title: Association of advanced glycation end products and chronic kidney disease with macroangiopathy in type 2 diabetes.
abstract: OBJECTIVE
  Accumulation of advanced glycation end-products (AGEs), may explain the major contribution of chronic kidney disease (CKD) to cardiovascular events in patients with type 2 diabetes (T2D) related to their impaired renal function. The aim of this study was to analyze the factors associated with AGE assessed by skin autofluorescence and their association with macroangiopathy in T2D.
  
  
  METHODS
  We measured skin autofluorescence in patients hospitalized for T2D. Glomerular filtration rates were estimated (eGFR) by the EPI-CKD formula. Associations between skin autofluorescence, renal function and macroangiopathy were explored by multivariate analyses adjusting for diabetes duration and control.
  
  
  RESULTS
  The 418 patients had T2D since 13.3 (SD 9.8) years on average, high mean HbA1C: 8.9%, (SD 1.8), (74 mmol/mol, (SD 15)) and often renal complications (49.4% with CKD). Their mean skin autofluorescence was 2.53 (SD 0.62) A.U. In multivariate linear regression, skin autofluorescence was significantly associated with age (+0.20 for ten more years, p<0.0001), renal insufficiency (-0.07 for less 10 mL/min/1.73 m² eGFR, p<0.0001) and smoking (+0.21, p=0.0004). Autofluorescence (p=0.01), but not CKD, was associated with macroangiopathy independent of diabetes duration and control.
  
  
  CONCLUSIONS
  Accumulation of AGEs is independently associated with renal insufficiency and macroangiopathy in patients with T2D.
authors.affiliation: Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France. Electronic address: vincent.rigalleau@chu-bordeaux.fr.
authors.forename: V
authors.initials: V
authors.lastname: Rigalleau
authors.affiliation: Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Cougnard-Gregoire
authors.affiliation: Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Nov
authors.affiliation: Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Gonzalez
authors.affiliation: Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Maury
authors.affiliation: Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Lorrain
authors.affiliation: Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France.
authors.forename: H
authors.initials: H
authors.lastname: Gin
authors.affiliation: Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Barberger-Gateau
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005453:Fluorescence; D005602:France / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012867:Skin / Q000378:metabolism*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D017127:Glycation End Products, Advanced
keywords: Advanced glycation end-products; Chronic kidney disease; Glomerular filtration rate; Macroangiopathy; Type 2 diabetes