皮肤自发荧光与中国 2 型糖尿病成人发生心血管事件的风险增加相关：来自香港糖尿病生物样本库的前瞻性队列研究。

Skin autofluorescence is associated with higher risk of cardiovascular events in Chinese adults with type 2 diabetes: A prospective cohort study from the Hong Kong Diabetes Biobank.

机构信息

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China; Chinese University of Hong Kong-Shanghai Jiao Tong University Joint Research Centre in Diabetes Genomics and Precision Medicine, Chinese University of Hong Kong, Hong Kong, China.

出版信息

J Diabetes Complications. 2021 Oct;35(10):108015. doi: 10.1016/j.jdiacomp.2021.108015. Epub 2021 Aug 4.

DOI:10.1016/j.jdiacomp.2021.108015

PMID:34384706

Abstract

AIMS

To investigate association between skin autofluorescence (SAF) and cardiovascular events (CVE) and assess its predictive value in Chinese adults with type 2 diabetes (T2D).

MATERIALS AND METHODS

SAF was measured non-invasively in 3806 Chinese adults with T2D between 2016 and 2019 with CVE as primary endpoint and individual components as secondary endpoints. Cox proportional hazard models were used to examine associations between SAF and endpoints with adjustment for conventional risk factors. C-statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were performed to evaluate SAF's predictive value.

RESULTS

During a median 1.8 (interquartile range, 1.2-3.1) years of follow-up, 172 individuals experienced CVE. Multivariate Cox model showed that SAF was independently associated with CVE (HR 1.18 per SD, 95% CI [1.02, 1.37]), coronary heart disease (HR 1.29 per SD, 95% CI [1.02, 1.63]), and congestive heart failure (HR 1.53 per SD, 95% CI [1.14, 2.05]). SAF yielded additional value on CVE risk stratification with enhanced IDI (95% CI) (0.023 [0.001, 0.057]) and continuous NRI (0.377 [0.002, 0.558]) over traditional risk factors.

CONCLUSIONS

Higher SAF was independently associated with CVE in Chinese adults with T2D and yielded incremental predictive information for CVE. SAF has potential as a prognostic maker for CVE.

摘要

目的

研究皮肤自发荧光（SAF）与心血管事件（CVE）之间的关联，并评估其在 2 型糖尿病（T2D）中国成年人中的预测价值。

材料与方法

2016 年至 2019 年间，对 3806 名患有 T2D 的中国成年人进行了非侵入性 SAF 测量，以 CVE 为主要终点，以各组成部分为次要终点。使用 Cox 比例风险模型，调整传统危险因素后，对 SAF 与终点之间的关系进行了检验。采用 C 统计量、综合判别改善（IDI）和净重新分类改善（NRI）评估 SAF 的预测价值。

结果

在中位随访 1.8 年（四分位距，1.2-3.1 年）期间，172 人发生 CVE。多变量 Cox 模型显示，SAF 与 CVE（每 SD 增加 1.18，95%CI [1.02，1.37]）、冠心病（每 SD 增加 1.29，95%CI [1.02，1.63]）和充血性心力衰竭（每 SD 增加 1.53，95%CI [1.14，2.05]）独立相关。SAF 对 CVE 风险分层具有额外价值，可提高 IDI（95%CI）（0.023 [0.001，0.057]）和连续 NRI（0.377 [0.002，0.558]）。