Department of Nephrology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Ren Fail. 2011;33(2):131-7. doi: 10.3109/0886022X.2010.541581.
Advanced glycation end product (AGE) levels are elevated in patients with decreased renal function and may contribute to the excessive cardiovascular disease in this population. However, their relation to nutrition, anemia, and micro inflammation is not well characterized. The aim of this study is to determine their relationship in patients with chronic kidney disease (CKD).
The studied group consisted of 203 subjects: 159 patients with CKD 1-5 and 44 healthy control subjects. AGE levels were assessed by spectrofluorimetry, and routine biochemical parameters were measured using standard methods.
AGE levels were significantly increased in CKD patients compared with controls (3.9 ± 1.7 × 105 AU in CKD 1-5 patients vs. 3.2 ± 0.48 × 105 AU in controls, p < 0.0001). AGE levels increased from CKD 3. AGE levels were positively associated with age, albumin, prealbumin, and orosomucoid, and were negatively associated with hemoglobin and estimated glomerular filtration rate. In multiple regression analysis, after adjustment to age and glomerular filtration rate, AGE levels remained independently correlated with albumin and prealbumin and negatively correlated with hemoglobin.
This study is the demonstration that nutrition markers, albumin and prealbumin, are the positive determinants and hemoglobin is the negative determinant of serum AGE levels in patients with CKD.
肾功能下降的患者体内晚期糖基化终产物(AGE)水平升高,这可能导致该人群心血管疾病高发。然而,其与营养、贫血和微炎症的关系尚未得到充分描述。本研究旨在确定慢性肾脏病(CKD)患者中它们之间的关系。
研究组包括 203 名受试者:159 名 CKD 1-5 期患者和 44 名健康对照者。采用荧光光谱法评估 AGE 水平,并用标准方法测量常规生化参数。
与对照组相比,CKD 患者的 AGE 水平显著升高(CKD 1-5 期患者为 3.9 ± 1.7×105 AU,对照组为 3.2 ± 0.48×105 AU,p<0.0001)。从 CKD 3 期开始,AGE 水平逐渐升高。AGE 水平与年龄、白蛋白、前白蛋白和转铁蛋白呈正相关,与血红蛋白和估计肾小球滤过率呈负相关。在多元回归分析中,调整年龄和肾小球滤过率后,AGE 水平仍与白蛋白和前白蛋白独立相关,与血红蛋白呈负相关。
本研究表明,营养标志物白蛋白和前白蛋白是 CKD 患者血清 AGE 水平的正相关决定因素,而血红蛋白是负相关决定因素。