皮肤自发荧光是一种非侵入性的 AGE 积累标志物，与动脉粥样硬化程度有关。
Skin autofluorescence, a non-invasive marker for AGE accumulation, is associated with the degree of atherosclerosis.
机构信息
Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands ; Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
出版信息
PLoS One. 2013 Dec 23;8(12):e83084. doi: 10.1371/journal.pone.0083084. eCollection 2013.
INTRODUCTION
Advanced glycation endproducts (AGEs) may be involved in the development of atherosclerosis, beyond diabetes and renal disease. Skin autofluorescence (AF) is a non-invasive marker for AGEs. We examined whether skin AF is increased in (subclinical) atherosclerosis and associated with the degree of atherosclerosis independent of diabetes and renal function.
METHODS
A cross-sectional study of 223 patients referred for primary (n = 163) or secondary (n = 60) prevention between 2006 and 2012 was performed. Skin AF was measured using the AGE-Reader. Ultrasonography was used to assess plaques in carotid and femoral arteries and computed tomography for the calculation of the coronary artery calcium score (CACS; in primary prevention only). Primary prevention patients were divided into a group with subclinical atherosclerosis defined as >1 plaque or CACS>100 (n = 67; age 53 year [interquartile range 48-56]; 49% male) and without (controls; 96; 43 [38-51]; 55%). Secondary prevention were patients with peripheral arterial disease (60; 64 [58-70]; 73%).
RESULTS
Skin AF was higher in subclinical and clinical atherosclerosis compared with controls (skin AF 2.11 [interquartile range 1.83-2.46] and 2.71 [2.15-3.27] vs. 1.87 [1.68-2.12] respectively; P = 0.005 and <0.001). In a multivariate analysis, the association of skin AF with the atherosclerosis categories was independent of age, sex, diabetes, presence of the metabolic syndrome, Framingham Risk Score, and renal function. Skin AF correlated with most cardiovascular risk factors, Framingham risk score, and IMT and CACS.
CONCLUSIONS
Skin AF is increased in documented subclinical and clinical atherosclerosis, independent of known risk factors such as diabetes and renal disease. These data suggest that AGEs may be associated with the burden of atherosclerosis and warrant a prospective study to investigate its clinical usability as a risk assessment tool for primary prevention.
简介
除糖尿病和肾病外，晚期糖基化终末产物（AGEs）可能与动脉粥样硬化的发展有关。皮肤自发荧光（AF）是AGEs 的一种非侵入性标志物。我们研究了皮肤 AF 是否在（亚临床）动脉粥样硬化中增加，并与糖尿病和肾功能无关的动脉粥样硬化程度相关。
方法
对 2006 年至 2012 年间因一级（n=163）或二级（n=60）预防而就诊的 223 例患者进行了横断面研究。使用 AGE-Reader 测量皮肤 AF。超声检查用于评估颈动脉和股动脉斑块，计算机断层扫描用于计算冠状动脉钙评分（CACS；仅在一级预防中）。将一级预防患者分为亚临床动脉粥样硬化组（定义为>1 个斑块或 CACS>100，n=67；年龄 53 岁[四分位距 48-56]；49%为男性）和无亚临床动脉粥样硬化组（对照组，n=96；年龄 43 岁[38-51]；55%为男性）。二级预防为外周动脉疾病患者（60 例；64 岁[58-70]；73%为男性）。
结果
与对照组相比，亚临床和临床动脉粥样硬化患者的皮肤 AF 更高（皮肤 AF 分别为 2.11[四分位距 1.83-2.46]和 2.71[2.15-3.27]；P=0.005 和 <0.001）。在多变量分析中，皮肤 AF 与动脉粥样硬化类别的相关性独立于年龄、性别、糖尿病、代谢综合征的存在、弗雷明汉风险评分和肾功能。皮肤 AF 与大多数心血管危险因素、弗雷明汉风险评分和 IMT 和 CACS 相关。
结论
有记录的亚临床和临床动脉粥样硬化患者的皮肤 AF 增加，与糖尿病和肾病等已知危险因素无关。这些数据表明，AGEs 可能与动脉粥样硬化的负担有关，并需要进行前瞻性研究，以调查其作为一级预防风险评估工具的临床可用性。
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