Table 3.
Concentrations of biomarkers by frequency of artificially sweetened beverage (ASB) intake among participants free of diabetes and CVD in the Nurses’ Health Study (n 8492)*
(Least-squares means and 95 % confidence intervals)
| Frequency of ASB intake | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Never or almost never | Less than once per week | Once to twice per week | Three to six times per week | Once per day or more | ||||||||||||
| Biomarker concentrations | Mean | 95% CI | Mean | 95% CI | Mean | 95% CI | Mean | 95% CI | Mean | 95% CI | Pfor trend | |||||
| Hepatic biomarker | ||||||||||||||||
| Fetuin-A (μg/ml) | ||||||||||||||||
| n | 564 | 236 | 132 | 315 | 162 | |||||||||||
| Model 1 | 458·2 | 4·5 | 465·7 | 6·9 | 468·4 | 9·2 | 461·5 | 6·0 | 475·7 | 8·4 | 0·12 | |||||
| Model 2 | 461·5 | 4·9 | 462·4 | 7·2 | 465·1 | 9·3 | 457·5 | 6·4 | 468·9 | 8·7 | 0·55 | |||||
| Alanine transaminase (U/l) | ||||||||||||||||
| n | 537 | 220 | 114 | 289 | 158 | |||||||||||
| Model 1 | 19·1 | 0·4 | 19·0 | 0·6 | 18·8 | 0·9 | 19·0 | 0·5 | 19·5 | 0·7 | 0·56 | |||||
| Model 2 | 19·4 | 0·4 | 18·9 | 0·6 | 18·1 | 0·9 | 18·3 | 0·6 | 18·8 | 0·8 | 0·61 | |||||
| γ-Glutamyl transferase (U/l) | ||||||||||||||||
| n | 537 | 220 | 114 | 287 | 158 | |||||||||||
| Model 1 | 23·7 | 1·2 | 23·1 | 1·9 | 20·9 | 2·6 | 23·2 | 1·7 | 25·0 | 2·3 | 0·54 | |||||
| Model 2 | 24·8 | 1·3 | 23·3 | 1·9 | 20·6 | 2·6 | 22·6 | 1·7 | 24·4 | 2·3 | 0·96 | |||||
| Lipid biomarkers | ||||||||||||||||
| TAG (mmol/l) | ||||||||||||||||
| n | 1290 | 556 | 330 | 779 | 374 | |||||||||||
| Model 1 | 2·66 | 0·04 | 2·77 | 0·06 | 2·91 | 0·08 | 2·80 | 0·05 | 2·86 | 0·07 | 0·03 | |||||
| Model 2 | 2·77 | 0·04 | 2·82 | 0·06 | 2·92 | 0·08 | 2·81 | 0·05 | 2·74 | 0·07 | ||||||
| Total cholesterol:HDL-cholesterol ratio | ||||||||||||||||
| n | 1109 | 471 | 268 | 651 | 348 | |||||||||||
| Model 1 | 3·74 | 0·04 | 3·75 | 0·06 | 3·91 | 0·08 | 3·93 | 0·05 | 3·91 | 0·08 | 0·03 | |||||
| Model 2 | 3·93 | 0·08 | 3·87 | 0·09 | 4·05 | 0·11 | 4·02 | 0·09 | 3·89 | 0·1 | 0·89 | |||||
| HDL-cholesterol (mmol/l) | ||||||||||||||||
| n | 1196 | 500 | 284 | 694 | 362 | |||||||||||
| Model 1 | 1·55 | 0·01 | 1·52 | 0·02 | 1·51 | 0·03 | 1·50 | 0·02 | 1·50 | 0·02 | 0·05 | |||||
| Model 2 | 1·49 | 0·02 | 1·48 | 0·02 | 1·46 | 0·03 | 1·47 | 0·02 | 1·50 | 0·03 | 0·69 | |||||
| LDL-cholesterol (mmol/l) | ||||||||||||||||
| n | 686 | 277 | 147 | 393 | 194 | |||||||||||
| Model 1 | 3·23 | 0·04 | 3·12 | 0·05 | 3·26 | 0·07 | 3·37 | 0·05 | 3·19 | 0·06 | 0·73 | |||||
| Model 2 | 3·24 | 0·05 | 3·11 | 0·06 | 3·24 | 0·08 | 3·30 | 0·06 | 3·14 | 0·07 | 0·57 | |||||
| Total cholesterol (mmol/l) | ||||||||||||||||
| n | 1547 | 654 | 391 | 947 | 495 | |||||||||||
| Model 1 | 5·51 | 0·03 | 5·47 | 0·04 | 5·54 | 0·05 | 5·52 | 0·03 | 5·56 | 0·04 | 0·26 | |||||
