Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
Department of Diabetes and Endocrinology, Toranomon Hospital Kajigaya, Kawasaki, Japan.
Cardiovasc Diabetol. 2023 Jun 23;22(1):147. doi: 10.1186/s12933-023-01882-9.
Type 2 diabetes is associated with an increased risk of developing cardiovascular events. Previous studies have reported that advanced glycation end products (AGEs) were related to cardiovascular events in type 2 diabetes. However, data on associations between long-term AGEs and cardiovascular events in type 2 diabetes are lacking. This study aimed to determine whether a long-time shift in the levels of serum AGEs is associated with cardiovascular events in patients with poorly controlled type 2 diabetes.
Two-time serum methyl-glyoxal-hydroimidazoline (MG-H1) levels were measured in 138 patients with type 2 diabetes whose mean glycated hemoglobin level was 10.1%. We categorized patients whose serum MG-H1 levels were < 2.8 µg/mL at both times as the continuous low MG-H1 group. The primary endpoints of this study were combined cardiovascular events, which were defined as heart disease, peripheral arterial disease, stroke, and all-cause death. Hazard ratios (HRs) for combined cardiovascular events with 95% confidence intervals (CIs) were calculated using the Cox proportional hazard models to compare the outcomes between the continuous low MG-H1 group and others.
The continuous low MG-H1 group was associated with a significantly lower risk than others in combined cardiovascular events after adjusting for possible confounders (HR: 0.50; 95% CI, 0.28-0.87; P = 0.02). Furthermore, the same relationship was observed in patients without a history of cardiovascular events.
Continuous low serum MG-H1 levels are associated with a low frequency of diabetes-related complications in patients with poorly controlled type 2 diabetes.
2 型糖尿病与心血管事件风险增加相关。先前的研究报告称，晚期糖基化终产物（AGEs）与 2 型糖尿病中的心血管事件有关。然而，关于 2 型糖尿病中长期 AGEs 与心血管事件之间的关联的数据尚缺乏。本研究旨在确定血清 AGEs 水平的长期变化是否与控制不佳的 2 型糖尿病患者的心血管事件相关。
对 138 名糖化血红蛋白水平平均为 10.1%的 2 型糖尿病患者进行了两次血清甲基乙二醛-羟咪唑啉（MG-H1）水平的测量。我们将两次血清 MG-H1 水平均<2.8 µg/mL 的患者归为连续低 MG-H1 组。本研究的主要终点为复合心血管事件，定义为心脏病、外周动脉疾病、中风和全因死亡。使用 Cox 比例风险模型计算复合心血管事件的风险比（HR）及其 95%置信区间（CI），以比较连续低 MG-H1 组和其他组的结局。
在校正了可能的混杂因素后，连续低 MG-H1 组的复合心血管事件风险显著低于其他组（HR：0.50；95%CI，0.28-0.87；P=0.02）。此外，在无心血管事件史的患者中也观察到了相同的关系。
在控制不佳的 2 型糖尿病患者中，持续低水平的血清 MG-H1 与糖尿病相关并发症的发生频率较低相关。
