Higher plasma levels of advanced glycation end products are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes: a 12-year follow-up study

Nin, Johanna W., Jorsal, Anders, Ferreira, Isabel, Schalkwijk, Casper G., Prins, Martin H., Parving, Hans-Henrik, Tarnow, Lise, Rossing, Peter and Stehouwer, Coen D. (2011) Higher plasma levels of advanced glycation end products are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes: a 12-year follow-up study. Diabetes Care, 34 2: 442-447. doi:10.2337/dc10-1087


Author Nin, Johanna W.
Jorsal, Anders
Ferreira, Isabel
Schalkwijk, Casper G.
Prins, Martin H.
Parving, Hans-Henrik
Tarnow, Lise
Rossing, Peter
Stehouwer, Coen D.
Title Higher plasma levels of advanced glycation end products are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes: a 12-year follow-up study
Journal name Diabetes Care   Check publisher's open access policy
ISSN 0149-5992
1935-5548
Publication date 2011-01-01
Year available 2011
Sub-type Article (original research)
DOI 10.2337/dc10-1087
Open Access Status Not yet assessed
Volume 34
Issue 2
Start page 442
End page 447
Total pages 6
Place of publication Alexandria, VA, United States
Publisher American Diabetes Association
Language eng
Formatted abstract
Objective: To investigate the associations of plasma levels of advanced glycation end products (AGEs) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal dysfunction, low-grade inflammation, and arterial stiffness. 

Research Design and Methods: We prospectively followed 169 individuals with diabetic nephropathy and 170 individuals with persistent normoalbuminuria who were free of CVD at study entry and in whom levels of Nε-(carboxymethyl)lysine, Nε-(carboxyethyl) lysine, pentosidine and other biomarkers were measured at baseline. The median follow-up duration was 12.3 (interquartile range 7.6-12.5) years.

Results: During the course of follow-up, 82 individuals (24.2%) died; 85 (25.1%) suffered a fatal (n = 48) and/or nonfatal (n = 53) CVD event. The incidence of fatal and nonfatal CVD and of all-cause mortality increased with higher baseline levels of AGEs independently of traditional CVD risk factors: hazard ratio (HR) = 1.30 (95% CI = 1.03-1.66) and HR = 1.27 (1.00-1.62), respectively. These associations were not attenuated after further adjustments for markers of renal or endothelial dysfunction, low-grade inflammation, or arterial stiffness.

Conclusions: Higher levels of AGEs are associated with incident fatal and nonfatal CVD as well as all-cause mortality in individuals with type 1 diabetes, independently of other risk factors and of several potential AGEs-related pathophysiological mechanisms. Thus, AGEs may explain, in part, the increased cardiovascular disease andmortality attributable to type 1 diabetes and constitute a specific target for treatment in these patients.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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