METHODS: We conducted a retrospective analysis of 504 patients hospitalized for uncontrolled and/or complicated T2DM between 2009 and 2017. SAF was measured using an AGE-Reader. Participants were followed up from admission to December 2020, for the onset of a CVE (myocardial infarction, stroke, revascularization procedures or cardiovascular death). The relationship between SAF and CVE was analyzed by multivariable Cox regression. Log-rank curves were used to compare CVE-free survival in patients whose SAF at admission was above versus below the whole-population median. The analysis was repeated in subjects without/with macroangiopathy (defined as myocardial infarction, stroke, peripheral revascularization) at baseline.
RESULTS: During 54 months of follow-up, 69 (13.7%) patients had a CVE. Baseline SAF was significantly higher in patients with T2DM who later experienced a CVE (2.89 ± 0.70 arbitrary units versus 2.64 ± 0.62 in others, P = 0.002). This relationship was significant after adjusting for age, sex, conventional risk factors (diabetes duration, HbA1c, arterial hypertension, dyslipidemia, smoking, body mass index), vascular complications, C-reactive protein, and treatments for diabetes. The CVE-free survival curves differed between subjects whose SAF was above the whole-population median (log-rank: P = 0.002) and those whose SAF was above the macroangiopathy-free sub-population median (log-rank: P = 0.016).
CONCLUSIONS: SAF of advanced glycation end-products was related to a higher incidence of later CVE in patients with T2DM.
方法:我们对2009年至2017年因不受控和/或并发T2DM住院的504例患者进行了回顾性分析。使用AGE-Reader测量SAF。参与者从入院到2020年12月进行了随访,发现了CVE(心肌梗塞,中风,血运重建手术或心血管死亡)。采用多变量Cox回归分析SAF与CVE的关系。使用Log-rank曲线比较入院时SAF高于和低于整个人群中位数的患者的无CVE生存率。在没有/有大血管病变(定义为心肌梗塞,中风,外周血运重建)在基线。
结果:在54个月的随访中,69例(13.7%)患者有CVE。随后出现CVE的T2DM患者的基线SAF明显更高(2.89±0.70任意单位与其他患者的2.64±0.62,P=0.002)。在调整了年龄后,这种关系很重要,性别,常规危险因素(糖尿病持续时间,HbA1c,动脉高血压,血脂异常,吸烟,体重指数),血管并发症,C反应蛋白,和糖尿病的治疗。无CVE生存曲线在SAF高于整个人群中位数(log-rank:P=0.002)的受试者和SAF高于无大血管病变亚人群中位数(log-rank:P=0.016)的受试者之间存在差异。
结论:在T2DM患者中,晚期糖基化终末产物的SAF与更高的CVE发生率相关。