通过皮肤自发荧光测定晚期糖基化终产物，作为 2 型糖尿病患者颈动脉粥样硬化的潜在标志物。

Advanced glycation end products via skin autofluorescence as potential marker of carotid atherosclerosis in patients with type 2 diabetes.

机构信息

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China.

Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China; University of Science and Technology of China, Hefei, 230026, China.

出版信息

Nutr Metab Cardiovasc Dis. 2021 Nov 29;31(12):3449-3456. doi: 10.1016/j.numecd.2021.09.005. Epub 2021 Sep 9.

DOI:10.1016/j.numecd.2021.09.005

PMID:34688535

Abstract

BACKGROUND AND AIMS

Advanced glycation end products (AGEs) are reported to be correlated with diabetic vascular complications. This study aimed to investigate the association between AGEs and carotid atherosclerosis (CAS) as a surrogate marker of cardiovascular disease (CVD).

METHODS AND RESULTS

A total of 1006 patients with type 2 diabetes were included. CAS was defined as the presence of carotid arterial atherosclerotic plaque in any of bilateral carotid artery segments measured by ultrasonography. AGEs were measured by the noninvasive skin autofluorescence method. AGE index was calculated as AGEs × age/100. Patients with CAS showed a significantly higher AGE (P < 0.01), and the prevalence of CAS increased with ascending AGE levels (P for trend < 0.001). Logistic regression analysis revealed that AGE was significantly positively associated with odds of CAS, and the odds ratios of the presence of CAS across quartiles of AGE were 1.00, 3.00 [95% confidence interval (CI) 1.90-4.74], 4.04 (95%CI 2.50-6.53) and 4.99 (95%CI 2.97-8.40) for the multivariable-adjusted model (P for trend <0.001), respectively. In the fully adjusted model, each 5.0 increase in AGE was associated with a 0.019 mm increment in carotid intima-media thickness. Furthermore, AGE presented an acceptable predictive value for CAS, with an optimal cutoff point of 43.2, and the sensitivity, specificity and area under the curve (AUC) were 74.5% (95%CI 70.7-78.1%), 61.9% (95%CI 57.2-66.4%) and 0.735 (0.706-0.762), respectively.

CONCLUSION

AGE, the noninvasive measurement of AGEs combined with age is a promising approach for triaging patients at high risk of CVDs.

摘要

背景与目的

晚期糖基化终产物（AGEs）与糖尿病血管并发症相关。本研究旨在探讨 AGEs 与颈动脉粥样硬化（CAS）的关系，后者可作为心血管疾病（CVD）的替代标志物。

方法和结果

共纳入 1006 例 2 型糖尿病患者。CAS 定义为超声检查双侧颈动脉节段中任何一节段存在颈动脉动脉粥样硬化斑块。AGEs 通过无创皮肤荧光法测量。AGE 指数计算为 AGEs×年龄/100。患有 CAS 的患者的 AGE 明显更高（P<0.01），并且随着 AGE 水平的升高，CAS 的患病率呈上升趋势（趋势 P<0.001）。Logistic 回归分析显示，AGE 与 CAS 的发生显著正相关，且按 AGE 四分位数划分时 CAS 的存在的比值比分别为 1.00、3.00（95%CI 1.90-4.74）、4.04（95%CI 2.50-6.53）和 4.99（95%CI 2.97-8.40）（多变量调整模型的趋势 P<0.001）。在完全调整的模型中，AGE 每增加 5.0，颈动脉内膜-中层厚度增加 0.019mm。此外，AGE 对 CAS 具有可接受的预测价值，最佳截断点为 43.2，其灵敏度、特异度和曲线下面积（AUC）分别为 74.5%（95%CI 70.7-78.1%）、61.9%（95%CI 57.2-66.4%）和 0.735（0.706-0.762）。