Increased serum levels of advanced glycation endproducts predict total, cardiovascular and coronary mortality in women with type 2 diabetes: a population-based 18 year follow-up study

• Published in: Diabetologia 2007-07, Vol.50 (7), p.1409-1417
• Main Authors: Kilhovd, B. K, Juutilainen, A, Lehto, S, Rönnemaa, T, Torjesen, P. A, Hanssen, K. F, Laakso, M
• Format: Article
• Language: English
• Subjects: Advanced glycation; Age; Age Factors; Aged; Amputation; Atherosclerosis; Biological and medical sciences; Blood pressure; Cardiology. Vascular system; Cardiovascular disease; cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - mortality; Coronary disease; Coronary heart disease; Diabetes; diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - mortality; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Glycation End Products, Advanced - blood; Heart; Heart attacks; Heart Diseases - blood; Heart Diseases - mortality; Hospitals; Humans; Hypertension; Immunoassay; Male; Medical sciences; Medicine; Middle Aged; Mortality; Proportional Hazards Models; Proteins; Sex Factors; Stroke; Time Factors; Treatment Outcome; women; Womens health
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-007-0687-z

Aims/hypothesis AGEs, modification products formed by glycation or glycoxidation of proteins and lipids, have been linked to premature atherosclerosis in patients with diabetes. We investigated whether increased serum levels of AGEs predict total, cardiovascular (CVD) or CHD mortality in a population-based study. Subjects and methods Serum levels of AGEs were determined by immunoassay in a random sample of 874 Finnish diabetic study participants (488 men, 386 women), aged 45-64 years. These participants were followed for 18 years for total, CVD and CHD mortality. Results Multivariate Cox regression models revealed that serum levels of AGEs were significantly associated with total (p = 0.002) and CVD mortality (p = 0.021) in women, but not in men. Serum levels of AGEs in the highest sex-specific quartile predicted all-cause (hazards ratio [HR] 1.51; 95% confidence intervals [CI], 1.14-1.99; p = 0.004), CVD (HR 1.56; 95% CI 1.12-2.19; p = 0.009), and CHD (HR 1.68; 95% CI 1.11-2.52; p = 0.013) mortality in women, even after adjustment for confounding factors, including high-sensitivity C-reactive protein. Conclusions/interpretation Increased serum levels of AGEs predict total and CVD mortality in women with type 2 diabetes.