University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, School of Public Health, 130 De Soto Street, Pittsburgh, PA 15231, USA.
University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, School of Public Health, 130 De Soto Street, Pittsburgh, PA 15231, USA.
J Diabetes Complications. 2021 Feb;35(2):107770. doi: 10.1016/j.jdiacomp.2020.107770. Epub 2020 Oct 23.
We assessed the association of skin intrinsic fluorescence (SIF) scores, as a measure of advanced glycation end-products (AGE), with all-cause mortality in type 1 diabetes (T1D).
This is an observational retrospective study of a convenience sample from the Epidemiology of Diabetes Complications (EDC) study. AGEs were measured with a SIF score between 2007 and 2014; vital status was assessed in 2020.
Among 245 participants, mean age was 48.6 ± 7.4 years, median diabetes duration was 39.5 years (IQR: 34.2, 44.9), and 53.5% were female. Compared to survivors, the deceased (n = 20) were older, with higher SIF scores, longer diabetes duration, lower body mass index (BMI), and an adverse risk factor profile (all p≤0.05). Univariate Cox regression showed a marginal association between SIF score and mortality (HR: 1.1, 95% CI 0.9-1.2, p = 0.06), which persisted after adjustment for multiple daily insulin shots/pump (MDI) use (HR: 1.1, 95% CI 1.0-1.2, p = 0.04). This association was attenuated after adjustment for T1D duration, A months, or estimated glomerular filtration rate (eGFR).
In individuals with long duration T1D, SIF scores adjusted for MDI predicted all-cause mortality, although this association was attenuated after adjustments. Given the nature of sampling and small number of events, our findings require replication.
我们评估了皮肤固有荧光（SIF）评分（AGE 的一种衡量指标）与 1 型糖尿病（T1D）全因死亡率之间的关联。
这是一项观察性回顾性研究，样本来自于糖尿病并发症的流行病学（EDC）研究中的便利样本。在 2007 年至 2014 年间测量了 AGE，在 2020 年评估了生存状况。
在 245 名参与者中，平均年龄为 48.6±7.4 岁，中位糖尿病病程为 39.5 年（IQR：34.2，44.9），53.5%为女性。与幸存者相比，已故者（n=20）年龄较大，SIF 评分较高，糖尿病病程较长，体重指数（BMI）较低，且具有不良的危险因素特征（均 p≤0.05）。单因素 Cox 回归显示 SIF 评分与死亡率之间存在边缘关联（HR：1.1，95%CI 0.9-1.2，p=0.06），在调整了多次每日胰岛素注射/泵（MDI）使用后仍然存在（HR：1.1，95%CI 1.0-1.2，p=0.04）。在调整了 T1D 病程、A 月或估算肾小球滤过率（eGFR）后，这种关联减弱了。
在病程较长的 T1D 个体中，调整 MDI 后 SIF 评分预测了全因死亡率，尽管这种关联在调整后减弱了。鉴于抽样性质和事件数量较少，我们的发现需要进一步证实。
