Cited by 63Advanced Glycation End Products researchChronic Kidney Disease and DiabetesDialysis and Renal Disease Management

The Advanced Glycation End Product Nε-Carboxymethyllysine Is Not a Predictor of Cardiovascular Events and Renal Outcomes in Patients With Type 2 Diabetic Kidney Disease and Hypertension

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Busch, Martin, Franke, Sybille, Wolf, Gunter, Brandstädt, Antje, Ott, Undine, Gerth, Jens, Hunsicker, Lawrence G., Stein, Guenter·2006·American Journal of Kidney Diseases

Abstract

Background Advanced glycation end products (AGEs) are implicated in the pathogenesis of vascular damage, especially in patients with diabetes and renal insufficiency. The oxidatively formed AGE N(epsilon)-carboxymethyllysine (CML) is thought to be a marker of oxidative stress.Methods Four hundred fifty patients with type 2 diabetes and nephropathy from the Irbesartan in Diabetic Nephropathy Trial cohort (mean age, 58 +/- 8.2 years; 137 women, 313 men) with a mean glomerular filtration rate of 48.2 mL/min (0.80 mL/s; Modification of Diet in Renal Disease formula) were followed up for 2.6 years. Serum CML was measured by using an enzyme-linked immunosorbent assay. Relationships between CML levels, traditional risk factors, and cardiovascular and renal events were tested in Cox proportional hazards models.Results Mean serum CML level was 599.9 +/- 276.0 ng/mL, and mean hemoglobin A1c level was 7.5% +/- 1.6%. One hundred forty-three first cardiovascular events occurred during follow-up; 74 patients died, 44 of cardiovascular causes. Final multivariate analysis showed age (relative risk [RR], 1.87; confidence interval [CI], 1.13 to 3.11; P = 0.016 for the highest compared with lowest quartile), history of prior cardiovascular events (RR, 1.96; CI, 1.35 to 2.85; P < 0.0005), and 24-hour urinary albumin-creatinine ratio (RR, 1.29; CI, 1.11 to 1.50 per doubling; P < 0.0005) to be independent risk factors for a first cardiovascular event, but not CML level. CML level also did not correlate significantly with renal outcome.Conclusion Serum CML level could not be identified as an independent risk factor for cardiovascular or renal outcomes in the examined population. This suggests that traditional risk factors might have a more important role for these end points or that other AGE compounds, as well as tissue AGE levels, might be of greater relevance compared with serum levels, which remains open to further study.

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Authors
Busch, M., Franke, S., Wolf, G., Brandstädt, A., Ott, U., Gerth, J., Hunsicker, L. G., & Stein, G.
Affiliations
University of Iowa (US)
Corresponding author
Busch, Martin
Venue
American Journal of Kidney Diseases
Publisher
Elsevier BV
Published
2006-10
Volume
48
Issue
4
Pages
571-579
ISSN
0272-6386 (ISSN-L)
OpenAlex
W2036685670
Cited by
63
References
42
Citations by year
2025: 2 · 2024: 3 · 2023: 3 · 2021: 3 · 2020: 1 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 5 · 2012: 3
FWCI
4.33
Type
journal article
Language
en
Open access
Locations
  • American Journal of Kidney Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords
advanced glycation end products, type 2 diabetes, diabetic nephropathy, hypertension, cardiovascular events, renal outcomes, oxidative stress, cardiovascular risk factors, albuminuria, serum biomarkers, HbA1c, age as risk factor, cardiovascular mortality
MeSH terms
Aged, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Diabetic Nephropathies, Female, Humans, Hypertension, Lysine, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, Multivariate Analysis, Proportional Hazards Models, Glycation End Products, Advanced, Oxidative Stress, Disease Progression

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