Abstract:
Advanced Glycation End Products (AGEs) contribute to the pathophysiology of type 2 diabetes mellitus (T2DM) and cardiovascular (CV) diseases (CVDs), making their non-invasive assessment through skin autofluorescence (SAF) increasingly important. This study aims to investigate the relationship between SAF levels, cardiovascular risk, and diabetic complications in T2DM patients. We conducted a single-center, cross-sectional study at Consultmed Hospital in Iasi, Romania, including 885 T2DM patients. The assessment of SAF levels was performed with the AGE Reader™, (Diagnoptics, Groningen, The Netherlands). CVD prevalence was 13.9%, and according to CV risk category distribution, 6.1% fell into the moderate-risk, 1.13% into the high-risk, and 92.77% into the very-high-risk category. The duration of DM averaged 9.0 ± 4.4 years and the mean HbA1c was 7.1% ± 1.3. After adjusting for age and eGFR, HbA1c values showed a correlation with SAF levels in the multivariate regression model, where a 1 SD increase in HbA1c was associated with a 0.105 SD increase in SAF levels (Nagelkerke R2 = 0.110; p < 0.001). For predicting very high risk with an SAF cut-off of 2.35, sensitivity was 67.7% and specificity was 56.2%, with an AUC of 0.634 (95% CI 0.560-0.709, p = 0.001). In T2DM, elevated SAF levels were associated with higher CV risk and HbA1c values, with 2.35 identified as the optimal SAF cut-off for very high CV risk.
摘要:
晚期糖基化终产物(AGEs)有助于2型糖尿病(T2DM)和心血管(CV)疾病(CVD)的病理生理学,通过皮肤自发荧光(SAF)进行非侵入性评估变得越来越重要。本研究旨在探讨SAF水平之间的关系,心血管风险,2型糖尿病患者的糖尿病并发症。我们进行了一个单中心,雅西咨询医院的横断面研究,罗马尼亚,包括885名T2DM患者。使用AGEReader™进行SAF水平评估,(诊断仪,格罗宁根,荷兰)。CVD患病率为13.9%,根据CV风险类别分布,6.1%属于中等风险,1.13%进入高风险,92.77%进入极高风险类别。DM的持续时间平均为9.0±4.4年,平均HbA1c为7.1%±1.3。在调整年龄和eGFR后,在多元回归模型中,HbA1c值与SAF水平存在相关性,其中HbA1c的1SD增加与SAF水平的0.105SD增加相关(NagelkerkeR2=0.110;p<0.001)。对于预测SAF截止值为2.35的极高风险,敏感性为67.7%,特异性为56.2%,AUC为0.634(95%CI0.560-0.709,p=0.001)。在T2DM中,SAF水平升高与较高的CV风险和HbA1c值相关,2.35被确定为非常高的CV风险的最佳SAF截止值。