水果和发酵食品中，自 20 世纪 90 年代以来也被用作人工甜味剂。尽管人们对其潜在的不良健康影响提出了一些疑问和进行了一些研究，但血清赤藓糖醇与长期死亡率之间的关系尚未得到评估。为了研究血清赤藓糖醇的生化状态与全因和死因特异性死亡率之间的关系，我们对先前选择进行代谢组学亚研究的 ATBC 研究（1985-1993 年）中的参与者进行了前瞻性队列分析。该分析包括 4468 名参与者，在平均 19.1 年的随访期间发生了 3377 例死亡。使用靶向、全局、高分辨率、精确质量的超高效液相和气相色谱的非靶向、全局、高分辨率、精确质量平台检测血清赤藓糖醇。通过芬兰统计数据和国际疾病分类确定死因特异性死亡。在调整了潜在混杂因素后，血清赤藓糖醇与全因死亡率升高相关（HR=1.50[95%CI=1.17-1.92]）。我们发现血清赤藓糖醇与心血管疾病死亡率风险呈正相关（HR=1.86[95%CI=1.18-2.94]），心脏病死亡率的相关性强于中风死亡率（HR=3.03[95%CI=1.00-9.17]和 HR=2.06[95%CI=0.72-5.90]）。癌症死亡率也与赤藓糖醇呈正相关（HR=1.54[95%CI=1.09-2.19]）。血清赤藓糖醇与全因死亡率之间的关联在年龄≥55 岁的男性和舒张压≥88mmHg 的人群中更强（交互作用 P 值分别为 0.045 和 0.01）。我们的研究表明，血清赤藓糖醇升高与全因、心血管疾病和癌症死亡率升高相关。需要进一步的研究来阐明内源性产生和饮食/饮料摄入赤藓糖醇在人类健康和死亡率中的作用。
