Abstract：
To investigate the relationship of the glycation gap (GGap) with all-cause and cardiovascular (CV) mortality in US adults.
This was a retrospective cohort study comprising 12 909 individual participant data from the National Health and Nutrition Examination Survey from 1999 to 2004 and their mortality data through 31 December 2019. Weighted Cox proportional hazards regression models and restricted cubic splines were used to investigate the associations between GGap and mortality.
During a median follow-up of 16.8 years, 3528 deaths occurred, including 1140 CV deaths. The associations of GGap with risk of all-cause and CV mortality were U-shaped (both P for non-linearity < .001). Compared with individuals with a GGap of 0.09%-0.38% (61st-80th centiles), the multivariable-adjusted HRs and 95% CIs for individuals with a GGap less than -0.83% (first-fifth centiles) and individuals with a GGap greater than 0.90% (96th-100th centiles) were 1.36 (1.10, 1.69) and 1.21 (1.00, 1.45) for all-cause mortality, and 1.77 (1.16, 2.71) and 1.43 (1.04, 1.95) for CV mortality. The GGap value associated with the lowest risk of all-cause and CV mortality was 0.38% in the general population and 0.78% among individuals with diabetes.
We found a U-shaped association between GGap and all-cause and CV mortality, with significant positive or negative GGap values associated with increased mortality risk, probably because of glycaemic variability and fructosamine-3-kinase activity.
This was a retrospective cohort study comprising 12 909 individual participant data from the National Health and Nutrition Examination Survey from 1999 to 2004 and their mortality data through 31 December 2019. Weighted Cox proportional hazards regression models and restricted cubic splines were used to investigate the associations between GGap and mortality.
During a median follow-up of 16.8 years, 3528 deaths occurred, including 1140 CV deaths. The associations of GGap with risk of all-cause and CV mortality were U-shaped (both P for non-linearity < .001). Compared with individuals with a GGap of 0.09%-0.38% (61st-80th centiles), the multivariable-adjusted HRs and 95% CIs for individuals with a GGap less than -0.83% (first-fifth centiles) and individuals with a GGap greater than 0.90% (96th-100th centiles) were 1.36 (1.10, 1.69) and 1.21 (1.00, 1.45) for all-cause mortality, and 1.77 (1.16, 2.71) and 1.43 (1.04, 1.95) for CV mortality. The GGap value associated with the lowest risk of all-cause and CV mortality was 0.38% in the general population and 0.78% among individuals with diabetes.
We found a U-shaped association between GGap and all-cause and CV mortality, with significant positive or negative GGap values associated with increased mortality risk, probably because of glycaemic variability and fructosamine-3-kinase activity.
摘要：
目的：糖基化缺口（GGAP）作用的证据，HbA1c与其他血糖估计值之间差异的指标，死亡率仍不清楚。这项研究旨在调查美国成年人Ggap与全因和心血管（CV）死亡率的关系。
方法：这是一项回顾性队列研究，包括1999年至2004年国家健康和营养调查（NHANES）的12,909名个体参与者数据以及截至2019年12月31日的死亡率数据。使用加权Cox比例风险回归模型和有限的三次样条来研究Ggap与死亡率之间的关联。
结果：在16.8年的中位随访中，3,528人死亡,包括1140例CV死亡。Ggap与全因死亡率和CV死亡率的关系呈U型（非线性均P<0.001）。与Ggap为0.09-0.38％（第61-80分）的个体相比，GGAP小于-0.83%(第1-5百分位数)的个体和GGAP大于0.90%(第96-100百分位数)的个体的多变量校正HR和95%CI分别为1.36(1.10,1.69)和1.21(1.00,1.45),心血管死亡率为1.77（1.16，2.71）和1.43（1.04，1.95）。与全因死亡率和心血管死亡率最低风险相关的GGap值在普通人群中为0.38％，在糖尿病患者中为0.78％。
结论：我们发现Ggap与全因死亡率和CV死亡率之间存在U型关联，具有与死亡风险增加相关的显著正或负的GGAP值，可能是由于血糖变异性和果糖胺-3-激酶活性。本文受版权保护。保留所有权利。
方法：这是一项回顾性队列研究，包括1999年至2004年国家健康和营养调查（NHANES）的12,909名个体参与者数据以及截至2019年12月31日的死亡率数据。使用加权Cox比例风险回归模型和有限的三次样条来研究Ggap与死亡率之间的关联。
结果：在16.8年的中位随访中，3,528人死亡,包括1140例CV死亡。Ggap与全因死亡率和CV死亡率的关系呈U型（非线性均P<0.001）。与Ggap为0.09-0.38％（第61-80分）的个体相比，GGAP小于-0.83%(第1-5百分位数)的个体和GGAP大于0.90%(第96-100百分位数)的个体的多变量校正HR和95%CI分别为1.36(1.10,1.69)和1.21(1.00,1.45),心血管死亡率为1.77（1.16，2.71）和1.43（1.04，1.95）。与全因死亡率和心血管死亡率最低风险相关的GGap值在普通人群中为0.38％，在糖尿病患者中为0.78％。
结论：我们发现Ggap与全因死亡率和CV死亡率之间存在U型关联，具有与死亡风险增加相关的显著正或负的GGAP值，可能是由于血糖变异性和果糖胺-3-激酶活性。本文受版权保护。保留所有权利。
