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Plasma Carboxymethyl‐Lysine, an Advanced Glycation End Product, and All‐Cause and Cardiovascular Disease Mortality in Older Community‐Dwelling Adults
Author(s) -
Semba Richard D.,
Bandinelli Stefania,
Sun Kai,
Guralnik Jack M.,
Ferrucci Luigi
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02438.x
Subject(s) - medicine , advanced glycation end product , glycation , lysine , gerontology , disease , intensive care medicine , biochemistry , amino acid , receptor , chemistry
OBJECTIVES: To determine whether older adults with high plasma carboxymethyl‐lysine (CML), an advanced glycation end product, are at higher risk of all‐cause and cardiovascular disease (CVD) mortality. DESIGN: Prospective cohort study. SETTING: Population‐based sample of adults aged 65 and older residing in Tuscany, Italy. PARTICIPANTS: One thousand thirteen adults participating in the Invecchiare in Chianti study. MEASUREMENTS: Anthropometric measures, plasma CML, fasting plasma total, high‐density and low‐density lipoprotein cholesterol, triglycerides, glucose, creatinine. Clinical measures: medical assessment, diabetes mellitus, hypertension, coronary heart disease, heart failure, stroke, cancer. Vital status measures: death certificates and causes of death according to the International Classification of Diseases . Survival methods were used to examine the relationship between plasma CML and all‐cause and CVD mortality, adjusting for potential confounders. RESULTS: During 6 years of follow‐up, 227 (22.4%) adults died, of whom 105 died with CVD. Adults with plasma CML in the highest tertile had greater all‐cause (hazard ratio (HR)=1.84, 95% confidence interval) CI)=1.30–2.60, P <.001) and CVD (HR=2.11, 95% CI=1.27–3.49, P =.003) mortality than those in the lower two tertiles after adjusting for potential confounders. In adults without diabetes mellitus, those with plasma CML in the highest tertile had greater all‐cause (HR=1.68, 95% CI=1.15–2.44, P =.006) and CVD (HR=1.74, 95% CI=1.00–3.01, P =.05) mortality than those in the lower two tertiles after adjusting for potential confounders. CONCLUSION: Older adults with high plasma CML are at higher risk of all‐cause and CVD mortality.