Abstract：
BACKGROUND: Cardiovascular disease is frequent in type 2 diabetes mellitus (T2DM). We investigated the relationship between skin autofluorescence (SAF) of advanced glycation end-products and later cardiovascular events (CVEs) in patients with T2DM.
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.
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.
摘要：
背景：心血管疾病在2型糖尿病（T2DM）中很常见。我们调查了T2DM患者晚期糖基化终产物的皮肤自发荧光（SAF）与晚期心血管事件（CVE）之间的关系。
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。
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。
