Wang Chun-Cheng, Wang Yao-Chang, Wang Guei-Jane, Shen Ming-Yi, Chang Yen-Lin, Liou Show-Yih, Chen Hung-Chih, Chang Chiz-Tzung
Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Division of Cardiology, Department of Internal Medicine, Taichung Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Taichung, Taiwan.
PLoS One. 2016 Jan 25;11(1):e0147771. doi: 10.1371/journal.pone.0147771. eCollection 2016.
Elevated levels of advanced glycation end products (AGEs) within tissues may contribute to endothelial dysfunction, an early indicator of atherosclerosis. We aimed to investigate whether levels of skin AGEs could be a useful marker to predict endothelial dysfunction in uremic subjects on hemodialysis.
One hundred and nineteen uremic patients on hemodialysis and 57 control subjects with moderate-to-high cardiovascular risk factors and without chronic kidney disease (CKD) were enrolled. We used ultrasound to measure flow-mediated vasodilation (FMD). An AGE reader measured skin autoflurorescence (AF). We then compared differences in FMD and skin AF values between the two groups. The uremic subjects had significantly higher levels of skin AF (3.47±0.76 AU vs. 2.21±0.45 arbitrary units; P<0.01) and significantly lower levels of FMD (4.79%±1.88% vs. 7.19%±2.17%; P<0.01) than the non-CKD subjects. After adjusting for all potential covariates, we found that skin AF level independently predicted FMD in both the hemodialysis and the non-CKD groups. In the hemodialysis group, skin AF ≥ 3.05 arbitrary units predicted abnormal FMD at a sensitivity of 87.9% and a specificity of 78.6% (P<0.01).
Skin AF could be a useful marker to predict endothelial dysfunction in uremic subjects on hemodialysis.
组织内晚期糖基化终产物（AGEs）水平升高可能导致内皮功能障碍，这是动脉粥样硬化的早期指标。我们旨在研究皮肤AGEs水平是否可作为预测血液透析尿毒症患者内皮功能障碍的有用标志物。
纳入119例接受血液透析的尿毒症患者和57例有中度至高度心血管危险因素且无慢性肾脏病（CKD）的对照受试者。我们使用超声测量血流介导的血管舒张（FMD）。用AGE阅读器测量皮肤自发荧光（AF）。然后比较两组之间FMD和皮肤AF值的差异。尿毒症受试者的皮肤AF水平显著高于非CKD受试者（3.47±0.76任意单位 vs. 2.21±0.45任意单位；P<0.01），FMD水平显著低于非CKD受试者（4.79%±1.88% vs. 7.19%±2.17%；P<0.01）。在调整所有潜在协变量后，我们发现皮肤AF水平在血液透析组和非CKD组中均独立预测FMD。在血液透析组中，皮肤AF≥3.05任意单位预测FMD异常的敏感性为87.9%，特异性为78.6%（P<0.01）。
皮肤AF可作为预测血液透析尿毒症患者内皮功能障碍的有用标志物。
