1型糖尿病中组织和循环晚期糖基化终产物与微血管和大血管并发症之间的关联：DIABAGE研究
Association Between the Tissue and Circulating Advanced Glycation End-Products and the Micro- and Macrovascular Complications in Type 1 Diabetes: The DIABAGE Study.
作者信息
Diallo Alpha M, Jaisson Stéphane, Barriquand Romain, Lukas Céline, Barraud Sara, Decoudier Bénédicte, Francois Maud, Ly Sang, Mahmoudi Rachid, Arndt Carl, Nazeyrollas Pierre, Gillery Philippe, Delemer Brigitte
机构信息
Service d'Endocrinologie, Diabète et Nutrition, CHU de Reims, Avenue du Général Koenig, 51092, Reims, France.
Laboratoire de recherche en Santé Publique, Vieillissement, Qualité de vie et Réadaptation des Sujets Fragiles, EA 3797, Université de Reims Champagne-Ardenne, Reims, France.
出版信息
Diabetes Ther. 2022 Aug;13(8):1531-1546. doi: 10.1007/s13300-022-01285-1. Epub 2022 Jul 2.
INTRODUCTION
Type 1 diabetes is associated with an increased risk of vascular complications. We aimed to investigate the association between serum and tissue advanced glycation end-products (AGEs) and micro- and macrovascular complications in type 1 diabetes (T1D).
METHODS
We conducted a cross-sectional study on 196 adults with T1D (mean age 44.53 ± 16, mean duration of diabetes 22 ± 12 years, mean HbA1c 8 ± 1.2%). AGEs were measured in blood serum (i.e., carboxymethyllysine (CML), methylglyoxal-hydroimidazolone-1 (MGH1), and pentosidine) and by measurement of skin autofluorescence (SAF). Associations between AGEs levels and vascular complications were analyzed using binary logistic regression. Correlations between AGEs and pulse wave velocity (PWV) were also assessed by linear regressions. Significant differences were set for p values less than 0.05.
RESULTS
We found positive associations between different AGEs and vascular complications. SAF was associated with both microangiopathy (retinopathy: OR = 1.92, p = 0.011; neuropathy: OR = 2.02, p = 0.04; any microangiopathy: OR = 2.83, p < 0.0001) and macroangiopathy (coronaropathy: OR = 3.11, p = 0.009; any macroangiopathy: OR = 2.78, p = 0.003). For circulating AGEs, pentosidine was significantly associated with coronaropathy (OR = 1.61, p = 0.01) and any macroangiopathy (OR = 1.52, p = 0.005) while MGH1 was associated with nephropathy (OR 1.72, p = 0.03). Furthermore, a significant linear correlation was found between PWV and SAF (r = 0.43, p < 0.001), pentosidine (r = 0.28, p < 0.001), and MGH1 (r = 0.16, p = 0.031), but not for CML (r = 0.03, p = 0.598).
CONCLUSIONS
Skin autofluorescence appears to be a useful marker for investigating both micro- and macrovascular complications in T1D. In this study, pentosidine was associated with macroangiopathy and MGH1 with nephropathy among the circulating AGEs. Furthermore, the correlations between PWV and AGEs may suggest their value in early prediction of vascular complications in T1D.
引言
1型糖尿病与血管并发症风险增加相关。我们旨在研究1型糖尿病（T1D）患者血清和组织晚期糖基化终产物（AGEs）与微血管及大血管并发症之间的关联。
方法
我们对196例成年T1D患者进行了一项横断面研究（平均年龄44.53±16岁，平均糖尿病病程22±12年，平均糖化血红蛋白8±1.2%）。检测血清中的AGEs（即羧甲基赖氨酸（CML）、甲基乙二醛 - 氢咪唑酮 -1（MGH1）和戊糖苷）以及通过测量皮肤自发荧光（SAF）来评估AGEs水平。使用二元逻辑回归分析AGEs水平与血管并发症之间的关联。还通过线性回归评估AGEs与脉搏波速度（PWV）之间的相关性。设定p值小于0.05为显著差异。
结果
我们发现不同的AGEs与血管并发症之间存在正相关。SAF与微血管病变（视网膜病变：比值比（OR）=1.92，p = 0.011；神经病变：OR = 2.02，p = 0.04；任何微血管病变：OR = 2.83，p < 0.0001）和大血管病变（冠心病：OR = 3.11，p = 0.009；任何大血管病变：OR = 2.78，p = 0.003）均相关。对于循环中的AGEs，戊糖苷与冠心病（OR = 1.61，p = 0.01）和任何大血管病变（OR = 1.52，p = 0.005）显著相关，而MGH1与肾病相关（OR = 1.72，p = 0.03）。此外，发现PWV与SAF（r = 0.43，p < 0.001）、戊糖苷（r = 0.28，p < 0.001）和MGH1（r = 0.16，p = 0.031）之间存在显著线性相关，但与CML无相关性（r = 0.03，p = 0.598）。
结论
皮肤自发荧光似乎是用于研究T1D患者微血管和大血管并发症的有用标志物。在本研究中，循环AGEs中戊糖苷与大血管病变相关，MGH1与肾病相关。此外，PWV与AGEs之间的相关性可能提示它们在T1D血管并发症早期预测中的价值。
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