(OR06-02-26) Plasma Protein Biomarkers of Sugar-Sweetened and Artificially Sweetened Beverage Intake and Incident Cardiovascular Disease

Saturday, July 25, 2026

10:12 AM - 10:24 AM ET

Location: National Harbor 4-5

Presenting Author(s)

Valerie K. Sullivan, PhD, MHS, RD

Assistant Scientist
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

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

Co-Author(s)

JC

Jingsha Chen

Johns Hopkins Bloomberg School of Public Health, United States
MR

Mary R. Rooney

Johns Hopkins Bloomberg School of Public Health, United States
JR

Jerome I. Rotter

The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, United States
WP

Wendy Post

Johns Hopkins University School of Medicine, United States
AW

Alexis C. Wood, PhD, FAHA (she/her/hers)

Associate Professor
Children's Nutrition Research Center, Baylor College of Medicine
Houston, Texas, United States
RD

Rajat Deo

Perelman School of Medicine at the University of Pennsylvania, United States
RD

Ruth Dubin

University of Texas Southwestern Medical Center, United States
PG

Peter Ganz

University of California, San Francisco, United States
Casey M. Rebholz, PhD, MPH, MNSP, MS

Associate Professor
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Disclosure(s):

Valerie K. Sullivan, PhD, MHS, RD: No relevant financial relationship(s) with ineligible companies to disclose.

Alexis C. Wood, PhD, FAHA: No relevant financial relationship(s) with ineligible companies to disclose.

Casey M. Rebholz, PhD, MPH, MNSP, MS: American Diabetes Association: Independent Contractor (including contracted research) (Ongoing)

Objectives: To identify proteomic markers of sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) intake and examine their associations with incident cardiovascular disease (CVD).

Methods: We assessed cross-sectional associations between SSB and ASB intake (servings/day) and 4955 plasma proteins in Atherosclerosis Risk in Communities (ARIC) study participants without cardiovascular disease at visit 3 (1993-95) using multivariable linear regression. Discovery analyses were conducted in a randomly selected 2/3 subsample (n=6303) with internal replication assessed in 1/3 (n=3135). External replication was assessed in Multi-Ethnic Study of Atherosclerosis (MESA) participants at exam 1 (2000-02; n=5106). In both cohorts, beverage intake was queried using food frequency questionnaires. Proteins were measured using the SomaScan assay (v4 in ARIC, v4.1 in MESA; SomaLogic) and log₂ transformed. Significant beverage-related proteins were identified at q < 0.05. We used Cox proportional hazards regression models to assess associations between SSB- and ASB-related proteins and incident CVD (coronary heart disease and stroke). Prospective associations were significant at p< 0.05.

Results: In ARIC participants (mean age 60 years, 57% women), higher SSB intake was associated with 24 proteins in discovery analyses, of which nine replicated internally. In MESA participants (mean age 62 years, 51% women), three proteins were externally replicated: INHBA (identified by two aptamers) and PI3 were positively associated with SSB intake. ASB intake was associated with three proteins in ARIC discovery. All three proteins replicated internally, and one protein’s inverse association with ASB intake (CILP2) was externally replicated in MESA. Over median follow-up of 21.9 years (ARIC) and 18.5 years (MESA), higher PI3 was associated with a higher risk of CVD (HR, 95% CI per protein doubling: ARIC 1.15, 1.05-1.25; MESA 1.17, 1.00-1.36) and CILP2 was associated with lower risk of CVD (HR, 95% CI: ARIC 0.74, 0.65-0.83; MESA 0.61, 0.48-0.76).

Conclusions: In older US adults, we identified proteomic markers of SSB (PI3) and ASB (CILP2) intake that were associated with incident CVD. Their roles in inflammation and glucose dysregulation may help explain cardiometabolic effects of SSB and ASB intake.

Funding Sources: NIH