Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Cardiovasc Diabetol. 2023 Nov 28;22(1):326. doi: 10.1186/s12933-023-02052-7.
Advanced glycation end products (AGEs) have been linked to cardiovascular disease (CVD), especially coronary heart disease (CHD), but their role in CVD pathogenesis remains unclear. Therefore, we investigated cross-sectional associations of skin AGEs with subclinical atherosclerosis, arterial stiffness, and hypertension after confirming their relation with CHD.
In the population-based Rotterdam Study, skin AGEs were measured as skin autofluorescence (SAF). Prevalent MI was obtained from digital medical records. Carotid plaques, carotid intima-media thickness (IMT), coronary artery calcification (CAC), pulse wave velocity (PWV), and hypertension were assessed. Associations of SAF with endophenotypes were investigated in logistic and linear regression models adjusting for common cardiovascular risk factors. Effect modification by sex, diabetes mellitus, and chronic kidney disease (CKD) was tested.
3001 participants were included (mean age 73 (SD 9) years, 57% women). One unit higher SAF was associated with the presence of carotid plaques (OR 1.2 (0.92, 1.57)), a higher max IMT (0.08 SD (0.01, 0.15)), higher CAC (OR 2.2 (1.39, 3.48)), and PWV (0.09 SD (0.01, 0.16)), but not with hypertension (OR 0.99 (0.81, 1.21)). The associations with endophenotypes were more pronounced in men and participants with diabetes or CKD with significant interactions.
Previously documented associations between SAF and CVD, also found in our study, may be explained by the endophenotypes atherosclerosis and arterial stiffness, especially in men and individuals with diabetes or CKD, but not by hypertension. Longitudinal studies are needed to replicate these findings and to test if SAF is an independent risk factor or biomarker of CVD.
The Rotterdam Study has been entered into the Netherlands National Trial Register (NTR; www.trialregister.nl ) and the WHO International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/network/primary/en/ ) under shared catalogue number NTR6831.
晚期糖基化终产物（AGEs）与心血管疾病（CVD），尤其是冠心病（CHD）有关，但它们在 CVD 发病机制中的作用尚不清楚。因此，在确认其与 CHD 的关系后，我们研究了皮肤 AGEs 与亚临床动脉粥样硬化、动脉僵硬和高血压之间的横断面关联。
在基于人群的鹿特丹研究中，皮肤 AGEs 被测量为皮肤自发荧光（SAF）。从数字病历中获得了现患 MI。评估颈动脉斑块、颈动脉内膜中层厚度（IMT）、冠状动脉钙化（CAC）、脉搏波速度（PWV）和高血压。在调整常见心血管危险因素后，使用逻辑和线性回归模型研究 SAF 与表型之间的关联。通过性别、糖尿病和慢性肾脏病（CKD）来检验效应修饰作用。
共纳入 3001 名参与者（平均年龄 73（9）岁，57%为女性）。SAF 每增加一个单位，颈动脉斑块的存在（OR 1.2（0.92，1.57））、最大 IMT 越高（0.08 SD（0.01，0.15））、CAC 越高（OR 2.2（1.39，3.48））和 PWV 越高（0.09 SD（0.01，0.16）），但高血压（OR 0.99（0.81，1.21））无此关联。在男性和患有糖尿病或 CKD 的参与者中，与表型的关联更为明显，存在显著的交互作用。
我们的研究也发现，之前在 SAF 和 CVD 之间记录的关联可能是通过动脉粥样硬化和动脉僵硬等表型来解释的，尤其是在男性和患有糖尿病或 CKD 的个体中，而不是通过高血压来解释的。需要进行纵向研究来复制这些发现，并测试 SAF 是否是 CVD 的独立危险因素或生物标志物。
鹿特丹研究已被纳入荷兰国家试验注册（NTR；www.trialregister.nl）和世界卫生组织国际临床试验注册平台（ICTRP；www.who.int/ictrp/network/primary/en/），共同编目号为 NTR6831。
