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Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus
Aim The United Kingdom Prospective Diabetes Study (UKPDS) study showed that glycaemic control (HbA1c) can predict vascular complications in Type 2 diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) study showed that accumulation of advanced glycation end products (AGEs) from skin...
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| Published in: | Diabetic medicine 2018-09, Vol.35 (9), p.1242-1248 |
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| container_end_page | 1248 |
| container_issue | 9 |
| container_start_page | 1242 |
| container_title | Diabetic medicine |
| container_volume | 35 |
| creator | Yozgatli, K. Lefrandt, J. D. Noordzij, M. J. Oomen, P. H. N. Brouwer, T. Jager, J. Castro Cabezas, M. Smit, A. J. |
| description | Aim
The United Kingdom Prospective Diabetes Study (UKPDS) study showed that glycaemic control (HbA1c) can predict vascular complications in Type 2 diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) study showed that accumulation of advanced glycation end products (AGEs) from skin biopsies predicts vascular complications in Type 1 diabetes. Previously, we showed that tissue AGEs can be measured non‐invasively using skin autofluorescence (SAF). The aim of this study was to compare the predictive value of HbA1c and SAF for new macrovascular events and microvascular complications in people with Type 2 diabetes.
Methods
A prospective cohort study of 563 participants, median age 64 years [interquartile range (IQR) 57–72], diabetes duration of 13 years, from five Dutch hospitals was performed.
Results
After a median follow‐up of 5.1 (IQR 4.3–5.9) years, 79 (15%) participants had died and 49 (9%) were lost to follow‐up. Some 133 (26%) developed a microvascular complication and 189 (37%) a macrovascular event. Tertiles of HbA1c were significantly associated with development of microvascular complications (log rank P = 0.022), but not with macrovascular events. Tertiles of SAF were significantly associated with macrovascular events (log rank P = 0.003). Cox regression analysis showed SAF was associated with macrovascular events: crude hazard ratio (HR) 1.53 (P |
| doi_str_mv | 10.1111/dme.13651 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2031027530</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2084744026</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4281-298c12536f1e32dc85694059807b4b6231d584e8441403ad2aab3a4f5c13e4553</originalsourceid><addsrcrecordid>eNp10ctq3DAUBmBRGprJtIu-QBF0kyyc0dWWl2FyKyRkk66NLB23CpY0tewJ80p5yijxpJRCtBGIj1_n8CP0lZJTms_KejilvJT0A1pQUYpCipp-RAtSCVZwUtFDdJTSAyGU1bz-hA5ZXaqqlGqBns6MmfzU69HFgGOHtd3qYMDiX_3OzK8QLN4M0U5mTNglrFOKxukxo0c3_sZemyFudTI5ZsCwhZCdDvsI8M5gE8M4xH7v3b_eRL_p3fxVjg_4frcBzLB1uoUREvbQ926c0md00Ok-wZf9vUQ_Ly_u19fFzd3Vj_XZTWEEU7RgtTKUSV52FDizRsmyFkTWilStaEvGqZVKgBKCCsK1ZVq3XItOGspBSMmX6HjOzTv_mSCNjXfJ5CF0gDilhhFOCaskJ5l-_48-xGkIebqslKiEIKzM6mRWee2UBuiazeC8HnYNJc1LgU0usHktMNtv-8Sp9WD_yrfGMljN4NH1sHs_qTm_vZgjnwGL9KdL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2084744026</pqid></control><display><type>article</type><title>Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus</title><source>Wiley</source><creator>Yozgatli, K. ; Lefrandt, J. D. ; Noordzij, M. J. ; Oomen, P. H. N. ; Brouwer, T. ; Jager, J. ; Castro Cabezas, M. ; Smit, A. J.</creator><creatorcontrib>Yozgatli, K. ; Lefrandt, J. D. ; Noordzij, M. J. ; Oomen, P. H. N. ; Brouwer, T. ; Jager, J. ; Castro Cabezas, M. ; Smit, A. J.</creatorcontrib><description>Aim
The United Kingdom Prospective Diabetes Study (UKPDS) study showed that glycaemic control (HbA1c) can predict vascular complications in Type 2 diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) study showed that accumulation of advanced glycation end products (AGEs) from skin biopsies predicts vascular complications in Type 1 diabetes. Previously, we showed that tissue AGEs can be measured non‐invasively using skin autofluorescence (SAF). The aim of this study was to compare the predictive value of HbA1c and SAF for new macrovascular events and microvascular complications in people with Type 2 diabetes.
