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We investigated whether plasma erythritol and other polyols (mannitol\/sorbitol) were associated with the risk of incident coronary heart disease (CHD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This prospective nested case\u2013control study included 762 incident cases of CHD and 762 controls from the Nurses\u2019 Health Study. Plasma concentrations of polyols were measured at baseline (1989\u201390 or 2000\u201302). Associations of erythritol with cardiometabolic risk factors were also analysed in the Women\u2019s Lifestyle Validation Study (n = 728; blood collected in 2010\u201312). Higher erythritol levels were related to more adverse cardiometabolic risk factor status. A relative risk (RR) for CHD per 1-SD increment was 1.15 [95% confidence interval (CI): 1.04, 1.28] for erythritol and 1.16 (95% CI: 1.05, 1.28) for mannitol\/sorbitol, after adjusting for diet quality, lifestyles, and adiposity. Compared with women in the lowest quartile, those in the highest quartile (Q4) of erythritol had an RR of 1.55 (95% CI: 1.13, 2.14) for CHD. The RR in the Q4 of erythritol was 1.61 (95% CI: 1.15, 2.24; P = 0.006) when hypertension and dyslipidaemia were further added to the model; the RR was 1.21 (95% CI: 0.86, 1.70) after adjustment for diabetes. For mannitol\/sorbitol, the RR in Q4 was 1.42 (95% CI: 1.05, 1.91; P = 0.022) for CHD in the multivariable-adjusted model including diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Higher levels of plasma erythritol and mannitol\/sorbitol were related to elevated risks of CHD even after adjustment for diet, lifestyles, adiposity, and other risk factors. The unfavourable association of mannitol\/sorbitol, but not of erythritol, with CHD risk remained significant independent of diabetes\/hyperglycaemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwae288","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T09:01:41Z","timestamp":1725526901000},"page":"404-414","source":"Crossref","is-referenced-by-count":15,"title":["Plasma levels of polyols erythritol, mannitol, and sorbitol and incident coronary heart disease among women"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0957-9309","authenticated-orcid":false,"given":"Yoriko","family":"Heianza","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University , 1440 Canal Street, Suite 1724, New Orleans, LA 70112 ,","place":["USA"]},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health , 677 Huntington Ave, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-1563","authenticated-orcid":false,"given":"Qi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health , 677 Huntington Ave, Boston, MA 02115 ,","place":["USA"]},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , 677 Huntington Ave, Boston, MA 02115 ,","place":["USA"]},{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 181 Longwood Avenue, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University , 1440 Canal Street, Suite 1724, New Orleans, LA 70112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saumya","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of California San Diego , 9500 Gilman Drive, La Jolla, CA 92093 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeramie D","family":"Watrous","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of California San Diego , 9500 Gilman Drive, La Jolla, CA 92093 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn M","family":"Rexrode","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 181 Longwood Avenue, Boston, MA 02115 ,","place":["USA"]},{"name":"Division of Women\u2019s Health, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 75 Francis St, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of California San Diego , 9500 Gilman Drive, La Jolla, CA 92093 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohit","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of California San Diego , 9500 Gilman Drive, La Jolla, CA 92093 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samia","family":"Mora","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 75 Francis St, Boston, MA 02115 ,","place":["USA"]},{"name":"Division of Preventive Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 900 Commonwealth Ave, Boston, MA 02215 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter C","family":"Willett","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health , 677 Huntington Ave, Boston, MA 02115 ,","place":["USA"]},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , 677 Huntington Ave, Boston, MA 02115 ,","place":["USA"]},{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 181 Longwood Avenue, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8041-7791","authenticated-orcid":false,"given":"Lu","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University , 1440 Canal Street, Suite 1724, New Orleans, LA 70112 ,","place":["USA"]},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health , 677 Huntington Ave, Boston, MA 02115 ,","place":["USA"]},{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School , 181 Longwood Avenue, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9426-7595","authenticated-orcid":false,"given":"JoAnn E","family":"Manson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. 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