Yoshioka Keiji
Yoshioka Diabetes Clinic, Moriguchi, Japan.
Diab Vasc Dis Res. 2018 Nov;15(6):559-566. doi: 10.1177/1479164118785314. Epub 2018 Jul 4.
The study aims to evaluate the relationship between skin autofluorescence, a marker of advanced glycated end-products accumulation in tissue, and high-sensitive cardiac troponin T, a cardiovascular biomarker, in Japanese subjects with diabetes. A total of 145 subjects with diabetes and 32 nondiabetic subjects as control attending the outpatient clinic were examined. Skin autofluorescence was measured using the AGE Reader™. Univariate and multivariate regression analyses were used to identify the factors associated with the high-sensitive cardiac troponin T and N-terminal pro-B-type natriuretic peptide values. Skin autofluorescence, high-sensitive cardiac troponin T, and maximum intima-media thickness values were significantly higher in subjects with diabetes than in nondiabetic subjects. Diabetic subjects with skin autofluorescence level⩾2.47 AU (median value) had higher levels of N-terminal pro-B-type natriuretic peptide ( p = 0.006), high-sensitive cardiac troponin T ( p < 0.0001), pentosidine ( p = 0.011) and maximum intima-media thickness ( p = 0.017) compared to those with skin autofluorescence level <2.47 AU. A multivariate regression analysis using variables that were significantly correlated with high-sensitive cardiac troponin T and N-terminal pro-B-type natriuretic peptide, revealed that estimated glomerular filtration rate (β = -0.364, p < 0.001) and skin autofluorescence (β = 0.254, p = 0.0022) were independent determinants of high-sensitive cardiac troponin T, but the variables that were significant in the univariate analysis were no longer predictors for N-terminal pro-B-type natriuretic peptide. Skin autofluorescence measured with the AGE Reader™ could be an easy and noninvasive surrogate marker for identifying diabetic subjects at high risk for subclinical cardiac injury.
本研究旨在评估日本糖尿病患者中，组织晚期糖基化终产物积累的标志物——皮肤自发荧光，与心血管生物标志物高敏心肌肌钙蛋白T之间的关系。共有145例糖尿病患者和32例非糖尿病患者作为对照参与了门诊检查。使用AGE Reader™测量皮肤自发荧光。采用单因素和多因素回归分析来确定与高敏心肌肌钙蛋白T和N末端B型利钠肽原值相关的因素。糖尿病患者的皮肤自发荧光、高敏心肌肌钙蛋白T和最大内膜中层厚度值显著高于非糖尿病患者。皮肤自发荧光水平⩾2.47 AU（中位数）的糖尿病患者，其N末端B型利钠肽原（p = 0.006）、高敏心肌肌钙蛋白T（p < 0.0001）、戊糖苷（p = 0.011）和最大内膜中层厚度（p = 0.017）水平均高于皮肤自发荧光水平<2.47 AU的患者。使用与高敏心肌肌钙蛋白T和N末端B型利钠肽原显著相关的变量进行多因素回归分析，结果显示，估计肾小球滤过率（β = -0.364，p < 0.001）和皮肤自发荧光（β = 0.254，p = 0.0022）是高敏心肌肌钙蛋白T的独立决定因素，但单因素分析中有意义的变量不再是N末端B型利钠肽原的预测指标。使用AGE Reader™测量的皮肤自发荧光可能是一种简便、无创的替代标志物，用于识别亚临床心脏损伤高危的糖尿病患者。
