Plasma carboxymethyl-lysine, an advanced glycation end product, and all-cause and cardiovascular disease mortality in older community-dwelling adults.

OBJECTIVES

To determine whether older adults with high plasma carboxymethyl-lysine (CML), an advanced glycation end product, are at higher risk of all-cause and cardiovascular disease (CVD) mortality.

DESIGN

Prospective cohort study.

SETTING

Population-based sample of adults aged 65 and older residing in Tuscany, Italy.

PARTICIPANTS

One thousand thirteen adults participating in the Invecchiare in Chianti study.

MEASUREMENTS

Anthropometric measures, plasma CML, fasting plasma total, high-density and low-density lipoprotein cholesterol, triglycerides, glucose, creatinine. Clinical measures: medical assessment, diabetes mellitus, hypertension, coronary heart disease, heart failure, stroke, cancer. Vital status measures: death certificates and causes of death according to the International Classification of Diseases. Survival methods were used to examine the relationship between plasma CML and all-cause and CVD mortality, adjusting for potential confounders.

RESULTS

During 6 years of follow-up, 227 (22.4%) adults died, of whom 105 died with CVD. Adults with plasma CML in the highest tertile had greater all-cause (hazard ratio (HR)=1.84, 95% confidence interval) CI)=1.30-2.60, P<.001) and CVD (HR=2.11, 95% CI=1.27-3.49, P=.003) mortality than those in the lower two tertiles after adjusting for potential confounders. In adults without diabetes mellitus, those with plasma CML in the highest tertile had greater all-cause (HR=1.68, 95% CI=1.15-2.44, P=.006) and CVD (HR=1.74, 95% CI=1.00-3.01, P=.05) mortality than those in the lower two tertiles after adjusting for potential confounders.

CONCLUSION

Older adults with high plasma CML are at higher risk of all-cause and CVD mortality.