Methods
A prospective cohort study of 563 participants, median age 64 years [interquartile range (IQR) 57–72], diabetes duration of 13 years, from five Dutch hospitals was performed.
Results
After a median follow‐up of 5.1 (IQR 4.3–5.9) years, 79 (15%) participants had died and 49 (9%) were lost to follow‐up. Some 133 (26%) developed a microvascular complication and 189 (37%) a macrovascular event. Tertiles of HbA1c were significantly associated with development of microvascular complications (log rank P = 0.022), but not with macrovascular events. Tertiles of SAF were significantly associated with macrovascular events (log rank P = 0.003). Cox regression analysis showed SAF was associated with macrovascular events: crude hazard ratio (HR) 1.53 (P < 0.001) per unit increase, HR 1.28 (P = 0.03) after correction for UKPDS score. HbA1c was predictive for microvascular complications: crude HR 1.20 (P = 0.004), HR 1.20 (P = 0.004) after correction for UKPDS score.
Conclusion
This study shows that tissue accumulation of AGEs, assessed by SAF, is associated with development of macrovascular events in people with Type 2 diabetes, whereas HbA1c is associated with the development of microvascular complications.
What's new?
Skin tissue advanced glycation end products as measured by skin autofluorescence, are predictive for the development of macrovascular complications.
Skin autofluorescence is of added value in the risk assessment of people with Type 2 diabetes mellitus in both primary care and secondary care.
Glycaemic control (HbA1c) is associated with the development of microvascular complications but is not associated with macrovascular complications.
The United Kingdom Prospective Diabetes Study risk score underestimates the cardiovascular risk of macrovascular events and microvascular complications in a secondary care setting.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.13651</identifier><identifier>PMID: 29687658</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Advanced glycosylation end products ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (insulin dependent) ; Diabetes mellitus (non-insulin dependent) ; Glycosylation ; Health risk assessment ; Microvasculature ; Skin</subject><ispartof>Diabetic medicine, 2018-09, Vol.35 (9), p.1242-1248</ispartof><rights>2018 Diabetes UK</rights><rights>2018 Diabetes UK.</rights><rights>Diabetic Medicine © 2018 Diabetes UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4281-298c12536f1e32dc85694059807b4b6231d584e8441403ad2aab3a4f5c13e4553</citedby><cites>FETCH-LOGICAL-c4281-298c12536f1e32dc85694059807b4b6231d584e8441403ad2aab3a4f5c13e4553</cites><orcidid>0000-0002-8482-1062</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.13651$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.13651$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29687658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yozgatli, K.</creatorcontrib><creatorcontrib>Lefrandt, J. D.</creatorcontrib><creatorcontrib>Noordzij, M. J.</creatorcontrib><creatorcontrib>Oomen, P. H. N.</creatorcontrib><creatorcontrib>Brouwer, T.</creatorcontrib><creatorcontrib>Jager, J.</creatorcontrib><creatorcontrib>Castro Cabezas, M.</creatorcontrib><creatorcontrib>Smit, A. J.</creatorcontrib><title>Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aim
The United Kingdom Prospective Diabetes Study (UKPDS) study showed that glycaemic control (HbA1c) can predict vascular complications in Type 2 diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) study showed that accumulation of advanced glycation end products (AGEs) from skin biopsies predicts vascular complications in Type 1 diabetes. Previously, we showed that tissue AGEs can be measured non‐invasively using skin autofluorescence (SAF). The aim of this study was to compare the predictive value of HbA1c and SAF for new macrovascular events and microvascular complications in people with Type 2 diabetes.
