Nutr Metab Cardiovasc Dis. 2026 Sep 8:104997. doi: 10.1016/j.numecd.2026.104997. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: Fatty liver disease (FLD) and impaired kidney function are associated with higher cardiovascular disease (CVD) mortality in CVD patients, despite using cardiovascular medication. In CVD-free populations, de novo lipogenesis (DNL) has been linked to these outcomes, but its role in CVD patients remains unclear. We examined associations between DNL and cardiometabolic outcomes in CVD patients, and explored mediation by DNL in the relation between carbohydrate quality and cardiometabolic outcomes.
METHODS AND RESULTS: Data from 4305 CVD patients from the Alpha Omega Cohort were analyzed. DNL was assessed using the lipogenic index (circulating palmitic acid/linoleic acid). Carbohydrate intakes were assessed with a food frequency questionnaire. Linear regressions estimated associations for annual change in estimated glomerular filtration rate, and Cox proportional hazards for prevalent FLD and CVD mortality risk. Mediation analyses assessed whether the lipogenic index mediated associations between carbohydrate quality and cardiometabolic outcomes. A high lipogenic index (Q5 vs Q1) was associated with more annual kidney function decline (β: -0.84, 95% confidence interval [-1.37, -0.31]), higher FLD prevalence (Prevalence Ratio: 1.60 [1.34, 1.92]), and higher CVD mortality risk during 3-year (Hazard Ratio: 1.83 [1.06, 3.15]) and 15-year follow-up (HR 1.37 [1.12, 1.67]). Higher intake of total polysaccharides (per 10 en%), replacing sugars, was associated with reduced 15-year CVD mortality risk (HR: 0.83 [0.68, 0.96]), but this was not mediated by the lipogenic index.
CONCLUSION: Elevated DNL was adversely linked to cardiometabolic outcomes in CVD patients. DNL did not mediate the association between carbohydrate quality and cardiometabolic outcomes.
PMID:42760235 | DOI:10.1016/j.numecd.2026.104997