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Nutritional Epidemiology (Poster Session)

(P17-043-25) Modifiable Risk Factors, Plasma Proteomics, and Risks of Major Adverse Cardiovascular Events Among Individuals With Type 2 Diabetes

Sunday, June 1, 2025
12:45 PM - 1:45 PM ET
Location: Poster Board A-42

    Presenting Author(s)

  • RL

    Ruyi Li, PhD candidate

    None
    Tongji Medical College, Huazhong University of Science and Technology
    wuhan, Hubei, China (People's Republic)

    • Co-Author(s)

  • ST

    Shufan Tian

    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health

  • YL

    Yunfei Liao

    Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China (People's Republic)

  • AP

    An Pan, PhD

    Professor
    Huazhong University of Science and Technology
    Wuhan, Hubei, China (People's Republic)

  • GL

    Gang Liu

    Huazhong University of Science and Technology, Tongji Medical College, School of Public Health

Disclosure(s):
Ruyi Li, PhD candidate: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: To investigate the associations of lifestyle behaviors and cardiometabolic factors with major adverse cardiovascular events among individuals with type 2 diabetes (T2D), and then estimate whether and to what extent plasma proteomics could mediate these associations.

Methods: This prospective cohort study included 14,102 participants with T2D. The cardiovascular health (CVH) score was derived from eight modifiable risk factors: dietary habits, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional hazards regression was applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of composite and individual major adverse cardiovascular events. In the proteomic subset (n=1,287), multivariable linear regression and the least absolute shrinkage and selection operator (LASSO) regression were used to select representative proteins. Mediation analysis was performed to evaluate the intermediate effects of plasma proteins.

Results: During a median follow-up of 12.4-13.4 years, a higher CVH score was associated with lower risks of composite and seven major adverse cardiovascular events among individuals with T2D. The primary beneficiary was peripheral artery disease (HR: 0.70, 95% CI: 0.66-0.75), with a population attributable fraction of 7.8% for diet. Of 2,915 proteins, 632 were significantly associated with the CVH score. Among the proteomic profiles of each risk factor, the diet-associated proteomic profile had the highest proportion of proteins showing intermediate effects (12.6%). Mediation analysis revealed that six vascular diseases shared the same mediator, UMOD (uromodulin). ADM (pro-adrenomedullin) showed the highest mediation proportions in associations of CVH score with four vascular diseases; the mediation proportions ranged from 20.7% to 42.3%.

Conclusions: These findings highlighted the important role of modifying risk factors, such as diet, in alleviating burden of major adverse cardiovascular events among individuals with T2D and facilitated the understanding of mediation effects of plasma proteomics underlying modifiable risk factors with future health risks.

Funding Sources: The National Key Research and Development Program of China