| Objective: Discussion on the relationship between Advanced glycation end products(AGEs)and Type 2 diabetes mellitus,Association of Cardiovascular autonomic neuropathy(CAN)in patients with T2 DM.Methods: A total of 172 patients with T2 DM admitted to the Department of Endocrinology,the Second People’s Hospital of Hefei from November 2020 to July 2022 were selected.General data such as gender,age,diabetes course and treatment plan(whether insulin was used for hypoglycemia)were collected,as well as the results of various laboratory tests.According to the Ewing test results,the patients were divided into diabetic cardiac autonomic neuropathy group(DCAN group,n=110)and non-diabetic cardiac autonomic neuropathy group(NDACN group,n=62).The new technology of skin AGEs detection was used to measure the accumulated amount of skin AGEs in the two groups,and the accumulated amount of skin AGEs in the two groups was compared.Clinical features of the two groups as well as related factors and risk factors of DCAN were analyzed.Results: 1.A total of 172 T2 DM patients were included in this study,including 106 male patients,66 female patients,110 patients in the DCAN group and 62 patients in the NDCAN group.Statistical analysis of general data and laboratory tests in both groups showed that: Gender,age,diabetes course,previous insulin use ratio,systolic blood pressure,diastolic blood pressure,body mass index(BMI),2 hours postprandial blood glucose(2h PG),fasting insulin(FINS),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL),high density lipoprotein cholesterol(HDL),uric acid(UA),creatinine(CREA),fasting C-peptide(FCP),insulin resistance index(HOMA-IR)and urinary albumin creatinine ratio(UACR)were no significant differences in 2 groups(P > 0.05).Compared with NDCAN group,fasting blood glucose(FPG),the proportion of diabetic retinopathy(DR),Hb A1 C and AGEs indexes in DCAN group were increased(all P < 0.05).Insulin secretion index(HOMA-β)and 2-hour C peptide(2h CP)were decreased(P < 0.05).2.Univariate Logistic regression analysis showed that: DCAN was positively correlated with skin AGEs,FPG,Hb A1 C and combined DR,and the OR values were 1.076,1.255,1.179 and4.077,respectively(P < 0.05).DCAN was negatively correlated with 2h CP,and the OR values were 0.828(P < 0.05).There was no significant difference in HOMA-β(P > 0.05).3.Further multivariate Logistic regression analysis showed that: Skin AGEs,combined DR And FPG were risk factors for DCAN,and the OR values were 1.087,2.625 and 1.325,respectively,with statistical significance(all P < 0.05),but there was no statistical significance in 2h CP and Hb A1C(all P > 0.05).4.ROC curve analysis of skin AGEs combined with DR And FPG for the occurrence of DCAN showed that the area under ROC curve(AUC)of skin AGEs for predicting DCAN was 0.709,the optimal diagnostic value was 85 a.u.,the sensitivity was 62.73%,and the specificity was 72.59%.The area under ROC curve(AUC)of DCAN prediction with or without DR Was 0.632,the sensitivity was 40.91%,and the specificity was85.48%.The area under ROC curve(AUC)of FPG predicted DCAN was 0.623,the best diagnostic value was 6.68mmol/L,the sensitivity was 79.09%,and the specificity was 40.32%.The differences were statistically significant(all P <0.05).Conclusion: 1.Skin AGEs,combined DR And FPG are risk factors for DCAN,and skin AGEs,combined DR And FPG are closely related to the incidence of DCAN.2.Skin AGEs have a certain predictive value for the diagnosis of DCAN,and more attention should be paid to preventing the occurrence of CAN in T2 DM patients with high skin AGEs level. |
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