Lipids and Atherosclerosis Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofia University Hospital/University of Córdoba, 14004 Córdoba, Spain.
CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Nutrients. 2020 Jan 16;12(1):238. doi: 10.3390/nu12010238.
Endothelial dysfunction and intima-media thickness of common carotid arteries (IMT-CC) are considered subclinical markers of atherosclerotic cardiovascular disease (ASCVD). Advanced glycation end products (AGEs) are increased in type 2 diabetes mellitus (T2DM) patients, compared with non-diabetics, being implicated in micro- and macrovascular complications. Our aim was to compare serum AGEs levels and subclinical atherosclerotic markers between patients with established and newly diagnosed T2DM. Among 540 patients with T2DM and coronary heart disease from the CORDIOPREV study, 350 patients had established T2DM and 190 patients had newly diagnosed T2DM. Serum levels of AGEs (methylglyoxal (MG) and N-carboxymethyl lysine (CML)) and subclinical atherosclerotic markers (brachial flow-mediated vasodilation (FMD) and IMT-CC) were measured. AGEs levels (all < 0.001) and IMT-CC ( = 0.025) were higher in patients with established vs. newly diagnosed T2DM, whereas FMD did not differ between the two groups. Patients with established T2DM and severe endothelial dysfunction (i.e., FMD < 2%) had higher serum MG levels, IMT-CC, HOMA-IR and fasting insulin levels than those with newly diagnosed T2DM and non-severe endothelial dysfunction (i.e., FMD ≥ 2%) (all < 0.05). Serum CML levels were greater in patients with established vs. newly diagnosed T2DM, regardless of endothelial dysfunction severity. Serum AGEs levels and IMT-CC were significantly higher in patients with established vs. newly diagnosed T2DM, highlighting the progressively increased risk of ASCVD in the course of T2DM. Establishing therapeutic strategies to reduce AGEs production and delay the onset of cardiovascular complications in newly diagnosed T2DM patients or minimize ASCVD risk in established T2DM patients is needed.
血管内皮功能障碍和颈总动脉内膜中层厚度 (IMT-CC) 被认为是动脉粥样硬化性心血管疾病 (ASCVD) 的亚临床标志物。与非糖尿病患者相比，2 型糖尿病 (T2DM) 患者的晚期糖基化终产物 (AGEs) 增加，这与微血管和大血管并发症有关。我们的目的是比较已确诊和新诊断的 2 型糖尿病患者的血清 AGEs 水平和亚临床动脉粥样硬化标志物。在 CORDIOPREV 研究中，540 名患有 2 型糖尿病和冠心病的患者中，350 名患者患有已确诊的 2 型糖尿病，190 名患者患有新诊断的 2 型糖尿病。测量了血清 AGEs（甲基乙二醛 (MG) 和 N-羧甲基赖氨酸 (CML)）水平和亚临床动脉粥样硬化标志物（肱动脉血流介导的血管舒张 (FMD) 和 IMT-CC）。与新诊断的 2 型糖尿病患者相比，已确诊的 2 型糖尿病患者的 AGEs 水平（均 < 0.001）和 IMT-CC（= 0.025）更高，而两组之间的 FMD 没有差异。患有已确诊的 2 型糖尿病和严重内皮功能障碍（即 FMD < 2%）的患者的血清 MG 水平、IMT-CC、HOMA-IR 和空腹胰岛素水平高于新诊断的 2 型糖尿病和非严重内皮功能障碍（即 FMD≥2%）的患者（均 < 0.05）。与新诊断的 2 型糖尿病患者相比，无论内皮功能障碍的严重程度如何，患有已确诊的 2 型糖尿病患者的血清 CML 水平更高。与新诊断的 2 型糖尿病患者相比，已确诊的 2 型糖尿病患者的血清 AGEs 水平和 IMT-CC 显著更高，这突显了 2 型糖尿病患者发生 ASCVD 的风险逐渐增加。需要制定治疗策略来减少 AGEs 的产生并延迟新诊断的 2 型糖尿病患者发生心血管并发症的时间，或者最大限度地降低已确诊的 2 型糖尿病患者的 ASCVD 风险。