| Model 2 | 5·55 | 0·03 | 5·49 | 0·04 | 5·55 | 0·05 | 5·53 | 0·04 | 5·55 | 0·05 | 0·78 | |||||
| Inflammatory biomarkers | ||||||||||||||||
| C-reactive protein (mg/l) | ||||||||||||||||
| n | 2248 | 994 | 550 | 1347 | 748 | |||||||||||
| Model 1 | 1·62 | 0·04 | 1·64 | 0·05 | 1·62 | 0·07 | 1·72 | 0·05 | 2·23 | 0·09 | < 0·0001 | |||||
| Model 2 | 1·79 | 0·05 | 1·7 | 0·06 | 1·65 | 0·07 | 1·72 | 0·05 | 1·93 | 0·08 | 0·04 | |||||
| Intracellular adhesion molecule 1 (ng/ml) | ||||||||||||||||
| n | 892 | 373 | 224 | 495 | 287 | |||||||||||
| Model 1 | 230·6 | 1·9 | 228·5 | 2·9 | 229·2 | 3·7 | 225·7 | 2·5 | 233·7 | 3·4 | 0·47 | |||||
| Model 2 | 238·9 | 2·1 | 239·3 | 3·1 | 241 0 | 3·9 | 236·3 | 2·7 | 239·6 | 3·5 | 1·00 | |||||
| Vascular cell adhesion protein 1 (ng/ml) | ||||||||||||||||
| n | 466 | 186 | 114 | 263 | 176 | |||||||||||
| Model 1 | 595·4 | 6·6 | 594·4 | 10·2 | 598·1 | 13·1 | 591·8 | 8·6 | 605·6 | 11·0 | 0·45 | |||||
| Model 2 | 592·0 | 7·0 | 592·2 | 10·3 | 592·3 | 13·1 | 590·4 | 8·6 | 600·5 | 11·0 | 0·53 | |||||
| Metabolic biomarkers | ||||||||||||||||
| Adiponectin (μg/ml) | ||||||||||||||||
| n | 2248 | 986 | 560 | 1406 | 808 | |||||||||||
| Model 1 | 10·7 | 0·1 | 11·0 | 0·2 | 10·9 | 0·2 | 11·0 | 0·1 | 10·4 | 0·2 | 0·15 | |||||
| Model 2 | 10·1 | 0·1 | 10·7 | 0·2 | 10·6 | 0·2 | 10·8 | 0·2 | 10·8 | 0·2 | 0·01 | |||||
| Insulin (μU/ml) | ||||||||||||||||
| n | 1042 | 440 | 281 | 624 | 338 | |||||||||||
| Model 1 | 4·53 | 0·10 | 5·04 | 0·17 | 5·27 | 0·22 | 5·16 | 0·15 | 5·47 | 0·22 | 0·0003 | |||||
| Model 2 | 4·86 | 0·12 | 5·02 | 0·17 | 4·87 | 0·2 | 4·89 | 0·15 | 4·86 | 0·19 | 0·86 | |||||
| HbA1C (%) | ||||||||||||||||
| n | 1708 | 699 | 406 | 985 | 560 | |||||||||||
| Model 1 | 5·39 | 0·01 | 5·38 | 0·01 | 5·38 | 0·02 | 5·37 | 0·01 | 5·41 | 0·01 | 0·15 | |||||
| Model 2 | 5·42 | 0·01 | 5·41 | 0·01 | 5·41 | 0·02 | 5·39 | 0·01 | 5·42 | 0·01 | 0·55 | |||||
Biomarker sample sizes vary: fetuin-A (n 1409), alanine transaminase (n 1318), γ-glutamyl transferase (n 1316), TAG (n 3329), total cholesterol:HDL-cholesterol ratio (n 2847), HDL-cholesterol (n 3036), LDL-cholesterol (n 1697), total cholesterol (n 4034), C-reactive protein (n 5887), intracellular adhesion molecule 1 (n 2271), vascular cell adhesion protein 1 (n 1205), adiponectin (n 6008), insulin (n 2725), HbA1c (n 4358). Values were determined using general linear models. Model 1 was adjusted for age at blood draw, fasting status (yes/no) and time of blood draw (blood collection cycle 1/2). Model 2 was adjusted for the variables in model 1 plus smoking status (current/former/never), alcohol intake (continuous), physical activity (tertile), total energy intake (tertile), Alternate Healthy Eating Index score excluding sugar-sweetened beverages (tertile), postmenopausal hormone use (yes/no) and BMI (continuous).