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Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes
OBJECTIVE: We investigated whether glycation gap (G-Gap), an index of intracellular glycation of proteins, was associated with diabetes complications. RESEARCH DESIGN AND METHODS: We measured concomitantly HbA(1c) and fructosamine in 925 patients with type 2 diabetes to calculate the G-Gap, defined...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687281/ https://www.ncbi.nlm.nih.gov/pubmed/23378625 http://dx.doi.org/10.2337/dc12-1780 |
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author | Cosson, Emmanuel Banu, Isabela Cussac-Pillegand, Camille Chen, Qinda Chiheb, Sabrina Jaber, Yahya Nguyen, Minh Tuan Charnaux, Nathalie Valensi, Paul |
author_facet | Cosson, Emmanuel Banu, Isabela Cussac-Pillegand, Camille Chen, Qinda Chiheb, Sabrina Jaber, Yahya Nguyen, Minh Tuan Charnaux, Nathalie Valensi, Paul |
author_sort | Cosson, Emmanuel |
collection | PubMed |
description | OBJECTIVE: We investigated whether glycation gap (G-Gap), an index of intracellular glycation of proteins, was associated with diabetes complications. RESEARCH DESIGN AND METHODS: We measured concomitantly HbA(1c) and fructosamine in 925 patients with type 2 diabetes to calculate the G-Gap, defined as the difference between measured HbA(1c), and fructosamine-based predicted HbA(1c). Patients were explored for retinopathy, nephropathy, peripheral neuropathy, cardiac autonomic neuropathy (n = 512), and silent myocardial ischemia (n = 506). RESULTS: Macroproteinuria was the only complication that was associated with G-Gap (prevalence in the first, second, and third tertile of G-Gap: 2.9, 6.2, and 11.0%, respectively; P < 0.001). The G-Gap was higher in patients with macroproteinuria than in those without (1.06 ± 1.62 vs. 0.03 ± 1.30%; P < 0.0001). Because HbA(1c) was associated with both G-Gap (HbA(1c) 7.0 ± 1.4, 7.9 ± 1.4, and 10.1 ± 1.8% in the first, second, and third G-Gap tertile, respectively; P < 0.0001) and macroproteinuria (HbA(1c) 8.8 ± 2.2% if macroproteinuria, 8.3 ± 2.0% if none; P < 0.05), and because it could have been a confounder, we matched 54 patients with macroproteinuria and 200 patients without for HbA(1c). Because macroproteinuria was associated with lower serum albumin and fructosamine levels, which might account for higher G-Gap, we calculated in this subpopulation albumin-indexed fructosamine and G-Gap; macroproteinuria was independently associated with male sex (odds ratio [OR] 3.2 [95% CI 1.5–6.7]; P < 0.01), hypertension (2.9 [1.1–7.5]; P < 0.05), and the third tertile of albumin-indexed G-Gap (2.3 [1.1–4.4]; P < 0.05) in multivariate analysis. CONCLUSIONS: In type 2 diabetic patients, G-Gap was associated with macroproteinuria, independently of HbA(1c), albumin levels, and confounding factors, suggesting a specific role of intracellular glycation susceptibility on kidney glomerular changes. |
format | Online Article Text |
id | pubmed-3687281 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-36872812014-07-01 Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes Cosson, Emmanuel Banu, Isabela Cussac-Pillegand, Camille Chen, Qinda Chiheb, Sabrina Jaber, Yahya Nguyen, Minh Tuan Charnaux, Nathalie Valensi, Paul Diabetes Care Original Research OBJECTIVE: We investigated whether glycation gap (G-Gap), an index of intracellular glycation of proteins, was associated with diabetes complications. RESEARCH DESIGN AND METHODS: We measured concomitantly HbA(1c) and fructosamine in 925 patients with type 2 diabetes to calculate the G-Gap, defined as the difference between measured HbA(1c), and fructosamine-based predicted HbA(1c). Patients were explored for retinopathy, nephropathy, peripheral neuropathy, cardiac autonomic neuropathy (n = 512), and silent myocardial ischemia (n = 506). RESULTS: Macroproteinuria was the only complication that was associated with G-Gap (prevalence in the first, second, and third tertile of G-Gap: 2.9, 6.2, and 11.0%, respectively; P < 0.001). The G-Gap was higher in patients with macroproteinuria than in those without (1.06 ± 1.62 vs. 0.03 ± 1.30%; P < 0.0001). Because HbA(1c) was associated with both G-Gap (HbA(1c) 7.0 ± 1.4, 7.9 ± 1.4, and 10.1 ± 1.8% in the first, second, and third G-Gap tertile, respectively; P < 0.0001) and macroproteinuria (HbA(1c) 8.8 ± 2.2% if macroproteinuria, 8.3 ± 2.0% if none; P < 0.05), and because it could have been a confounder, we matched 54 patients with macroproteinuria and 200 patients without for HbA(1c). Because macroproteinuria was associated with lower serum albumin and fructosamine levels, which might account for higher G-Gap, we calculated in this subpopulation albumin-indexed fructosamine and G-Gap; macroproteinuria was independently associated with male sex (odds ratio [OR] 3.2 [95% CI 1.5–6.7]; P < 0.01), hypertension (2.9 [1.1–7.5]; P < 0.05), and the third tertile of albumin-indexed G-Gap (2.3 [1.1–4.4]; P < 0.05) in multivariate analysis. CONCLUSIONS: In type 2 diabetic patients, G-Gap was associated with macroproteinuria, independently of HbA(1c), albumin levels, and confounding factors, suggesting a specific role of intracellular glycation susceptibility on kidney glomerular changes. American Diabetes Association 2013-07 2013-06-12 /pmc/articles/PMC3687281/ /pubmed/23378625 http://dx.doi.org/10.2337/dc12-1780 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Original Research Cosson, Emmanuel Banu, Isabela Cussac-Pillegand, Camille Chen, Qinda Chiheb, Sabrina Jaber, Yahya Nguyen, Minh Tuan Charnaux, Nathalie Valensi, Paul Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes |
title | Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes |
title_full | Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes |
title_fullStr | Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes |
title_full_unstemmed | Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes |
title_short | Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes |
title_sort | glycation gap is associated with macroproteinuria but not with other complications in patients with type 2 diabetes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687281/ https://www.ncbi.nlm.nih.gov/pubmed/23378625 http://dx.doi.org/10.2337/dc12-1780 |
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