(OR37-03-24) Sugar- and Artificially Sweetened Beverages, Proteomic Signatures, and Risk of Liver Outcomes: A Prospective Cohort Study in the UK Biobank

Tuesday, July 2, 2024

10:24 AM – 10:36 AM CT

Location: W375B

Presenting Author(s)

Longgang Zhao, PhD (he/him/his)

Postdoctoral associate
Yale School of Nursing
Orange, Connecticut, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

Xinyuan Zhang, PhD

Postdoctoral Fellow
Brigham and Women's Hospital and Harvard Medical School
Boston, Massachusetts, United States
JZ

Jiali Zheng

Associate professor
Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai, China (People's Republic)
Yun Chen, PhD (she/her/hers)

Postdoctoral Research Fellow
Yale School of Nursing
New Haven, Connecticut, United States
HZ

Hongmei Zeng

Harvard T.H. Chan School of Public Health, United States
Frank B. Hu, MD, PhD

Professor
Harvard University
Boston, Massachusetts, United States
KM

Katherine A. McGlynn, PhD

National Cancer Institute
Bethesda, Maryland, United States
XZ

Xuehong Zhang, MD, ScD

Brigham and Women’s Hospital and Harvard Medical School
Boston, Massachusetts, United States

Objectives: To evaluate the association of sweetened beverages and their plasma proteomic signatures with the risk of adverse liver outcomes.

Methods: We used data from the UK Biobank with 173,840 participants (40-69 years). Sugar- and artificially sweetened beverage intake were assessed by multiple 24-hour dietary recalls. Liver outcomes were ascertained using data from the in-hospital records, cancer registry, and death registry, including a full spectrum of liver disease and mortality. We used elastic net regression to calculate the proteomic score (Olink platform) related to sweetened beverage intake and Cox proportional hazards regression models to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for sweetened beverage intake or proteomic signatures and liver outcomes adjusting for multiple confounding factors.

Results: After a median follow-up of 8.9 years, we documented 1112 NAFLD, 954 cirrhosis, 204 liver cancer, 548 severe liver diseases (SLD), and 60 chronic liver disease (CLD) deaths. One serving increment of sugar-sweetened beverage daily was positively associated with risk of NAFLD (HR [95% CI]: 1.10 [1.02-1.19]), cirrhosis (1.21 [1.12-1.32]), SLD (1.18 [1.06-1.31]), and CLD mortality (1.37 [1.06-1.78]), but nonsignificant association with liver cancer. Artificially sweetened beverage intake was positively associated with risk of NAFLD (1.15 [1.07-1.23]), SLD (1.14 [1.02-1.26]), and CLD deaths (1.41 [1.13-1.75]). The proteomic score of sugar-sweetened beverages (96 proteins) and artificially sweetened beverages (105 proteins) showed stronger positive associations with the risk of NAFLD, liver cirrhosis, and SLD (all P<sub>trend < 0.05) with HRs for one-unit standard deviation increase ranging from 1.57 for cirrhosis to 2.34 for SLD.

Conclusions: In this prospective cohort, sugar- and artificially sweetened beverages intake and their proteomic signatures are associated with a spectrum of liver diseases indicating the potential importance of reducing sweetened beverage intake to improve liver health.

Funding Sources: Xuehong Zhang is supported by NIH/NCI R21 CA238651, R21 CA252962, R37 CA262299, U01 CA259208, U01 CA272452, American Cancer Society (RSG NEC-130476, PASD-22-1003396).