Dong X, Zhou W, Li H, et al. - Researchers investigated if HbA1c influences incident cardiovascular disease (CVD) by regulating endogenous metabolites. By means of liquid chromatography-quadrupole time-of-flight mass spectrometry, analysis of 2019 plasma samples was performed. The metabolites which were related to both CVD and HbA1c were screened using logistic regression and linear regression. In the counterfactual model, the direct effect and indirect effect were evaluated by performing the VanderWeele's mediation approach. They identified a link between 48 metabolites and both HbA1c and CVD risk. According to the findings, high level HbA1c plays a part in incident CVD, which could be mediated by metabolite functions.