Abstract 9777: Dietary Phosphatidylcholine and Risk of All-cause and Cardiovascular-specific Mortality Among Women and Men With Type 2 Diabetes

Introduction: The trimethylamine-containing nutrient phosphatidylcholine is the major dietary source for gut microbiota metabolite trimethylamine-N-oxide, which has been related to cardiovascular diseases (CVD) and mortality. We recently found higher dietary phosphatidylcholine intake was associated with an increased risk of diabetes. No study has analyzed whether phosphatidylcholine intake is related to all-cause and CVD mortality in diabetic patients, who have a higher risk of CVD and premature mortality than the general population. Methods: In total, we included 10061 women and 3668 men with type 2 diabetes in the Nurses’ Health Study and Health Professionals Follow-up Study, respectively. Dietary intakes and potential confounders were assessed with regularly administered questionnaires. Results: We documented 2427 all-cause and 807 CVD deaths during up to 30-year follow-up. After multivariate adjustment for potential confounders, including age, smoking, body mass index, physical activity, dietary intakes and duration of diabetes, higher phosphatidylcholine intake was associated with an increased risk of all-cause and CVD mortality. The pooled relative risk comparing top to bottom quartiles of phosphatidylcholine intake was 1.22 (95%CI, 1.07-1.39; P for trend across quartiles=0.003) for all-cause mortality and 1.33 (1.04-1.69; P for trend=0.03) for CVD mortality. Conclusions: These data indicate that higher phosphatidylcholine consumption is associated with higher all-cause and CVD mortality in diabetic population, independent of other risk factors. Our findings suggest dietary modulation may be a potential interventional strategy to reduce mortality related to gut microbiota metabolites.