Alejandra Planas1,2, Olga Simó-Servat1,2, Jordi Bañeras3,4, Mónica Sánchez1, Esther García1, Ángel M Ortiz1,2, Marisol Ruiz-Meana3,5, Cristina Hernández1,2, Ignacio Ferreira-González3,4, Rafael Simó6,7. 1. Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Autonomous University of Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. 2. CIBER en Diabetes y Enfermedades Metabólicas (CIBERDEM), Spanish Institute of Health (ISCIII), Madrid, Spain. 3. Cardiology Department, Vall d'Hebron University Hospital and Research Institute, Autonomous University of Barcelona, Barcelona, Spain. 4. CIBER en Epidemiología y Salud Pública (CIBERESP), Spanish Institute of Health (ISCIII), Madrid, Spain. 5. CIBER-CV, Spanish Institute of Health (ISCIII), Madrid, Spain. 6. Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Autonomous University of Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. rafael.simo@vhir.org. 7. CIBER en Diabetes y Enfermedades Metabólicas (CIBERDEM), Spanish Institute of Health (ISCIII), Madrid, Spain. rafael.simo@vhir.org.
Abstract
AIM: The early identification of type 2 diabetic (T2D) patients at risk of developing coronary artery disease (CAD) remains a challenge. The coronary artery calcium score (CACs) is considered the most sensitive tool for assessing CAD risk in diabetic population, and the identification of a more targeted population in which the CACs would be more cost-efficient seems warranted. The accumulation of advanced glycation end products plays an important role in the pathogenesis of cardiovascular disease (CVD) in patients with diabetes. The aim of this study was to evaluate whether the assessment of skin autofluorescence (SAF) could be useful tool to identify those diabetic patients in whom CACs assessment should be prioritized. METHODS: Prospective case-control study, comprising 156 subjects with T2D with no history of clinical CVD and 52 non-diabetic subjects matched by age. A value of CACs ≥ 400 Agatston Units (AU) was considered as "high CVD risk." Logistic regression analysis to predict a CACs ≥ 400 AU was performed. Sensibility and specificity were calculated using the optimal cutoff point based on ROC curve. RESULTS: T2D patients had higher value of SAF compared to controls (p = 0.011). Among subjects with diabetes, 122 presented CACs < 400 AU and 35 CACs ≥ 400 AU. SAF values were significantly higher among the group with CACs ≥ 400AU compared to patients with CACs < 400 (2.96 ± 0.86 vs. 2.59 ± 0.57; p = 0.0035). The logistic regression analysis showed that age, HDL-cholesterol and SAF values were independently related to CACs ≥ 400UA. CONCLUSION: Our finding suggests that SAF could be useful in selecting T2D patients in whom the screening for CAD by means of CACs assessment would be more cost-effective.
AIM: The early identification of type 2 diabetic (T2D) patients at risk of developing coronary artery disease (CAD) remains a challenge. The coronary artery calcium score (CACs) is considered the most sensitive tool for assessing CAD risk in diabetic population, and the identification of a more targeted population in which the CACs would be more cost-efficient seems warranted. The accumulation of advanced glycation end products plays an important role in the pathogenesis of cardiovascular disease (CVD) in patients with diabetes. The aim of this study was to evaluate whether the assessment of skin autofluorescence (SAF) could be useful tool to identify those diabeticpatients in whom CACs assessment should be prioritized. METHODS: Prospective case-control study, comprising 156 subjects with T2D with no history of clinical CVD and 52 non-diabetic subjects matched by age. A value of CACs ≥ 400 Agatston Units (AU) was considered as "high CVD risk." Logistic regression analysis to predict a CACs ≥ 400 AU was performed. Sensibility and specificity were calculated using the optimal cutoff point based on ROC curve. RESULTS: T2D patients had higher value of SAF compared to controls (p = 0.011). Among subjects with diabetes, 122 presented CACs < 400 AU and 35 CACs ≥ 400 AU. SAF values were significantly higher among the group with CACs ≥ 400AU compared to patients with CACs < 400 (2.96 ± 0.86 vs. 2.59 ± 0.57; p = 0.0035). The logistic regression analysis showed that age, HDL-cholesterol and SAF values were independently related to CACs ≥ 400UA. CONCLUSION: Our finding suggests that SAF could be useful in selecting T2D patients in whom the screening for CAD by means of CACs assessment would be more cost-effective.
Entities:
Keywords:
Advanced glycation end products; Coronary artery calcium score; Skin autofluorescence; Subclinical cardiovascular disease; Type 2 diabetes
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