Furuya Fumihiko, Shimura Hiroki, Takahashi Kazuya, Akiyama Daiichiro, Motosugi Ai, Ikegishi Yukinobu, Haraguchi Kazutaka, Kobayashi Tetsuro
Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
Ther Apher Dial. 2015 Feb;19(1):40-4. doi: 10.1111/1744-9987.12204. Epub 2014 Dec 29.
Accelerated formation and tissue accumulation of advanced glycation end products (AGEs), reflecting cumulative glycemic and oxidative stress, occurs in age-related and chronic diseases like diabetes mellitus (DM) and renal failure, and contributes to vascular damage. Skin autofluorescence (AFR), a noninvasive measurement method, reflects tissue accumulation of AGEs. AFR has been reported to be an independent predictor of mortality in Caucasian hemodialysis patients. We assessed the relationship between levels of AFR and the prevalence of cardiovascular disease (CVD), and clarified the prognostic usefulness of skin AFR levels in Asian (non-Caucasian) hemodialysis (HD) patients. AFR was measured with an autofluorescence reader in 64 HD patients. Overall and cardiovascular mortality was monitored prospectively during the 3-year follow-up. During follow-up, CVD events occurred in 21 patients. The deaths of 10 HD patients were associated with CVD. Multivariate logistic regression analyses showed that initial AFR was an independent risk factor for de novo CVD in HD patients with or without diabetes. When patients were classified on the basis of AFR tertiles, Cochran-Armitage analysis demonstrated that the highest tertile of AFR level showed an increased odds ratio for the prevalence of CVD. These findings suggest that AFR levels can be used to detect the prevalence of CVD in HD patients with or without diabetes.
晚期糖基化终产物（AGEs）的加速形成和组织蓄积反映了累积的血糖和氧化应激，见于糖尿病（DM）和肾衰竭等与年龄相关的慢性疾病，并会导致血管损伤。皮肤自发荧光（AFR）是一种非侵入性测量方法，可反映AGEs的组织蓄积情况。据报道，AFR是白种人血液透析患者死亡率的独立预测指标。我们评估了AFR水平与心血管疾病（CVD）患病率之间的关系，并阐明了皮肤AFR水平在亚洲（非白种人）血液透析（HD）患者中的预后价值。使用自发荧光读数器对64例HD患者进行AFR测量。在3年随访期间对全因死亡率和心血管死亡率进行前瞻性监测。随访期间，21例患者发生CVD事件。10例HD患者的死亡与CVD相关。多因素逻辑回归分析显示，初始AFR是有或无糖尿病的HD患者新发CVD的独立危险因素。当根据AFR三分位数对患者进行分类时， Cochr an-Armitage分析表明，AFR水平最高的三分位数显示CVD患病率的比值比增加。这些发现表明，AFR水平可用于检测有或无糖尿病的HD患者的CVD患病率。
