Advanced Glycation End Products, Oxidation Products, and Incident Cardiovascular Events in Patients With Type 2 Diabetes.
Advanced Glycation End Products, Oxidation Products, and Incident Cardiovascular Events in Patients With Type 2 Diabetes.
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DOI：
10.2337/dc17-1740
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发表时间：
2018-03
期刊：
影响因子：
16.2
通讯作者：
VADT Investigators
中科院分区：
文献类型：
--
作者：
Koska J;Saremi A;Howell S;Bahn G;De Courten B;Ginsberg H;Beisswenger PJ;Reaven PD;VADT Investigators
本研究的目的是确定血浆晚期糖基化终末产物(AGE)和氧化产物(OP)水平是否预测2型糖尿病心血管疾病(CVD)的发生率。在两项强化降糖研究中，在基线上测量了五个特定的年龄(甲基乙二醛羟基咪唑酮、羧甲基赖氨酸、羧乙基赖氨酸、3-脱氧葡萄糖氢咪唑酮和乙二醛氢咪唑酮)和两个OP(2-氨基己二酸和甲硫氨酸亚砜[Metso])：1)退伍军人事件糖尿病试验(VADT)的子队列(n=445)和2)来自控制糖尿病心血管风险行动(ACCORD)研究(n=271)的嵌套病例对照亚组。多个年龄和OP水平的升高与高龄、肾功能下降、既往心血管疾病史和较长的糖尿病病程相关，但与血红蛋白A1c无关。在VADT中，在调整了年龄、种族/民族、性别、既往心血管事件、肾功能、治疗分配和糖尿病病程后，发生心血管事件的风险增加与较低的Metso相关(危险比[HR]0.53；95%可信区间0.28-0.99；P=0.047)。低Metso浓度和高3-脱氧葡萄糖氢咪唑酮浓度的个体患心血管疾病的风险最高(HR 1.70；P=0.01)。在ACCORD研究中，有心血管事件的患者(n=136)的Metso较低(下降14%；P=0.007)，乙二醛氢咪唑酮和羧甲基赖氨酸(分别下降18%和15%，P=0.04)；然而，只有在调整了既往心血管事件后Metso的差异仍然显著(P=0.002)。较低的Metso水平和较高的选择年龄水平与心血管疾病的发生率增加有关，这可能有助于解释强化降糖对2型糖尿病的有限益处。
The goal of this study was to determine whether plasma levels of advanced glycation end products (AGE) and oxidation products (OP) predict the incidence of cardiovascular disease (CVD) in type 2 diabetes. Five specific AGE (methylglyoxal hydroimidazolone, carboxymethyl lysine, carboxyethyl lysine, 3-deoxyglucosone hydroimidazolone, and glyoxal hydroimidazolone) and two OP (2-aminoadipic acid and methionine sulfoxide [MetSO]) were measured at baseline in two intensive glucose-lowering studies: 1) a subcohort of the Veterans Affairs Diabetes Trial (VADT) (n = 445) and 2) a nested case-control subgroup from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study (n = 271). Increased levels of several AGE and OP were associated with older age, decreased kidney function, previous CVD, and longer diabetes duration, but not with hemoglobin A1c. In the VADT, increased risk of incident CVD events (n = 107) was associated with lower MetSO after adjusting for age, race/ethnicity, sex, prior CVD event, kidney function, treatment assignment, and diabetes duration (hazard ratio [HR] 0.53; 95% CI 0.28–0.99; P = 0.047). Individuals with both low MetSO and high 3-deoxyglucosone hydroimidazolone concentrations were at highest risk for CVD (HR 1.70; P = 0.01). In the ACCORD study, those with incident CVD events (n = 136) had lower MetSO (by 14%; P = 0.007) and higher glyoxal hydroimidazolone and carboxymethyl lysine (by 18% and 15%, respectively; P = 0.04 for both); however, only the difference in MetSO remained significant after adjustment for prior CVD event (P = 0.002). Lower levels of MetSO and higher levels of select AGE are associated with increased incident CVD and may help account for the limited benefit of intensive glucose lowering in type 2 diabetes.
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影响因子：
5.3
作者：
Kizer, Jorge R.;Benkeser, David;Arnold, Alice M.;Ix, Joachim H.;Mukamal, Kenneth J.;Djousse, Luc;Tracy, Russell P.;Siscovick, David S.;Psaty, Bruce M.;Zieman, Susan J.
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Zieman, Susan J.
影响因子：
16.2
作者：
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影响因子：
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影响因子：
3.5
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影响因子：
5.8
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Schalkwijk, Casper G.