Circulating sphingomyelins and mortality in a community-based Korean cohort: the Korean Genome and epidemiology study.

None of the seven circulating sphingomyelin species were significantly associated with all-cause, cardiovascular, or non-cardiovascular mortality, or with the composite cardiovascular outcome, after multiple-testing correction.

• The cohort comprised 2,434 participants from the Ansan-Ansung cohort of the Korean Genome and Epidemiology Study.
• Seven SM species were measured at the 2005-2006 examination, and mortality was linked through December 2024.
• Cox proportional hazards models were adjusted for demographic, lifestyle, clinical and laboratory factors.
• Benjamini-Hochberg correction was applied across 28 tests within each adjustment model.

Higher SM 16:0 was nominally associated with higher all-cause mortality in the fully adjusted model, but the association did not survive multiple-testing correction.

• Hazard ratio 1.70; 95% CI, 1.07-2.70; P = 0.025.
• The association was not statistically significant after Benjamini-Hochberg correction.

The cohort had long follow-up with a modest number of cardiovascular deaths.

• Median follow-up was 18.5 years.
• 426 deaths occurred, including 79 cardiovascular deaths.

The authors conclude that the prognostic relevance of circulating SMs may be limited and may vary by population characteristics.

• Prior studies in other populations had proposed SMs as biomarkers of mortality and cardiovascular risk, but findings varied across populations.
• The Korean community-based findings were null after correction for multiple testing.