Ramsauer Bernd, Graaff Reindert, Sikole Aleksandar, Trajceska Lada, Lundström Sara, Arsov Stefan, Hadimeri Henrik, Stegmayr Bernd
Department of Nephrology, Skaraborgs Hospital, Skövde, Sweden.
Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
Artif Organs. 2019 Feb;43(2):173-180. doi: 10.1111/aor.13320. Epub 2018 Sep 19.
Tissue advanced glycation end products (AGEs) are a measure of cumulative metabolic and oxidative stress and cytokine-driven inflammatory reactions. AGEs are thought to contribute to the cardiovascular complications of hemodialysis (HD) patients. Skin autofluorescence (SAF) is related to the tissue accumulation of AGEs and rises with age. SAF is one of the strongest prognostic markers of mortality in these patients. The content of AGEs is high in barbecue food. Due to the location in northern Sweden, there is a short intense barbecue season between June and August. The aim of this study was to investigate if seasonal variations in SAF exist in HD patients, especially during the barbecue season. SAF was measured noninvasively with an AGE Reader in 34 HD-patients (15 of those with diabetes mellitus, DM). Each time the median of three measures were used. Skin-AF was measured before and after each one HD at the end of February and May in 31 patients (22 men/9 women); the end of May and August in 28 (20 m/8 w); the end of August and March in 25 (19 m/6 w). Paired statistical analyses were performed during all four periods (n = 23, 17 m/6 w); as was HbA1c of those with DM. There was at a median 5.6% increase in skin-AF during the winter period (February-May, P = 0.004) and a 10.6% decrease in the skin-AF during the summer (May-August, P < 0.001). HbA1c in the DM rose during the summer (P = 0.013). In conclusion, skin-AF decreased significantly during the summer. Future studies should look for favorable factors that prevent skin-AF and subsequently cardiovascular diseases.
组织晚期糖基化终末产物(AGEs)是累积代谢、氧化应激以及细胞因子驱动的炎症反应的一个指标。AGEs被认为与血液透析(HD)患者的心血管并发症有关。皮肤自发荧光(SAF)与AGEs的组织蓄积有关,并随年龄增长而升高。SAF是这些患者死亡率最强的预后标志物之一。烧烤食物中AGEs含量很高。由于位于瑞典北部,6月至8月间有一个短暂的烧烤旺季。本研究的目的是调查HD患者中SAF是否存在季节性变化,尤其是在烧烤季节。使用AGE阅读器对34例HD患者(其中15例患有糖尿病,DM)进行无创SAF测量。每次采用三次测量的中位数。在2月和5月底、5月和8月底、8月和3月底分别对31例患者(22例男性/9例女性)、28例患者(20例男性/8例女性)、25例患者(19例男性/6例女性)在每次HD前后测量皮肤AF。在所有四个时期(n = 23,17例男性/6例女性)进行配对统计分析;患有DM的患者的糖化血红蛋白(HbA1c)也进行了分析。冬季(2月至5月)皮肤AF中位数增加了5.6%(P = 0.004),夏季(5月至8月)皮肤AF下降了10.6%(P < 0.001)。夏季DM患者的HbA1c升高(P = 0.013)。总之,夏季皮肤AF显著下降。未来的研究应寻找预防皮肤AF及随后心血管疾病的有利因素。