Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
BMC Cardiovasc Disord. 2020 Apr 23;20(1):195. doi: 10.1186/s12872-020-01484-3.
Advanced glycation end products (AGEs) are associated with aging, diabetes mellitus (DM), and other chronic diseases. Recently, the accumulation of AGEs can be evaluated by skin autofluorescence (SAF). However, the relationship between SAF levels and exercise capacity in patients with cardiovascular disease (CVD) remains unclear. This study aimed to investigate the association between the tissue accumulation of AGEs and clinical characteristics, including exercise capacity, in patients with CVD.
We enrolled 319 consecutive CVD patients aged ≥40 years who underwent early phase II cardiac rehabilitation (CR) at our university hospital between November 2015 and September 2017. Patient background, clinical data, and the accumulation of AGEs assessed by SAF were recorded at the beginning of CR. Characteristics were compared between two patient groups divided according to the median SAF level (High SAF and Low SAF).
The High SAF group was significantly older and exhibited a higher prevalence of DM than the Low SAF group. The sex ratio did not differ between the two groups. AGE levels showed significant negative correlations with peak oxygen uptake and ventilator efficiency (both P < 0.0001). Exercise capacity was significantly lower in the high SAF group than in the low SAF group, regardless of the presence or absence of DM (P < 0.05). A multivariate logistic regression analysis showed that SAF level was an independent factor associated with reduced exercise capacity (odds ratio 2.10; 95% confidence interval 1.13-4.05; P = 0.02).
High levels of tissue accumulated AGEs, as assessed by SAF, were significantly and independently associated with reduced exercise capacity. These data suggest that measuring the tissue accumulation of AGEs may be useful in patients who have undergone CR, irrespective of whether they have DM.
晚期糖基化终产物（AGEs）与衰老、糖尿病（DM）和其他慢性疾病有关。最近，AGEs 的积累可以通过皮肤自发荧光（SAF）来评估。然而，SAF 水平与心血管疾病（CVD）患者的运动能力之间的关系尚不清楚。本研究旨在探讨 CVD 患者组织中 AGEs 积累与包括运动能力在内的临床特征之间的关系。
我们纳入了 2015 年 11 月至 2017 年 9 月在我们大学医院接受早期二期心脏康复（CR）的 319 名年龄≥40 岁的连续 CVD 患者。在 CR 开始时记录了患者背景、临床数据和 SAF 评估的 AGEs 积累。根据 SAF 中位数将患者分为两组（高 SAF 组和低 SAF 组），比较两组之间的特征。
高 SAF 组明显比低 SAF 组年龄更大，DM 患病率更高。两组之间的性别比例没有差异。AGE 水平与峰值摄氧量和通气效率呈显著负相关（均 P<0.0001）。高 SAF 组的运动能力明显低于低 SAF 组，无论是否存在 DM（P<0.05）。多变量逻辑回归分析显示，SAF 水平是与运动能力下降相关的独立因素（优势比 2.10；95%置信区间 1.13-4.05；P=0.02）。
SAF 评估的组织中 AGEs 的高水平与运动能力下降显著且独立相关。这些数据表明，无论患者是否患有 DM，测量组织中 AGEs 的积累可能对接受 CR 的患者有用。