Methods
A prospective cohort study of 563 participants, median age 64 years [interquartile range (IQR) 57–72], diabetes duration of 13 years, from five Dutch hospitals was performed.
Results
After a median follow‐up of 5.1 (IQR 4.3–5.9) years, 79 (15%) participants had died and 49 (9%) were lost to follow‐up. Some 133 (26%) developed a microvascular complication and 189 (37%) a macrovascular event. Tertiles of HbA1c were significantly associated with development of microvascular complications (log rank P = 0.022), but not with macrovascular events. Tertiles of SAF were significantly associated with macrovascular events (log rank P = 0.003). Cox regression analysis showed SAF was associated with macrovascular events: crude hazard ratio (HR) 1.53 (P < 0.001) per unit increase, HR 1.28 (P = 0.03) after correction for UKPDS score. HbA1c was predictive for microvascular complications: crude HR 1.20 (P = 0.004), HR 1.20 (P = 0.004) after correction for UKPDS score.
Conclusion
This study shows that tissue accumulation of AGEs, assessed by SAF, is associated with development of macrovascular events in people with Type 2 diabetes, whereas HbA1c is associated with the development of microvascular complications.
What's new?
Skin tissue advanced glycation end products as measured by skin autofluorescence, are predictive for the development of macrovascular complications.
Skin autofluorescence is of added value in the risk assessment of people with Type 2 diabetes mellitus in both primary care and secondary care.
Glycaemic control (HbA1c) is associated with the development of microvascular complications but is not associated with macrovascular complications.
The United Kingdom Prospective Diabetes Study risk score underestimates the cardiovascular risk of macrovascular events and microvascular complications in a secondary care setting.</description><subject>Advanced glycosylation end products</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Glycosylation</subject><subject>Health risk assessment</subject><subject>Microvasculature</subject><subject>Skin</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp10ctq3DAUBmBRGprJtIu-QBF0kyyc0dWWl2FyKyRkk66NLB23CpY0tewJ80p5yijxpJRCtBGIj1_n8CP0lZJTms_KejilvJT0A1pQUYpCipp-RAtSCVZwUtFDdJTSAyGU1bz-hA5ZXaqqlGqBns6MmfzU69HFgGOHtd3qYMDiX_3OzK8QLN4M0U5mTNglrFOKxukxo0c3_sZemyFudTI5ZsCwhZCdDvsI8M5gE8M4xH7v3b_eRL_p3fxVjg_4frcBzLB1uoUREvbQ926c0md00Ok-wZf9vUQ_Ly_u19fFzd3Vj_XZTWEEU7RgtTKUSV52FDizRsmyFkTWilStaEvGqZVKgBKCCsK1ZVq3XItOGspBSMmX6HjOzTv_mSCNjXfJ5CF0gDilhhFOCaskJ5l-_48-xGkIebqslKiEIKzM6mRWee2UBuiazeC8HnYNJc1LgU0usHktMNtv-8Sp9WD_yrfGMljN4NH1sHs_qTm_vZgjnwGL9KdL</recordid><startdate>201809</startdate><enddate>201809</enddate><creator>Yozgatli, K.</creator><creator>Lefrandt, J. D.</creator><creator>Noordzij, M. J.</creator><creator>Oomen, P. H. N.</creator><creator>Brouwer, T.</creator><creator>Jager, J.</creator><creator>Castro Cabezas, M.</creator><creator>Smit, A. J.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8482-1062</orcidid></search><sort><creationdate>201809</creationdate><title>Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus</title><author>Yozgatli, K. ; Lefrandt, J. D. ; Noordzij, M. J. ; Oomen, P. H. N. ; Brouwer, T. ; Jager, J. ; Castro Cabezas, M. ; Smit, A. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4281-298c12536f1e32dc85694059807b4b6231d584e8441403ad2aab3a4f5c13e4553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Advanced glycosylation end products</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Glycosylation</topic><topic>Health risk assessment</topic><topic>Microvasculature</topic><topic>Skin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yozgatli, K.</creatorcontrib><creatorcontrib>Lefrandt, J. D.</creatorcontrib><creatorcontrib>Noordzij, M. J.</creatorcontrib><creatorcontrib>Oomen, P. H. N.</creatorcontrib><creatorcontrib>Brouwer, T.</creatorcontrib><creatorcontrib>Jager, J.</creatorcontrib><creatorcontrib>Castro Cabezas, M.</creatorcontrib><creatorcontrib>Smit, A. J.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yozgatli, K.</au><au>Lefrandt, J. D.</au><au>Noordzij, M. J.</au><au>Oomen, P. H. N.</au><au>Brouwer, T.</au><au>Jager, J.</au><au>Castro Cabezas, M.</au><au>Smit, A. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2018-09</date><risdate>2018</risdate><volume>35</volume><issue>9</issue><spage>1242</spage><epage>1248</epage><pages>1242-1248</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Aim
The United Kingdom Prospective Diabetes Study (UKPDS) study showed that glycaemic control (HbA1c) can predict vascular complications in Type 2 diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) study showed that accumulation of advanced glycation end products (AGEs) from skin biopsies predicts vascular complications in Type 1 diabetes. Previously, we showed that tissue AGEs can be measured non‐invasively using skin autofluorescence (SAF). The aim of this study was to compare the predictive value of HbA1c and SAF for new macrovascular events and microvascular complications in people with Type 2 diabetes.
Methods
A prospective cohort study of 563 participants, median age 64 years [interquartile range (IQR) 57–72], diabetes duration of 13 years, from five Dutch hospitals was performed.
Results
After a median follow‐up of 5.1 (IQR 4.3–5.9) years, 79 (15%) participants had died and 49 (9%) were lost to follow‐up. Some 133 (26%) developed a microvascular complication and 189 (37%) a macrovascular event. Tertiles of HbA1c were significantly associated with development of microvascular complications (log rank P = 0.022), but not with macrovascular events. Tertiles of SAF were significantly associated with macrovascular events (log rank P = 0.003). Cox regression analysis showed SAF was associated with macrovascular events: crude hazard ratio (HR) 1.53 (P < 0.001) per unit increase, HR 1.28 (P = 0.03) after correction for UKPDS score. HbA1c was predictive for microvascular complications: crude HR 1.20 (P = 0.004), HR 1.20 (P = 0.004) after correction for UKPDS score.
Conclusion
This study shows that tissue accumulation of AGEs, assessed by SAF, is associated with development of macrovascular events in people with Type 2 diabetes, whereas HbA1c is associated with the development of microvascular complications.
What's new?
Skin tissue advanced glycation end products as measured by skin autofluorescence, are predictive for the development of macrovascular complications.
Skin autofluorescence is of added value in the risk assessment of people with Type 2 diabetes mellitus in both primary care and secondary care.
Glycaemic control (HbA1c) is associated with the development of microvascular complications but is not associated with macrovascular complications.
The United Kingdom Prospective Diabetes Study risk score underestimates the cardiovascular risk of macrovascular events and microvascular complications in a secondary care setting.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29687658</pmid><doi>10.1111/dme.13651</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8482-1062</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Advanced glycosylation end products Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes mellitus (non-insulin dependent) Glycosylation Health risk assessment Microvasculature Skin |
| title | Accumulation of advanced glycation end products is associated with macrovascular events and glycaemic control with microvascular complications in Type 2 diabetes mellitus |
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